Drug/ion co-delivery multi-functional nanocarrier to regenerate infected tissue defect

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Jung-Hwan Lee, Ahmed El-Fiqi, Nandin Mandakhbayar, Hae-Hyoung Lee, Hae-Won Kim
Regeneration of infected tissues is a globally challenging issue in medicine and dentistry. Common clinical therapies involving a complete removal of infected areas together with a treatment of antimicrobial drugs are often suboptimal. Biomaterials with anti-bacterial and pro-regenerative potential can offer a solution to this. Here we design a novel nanocarrier based on a mesoporous silicate-calcium glass by doping with Ag ions and simultaneously loading antimicrobial drugs onto mesopores. The nanocarriers could controllably release multiple ions (silver, calcium, and silicate) and drugs (tetracycline or chlorohexidine) to levels therapeutically relevant, and effectively internalize to human dental stem cells (∼90%) with excellent viability, ultimately stimulating odontogenic differentiation. The release of Ag ions had profound effects on most oral bacteria species through a membrane rupture, and the antibiotic delivery complemented the antibacterial functions by inhibiting protein synthesis. Of note, the nanocarriers easily anchored to bacteria membrane helping the delivery of molecules to an intra-bacterial space. When administered to an infected dentin-pulp defect in rats, the therapeutic nanocarriers effectively regenerated tissues following a complete bacterial killing. This novel concept of multiple-delivering ions and drug can be extensively applied to other infectious tissues that require relayed biological functions (anti-bacterial then pro-regenerative) for successful healing.



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Tailor-made purified human platelet lysate concentrated in neurotrophins for treatment of Parkinson's disease

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Ming-Li Chou, Joe-Wei Wu, Flore Gouel, Aurélie Jonneaux, Kelly Tillerman, Ting-Yi Renn, Charlotte Laloux, Hung-Ming Chang, Liang-Tzung Lin, Jean-Christophe Devedjian, David Devos, Thierry Burnouf
Human platelet lysates (PLs), which contain multiple neurotrophins, have been proposed for treating neurodegenerative disorders, including Parkinson's disease (PD). However, current PLs suspended in plasma have high protein content and contain fibrinogen/fibrin and, following activation, also proteolytic and thrombogenic enzymes. Upon brain administration, such PLs may saturate the cerebrospinal fluid and exert neurotoxicity. We assessed whether purified PLs, concentrated in neurotrophins, protected dopaminergic neurons in PD models. Platelet concentrates were collected by apheresis and centrifuged to eliminate plasma and recover the platelets. Platelets were lysed by freeze-thaw cycles, and the 10-fold concentrated platelet pellet lysates (PPLs) were heat-treated (at 56 °C for 30 min). The heat-treated PPLs were low in total proteins, depleted in both plasma and platelet fibrinogen, and devoid of thrombogenic and proteolytic activities. They exerted very high neuroprotective activity when non-oncogenic, Lund human mesencephalic (LUHMES) cells that had differentiated into dopaminergic neurons were exposed to the MPP⁺ neurotoxin. Heat treatment improved the neuroprotection and inactivated the neurotoxic blood-borne hepatitis C virus. PPL did not induce inflammation in BV2 microglial cells and inhibited COX-2 expression upon lipopolysaccharide exposure. Intranasal administration in mice revealed (a) diffusion of neurotrophins in the striatum and cortex, and (b) MPTP intoxication neuroprotection in the substantia nigra and striatum and the absence of neuroinflammation. These dedicated heat-treated PPLs can be a safe and valuable candidate for a therapeutic strategy for PD.

Graphical abstract

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Repairing sciatic nerve injury with an EPO-loaded nerve conduit and sandwiched-in strategy of transplanting mesenchymal stem cells

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Wei Zhang, Lihai Zhang, Jianheng Liu, Licheng Zhang, Jian Zhang, Peifu Tang
Transplantation of a biosynthetic nerve conduit carrying neuro-protective cytokines is promising for treating peripheral nerve injury. Here we developed a novel strategy for repairing sciatic nerve injury by EPO-loaded Chitosan nerve conduit (EPO/Chi) and sandwiched-in transplantation of mesenchymal stem cells (MSCs). Then, the beneficial effect of EPO/Chi + MSCs on nerve regeneration was also further investigated by in vitro cellular experiments. In vivo experiment showed that combination of EPO-loaded Chitosan nerve conduit with MSCs could significantly accelerate nerve healing and improve morphological repair. Furthermore, the in vitro cellular experiments results demonstrated that the loaded EPO in nerve conduit could significantly reinforce the repair performance of both MSCs and Schwann cells, which may also contribute to the therapeutic outcome of the EPO/Chi + MSCs strategy. Collectively, the EPO-loaded nerve conduit and sandwiched-in transplantation of MSCs we reported in the study may represent a new potential strategy for peripheral nerve reconstruction.



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Enrichment of endogenous fractalkine and anti-inflammatory cells via aptamer-functionalized hydrogels

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Syed Faaiz Enam, Jack R. Krieger, Tarun Saxena, Brian E. Watts, Claire E. Olingy, Edward A. Botchwey, Ravi V. Bellamkonda
Early recruitment of non-classical monocytes and their macrophage derivatives is associated with augmented tissue repair and improved integration of biomaterial constructs. A promising therapeutic approach to recruit these subpopulations is by elevating local concentrations of chemoattractants such as fractalkine (FKN, CX3CL1). However, delivering recombinant or purified proteins is not ideal due to their short half-lives, suboptimal efficacy, immunogenic potential, batch variabilities, and cost. Here we report an approach to enrich endogenous FKN, obviating the need for delivery of exogenous proteins. In this study, modified FKN-binding-aptamers are integrated with poly(ethylene glycol) diacrylate to form aptamer-functionalized hydrogels ("aptagels") that localize, dramatically enrich and passively release FKN in vitro for at least one week. Implantation in a mouse model of excisional skin injury demonstrates that aptagels enrich endogenous FKN and stimulate significant local increases in Ly6C^loCX3CR1^hi non-classical monocytes and CD206⁺ M2-like macrophages. The results demonstrate that orchestrators of inflammation can be manipulated without delivery of foreign proteins or cells and FKN-aptamer functionalized biomaterials may be a promising approach to recruit anti-inflammatory subpopulations to sites of injury. Aptagels are readily synthesized, highly customizable and could combine different aptamers to treat complex diseases in which regulation or enrichment of multiple proteins may be therapeutic.



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Interleukin-4 receptor-targeted delivery of Bcl-xL siRNA sensitizes tumors to chemotherapy and inhibits tumor growth

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Padmanaban Guruprasath, Jihoon Kim, Gowri Rangaswamy Gunassekaran, Lianhua Chi, Soyoun Kim, Rang-Woon Park, Sang-Hyun Kim, Moon-Chang Baek, Sang Mun Bae, Sang-Yeob Kim, Dong-Kyu Kim, In-Kyu Park, Won-Jong Kim, Byungheon Lee
IL-4 receptor (IL-4R) is commonly up-regulated on tumor cells, and interactions between the receptor and Interleukin-4 (IL-4) can induce the expression of anti-apoptotic proteins, including Bcl-xL. This contributes to tumor cell survival and their resistance to chemotherapy. In this study, we exploited IL-4R-targeted delivery of Bcl-xL siRNA to IL-4R-expressing tumor cells in order to sensitize them to chemotherapy. To target IL-4R, an IL-4R-binding peptide, IL4RPep-1, was attached to branched polyethyleneimine-superparamagnetic iron oxide nanoparticles (BPEI-SPION). These nanoparticles were then complexed with Bcl-xL-targeting siRNA. IL-4R-targeted BPEI-SPION/Bcl-xL siRNA more efficiently reduced Bcl-xL gene expression and enhanced cytotoxicity of doxorubicin in MDA-MB231 breast tumor cells compared to untargeted BPEI-SPION/Bcl-xL siRNA. The siRNA was released from the complexes after 15 h of incubation at pH 5.5 and was stable in the complexes up to 72 h in the serum. The IL-4R-targeted BPEI-SPION/siRNA was internalized by cells through IL-4R, successfully escaped the endosomes, and was dispersed into the cytoplasm. Near-infrared fluorescence and magnetic resonance imaging demonstrated that in vivo tumor homing and accumulation of IL-4R-targeted BPEI-SPION/siRNA were both higher than untargeted BPEI-SPION/siRNA. The IL-4R-targeted BPEI-SPION/Bcl-xL siRNA, in combination with doxorubicin, significantly inhibited tumor growth in mice compared to untargeted BPEI-SPION/Bcl-xL siRNA. These results suggest that the IL-4R-targeted delivery of Bcl-xL siRNA to IL-4R-expressing tumors can sensitize tumors to chemotherapy and enhance the efficacy of anti-tumor therapeutics.

Graphical abstract

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Resectable adenocarcinoma developing in the remnant pancreas 7 years after partial pancreatoduodenectomy for invasive ductal adenocarcinoma of the pancreas: a case report

Pancreatic adenocarcinoma still has an excessively high mortality rate and resection is the only potentially curative treatment. The postoperative 5-year survival rate is approximately 20% and recurrence devel...

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Waardenburg syndrome type 2

Publication date: Available online 17 July 2017
Source:Medical Journal Armed Forces India
Author(s): Subhash Chandra Shaw, Shekhar Neema, Amit Devgan, Rakesh Maggon




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Combat psychiatry: Indian perspective

Publication date: Available online 17 July 2017
Source:Medical Journal Armed Forces India
Author(s): P.S. Bhat
Indian Armed Forces have been engaged in various combat duties for long. The adverse effect of prolonged and repetitive deployment of troops in these highly stressful environment leads to many combat stress behaviors as well as misconduct behaviors. Preventing, identifying and managing these disruptive behaviors are an essential part of combat psychiatry within the larger domain of combat medicine. Indian Armed Forces have a well-oiled mechanism to handle these issues and military psychiatrists are deeply engaged in providing holistic mental health care to the esteemed clientele. Relevant issues on this subject are elaborated in the article.



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Giant omental lipoma in an elderly female patient

Publication date: Available online 17 July 2017
Source:Medical Journal Armed Forces India
Author(s): Debraj Sen, Ritwik Chakrabarti, Madhamshetty Ranjith, Deepika Gulati




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Non-traumatic rupture of eventration of diaphragm in a child

Publication date: Available online 17 July 2017
Source:Medical Journal Armed Forces India
Author(s): M.S. Vinod Kumar, Subhash Chandra Shaw, Amit Devgan




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“Miner's cap-like” solitary frontal bone metastasis from rectal adenocarcinoma on 18F-FDG PET/CT

Publication date: Available online 17 July 2017
Source:Revista Española de Medicina Nuclear e Imagen Molecular
Author(s): I. Banzo, I. Martínez-Rodríguez, N. Martínez-Amador, M. Jiménez-Alonso, R. Quirce, J. Jiménez-Bonilla




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FDA Petition for Cancer Warnings

ECAN petitioned the U.S. Food and Drug Administration (FDA) for new labels on over-the-counter (OTC) heartburn medications warning of the risk of Esophageal Cancer.

The Citizen Petition requests that the FDA order new labels on all OTC acid reflux medications.  The labels would include a bold warning reading: PERSISTENT HEARTBURN CAN INDICATE INCREASED RISK OF DEVELOPING ESOPHAGEAL CANCER.  THIS MEDICATION WILL NOT ELIMINATE THAT RISK.

"So many patients tell us that they took over-the-counter heartburn medications for years, but never knew they were at risk for cancer – until it was too late," said ECAN's Board Chairman Dr. John Lipham who is Chief, Upper GI and General Surgery, Keck School of Medicine at the University of Southern California.  Dr. Lipham signed the petition with ECAN President & CEO Mindy Mintz Mordecai. "We know we can save lives with increased awareness and early detection," Dr. Lipham added.

Many Have Heartburn – Few are Aware of Cancer Risk

As many as 15 million Americans experience heartburn every day. Persistent heartburn (two or more times per week) can be a symptom of gastroesophageal reflux disease (GERD).  Reflux disease is a condition where stomach contents, including acid, splash into the esophagus, producing cellular changes that can ultimately result in cancer.  For some patients with esophageal cancer, heartburn symptoms are the only warning they will ever receive that they are at risk for cancer.

Too often esophageal cancer patients' first sign that something is wrong is when they have a tumor in their esophagus that prevents swallowing.  Unfortunately, by then, treatment is rarely successful. Less than one in five patients will survive five years after an esophageal cancer diagnosis, largely because the disease is usually discovered at late stages.  ECAN recently commissioned a market research survey of more than 1,000 American adults. Only 14 percent were aware that reflux disease could cause cancer.

"We aren't surprised by the numbers, but we are motivated to change them," said Mordecai, who founded ECAN after losing her husband and the father of her young daughters to esophageal cancer nine years ago. "Folks need to know that if they are experiencing reflux symptoms on a regular basis, they should see their doctors and get checked – that's why we filed our Petition."

"Esophageal Cancer is preventable and our survey shows why the labels we are requesting are so necessary.  We can save lives and stop the senseless losses that families like ours continue to endure," she added.

Drugs So Effective Doctors Aren't Told About Heartburn

Many OTC drug products relieve or prevent heartburn associated with acid indigestion. Some were formerly available by prescription and are very effective in relieving the symptoms associated with heartburn.  Because these products work so well, many patients will not tell their healthcare providers about their persistent heartburn.  Like most Americans, they don't know that acid reflux can lead to Barrett's Esophagus, the precursor to esophageal cancer, and esophageal cancer.

"Existing warnings on anti-reflux medications are not sufficient to alert patients to the risk of esophageal cancer associated with persistent heartburn resulting from reflux disease, acid indigestion or sour stomach," said David Rosen, a partner with the law firm of Foley & Lardner who worked for the FDA for 15 years and is representing ECAN in its filing.  "The FDA should act swiftly to include a bold prominent and strong warning label to better inform patients of the risks associated with persistent heartburn and the need to see their physician due to the risk of esophageal cancer that can go undetected if the patient is getting symptomatic relief from the OTC drug products," Rosen said.

Such products include antacid products such as magnesium hydroxide, aluminum hydroxide, calcium carbonate, ranitidine, famotidine, cimetidine, esomeprazole, omeprazole, lansoprazole, pantoprazole and nizatidine.

Coverage of Petition has Reached Millions

Even before the FDA rules on ECAN's request, it is still serving to increase awareness.  The public is learning about the link between reflux disease and Esophageal Cancer because of the media coverage of the Citizen Petition that has reached millions of Americans from coast-to-coast through newspapers, magazines, television, radio and through online news sources.

ECAN encourages those who support the Petition to contact ECAN at info@ecan.org to find out how to let the FDA know that you are in favor of the new warning labels.  ECAN is hoping for a public hearing on the Petition that would allow experts to testify about why the labels are so important in the battle against Esophageal Cancer, the fastest increasing cancer among American men.  Here are some examples of the coverage the Petition has garnered:

The Baltimore Sun, May 1, 2017, Andrea K. McDaniels, "National group wants cancer warning labels on acid reflux drugs" 

Healio, May 4, 2017, "FDA petitioned to require esophageal cancer warning on OTC reflux drugs"

Notey, May 5, 2017, "Cancer Warning Urged for Nexium, Prilosec, Other Heartburn Drugs"

Drugwatch, May 11, 2017, Elaine Silvestrini, "Petition to FDA Seeks Cancer Warning on Antacids"

Chicago Tonight, May 12, 2017, Kristen Thometz, "Nonprofit Wants Stronger Warning Labels on Reflux Medications"

A Woman's Health (CancerConnect), Summer 2017, Sharon Reynolds, GERD, "Raising Awareness about an Unknown Killer"

The post FDA Petition for Cancer Warnings appeared first on Esophageal Cancer Action Network.

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Using the Gluteal Artery Perforator Flap to Reconstruct Sacral Sore

No abstract available

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Long-Term Health-Related Quality of Life after Breast Reconstruction: Comparing 4 Different Methods of Reconstruction

Background: Studies have confirmed that breast reconstruction is beneficial to improve health-related quality of life (HR-QoL) in breast cancer patients. Our aim was to compare 4 different methods of breast reconstruction on patient satisfaction and HR-QoL using both general and specific patient-reported outcome instruments. Methods: Retrospectively, 459 patients who underwent breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap, latissimus dorsi flap, lateral thoracodorsal flap, or expander with secondary implant and who had responded to the questionnaires were enrolled. Questionnaire answers, together with demographic and follow-up data, were statistically analyzed and compared between groups. Short-Form 36 Health Survey (SF-36) results were also compared with those from a sample of 930 age-matched women from the Swedish population. Results: There were slight differences in the SF-36 results but no significant differences in Psychological General Well-Being Index and EuroQoL-5 Dimension Questionnaire results between groups. Analysis of Breast-Q showed that the DIEP group had significantly higher score on the scale satisfaction with breast, significantly higher score in satisfaction with outcome than the lateral thoracodorsal flap (P = 0.014) and EXP groups (P = 0.024). There were no significant differences in most of the domains of the HR-QoL instruments. The higher satisfaction with breasts and outcome in the DIEP group is interesting, considering the higher complication rates associated with this reconstruction method. Conclusions: Patients who underwent breast reconstruction with a DIEP flap were more satisfied with their reconstructed breast and outcome than the other 3 groups. Breast reconstruction centers should make DIEP reconstruction widely available to patients after mastectomy.

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FoxP3 and TLR2 in co-expression in oral cancer

Publication date: Available online 17 July 2017
Source:Acta Histochemica
Author(s): H.M. Hussaini, V.P.B. Parachuru, G.J. Seymour, A.M. Rich




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Granulomatous reaction to hyaluronic acid filler material in oral and perioral region: A case report and review of literature

Summary

The use of cosmetic fillers agents in orofacial region has become more often used for esthetic concern. Although adverse effects are rare, some patients may develop foreign body reaction to such fillers. Hyaluronic acid (HA) is a biomaterial in the spotlight, because it is normally present in several tissues of human body. The aim of this study was to report a case of a 54-year-old white woman with granulomatous reaction to the HA located in the lips. In addition, a review of the English-language literature of all previously described cases of this condition in oral and perioral region was performed. The location, clinical features, symptoms, time between injection and reaction, type of treatment and treatment outcome of 17 cases were summarized. The clinical and histopathological examination along with a detailed history about this condition is very important to management of patients with nodular lesions in maxillofacial region.

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New imaging tools for an old disease: Secondary syphilis

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New imaging tools for an old disease: Secondary syphilis

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When is a sentinel node biopsy indicated for patients with primary melanoma? An update of the ‘Australian guidelines for the management of cutaneous melanoma’

Abstract

A sentinel lymph node biopsy is a surgical staging procedure performed for patients with primary cutaneous melanoma who are clinically lymph-node negative to determine whether there is low volume nodal metastasis in the draining lymph node field. A systematic review was recently performed to update the Australian clinical practice guidelines for the diagnosis and management of melanoma, addressing the question, 'When is a sentinel lymph node biopsy indicated?' This article discusses the findings of the systematic review and the evidence base for the updated guidelines.

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When is a sentinel node biopsy indicated for patients with primary melanoma? An update of the ‘Australian guidelines for the management of cutaneous melanoma’

Abstract

A sentinel lymph node biopsy is a surgical staging procedure performed for patients with primary cutaneous melanoma who are clinically lymph-node negative to determine whether there is low volume nodal metastasis in the draining lymph node field. A systematic review was recently performed to update the Australian clinical practice guidelines for the diagnosis and management of melanoma, addressing the question, 'When is a sentinel lymph node biopsy indicated?' This article discusses the findings of the systematic review and the evidence base for the updated guidelines.

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Plaque psoriasis is associated with subclinical atherosclerosis in a Chinese population

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Plaque psoriasis is associated with subclinical atherosclerosis in a Chinese population

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Intermittent administration of parathyroid hormone ameliorated alveolar bone loss in experimental periodontitis in streptozotocin-induced diabetic rats

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Helin Chen, Taozi Fu, Yuanyuan Ma, Xiangnan Wu, Xianxian Li, Xinyi Li, Jiefei Shen, Hang Wang
ObjectiveIntermittent administration of parathyroid hormone (PTH) has been demonstrated to have anabolic effects on bone metabolism and is approved for use in the treatment of osteoporosis. This study evaluates the role of intermittent PTH administration on alveolar bone loss in streptozotocin (STZ)-induced diabetic rats.DesignFifty male Sprague Dawley rats were randomly divided into the following five groups: (1) a control group (saline placebo without ligature and STZ injection), (2) a PTH group (PTH administration without ligature and STZ injection), (3) an L group (saline placebo with ligature), (4) an L+STZ group (saline placebo with ligature and STZ injection), and (5) an L+STZ+PTH group (PTH administration with ligature and STZ injection). PTH was administered at 75μg/kg per dose four times a week for 28days. Subsequently, all rats were sacrificed, and their mandibles were extracted for micro-computed tomography (micro-CT) scanning, as well as histological and immunochemical evaluation.ResultsMicro-CT scanning demonstrated the anabolic effect of PTH on alveolar bone metabolism in STZ-induced diabetic rats (P<0.05), and histomorphometry indicated that PTH inhibited inflammation of the periodontium and increased the level of osteoblastic activity (P<0.05). Immunochemical evaluation showed that rats subjected to both ligature placement and STZ injection had the highest receptor activator of nuclear factor kappa B ligand (RANKL)/osteoprotegerin (OPG) ratio and that PTH administration decreased this ratio.ConclusionIntermittent systemic PTH administration effectively reduced alveolar bone loss and ameliorated the manifestation of experimental periodontitis in STZ-induced diabetic rats.



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Gene expression profiles of fin regeneration in loach (Paramisgurnus dabryanu)

Publication date: Available online 18 July 2017
Source:Gene Expression Patterns
Author(s): Li Li, Jingya He, Linlin Wang, Weihua Chen, Zhongjie Chang
Teleost fins can regenerate accurate position-matched structure and function after amputation. However, we still lack systematic transcriptional profiling and methodologies to understand the molecular basis of fin regeneration. After histological analysis, we established a suppression subtraction hybridization library containing 418 distinct sequences expressed differentially during the process of blastema formation and differentiation in caudal fin regeneration. Genome ontology and comparative analysis of differential distribution of our data and the reference zebrafish genome showed notable subcategories, including multi-organism processes, response to stimuli, extracellular matrix, antioxidant activity, and cell junction function. KEGG pathway analysis allowed the effective identification of relevant genes in those pathways involved in tissue morphogenesis and regeneration, including tight junction, cell adhesion molecules, mTOR and Jak-STAT signaling pathway. From relevant function subcategories and signaling pathways, 78 clones were examined for further Southern-blot hybridization. Then, 17 genes were chosen and characterized using semi-quantitative PCR. Then 4 candidate genes were identified, including F11r, Mmp9, Agr2 and one without a match to any database. After real-time quantitative PCR, the results showed obvious expression changes in different periods of caudal fin regeneration. We can assume that the 4 candidates, likely valuable genes associated with fin regeneration, deserve additional attention. Thus, our study demonstrated how to investigate the transcript profiles with an emphasis on bioinformatics intervention and how to identify potential genes related to fin regeneration processes. The results also provide a foundation or knowledge for further research into genes and molecular mechanisms of fin regeneration.

Graphical abstract

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Table of contents

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Masthead

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The yeast-like fungus Aureobasidium thailandense LB01 produces a new biosurfactant using olive oil mill wastewater as an inducer

Publication date: Available online 17 July 2017
Source:Microbiological Research
Author(s): Dayana P. Meneses, Eduardo J. Gudiña, Fabiano Fernandes, Luciana R.B. Gonçalves, Lígia R. Rodrigues, Sueli Rodrigues
In this study, the biosurfactant production by an Aureobasidium thailandense LB01 was reported for the first time. Different agro-industrial by-products (corn steep liquor, sugarcane molasses, and olive oil mill wastewater) were evaluated as alternative low-cost substrates. The composition of the culture medium was optimized through response surface methodology. The highest biosurfactant production (139±16mg/L) was achieved using a culture medium containing yeast extract (2g/L); olive oil mill wastewater (1.5%, w/w); glucose (6g/L) and KH2PO4 (1g/L) after 48h of fermentation. The partially purified biosurfactant exhibited a critical micelle concentration of 550mg/L, reducing the surface tension of water up to 31.2 mN/m. Its molecular structure was found to be similar to a lauric acid ester. The biosurfactant exhibited a better performance than the chemical surfactant sodium dodecyl sulfate (SDS) in oil dispersion assays, thus suggesting its potential application in bioremediation.



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Nutrients and host attributes modulate the abundance and functional traits of phyllosphere microbiome in rice

Publication date: Available online 17 July 2017
Source:Microbiological Research
Author(s): Shobit Thapa, Radha Prasanna, Kunal Ranjan, Kulandaivelu Velmourougane, Balasubramanian Ramakrishnan
The abundance of phyllosphere bacterial communities of seven genotypes of rice −ADT- 38, ADT-43, CR-1009, PB-1, PS-5, P-44, and Pusa Basmati was investigated, in relation to nutrient dynamics of rhizosphere and leaves. P-44 genotype recorded highest pigment accumulation, while genotypes CR-1009 and P-44 exhibited most number of different bacterial morphotypes, Colony forming units in two media (Nutrient agar and R2A) varied significantly and ranged from 10⁶-10⁷ per g plant tissues. Among the selected 60 distinct morphotypes, IAA and siderophore producers were the dominant functional types. Biocontrol activity against Drechslera oryzae was shown by 38 isolates, while 17 and 9 isolates were potent against Rhizoctonia solani and Magnaporthe oryzae respectively. Principal Component Analysis (PCA) illustrated the significant effects of selected soil and leaf nutrients of seven rice varieties on the culturable phyllospheric population (log CFU), particularly in the R2A medium. Eigen values revealed that 83% of the variance observed could be assigned to Leaf-Fe, Leaf-Mn, chlorophyll b and soil organic carbon (OC). Quantitative PCR analyses of abundance of bacteria, cyanobacteria and archaebacteria revealed a host-specific response, with CR-1009 showing highest number of 16S rRNA copies of bacterial members, while both P-44 and PS-5 had higher cyanobacterial abundance, but lowest number of those belonging to archaebacteria. Nutritional aspects of leaf and soil influenced the abundance of bacteria and their functional attributes; this is of interest for enhancing the efficacy of foliar inoculants for improving plant growth and disease tolerance.



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Table of contents

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Masthead

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Error rate of automated calculation for wound surface area using a digital photography

Abstract

Background

Although measuring would size using digital photography is a quick and simple method to evaluate the skin wound, the possible compatibility of it has not been fully validated.

Purpose

To investigate the error rate of our newly developed wound surface area calculation using digital photography.

Methods

Using a smartphone and a digital single lens reflex (DSLR) camera, four photographs of various sized wounds (diameter: 0.5-3.5 cm) were taken from the facial skin model in company with color patches. The quantitative values of wound areas were automatically calculated. The relative error (RE) of this method with regard to wound sizes and types of camera was analyzed.

Results

RE of individual calculated area was from 0.0329% (DSLR, diameter 1.0 cm) to 23.7166% (smartphone, diameter 2.0 cm). In spite of the correction of lens curvature, smartphone has significantly higher error rate than DSLR camera (3.9431±2.9772 vs 8.1303±4.8236). However, in cases of wound diameter below than 3 cm, REs of average values of four photographs were below than 5%. In addition, there was no difference in the average value of wound area taken by smartphone and DSLR camera in those cases.

Conclusion

For the follow-up of small skin defect (diameter: <3 cm), our newly developed automated wound area calculation method is able to be applied to the plenty of photographs, and the average values of them are a relatively useful index of wound healing with acceptable error rate.

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Linking arsenite- and cadmium-generated oxidative stress to microsatellite instability in vitro and in vivo

Publication date: November 2017
Source:Free Radical Biology and Medicine, Volume 112
Author(s): Chang-Lin Wu, Li-Yan Huang, Christina L. Chang
Mismatch repair (MMR) corrects replicative errors and minimizes DNA damage that occurs frequently in microsatellites. MMR deficiency is manifested as microsatellite instability (MSI), which contributes to hypermutability and cancer pathogenesis. Genomic instability, including MSI and chromosomal instability, appears to be responsible for the carcinogenesis of arsenic and cadmium, common contaminants in our environment. However, few studies have addressed arsenic- or cadmium-induced MSI, especially its potential link with arsenic- or cadmium-generated oxidative stress, due to the lack of quantifiable MSI assays and cost-effective animal models. Here, using a dual-fluorescent reporter, we demonstrate that sub-lethal doses of cadmium or arsenite, but not arsenate, increased the MSI frequency in human colorectal cancer cells. Arsenite- and cadmium-induced MSI occurred concomitantly with increased levels of reactive species and oxidative DNA damage, and with decreased levels of MMR proteins. However, N-acetyl-l-cysteine (NAC) suppressed arsenite- and cadmium-induced MSI and oxidative stress while restoring the levels of MMR proteins in the cells. Similarly, MSI was induced separately by arsenite and cadmium, and suppressed by NAC, in zebrafish in a fluorescinated PCR-based assay with newly-developed microsatellite markers and inter-segmental comparisons. Of five selected antioxidants examined, differential effects were exerted on the MSI induction and cytotoxicity of both arsenite and cadmium. Compared to MMR-proficient cells, MMR-deficient cells were more resistant to arsenic-mediated and cadmium-mediated cytotoxicity. Our findings demonstrate a novel linkage between arsenite-generated and cadmium-generated oxidative stress and MSI induction. Our findings also caution that antioxidants must be individually validated before being used for preventing arsenite- and cadmium-induced MSI that is associated with cancer development.

Graphical abstract

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Re: “Thyroglobulin as a Functional Biomarker of Iodine Status in a Cohort Study of Pregnant Women in the United Kingdom” by Bath et al. (Thyroid 2017;27:426–433)

Thyroid , Vol. 0, No. 0.


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A case of acquired epidermodysplasia verruciformis in a renal transplant recipient clearing with multimodal treatment including HPV (Gardasil) vaccination

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A case of acquired epidermodysplasia verruciformis in a renal transplant recipient clearing with multimodal treatment including HPV (Gardasil) vaccination

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Erratum to: The German Lipoprotein Apheresis Registry (GLAR) – almost 5 years on

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BCG — old workhorse, new skills

M Gengenbacher | NE Nieuwenhuizen | SHE Kaufmann

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Non-human primates as a model for understanding the mechanism of action of toll-like receptor-based vaccine adjuvants

Elizabeth A .Thompson | Karin Loré

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Adolescent maturation of the relationship between cortical gyrification and cognitive ability

Publication date: September 2017
Source:NeuroImage, Volume 158
Author(s): Yu Sun Chung, Christopher J. Hyatt, Michael C. Stevens
There are changes to the degree of cortical folding from gestation through adolescence into young adulthood. Recent evidence suggests that degree of cortical folding is linked to individual differences in general cognitive ability in healthy adults. However, it is not yet known whether age-related cortical folding changes are related to maturation of specific cognitive abilities in adolescence. To address this, we examined the relationship between frontoparietal cortical folding as measured by a Freesurfer-derived local gyrification index (lGI) and performance on subtests from the Wechsler Abbreviated Scale of Intelligence and scores from Conner's Continuous Performance Test-II in 241 healthy adolescents (ages 12–25 years). We hypothesized that age-related lGI changes in the frontoparietal cortex would contribute to cognitive development. A secondary goal was to explore if any gyrification-cognition relationships were either test-specific or sex-specific. Consistent with previous studies, our results showed a reduction of frontoparietal local gyrification with age. Also, as predicted, all cognitive test scores (i.e., Vocabulary, Matrix Reasoning, the CPT-II Commission, Omission, Variabiltiy, d') showed age × cognitive ability interaction effects in frontoparietal and temporoparietal brain regions. Mediation analyses confirmed a causal role of age-related cortical folding changes only for CPT-II Commission errors. Taken together, the results support the functional significance of cortical folding, as well as provide the first evidence that cortical folding maturational changes play a role in cognitive development.



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Distinguishing early and late brain aging from the Alzheimer's disease spectrum: consistent morphological patterns across independent samples

Publication date: September 2017
Source:NeuroImage, Volume 158
Author(s): Nhat Trung Doan, Andreas Engvig, Krystal Zaske, Karin Persson, Martina Jonette Lund, Tobias Kaufmann, Aldo Cordova-Palomera, Dag Alnæs, Torgeir Moberget, Anne Brækhus, Maria Lage Barca, Jan Egil Nordvik, Knut Engedal, Ingrid Agartz, Geir Selbæk, Ole A. Andreassen, Lars T. Westlye
Alzheimer's disease (AD) is a debilitating age-related neurodegenerative disorder. Accurate identification of individuals at risk is complicated as AD shares cognitive and brain features with aging. We applied linked independent component analysis (LICA) on three complementary measures of gray matter structure: cortical thickness, area and gray matter density of 137 AD, 78 mild (MCI) and 38 subjective cognitive impairment patients, and 355 healthy adults aged 18–78 years to identify dissociable multivariate morphological patterns sensitive to age and diagnosis. Using the lasso classifier, we performed group classification and prediction of cognition and age at different age ranges to assess the sensitivity and diagnostic accuracy of the LICA patterns in relation to AD, as well as early and late healthy aging. Three components showed high sensitivity to the diagnosis and cognitive status of AD, with different relationships with age: one reflected an anterior-posterior gradient in thickness and gray matter density and was uniquely related to diagnosis, whereas the other two, reflecting widespread cortical thickness and medial temporal lobe volume, respectively, also correlated significantly with age. Repeating the LICA decomposition and between-subject analysis on ADNI data, including 186 AD, 395 MCI and 220 age-matched healthy controls, revealed largely consistent brain patterns and clinical associations across samples. Classification results showed that multivariate LICA-derived brain characteristics could be used to predict AD and age with high accuracy (area under ROC curve up to 0.93 for classification of AD from controls). Comparison between classifiers based on feature ranking and feature selection suggests both common and unique feature sets implicated in AD and aging, and provides evidence of distinct age-related differences in early compared to late aging.



http://ift.tt/2vwy9f5

Subthalamic deep brain stimulation sweet spots and hyperdirect cortical connectivity in Parkinson's disease

Publication date: September 2017
Source:NeuroImage, Volume 158
Author(s): Harith Akram, Stamatios N. Sotiropoulos, Saad Jbabdi, Dejan Georgiev, Philipp Mahlknecht, Jonathan Hyam, Thomas Foltynie, Patricia Limousin, Enrico De Vita, Marjan Jahanshahi, Marwan Hariz, John Ashburner, Tim Behrens, Ludvic Zrinzo
ObjectivesFirstly, to identify subthalamic region stimulation clusters that predict maximum improvement in rigidity, bradykinesia and tremor, or emergence of side-effects; and secondly, to map-out the cortical fingerprint, mediated by the hyperdirect pathways which predict maximum efficacy.MethodsHigh angular resolution diffusion imaging in twenty patients with advanced Parkinson's disease was acquired prior to bilateral subthalamic nucleus deep brain stimulation. All contacts were screened one-year from surgery for efficacy and side-effects at different amplitudes. Voxel-based statistical analysis of volumes of tissue activated models was used to identify significant treatment clusters. Probabilistic tractography was employed to identify cortical connectivity patterns associated with treatment efficacy.ResultsAll patients responded well to treatment (46% mean improvement off medication UPDRS-III [p < 0.0001]) without significant adverse events. Cluster corresponding to maximum improvement in tremor was in the posterior, superior and lateral portion of the nucleus. Clusters corresponding to improvement in bradykinesia and rigidity were nearer the superior border in a further medial and posterior location. The rigidity cluster extended beyond the superior border to the area of the zona incerta and Forel-H2 field. When the clusters where averaged, the coordinates of the area with maximum overall efficacy was X = −10(−9.5), Y = −13(-1) and Z = −7(−3) in MNI(AC-PC) space. Cortical connectivity to primary motor area was predictive of higher improvement in tremor; whilst that to supplementary motor area was predictive of improvement in bradykinesia and rigidity; and connectivity to prefrontal cortex was predictive of improvement in rigidity.InterpretationThese findings support the presence of overlapping stimulation sites within the subthalamic nucleus and its superior border, with different cortical connectivity patterns, associated with maximum improvement in tremor, rigidity and bradykinesia.



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The Best We Can Be.

Author: Skolnik, Neil MD

Page: 247-248

http://ift.tt/2u3LhKM

Lower Risk of Heart Failure and Death in Patients Initiated on Sodium-Glucose Cotransporter-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL Study (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors).

Author: Kosiborod, Mikhail MD; Cavender, Matthew A. MD, MPH; Fu, Alex Z. PhD; Wilding, John P. MD, PhD; Khunti, Kamlesh MD, PhD; Holl, Reinhard W. MD, PhD; Norhammar, Anna MD; Birkeland, Kare I. MD, PhD; Jorgensen, Marit Eika MD, PhD; Thuresson, Marcus PhD; Arya, Niki MSc; Bodegard, Johan MD, PhD; Hammar, Niklas PhD; Fenici, Peter MD, PhD; on behalf of the CVD-REAL Investigators and Study Group

Page: 249-259

http://ift.tt/2tAq7Aq

Reality and Truth: Balancing the Hope and the Hype of Real-World Evidence.

Author: Patel, Anushka MD, PhD; Billot, Laurent MRes

Page: 260-262

http://ift.tt/2u3LopP

Coronary Plaque Characterization in Psoriasis.

Author: Kivelevitch, Dario MD; Schussler, Jeffrey M. MD; Menter, Alan MD

Page: 277-280

http://ift.tt/2u3ZlEc

BAG3 (Bcl-2-Associated Athanogene-3) Coding Variant in Mice Determines Susceptibility to Ischemic Limb Muscle Myopathy by Directing Autophagy.

Author: McClung, Joseph M. PhD; McCord, Timothy J. BS; Ryan, Terence E. PhD; Schmidt, Cameron A. BS; Green, Tom D. BS; Southerland, Kevin W. MD; Reinardy, Jessica L. PhD; Mueller, Sarah B. PhD; Venkatraman, Talaignair N. PhD; Lascola, Christopher D. MD, PhD; Keum, Sehoon PhD; Marchuk, Douglas A. PhD; Spangenburg, Espen E. PhD; Dokun, Ayotunde MD; Annex, Brian H. MD; Kontos, Christopher D. MD

Page: 281-296

http://ift.tt/2tAkxOp

CD73 on T Cells Orchestrates Cardiac Wound Healing After Myocardial Infarction by Purinergic Metabolic Reprogramming.

Author: Borg, Nadine PhD; Alter, Christina PhD; Gorldt, Nicole MSc; Jacoby, Christoph PhD; Ding, Zhaoping MD; Steckel, Bodo; Quast, Christine MD; Bonner, Florian MD; Friebe, Daniela PhD; Temme, Sebastian PhD; Flogel, Ulrich PhD; Schrader, Jurgen MD

Page: 297-313

http://ift.tt/2u3QJwY

Mechanical Circulatory Support Devices for Acute Right Ventricular Failure.

Author: Kapur, Navin K. MD; Esposito, Michele L. MD; Bader, Yousef MD; Morine, Kevin J. MD; Kiernan, Michael S. MD; Pham, Duc Thinh MD; Burkhoff, Daniel MD, PhD

Page: 314-326

http://ift.tt/2tzRoTz

From the Literature.

Author: Hampton, Tracy PhD

Page: 327-328

http://ift.tt/2u3htOe

Prosthetic Valve Endocarditis After Surgical Aortic Valve Replacement.

Author: Glaser, Natalie MD; Jackson, Veronica MD, PhD; Holzmann, Martin J. MD, PhD; Franco-Cereceda, Anders MD, PhD; Sartipy, Ulrik MD, PhD

Page: 329-331

http://ift.tt/2tzPGl4

Long-Term Efficacy and Safety of the Microsomal Triglyceride Transfer Protein Inhibitor Lomitapide in Patients With Homozygous Familial Hypercholesterolemia.

Author: Blom, Dirk J. MBChB, MMed, PhD; Averna, Maurizio R. MD; Meagher, Emma A. MD; du Toit Theron, Hendrik MD; Sirtori, Cesare R. MD, PhD; Hegele, Robert A. MD; Shah, Prediman K. MD; Gaudet, Daniel MD, PhD; Stefanutti, Claudia MD, PhD; Vigna, Giovanni B. MD, PhD; Larrey, Dominique MD, PhD; Bloedon, LeAnne T. BS, MS, RD; Foulds, Pamela MD; Rader, Daniel J. MD; Cuchel, Marina MD, PhD

Page: 332-335

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Letter by Ceylan Regarding Article, "Risk Factors for Coarctation of the Aorta on Prenatal Ultrasound: A Systematic Review and Meta-Analysis".

Author: Ceylan, Ozben MD

Page: 336-337

http://ift.tt/2tzZtaZ

Response to Letter Regarding Article, "Risk Factors for Coarctation of the Aorta on Prenatal Ultrasound: A Systematic Review and Meta-Analysis".

Author: Familiari, Alessandra MD; Morlando, Maddalena MD; Sonesson, Sven-Erik MD, PhD; Rizzo, Giuseppe MD; Acharya, Ganesh MD, PhD; Manzoli, Lamberto MD, PhD; D'Antonio, Francesco MD, PhD

Page: 338-339

http://ift.tt/2u46qEz

Letter by Leggio et al Regarding Article, "Mediterranean Diet Improves High-Density Lipoprotein Function in High-Cardiovascular-Risk Individuals: A Randomized Controlled Trial".

Author: Leggio, Massimo MD, PhD; Bendini, Maria Grazia MD; Mazza, Andrea MD

Page: 340-341

http://ift.tt/2tApYgm

Response to Letter Regarding Article, "Mediterranean Diet Improves High-Density Lipoprotein Function in High-Cardiovascular-Risk Individuals: A Randomized Controlled Trial".

Author: Hernaez, Alvaro PharmD, PhD; Castaner, Olga MD, PhD; Fito, Montserrat MD, PhD

Page: 342-343

http://ift.tt/2u3nwT2

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association.

Author: Sacks, Frank M. MD, FAHA, Chair; Lichtenstein, Alice H. DSc, FAHA; Wu, Jason H.Y. PhD, MSc; Appel, Lawrence J. MD, MPH, FAHA; Creager, Mark A. MD, FAHA; Kris-Etherton, Penny M. PhD, RD, FAHA; Miller, Michael MD, FAHA; Rimm, Eric B. ScD, FAHA; Rudel, Lawrence L. PhD, FAHA; Robinson, Jennifer G. MD, MPH, FAHA, Vice Chair; Stone, Neil J. MD, FAHA; Van Horn, Linda V. PhD, RD, FAHA, Vice Chair; On behalf of the American Heart Association

Page: e1-e23

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Correction.

Author:

Page: e24

http://ift.tt/2u3LrBH

Association analysis for young stock survival index with imputed whole-genome sequence variants in Nordic Holstein cattle

Publication date: August 2017
Source:Journal of Dairy Science, Volume 100, Issue 8
Author(s): Xiaoping Wu, Bernt Guldbrandtsen, Ulrik Sander Nielsen, Mogens Sandø Lund, Goutam Sahana
Identification of the genetic variants associated with calf survival in dairy cattle will aid in the elimination of harmful mutations from the cattle population and the reduction of calf and young stock mortality rates. We used de-regressed estimated breeding values for the young stock survival (YSS) index as response variables in a genome-wide association study with imputed whole-genome sequence variants. A total of 4,610 bulls with estimated breeding values were genotyped with the Illumina BovineSNP50 (Illumina, San Diego, CA) single nucleotide polymorphism (SNP) genotyping array. Genotypes were imputed to whole-genome sequence variants. After quality control, 15,419,550 SNP on 29 Bos taurus autosomes (BTA) were used for association analysis. A modified mixed-model association analysis was used for a genome scan, followed by a linear mixed-model analysis for selected genetic variants. We identified 498 SNP on BTA5 and BTA18 that were associated with the YSS index in Nordic Holstein. The SNP rs440345507 (Chr5:94721790) on BTA5 was the putative causal mutation affecting YSS. Two haplotype-based models were used to identify haplotypes with the largest detrimental effects on YSS index. For each association signal, 1 haplotype region with harmful effects and the lead associated SNP were identified. Detected haplotypes on BTA5 and BTA18 explained 1.16 and 1.20%, respectively, of genetic variance for the YSS index. We examined whether YSS quantitative trait loci (QTL) on BTA5 and BTA18 were associated with stillbirth. YSS QTL on BTA18 overlapped a QTL region for stillbirth, but most likely 2 different causal variants were responsible for these 2 QTL. Four component traits of the YSS index, defined by sex and age, were analyzed separately by the modified mixed-model approach. The same genomic regions were associated with both bull and heifer calf mortality. Several genes (EPS8, LOC100138951, and KLK family genes) contained a lead associated SNP or were included in haplotypes with large detrimental effects on YSS in Nordic Holstein cattle.



http://ift.tt/2utsLMI

News and Announcements

Publication date: August 2017
Source:Journal of Dairy Science, Volume 100, Issue 8





http://ift.tt/2t9GcxC

An attempt at predicting blood β-hydroxybutyrate from Fourier-transform mid-infrared spectra of milk using multivariate mixed models in Polish dairy cattle

Publication date: August 2017
Source:Journal of Dairy Science, Volume 100, Issue 8
Author(s): T.K. Belay, B.S. Dagnachew, Z.M. Kowalski, T. Ådnøy
Fourier transform mid-infrared (FT-MIR) spectra of milk are commonly used for phenotyping of traits of interest through links developed between the traits and milk FT-MIR spectra. Predicted traits are then used in genetic analysis for ultimate phenotypic prediction using a single-trait mixed model that account for cows' circumstances at a given test day. Here, this approach is referred to as indirect prediction (IP). Alternatively, FT-MIR spectral variable can be kept multivariate in the form of factor scores in REML and BLUP analyses. These BLUP predictions, including phenotype (predicted factor scores), were converted to single-trait through calibration outputs; this method is referred to as direct prediction (DP). The main aim of this study was to verify whether mixed modeling of milk spectra in the form of factors scores (DP) gives better prediction of blood β-hydroxybutyrate (BHB) than the univariate approach (IP). Models to predict blood BHB from milk spectra were also developed. Two data sets that contained milk FT-MIR spectra and other information on Polish dairy cattle were used in this study. Data set 1 (n = 826) also contained BHB measured in blood samples, whereas data set 2 (n = 158,028) did not contain measured blood values. Part of data set 1 was used to calibrate a prediction model (n = 496) and the remaining part of data set 1 (n = 330) was used to validate the calibration models, as well as to evaluate the DP and IP approaches. Dimensions of FT-MIR spectra in data set 2 were reduced either into 5 or 10 factor scores (DP) or into a single trait (IP) with calibration outputs. The REML estimates for these factor scores were found using WOMBAT. The BLUP values and predicted BHB for observations in the validation set were computed using the REML estimates. Blood BHB predicted from milk FT-MIR spectra by both approaches were regressed on reference blood BHB that had not been used in the model development. Coefficients of determination in cross-validation for untransformed blood BHB were from 0.21 to 0.32, whereas that for the log-transformed BHB were from 0.31 to 0.38. The corresponding estimates in validation were from 0.29 to 0.37 and 0.21 to 0.43, respectively, for untransformed and logarithmic BHB. Contrary to expectation, slightly better predictions of BHB were found when univariate variance structure was used (IP) than when multivariate covariance structures were used (DP). Conclusive remarks on the importance of keeping spectral data in multivariate form for prediction of phenotypes may be found in data sets where the trait of interest has strong relationships with spectral variables.



http://ift.tt/2uu4ciK

Counterclockwise maxillomandibular advancement surgery and disc repositioning: can condylar remodeling in the long-term follow-up be predicted?

This study investigated predictive risk factors of condylar remodeling changes after counterclockwise maxillomandibular advancement (CCW-MMA) and disc repositioning surgery. Forty-one female patients (75 condyles) treated with CCW-MMA and disc repositioning had cone beam computed tomography (CBCT) scans taken pre-surgery, immediately after surgery, and at an average 16 months post-surgery. Pre- and post-surgical three-dimensional models were superimposed using automated voxel-based registration on the cranial base to evaluate condylar displacements after surgery.

http://ift.tt/2tkIcHm

Comment on comparing the outcomes of different compression screw systems in the fixation of mandibular fractures

We read with interest the article by Kotrashetti and Singh1, comparing the use of Herbert type headless compression screws (HCS) with lag screws for the fixation of mandibular fractures, and wish to make a few critical observations.

http://ift.tt/2u30ytw

Aesthetic outcome and complications of simple interrupted versus running subcuticular sutures in facial surgery: A randomized controlled trial

The suturing technique and its associated complications could affect cosmetic outcome after facial surgery. Literature on this topic is limited.

http://ift.tt/2utmQrd

Re-Raising Muscle Flaps: A Randomised Controlled Animal Study

In the experience of our centre, 33% of reconstructed compound lower limb injuries will need orthopaedic revision [1]. There are numerous methods through which a flap may be re-raised and historically the approach of choice has been based on the principal of protecting the vascular pedicle, rather than the inset. Our aim was to determine whether a marginal versus a split approach to re-raising inferred a higher risk of flap necrosis and whether more attention should be paid to protecting the inset of the flap particularly at the distal portion.

http://ift.tt/2t9sWsQ

Language Sampling With Adolescents: Building a Normative Database With Fables

Purpose

The goal of the study was to create a language sampling task appropriate for adolescents and to contribute normative data from speakers with typical language development.

Method

Thirty adolescents (mean age = 14 years, 1 month) participated in an interview that involved the retelling and interpretation of 4 Greek fables. Each speaker's performance on the task was audio-recorded, transcribed verbatim, and entered into the Systematic Analysis of Language Transcripts computer program (Miller & Iglesias, 2015). Samples were analyzed statistically for language productivity and syntactic complexity. In addition, each participant's perspective on the moral messages of the fables was examined informally.

Results

The Fables task was effective in prompting adolescents to use complex language and in encouraging them to express their opinions about the moral messages. Although boys and girls did not differ in their performance on the task, some fables were more effective than others at eliciting spoken language and complex syntax. Moreover, the adolescents tended to agree with the moral messages of the fables and appeared to find them relevant to their lives.

Conclusion

The Fables task has potential for clinical use with adolescents. Research is necessary to expand the normative database to include larger and more diverse groups of adolescents.

http://ift.tt/2uCKH89

Discectomy without replacement improves function in patients with internal derangement of the temporomandibular joint

Treatment of internal derangement is controversial. This study assessed the effectiveness of discectomy without replacement in improving jaw function and decreasing pain.

http://ift.tt/2u35hvo

Response to the letter from Professor Helena Hachul and colleagues

Thank you for your interest regarding our recent paper entitled: "Individuals with pain need more sleep in the early stage of mild traumatic brain injury (mTBI)" published in Sleep Medicine [1]. Overall, we found that 29% of recovering mTBI individuals express an increased need for sleep (suggesting a subgroup effect) at one month post-trauma, particularly in the context of unrelieved acute pain (1).

http://ift.tt/2uCx5di

Solid-phase extraction of multi-class pharmaceuticals from environmental water samples onto modified multi-walled carbon nanotubes followed by LC-MS/MS

Abstract

In this paper, pristine and chemically treated multi-walled carbon nanotubes (MWCNTs) were employed as solid-phase extraction sorbents for the isolation and enrichment of multi-class pharmaceuticals from the surface water and groundwater, prior to liquid chromatography-tandem mass spectrometry analysis. Thirteen pharmaceuticals that belong to different therapeutical classes (erythromycin, azithromycin, sulfamethoxazole, diazepam, lorazepam, carbamazepine, metoprolol, bisoprolol, enalapril, cilazapril, simvastatin, clopidogrel, diclofenac) and two metabolites of metamizole (4-acetylaminoantipyrine and 4-formylaminoantipyrine) were selected for this study. The influence of chemical treatment on MWCNT surface characteristics and extraction efficiency was studied, and it was shown that HCl treatment of MWCNT leads to a decrease in the amount of surface oxygen groups and at the same time favorably affects the efficiency toward extraction of selected pharmaceuticals. After the optimization of the SPE procedure, the following conditions were chosen: 50 mg of HCl-treated MCWNT as a sorbent, 100 mL of water sample at pH 6, and 15 mL of the methanol-dichloromethane mixture (1:1, v/v) as eluent. Under optimal conditions, high recoveries (79–119%), as well as low detection (0.2 to 103 ng L⁻¹) and quantitation (0.5–345 ng L⁻¹) limits, were obtained. The optimized method was applied to the analysis of five surface water and two groundwater samples, and three pharmaceuticals were detected, the antiepileptic drug carbamazepine and two metabolites of antipyretic metamizole.

http://ift.tt/2t9bAMI

Comprehensive analysis of mercury pollution in the surface riverine sediments in the Haihe Basin, China

Abstract

The Haihe Basin extends over 318,000 km² or 3.3% of the total area of China, has a population of over 120 million, and is one of China's most polluted river basins. We investigated the pollution and risks from mercury (Hg) in surface riverine sediments of this basin and found that total Hg concentrations in surface sediments ranged from 0.001 to 1.05 mg/kg and averaged 0.054 mg/kg. Using the modified European Community Bureau of Reference standard method, we found that the exchangeable/acid-soluble, reducible, oxidizable, and residual fractions of Hg accounted for 9.86, 6.54, 11.0, and 72.6% of total Hg, respectively. The riverine sediments in the Da Qing He watershed had the highest anthropogenic enrichment of Hg (enrichment factor >1.5). There was a high potential ecological risk from Hg in the riverine sediments in the upper reaches of the Bei San He and Da Qing He watersheds, the middle reaches of the Luan He and Hei Long Gang watersheds, and the lower reaches of the Zi Ya He watershed. Comparison with risk assessment code showed that the riverine sediments in the Da Qing He, Luan He, and Tu-Hai Ma-Xia He watersheds represented a medium risk, with 16.6, 11.9, and 11.8% of Hg in the exchangeable/acid-soluble fraction, respectively.

http://ift.tt/2t9PIRe

Predicting attenuation of solar radiation (UV-B, UV-A and PAR) in waste stabilization ponds under Sahelian climatic conditions

Abstract

Because of its importance in pathogen removal and algal productivity in waste stabilization ponds, sunlight penetration was measured in microcosms and in situ under Sahelian climatic conditions. The different wavelengths were detected using a submersible radiometer equipped with three sensors: UV-B (311 nm), UV-A (369 nm) and photosynthetically available radiation (PAR, 400–700 nm). UV-B was more attenuated than UV-A and PAR. Facultative pond was more light-attenuating than maturation pond. The mean euphotic depths for UV-B were 0.20 and 0.31 m, respectively, in the facultative and maturation ponds; PAR penetrated deeper with mean euphotic depths of 0.27 and 0.42 m, respectively. The mean Secchi depths were 0.16 and 0.10 m in the maturation and facultative ponds waters, respectively. In view of the reported results, the contribution of the deeper sections of ponds to pathogen removal mediated by sunlight seems negligible. Therefore, when designing WSPs, these findings should be considered to increase the penetration of damaging wavelengths in order to ensure efficient microbial removal. For more pathogen elimination, downstream shallow ponds could be considered. The paper also shows how suspended solids, turbidity, and Secchi depth are related to the attenuation coefficients and euphotic depths. The developed models could be used to predict light penetration and then algal growth and pathogen removal mediated by sunlight in waste stabilization ponds located in Sahelian climate.

http://ift.tt/2usZT7n

Learning-based structurally-guided construction of resting-state functional correlation tensors

Publication date: Available online 17 July 2017
Source:Magnetic Resonance Imaging
Author(s): Lichi Zhang, Han Zhang, Xiaobo Chen, Qian Wang, Pew-Thian Yap, Dinggang Shen
Functional magnetic resonance imaging (fMRI) measures changes in blood-oxygenation-level-dependent (BOLD) signals to detect brain activities. It has been recently reported that the spatial correlation patterns of resting-state BOLD signals in the white matter (WM) also give WM information often measured by diffusion tensor imaging (DTI). These correlation patterns can be captured using functional correlation tensor (FCT), which is analogous to the diffusion tensor (DT) obtained from DTI. In this paper, we propose a noise-robust FCT method aiming at further improving its quality, and making it eligible for further neuroscience study. The novel FCT estimation method consists of three major steps: First, we estimate the initial FCT using a patch-based approach for BOLD signal correlation to improve the noise robustness. Second, by utilizing the relationship between functional and diffusion data, we employ a regression forest model to learn the mapping between the initial FCTs and the corresponding DTs using the training data. The learned forest can then be applied to predict the DTI-like tensors given the initial FCTs from the testing fMRI data. Third, we re-estimate the enhanced FCT by utilizing the DTI-like tensors as a feedback guidance to further improve FCT computation. We have demonstrated the utility of our enhanced FCTs in Alzheimer's disease (AD) diagnosis by identifying mild cognitive impairment (MCI) patients from normal subjects.



http://ift.tt/2u2JRQy

Histamine H2 receptor stimulation up-regulates Th2 chemokine CCL17 production in human M2a macrophages

Stimulation of the histamine H2 receptor significantly increased CCL17 production in human monocyte derived M2a macrophages. These results may be helpful to identify novel therapeutical target structures in diseases driven at least in part by histamine.

http://ift.tt/2ut8I1c

Airway microbiota signals anabolic and catabolic remodeling in the transplanted lung

The rate of matrix deposition varies with the microbial composition in the transplanted lung, potentially impacting upon graft survival.

http://ift.tt/2t9QIVu

The “Dangers” of Chronic Proton Pump Inhibitor Use

http://ift.tt/2ut6w9Z

Temporal Envelope Coding by Inferior Colliculus Neurons with Cochlear Implant Stimulation

Abstract

Modulations in temporal envelopes are a ubiquitous property of natural sounds and are especially important for hearing with cochlear implants (CIs) because these devices typically discard temporal fine structure information. With few exceptions, neural temporal envelope processing has been studied in both normal hearing (NH) and CI animals using only pure sinusoidal amplitude modulation (SAM) which poorly represents the diversity of envelope shapes contained in natural sounds because it confounds repetition rate and the width of each modulation cycle. Here, we used stimuli that allow independent manipulation of the two parameters to characterize envelope processing by inferior colliculus (IC) neurons in barbiturate-anesthetized cats with CIs. Specifically, the stimuli were amplitude modulated, high rate pulse trains, where the envelope waveform interleaved single cycles ("bursts") of a sinusoid with silent intervals. We found that IC neurons vary widely with respect to the envelope parameters that maximize their firing rates. In general, pure SAM was a relatively ineffective stimulus. The majority of neurons (60 %) preferred a combination of short bursts and low repetition rates (long silent intervals). Others preferred low repetition rates with minimal dependence on envelope width (17 %), while the remainder responded most strongly to brief bursts with lesser sensitivity to repetition rate (23 %). A simple phenomenological model suggests that a combination of inhibitory and intrinsic cellular mechanisms suffices to account for the wide variation in optimal envelope shapes. In contrast to the strong dependence of firing rate on envelope shape, neurons tended to phase lock precisely to the envelope regardless of shape. Most neurons tended to fire specifically near the peak of the modulation cycle, with little phase dispersion within or across neurons. Such consistently precise timing degrades envelope coding compared to NH processing of real-world sounds, because it effectively eliminates spike timing as a cue to envelope shape.

http://ift.tt/2uwhRWm

Temporal Envelope Coding by Inferior Colliculus Neurons with Cochlear Implant Stimulation

Abstract

Modulations in temporal envelopes are a ubiquitous property of natural sounds and are especially important for hearing with cochlear implants (CIs) because these devices typically discard temporal fine structure information. With few exceptions, neural temporal envelope processing has been studied in both normal hearing (NH) and CI animals using only pure sinusoidal amplitude modulation (SAM) which poorly represents the diversity of envelope shapes contained in natural sounds because it confounds repetition rate and the width of each modulation cycle. Here, we used stimuli that allow independent manipulation of the two parameters to characterize envelope processing by inferior colliculus (IC) neurons in barbiturate-anesthetized cats with CIs. Specifically, the stimuli were amplitude modulated, high rate pulse trains, where the envelope waveform interleaved single cycles ("bursts") of a sinusoid with silent intervals. We found that IC neurons vary widely with respect to the envelope parameters that maximize their firing rates. In general, pure SAM was a relatively ineffective stimulus. The majority of neurons (60 %) preferred a combination of short bursts and low repetition rates (long silent intervals). Others preferred low repetition rates with minimal dependence on envelope width (17 %), while the remainder responded most strongly to brief bursts with lesser sensitivity to repetition rate (23 %). A simple phenomenological model suggests that a combination of inhibitory and intrinsic cellular mechanisms suffices to account for the wide variation in optimal envelope shapes. In contrast to the strong dependence of firing rate on envelope shape, neurons tended to phase lock precisely to the envelope regardless of shape. Most neurons tended to fire specifically near the peak of the modulation cycle, with little phase dispersion within or across neurons. Such consistently precise timing degrades envelope coding compared to NH processing of real-world sounds, because it effectively eliminates spike timing as a cue to envelope shape.

http://ift.tt/2uwhRWm

Temporal Envelope Coding by Inferior Colliculus Neurons with Cochlear Implant Stimulation

Abstract

Modulations in temporal envelopes are a ubiquitous property of natural sounds and are especially important for hearing with cochlear implants (CIs) because these devices typically discard temporal fine structure information. With few exceptions, neural temporal envelope processing has been studied in both normal hearing (NH) and CI animals using only pure sinusoidal amplitude modulation (SAM) which poorly represents the diversity of envelope shapes contained in natural sounds because it confounds repetition rate and the width of each modulation cycle. Here, we used stimuli that allow independent manipulation of the two parameters to characterize envelope processing by inferior colliculus (IC) neurons in barbiturate-anesthetized cats with CIs. Specifically, the stimuli were amplitude modulated, high rate pulse trains, where the envelope waveform interleaved single cycles ("bursts") of a sinusoid with silent intervals. We found that IC neurons vary widely with respect to the envelope parameters that maximize their firing rates. In general, pure SAM was a relatively ineffective stimulus. The majority of neurons (60 %) preferred a combination of short bursts and low repetition rates (long silent intervals). Others preferred low repetition rates with minimal dependence on envelope width (17 %), while the remainder responded most strongly to brief bursts with lesser sensitivity to repetition rate (23 %). A simple phenomenological model suggests that a combination of inhibitory and intrinsic cellular mechanisms suffices to account for the wide variation in optimal envelope shapes. In contrast to the strong dependence of firing rate on envelope shape, neurons tended to phase lock precisely to the envelope regardless of shape. Most neurons tended to fire specifically near the peak of the modulation cycle, with little phase dispersion within or across neurons. Such consistently precise timing degrades envelope coding compared to NH processing of real-world sounds, because it effectively eliminates spike timing as a cue to envelope shape.

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The “Dangers” of Chronic Proton Pump Inhibitor Use

Publication date: Available online 17 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Rena Yadlapati, Peter J. Kahrilas




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Percutaneous Edge-to-Edge Repair of Recurrent Severe Mitral Regurgitation After Surgical Mitral Valve Repair

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Correction

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Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults

AbstractBackground

Plant-based diets are recommended for coronary heart disease (CHD) prevention. However, not all plant foods are necessarily beneficial for health.

Objectives

This study sought to examine associations between plant-based diet indices and CHD incidence.

Methods

We included 73,710 women in NHS (Nurses' Health Study) (1984 to 2012), 92,329 women in NHS2 (1991 to 2013), and 43,259 men in Health Professionals Follow-up Study (1986 to 2012), free of chronic diseases at baseline. We created an overall plant-based diet index (PDI) from repeated semiquantitative food-frequency questionnaire data, by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful plant-based diet index (hPDI) where healthy plant foods (whole grains, fruits/vegetables, nuts/legumes, oils, tea/coffee) received positive scores, whereas less-healthy plant foods (juices/sweetened beverages, refined grains, potatoes/fries, sweets) and animal foods received reverse scores. To create an unhealthful PDI (uPDI), we gave positive scores to less-healthy plant foods and reverse scores to animal and healthy plant foods.

Results

Over 4,833,042 person-years of follow-up, we documented 8,631 incident CHD cases. In pooled multivariable analysis, higher adherence to PDI was independently inversely associated with CHD (hazard ratio [HR] comparing extreme deciles: 0.92; 95% confidence interval [CI]: 0.83 to 1.01; p trend = 0.003). This inverse association was stronger for hDPI (HR: 0.75; 95% CI: 0.68 to 0.83; p trend <0.001). Conversely, uPDI was positively associated with CHD (HR: 1.32; 95% CI: 1.20 to 1.46; p trend <0.001).

Conclusions

Higher intake of a plant-based diet index rich in healthier plant foods is associated with substantially lower CHD risk, whereas a plant-based diet index that emphasizes less-healthy plant foods is associated with higher CHD risk.

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Hypertension Treatment in the Elderly: Individualized Target or Intensive Blood Pressure Lowering?

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Healthy Plant-Based Diet: What Does it Really Mean?

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Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy: A Word of Balance

Abstract

The management of drug-refractory symptoms of obstructive hypertrophic cardiomyopathy has long been debated and is primarily centered on the choice between surgical myectomy and alcohol septal ablation. Decision making in these patients requires consideration of procedural risk, expertise and efficacy, and the long-term impact on patients' survival. Although there have been numerous reports on these procedures that may help guide decision making, these data continue to be self-reported and voluntary. Greater insight into the real-world experience for these therapies and how they should be applied in practice would be gained from mandatory reporting, akin to other multidisciplinary, transcatheter-based therapies.

http://ift.tt/2usy7Ih

Spontaneous Coronary Artery Dissection Associated With Pregnancy

AbstractBackground

Spontaneous coronary artery dissection (SCAD) is the most common cause of pregnancy-associated myocardial infarction and remains poorly characterized.

Objectives

This study sought to assess presentation, clinical factors, and outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD) compared with spontaneous coronary artery dissection not associated with pregnancy (NP-SCAD).

Methods

A Mayo Clinic registry was established in 2010 to include comprehensive retrospective and prospective SCAD data. Records were reviewed to identify women who were pregnant or ≤12 weeks postpartum at time of SCAD. Complete records were available for 323 women; 54 women met criteria for P-SCAD (4 during pregnancy) and they were compared with 269 women with NP-SCAD.

Results

Most events occurred within the first month postpartum (35 of 50). Compared with NP-SCAD, P-SCAD patients more frequently presented with ST-segment elevation myocardial infarction (57% vs. 36%; p = 0.009), left main or multivessel SCAD (24% vs. 5%; p < 0.0001; and 33% vs. 14%; p = 0.0027, respectively), and left ventricular function ≤35% (26% vs. 10%; p = 0.0071). Among women with imaging of other vascular territories, P-SCAD was less likely with a diagnosis of fibromuscular dysplasia and extracoronary vascular abnormalities (42% vs. 64%; p = 0.047; and 46% vs. 77%; p = 0.0032, respectively). Compared with U.S. birth data, women with P-SCAD were more often multiparous (p = 0.0167), had a history of infertility therapies (p = 0.0004), and had pre-eclampsia (p = 0.001). On long-term follow-up (median 2.3 years) recurrent SCAD occurred in 51 patients, with no difference in the Kaplan Meier 5-year recurrence rates (10% vs. 23%; p = 0.18).

Conclusions

P-SCAD patients had more acute presentations and high-risk features than women with NP-SCAD did. The highest frequency of P-SCAD occurred during the first postpartum month and P-SCAD patients less often had extracoronary vascular abnormalities. Hormonal, hemodynamic variations, and yet-undefined mechanisms might be significant contributors to P-SCAD. (The "Virtual" Multicenter Spontaneous Coronary Artery Dissection [SCAD] Registry [SCAD]; NCT01429727; Genetic Investigations in Spontaneous Coronary Artery Dissection [SCAD]; NCT01427179)

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Relevance of Indications for CABG in Evaluating the Effect of Dual Antiplatelet Therapy

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Spontaneous Coronary Artery Dissection: The Zebra Has Been Spotted: Now Lets Study its Stripes

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Reply: Hypertension Treatment in the Elderly: Individualized Target or Intensive Blood Pressure Lowering?

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Transcatheter Versus Surgical Aortic Valve Replacement: Propensity-Matched Comparison

AbstractBackground

Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged.

Objectives

The aim of this study was to determine the safety and effectiveness of TAVR versus surgical aortic valve replacement (SAVR), particularly in intermediate- and high-risk patients, in a nationally representative real-world cohort.

Methods

Using data from the Transcatheter Valve Therapy Registry and Society of Thoracic Surgeons National Database linked to Medicare administrative claims for follow-up, 9,464 propensity-matched intermediate- and high-risk (Society of Thoracic Surgeons Predicted Risk of Mortality score ≥3%) U.S. patients who underwent commercial TAVR or SAVR were examined. Death, stroke, and days alive and out of the hospital to 1 year were compared, as well as discharge home, with subgroup analyses by surgical risk, demographics, and comorbidities.

Results

In a propensity-matched cohort (median age 82 years, 48% women, median Society of Thoracic Surgeons Predicted Risk of Mortality score 5.6%), TAVR and SAVR patients experienced no difference in 1-year rates of death (17.3% vs. 17.9%; hazard ratio: 0.93; 95% confidence interval [CI]: 0.83 to 1.04) and stroke (4.2% vs. 3.3%; hazard ratio: 1.18; 95% CI: 0.95 to 1.47), and no difference was observed in the proportion of days alive and out of the hospital to 1 year (rate ratio: 1.00; 95% CI: 0.98 to 1.02). However, TAVR patients were more likely to be discharged home after treatment (69.9% vs. 41.2%; odds ratio: 3.19; 95% CI: 2.84 to 3.58). Results were consistent across most subgroups, including among intermediate- and high-risk patients.

Conclusions

Among unselected intermediate- and high-risk patients, TAVR and SAVR resulted in similar rates of death, stroke, and DAOH to 1 year, but TAVR patients were more likely to be discharged home.

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JACC Instructions for Authors

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Effectiveness in a Real-World Observation Confirms Efficacy of Controlled Clinical Trials

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2017 ACC/AAP/AHA Health Policy Statement on Opportunities and Challenges in Pediatric Drug Development: Learning From Sildenafil

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Contemporary Outcomes in Patients With Long QT Syndrome

AbstractBackground

Long QT syndrome (LQTS) is a potentially lethal cardiac channelopathy with a 1% to 5% annual risk of LQTS-triggered syncope, aborted cardiac arrest, or sudden cardiac death.

Objectives

This study sought to evaluate LQTS outcomes from a single center in the contemporary era.

Methods

The authors conducted a retrospective study comprising the 606 patients with LQTS (LQT1 in 47%, LQT2 in 34%, and LQT3 in 9%) who were evaluated in Mayo Clinic's Genetic Heart Rhythm Clinic from January 1999 to December 2015. Breakthrough cardiac events (BCEs) were defined as LQTS-attributable syncope or seizures, aborted cardiac arrest, appropriate ventricular fibrillation–terminating implantable cardioverter-defibrillator shocks, and sudden cardiac death.

Results

There were 166 (27%) patients who were symptomatic prior to their first Mayo Clinic evaluation. Median age at first symptom was 12 years. Treatment strategies included no active therapy in 47 (8%) patients, beta-blockers alone in 350 (58%) patients, implantable cardioverter-defibrillators alone in 25 (4%) patients, left cardiac sympathetic denervation alone in 18 (3%) patients, and combination therapy in 166 (27%) patients. Over a median follow-up of 6.7 (IQR: 3.9 to 9.8) years, 556 (92%) patients have not experienced an LQTS-triggered BCE. Only 8 of 440 (2%) previously asymptomatic patients have experienced a single BCE. In contrast, 42 of 166 (25%) previously symptomatic patients have experienced ≥1 BCE. Among the 30 patients with ≥2 BCEs, 2 patients have died and 3 LQT3 patients underwent cardiac transplantation.

Conclusions

Although outcomes have improved markedly, further optimization of treatment strategies is still needed given that 1 in 4 previously symptomatic patients experienced at least 1 subsequent, albeit nonlethal, LQTS-triggered cardiac event.

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Telomere Length and Risk of Cardiovascular Disease and Cancer

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Evolution in Managing Long QT Syndrome: From Registries to Centers of Excellence

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Reply: Relevance of Indications for CABG in Evaluating the Effect of Dual Antiplatelet Therapy

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Magnetic Resonance in Transthyretin Cardiac Amyloidosis

AbstractBackground

Cardiac transthyretin amyloidosis (ATTR) is an increasingly recognized cause of heart failure. Cardiac magnetic resonance (CMR), with late gadolinium enhancement (LGE) and T1 mapping, is emerging as a reference standard for diagnosis and characterization of cardiac amyloidosis.

Objectives

The authors used CMR with extracellular volume fraction (ECV) measurement to characterize cardiac involvement in relation to outcome in ATTR.

Methods

Subjects comprised 263 patients with cardiac ATTR corroborated by grade 2 to 3 ^99mTc-DPD (^99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid) cardiac uptake, 17 with suspected cardiac ATTR (grade 1 ^99mTc-DPD), and 12 asymptomatic individuals with amyloidogenic transthyretin (TTR) mutations. Fifty patients with cardiac light-chain (AL) amyloidosis acted as disease comparators.

Results

Unlike cardiac AL amyloidosis, asymmetrical septal left ventricular hypertrophy (LVH) was present in 79% of patients with ATTR (70% sigmoid septum and 30% reverse septal contour), whereas symmetrical LVH was present in 18%, and 3% had no LVH. In patients with cardiac amyloidosis, the pattern of LGE was always typical for amyloidosis (29% subendocardial, 71% transmural), including right ventricular LGE (96%). During follow-up (19 ± 14 months), 65 patients died. ECV independently correlated with mortality and remained independent after adjustment for age, N-terminal pro-B-type natriuretic peptide, ejection fraction, E/E', and left ventricular mass (hazard ratio: 1.164; 95% confidence interval: 1.066 to 1.271; p < 0.01).

Conclusions

Asymmetrical hypertrophy, traditionally associated with hypertrophic cardiomyopathy, was the commonest pattern of ventricular remodeling in ATTR. LGE imaging was typical in all patients with cardiac ATTR. ECV correlated with amyloid burden and was an independent prognostic factor for survival in this cohort of patients.

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The Importance of Invasive Hemodynamics for Pulmonary Hypertension Screening in TAVR Patients

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The Comparative Safety of TNF Inhibitors in Ankylosing Spondylitis—a Meta-Analysis Update of 14 Randomized Controlled Trials

Abstract

TNF inhibitors have been used in ankylosing spondylitis (AS). The efficacy of TNF inhibitors was already evaluated by meta-analysis of randomized controlled trials (RCTs). However, the safety of TNF inhibitors is still unclear. Therefore, we aimed to evaluate and update the safety data from RCTs of TNF inhibitors in patients treated for AS. A systematic literature search was conducted from 1990 through May 31, 2016. All studies included were randomized, double-blind, controlled trials of patients with ankylosing spondylitis that evaluated adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab treatment. The overall serious adverse events, the risk of serious infection events, and the risk of malignancy and discontinuation rates were abstracted, and risk estimates were calculated by Peto odds ratios (ORs). Fourteen randomized controlled trials involving 2032 subjects receiving TNF inhibitors and 1030 subjects receiving placebo and/or traditional disease-modifying anti-rheumatic drugs (DMARDs) were included. The overall serious adverse events (OR, 1.34; 95% CI, 0.87–2.05), the risk of serious infection events (OR, 1.59; 95% CI, 0.63–4.01), the risk of malignancy (OR, 0.98; 95% CI, 0.25–3.85), and discontinuation due to adverse events (OR, 1.55; 95% CI, 0.95–2.54) in patients treated with TNF inhibitors as a group were not significantly different from those treated with placebo in the control group. TNF inhibitors were generally safe for treatment of ankylosing spondylitis. These data may help guide clinical comparative decision making in the management of AS.

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Cognitive restructuring of gambling-related thoughts: A systematic review

Publication date: December 2017
Source:Addictive Behaviors, Volume 75
Author(s): Maxime Chrétien, Isabelle Giroux, Annie Goulet, Christian Jacques, Stéphane Bouchard
Gamblers' thoughts have a fundamental influence on their gambling problem. Cognitive restructuring is the intervention of choice to correct those thoughts. However, certain difficulties are noted in the application of cognitive restructuring techniques and the comprehension of their guidelines. Furthermore, the increase of skill game players (e.g. poker) entering treatment creates a challenge for therapists, as these gamblers present with different thoughts than those of the gamblers usually encountered in treatment (e.g. chance-only games like electronic gambling machines). This systematic review aims to describe how cognitive restructuring is carried out with gamblers based on the evidence available in empirical studies that include cognitive interventions for gambling. Of the 2607 studies collected, 39 were retained. The results highlight exposure as the most frequently used technique to facilitate identification of gambling-related thoughts (imaginal=28.2%; in vivo=10.3%). More than half of the studies (69.2%) clearly reported therapeutic techniques aimed to correct gamblers' thoughts, of which 37% involved visual support to challenge those thoughts (e.g. ABC log). Of the 39 studies retained, 48.7% included skill game players (i.e., poker, blackjack, sports betting) in their sample. However, none of these studies mentioned whether cognitive restructuring had been adapted for these gamblers. Several terms referring to gamblers' thoughts were used interchangeably (e.g. erroneous, dysfunctional or inadequate thoughts), although each of these terms could refer to specific content. Clinical implications of the results are discussed with regard to the needs of therapists. This review also suggests recommendations for future research.



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Measures and predictors of varenicline adherence in the treatment of nicotine dependence

Publication date: December 2017
Source:Addictive Behaviors, Volume 75
Author(s): Annie R. Peng, Mark Morales, E. Paul Wileyto, Larry W. Hawk, Paul Cinciripini, Tony P. George, Neal L. Benowitz, Nicole L. Nollen, Caryn Lerman, Rachel F. Tyndale, Robert Schnoll
IntroductionWhile adherence to medication in smoking cessation clinical trials is strongly associated with clinical outcome, very few studies have evaluated the validity of pill count as a measure of adherence relative to a biological assay, and evaluated a broad range of correlates of adherence.MethodsIn a smoking cessation clinical trial of varenicline, we compared pill counts collected over 4 different time periods to varenicline salivary levels taken after 2weeks of treatment, as well as evaluated predictors of adherence to varenicline.ResultsUsing a binary measure of adherence based on salivary varenicline levels, adherence was higher among older, white, and more educated participants. Relative to 3, 7, and 14-day pill count, 12-week pill count was the only significant measure able to discriminate adherence as defined by salivary varenicline levels (assessed by area under the receiver operating characteristic curve; AUC=0.59, p=0.004). Seventy-two percent of participants who indicated adherence on 12-week pill count were classified as adherent based on varenicline saliva levels (sensitivity=0.80; specificity=0.40). There was modest variability in the relationship between 12-week pill count and varenicline levels across race and rate of nicotine metabolism. Lastly, General Estimating Equation models demonstrated that longitudinal changes in withdrawal, craving, negative and positive affect, and side effect count and severity were not related to adherence based on salivary varenicline levels.ConclusionsThese results indicate that 12-week pill count was the best, albeit a relatively weak, measure of varenicline adherence; additional factors associated with treatment adherence need to be identified.



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Predictors of smoking cessation group treatment engagement among veterans with serious mental illness

Publication date: December 2017
Source:Addictive Behaviors, Volume 75
Author(s): Letitia E. Travaglini, Lan Li, Clayton H. Brown, Melanie E. Bennett
High prevalence rates of tobacco use, particularly cigarettes, pose a serious health threat for individuals with serious mental illness (SMI), and research has demonstrated the effectiveness of pharmacotherapy and psychosocial interventions to reduce tobacco use in this group. However, few studies have considered predictors of tobacco cessation treatment engagement among individuals with SMI. The current study examined predictors of engagement in smoking cessation groups among veterans with SMI engaged in mental health services at three VA medical centers. All veterans were participating in a smoking cessation treatment study. Of 178 veterans who completed baseline assessments, 127 (83.6%) engaged in treatment, defined as attending at least three group sessions. Forty-one (N=41) predictors across five domains (demographics, psychiatric concerns, medical concerns, smoking history, and self-efficacy to quit smoking) were identified based on previous research and clinical expertise. Using backward elimination to determine a final multivariable logistic regression model, three predictors were found to be significantly related to treatment engagement: marital status (never-married individuals more likely to engage); previous engagement in group smoking cessation services; and greater severity of positive symptoms on the Brief Psychiatric Rating Scale. When included in the multivariable logistic regression model, the full model discriminates between engagers and non-engagers reasonably well (c statistic=0.73). Major considerations based on these findings are: individuals with SMI appear to be interested in smoking cessation services; and serious psychiatric symptomatology should not discourage treatment providers from encouraging engagement in smoking cessation services.



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Reduction of individual or combined toxicity of fumonisin B 1 and zearalenone via dietary inclusion of organo-modified nano-montmorillonite in rats

Abstract

Fusarium mycotoxins are nature environmental contaminants worldwide in animal feed and human food resulting in a serious health risk. The present study aimed to evaluate the potential role of organo-modified nano-montmorillonite (OMNM) against the health risk and the oxidative stress resulted from the exposure of fumonisin (FB₁) and zearalenone (ZEN) individually and in combination in rats. Eight groups of female Sprague Dawley rats were treated orally for 3 weeks including the control group, FB₁ alone-treated group (50 mg/kg b.w.), ZEN alone-treated group (40 μg/kg b.w), FB₁ plus ZEN-treated group, the group fed basal diet supplemented with OMNM (5 g/kg diet), and the groups fed basal diet supplemented with OMNM and treated with FB₁ and/or ZEN. At the end of the experimental period, samples of blood and tissues were collected for different biochemical and histological analyses. The results revealed that administration of FB₁ and/or ZEN resulted in significant disturbances in the biochemical parameters tested, lipid profiles, serum cytokines, oxidative stress indices, the activity of antioxidant enzymes, and the histological status of the liver and kidney. Co-administration of both mycotoxins indicated a synergistic effect. OMNM alone was safe and succeeded to reduce and/or prevent most of the toxicity of both mycotoxins. It could be concluded that OMNM is a novel and promising nanograde adsorbent suitable for the protection against the combined exposure to FB₁ and ZEN.

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Application of phototherapy for the healing of the navels of neonatal dairy calves

Abstract

The present work evaluated the effects of LED light irradiation on the healing of the navels of neonatal dairy calves. Fifty-seven neonatal calves were divided into two groups. Animals had their umbilical stumps immersed in 10% iodine tincture for 60 s, and this process was repeated every 24 h for three consecutive days. The 29 animals in the first group did not receive LED therapy. The 28 animals in the second group received LED light irradiation at 640 nm with 300 mW power, 46.8 J/cm² energy density, 60 s irradiation time, and 0.385 cm² spot size. The animals were irradiated at four points (46.8 J/cm² per point) evenly distributed around the insertion site of the umbilical stump every 24 h for three consecutive days. Irradiation with LED light was applied before the umbilical stumps were immersed in the iodine solution. The time after birth at which the umbilical stump fell off of each calf was noted. The umbilical stumps of all animals fell off by the 25th day of age. After the umbilical stump fell off, the healing of the remnant wound was followed up to the 30th day after birth. The area of the wound was measured on the 15th, 20th, and 25th day after birth using digital photographs and computer-assisted area measurements. A two-tailed unpaired t test was applied to analyze the falling off the umbilical stump, whereas a Kruskal-Wallis one-way ANOVA test with a Dunn's multiple comparison test was used for the wound size evolution. GraphPad Prisma 5.0® and GraphPad StatMate 2.00® were used for the statistical analysis. The results revealed that phototherapy hastened the falling off the umbilical stump, accelerated navel healing, and reduced the mortality rate in newborn calves. Therefore, this study introduced a preventive and adjuvant after birth treatment that proved to be effective in reducing the incidences of omphalitis and newborn mortality.

http://ift.tt/2uBu3FU

New insight in spiral drawing analysis methods - Application to action tremor quantification

Publication date: Available online 17 July 2017
Source:Clinical Neurophysiology
Author(s): André Pierre Legrand, Isabelle Rivals, Aliénor Richard, Emmanuelle Apartis, Emmanuel Roze, Marie Vidailhet, Sabine Meunier, Elodie Hainque
ObjectiveSpiral drawing is one of the standard tests used to assess tremor severity for the clinical evaluation of medical treatments. Tremor severity is estimated through visual rating of the drawings by movement disorders experts. Different approaches based on the mathematical signal analysis of the recorded spiral drawings were proposed to replace this rater dependent estimate. The objective of the present study is to propose new numerical methods and to evaluate them in terms of agreement with visual rating and reproducibility.MethodsSeries of spiral drawings of patients with essential tremor were visually rated by a board of experts. In addition to the usual velocity analysis, three new numerical methods were tested and compared, namely static and dynamic unraveling, and empirical mode decomposition. The reproducibility of both visual and numerical ratings was estimated, and their agreement was evaluated.ResultsThe statistical analysis demonstrated excellent agreement between visual and numerical ratings, and more reproducible results with numerical methods than with visual ratings.ConclusionsThe velocity method and the new numerical methods are in good agreement. Among the latter, static and dynamic unravelling both display a smaller dispersion and are easier for automatic analysis.SignificanceThe reliable scores obtained through the proposed numerical methods allow considering that their implementation on a digitized tablet, be it connected with a computer or independent, provides an efficient automatic tool for tremor severity assessment.



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Extreme delta brushes in anti NMDA receptor encephalitis – muscle artefact or an EEG phenomenon? A case report

Publication date: Available online 17 July 2017
Source:Clinical Neurophysiology
Author(s): Anna A.E. van der Meulen, Johannes H. van der Hoeven, Bauke M. de Jong, Jan Willem J Elting




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Metabolic phenotype in the mouse model of osteogenesis imperfecta

Osteogenesis Imperfecta (OI) is the most common heritable bone fragility disorder, usually caused by dominant mutations in genes coding for collagen type I alpha chains, COL1A1 or COL1A2. Osteocalcin is now recognized as a bone-derived regulator of insulin secretion and sensitivity and glucose homeostasis. Since OI is associated with increased rates of bone formation and resorption, we hypothesized that the levels of undercarboxylated osteocalcin are increased in OI. The objective of this study was to determine changes in osteocalcin and to elucidate the metabolic phenotype in the Col1a1Jrt/+ mouse, a model of dominant OI caused by a Col1a1 mutation. Circulating levels of undercarboxylated osteocalcin were higher in 4-week old OI mice and normal by 8 weeks of age. Young OI animals exhibited a sex-dependent metabolic phenotype, including increased insulin levels in males, improved glucose tolerance in females, lower levels of non-fasted glucose and low adiposity in both sexes. The rates of O2 consumption and CO2 production, as well as energy expenditure assessed using indirect calorimetry were significantly increased in OI animals of both sexes, while respiratory exchange ratio was significantly higher in OI males only. While OI mice have significant physical impairment that may contribute to metabolic differences, we specifically accounted for movement and compared OI and WT animals during the periods of similar activity levels. Taken together, our data strongly suggest that OI animals have alterations in whole body energy metabolism that are consistent with the action of undercarboxylated osteocalcin.

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The Origins of Oral Medicine in the Hippocratic Collected Works

Abstract

The collected works of Hippocrates describe for the first time in a systematic way a large number of oral diseases, such as ulcers, inflammations, abscesses and tumours from the epiglottis, mouth, tongue, palate, uvula and the sublingual area. Several of these case reports are remarkable for the accurate observation of clinical symptoms and signs, the aetiology, the pathogenesis and their therapeutic approach in relation to prognosis. The Hippocratic authors report cases of 'aphthae' as part of a polysystemic disease, described many centuries later by Behçet and Adamantiades, while they associate features of splenomegaly from endemic malaria with gingivitis ('ulitis'). Benign lip ulcers, caused by sharp teeth bites, were distinguished from the difficult to treat herpes labialis ('herpes') and from the necrotising 'nomae'. Although staphylitis and angina ('kynanche') were attributed to phlegm accumulation, they were recognised as true emergencies when they were associated with a swollen tongue and uvula. Several cases of 'kynanche' with forward displacement of the first cervical vertebrae, atrophy of uvula and oedema of the jaws are illustrated. A fatal outcome was anticipated in cases of 'phagedaenic' ulcers of the teeth, causing necrosis and abscess formation. The therapeutic approach of oral diseases proceeded step by step, starting with simple regimens and progressing to invasive techniques, such as phlebotomy, surgical incisions for fluid drainage and cauterisation. With the aim to avoid adverse events, special attention was paid to the correct timing of surgery and the maintenance of a patent airway with the insertion of small pharyngeal tubes.

This article is protected by copyright. All rights reserved.

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Electroacupuncture Alleviates Brain Damage Through Targeting of Neuronal Calcium Sensor 1 by miR-191a-5p After Ischemic Stroke

Rejuvenation Research , Vol. 0, No. 0.


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Newcomers in paediatric GI pathology: childhood enteropathies including very early onset monogenic IBD

Abstract

Childhood enteropathies are a group of diseases causing severe chronic (>2–3 weeks) diarrhoea often starting in the first week of life with the potential for fatal complications for the affected infant. Early identification and accurate classification of childhood enteropathies are, therefore, crucial for making treatment decisions to prevent life-threatening complications. Childhood enteropathies are classified into four groups based on the underlying pathology: (i) conditions related to defective digestion, absorption and transport of nutrients and electrolytes; (ii) disorders related to enterocyte differentiation and polarization; (iii) defects of enteroendocrine cell differentiation; and (iv) disorders associated with defective modulation of intestinal immune response. While the intestinal mucosa is usually normal in enteropathies related to congenital transport or enzyme deficiencies, the intestinal biopsy in other disorders may reveal a wide range of abnormalities varying from normal villous architecture to villous atrophy and/or inflammation, or features specific to the underlying disorder including epithelial abnormalities, lipid vacuolization in the enterocytes, absence of plasma cells, lymphangiectasia, microorganisms, and mucosal eosinophilic or histiocytic infiltration. This review intends to provide an update on small intestinal biopsy findings in childhood enteropathies, the "newcomers", including very early onset monogenic inflammatory bowel disease (IBD), in particular, for the practicing pathologist.

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