Head and Neck Diseases by Alexandros G.Sfakianakis: 04/27/18

Παρασκευή 27 Απριλίου 2018

Ammonia production in poultry houses can affect health of humans, birds, and the environment—techniques for its reduction during poultry production

Abstract

Due to greater consumption of poultry products and an increase in exports, more poultry houses will be needed. Therefore, it is important to investigate ways that poultry facilities can coexist in close proximity to residential areas without odors and environmental challenges. Ammonia (NH₃) is the greatest concern for environmental pollution from poultry production. When birds consume protein, they produce uric acid, ultimately converted to NH₃ under favorable conditions. Factors that increase production include pH, temperature, moisture content, litter type, bird age, manure age, relative humidity, and ventilation rate (VR). NH₃ concentration and emissions in poultry houses depend on VR; seasons also have effects on NH₃ production. Modern ventilation systems can minimize NH₃ in enclosed production spaces quickly but increase its emissions to the environment. NH₃ adversely affects the ecosystem, environment, and health of birds and people. Less than 10 ppm is the ideal limit for exposure, but up to 25 ppm is also not harmful. NH₃ can be minimized by housing type, aerobic and anaerobic conditions, manure handling practices, litter amendment, and diet manipulation without affecting performance and production. Antibiotics can minimize NH₃, but consumers have concerns about health effects. Administration of probiotics seems to be a useful replacement for antibiotics. More studies have been conducted on broilers, necessitating the need to evaluate the effect of probiotics on NH₃ production in conjunction with laying hen performance and egg quality. This comprehensive review focuses on research from 1950 to 2018.

https://ift.tt/2Fm46uV

The nexus between energy consumption and financial development: estimating the role of globalization in Next-11 countries

Abstract

In the modern era of globalization, the economic activities expand with the passage of time. This expansion may increase demand for energy both in developing and developed countries. Therefore, this study assesses the impact of financial development on energy consumption incorporating the role of globalization in Next-11 countries. A group of panel estimation techniques is used to analyze the panel data and time series data for the time 1990–2014. The empirical results of the study suggest that financial development stimulates energy consumption. Also, globalization increases demand for energy consumption, although the single country analysis suggests that the effect of globalization on energy demand is heterogeneous among N-11 countries. Furthermore, feedback hypothesis is confirmed between financial development and energy consumption. Also, bidirectional causality is found between economic growth and energy consumption. The findings urge for the attention of policymaker in emerging countries to develop a strategy to reduce the consequences of energy consumption by controlling resource transfer through globalization to the host country and by adopting energy conversation policies.

https://ift.tt/2KmdBOA

Degradation of polycyclic aromatic hydrocarbons (PAHs) during Sphagnum litters decay

Abstract

The dynamics of polycyclic aromatic hydrocarbon (PAH) degradation in Sphagnum litters and the decomposition of the litters were investigated. PAH concentration decreased to approximately half of the initial concentration as Sphagnum litters decayed. The initial PAH concentration was 489.2 ± 72.2 ng g⁻¹, and the concentration after 120 days of incubation was 233.0 ± 5.8 ng g⁻¹. The different PAH compositions changed concentrations at different times. The low-molecular-weight (LMW) and high-molecular-weight (HMW) PAHs started to be degraded after incubation and after 40 days of incubation, respectively. PAH concentrations in the Sphagnum litters correlated with the total organic carbon (TOC) content (p < 0.05), indicating that PAHs were associated with the TOC of the Sphagnum litters and were degraded as organic matter decayed. The positive relationship between LMW PAH concentration and the soluble carbohydrate content (p < 0.05) indicated that LMW PAHs and the readily decomposed organic carbon fractions were cometabolized, or that LMW PAHs were mainly absorbed by soluble carbohydrate. The weak negative correlation between fulvic acid (FA) and PAH concentrations (p < 0.1) indicated that FA may enhance PAH degradation. Redundancy analysis suggested that the contents of both soluble carbohydrate and cellulose significantly affected the changes in PAH concentrations (p < 0.05), and that FA content and C/N ratios may also contribute to the changes in PAH concentrations (p < 0.1). However, the polyphenol that was related to microbial activities was not associated with changes in PAH concentrations. These results suggested that litter quality is more important than microbial activities in PAH degradation in Sphagnum litters.

https://ift.tt/2FotPmy

CAD/CAM Custom Abutments for Esthetic Anterior Implant-Supported Restoration: Materials and Design

Abstract

Purpose of Review

The purpose of this review is to discuss the use of computer-aided design and computer-aided manufacturing (CAD/CAM) custom abutments in the anterior region with a focus on abutment design and material selection. Advantages, disadvantages, and complications of CAD/CAM abutments are also considered.

Recent Findings

CAD/CAM abutments are available in various materials and with different connection platforms to the implant in order to meet esthetic, functional, and biological demands. Use of CAD/CAM concepts in the fabrication of custom abutments allows for definite advantages over both stock abutments and conventional cast custom abutments.

Summary

CAD/CAM technology should be considered when restoring dental implants in the esthetic zone.

https://ift.tt/2KlFWEL

Changes in Perceived Supervision Quality After Introduction of Competency-Based Orthopedic Residency Training: A National 6-Year Follow-Up Study

Publication date: Available online 27 April 2018
Source:Journal of Surgical Education
Author(s): Stefan N. van Vendeloo, Paul L.P. Brand, Boudewijn J. Kollen, Cees C.P.M. Verheyen
ObjectiveTo evaluate the perceived quality of the learning environment, before and after introduction of competency-based postgraduate orthopedic education.DesignFrom 2009 to 2014, we conducted annual surveys among Dutch orthopedic residents. The validated Dutch Residency Educational Climate Test (D-RECT, 50 items on 11 subscales) was used to assess the quality of the learning environment. Scores range from 1 (poor) to 5 (excellent).SettingDynamic cohort follow-up study.ParticipantsAll Dutch orthopedic residents were surveyed during annual compulsory courses.ResultsOver the 6-year period, 641 responses were obtained (response rate 92%). Scores for "supervision" (95% CI for difference 0.06-0.28, p = 0.002) and "coaching and assessment" (95% CI 0.11-0.35, p < 0.001) improved significantly after introduction of competency-based training. There was no significant change in score on the other subscales of the D-RECT.ConclusionsAfter the introduction of some of the core components of competency-based postgraduate orthopedic education the perceived quality of "supervision" and "coaching and assessment" improved significantly.

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In this issue

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Dysphagia 27 years after cervical disc arthroplasty

Publication date: Available online 27 April 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): E. Lemaire, S. Ciftci, C. Debry
IntroductionDysphagia is a frequent postoperative symptom after anterior cervical disc arthroplasty. However, onset of dysphagia and neck pain a long time after surgery should suggest a diagnosis of prosthesis dislocation.Care reportA 65-year-old man with a history of cervical disc arthroplasty 27 years previously consulted for rapidly progressive dysphagia with no other associated symptoms. Physical examination and CT scan confirmed the diagnosis of anterior dislocation of the prosthesis with no signs of perforation. Surgical extraction via a neck incision allowed resolution of the symptoms.DiscussionProsthesis dislocation should be considered in a patient with a history of cervical disc arthroplasty presenting with dysphagia and neck pain. The clinical and radiological assessment confirmed the diagnosis and early surgical management allowed resolution of the symptoms and avoided complications such as pharyngo-oesophageal perforation.

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Semilunar conchal cartilage graft in saddle nose reconstruction

Publication date: Available online 27 April 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): I. Rašić, A. Košec, A. Pegan
IntroductionThe saddle nose deformity is easily recognized by the loss of septal support and nasal dorsal height with adverse functional and aesthetic consequences.TechniqueWe treated a 50-year-old woman and a 54-year old man that presented with a moderate saddle nose deformity following a previous septorhinoplasty (female patient) and a posttraumatic severe saddle nose deformity (male patient). The patients were treated by open approach rhinoplasty under general anesthesia, and the saddle nose deformity was reconstructed with a semilunar conchal cartilage graft. A semilunar part of the conchal cartilage is excised, lending its name to the graft. A smaller leaf shaped cartilage part is excised and sutured upside-down with PDS 5-0 sutures on the opposite of the cartilage, so that the concave surfaces are facing each other. The newly formed graft is then sutured in its place on the nasal dorsum in the supratip saddle area over the triangular cartilages to widen the inner nasal valve angle. The lateral tips of the semilunar graft are placed below the lateral alar crura to improve external nasal valve functionality.DiscussionThis modified conchal cartilage graft presents itself as an excellent reconstructive option, especially considering its low morbidity, availability and ability to retrieve an adequate amount of cartilage in the vast majority of patients. These modifications of the conchal cartilage are previously unreported, and provide the needed height and elasticity in saddle nose reconstruction without the need for additional grafting. It is important to stress that when positioned properly, a beneficial effect in peak nasal inspiratory flow may be observed, adding to its usefulness in repairing both function and aesthetics.

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Grasping at Laws: Speed-Accuracy Trade-Offs in Manual Prehension.

Author: McIntosh, Robert D.; Mon-Williams, Mark; Tresilian, James R.

DOI: 10.1037/xhp0000512

Publication Date: POST AUTHOR CORRECTIONS, 26 April 2018

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Emerging topics and practical aspects for an appropriate use of amyloid PET in the current italian context.

Emerging topics and practical aspects for an appropriate use of amyloid PET in the current italian context.

Q J Nucl Med Mol Imaging. 2018 Apr 24;:

Authors: Nobili F, Cagnin A, Calcagni ML, Chincarini A, Guerra UP, Morbelli S, Padovani A, Paghera B, Pappatà S, Parnetti L, Sestini S, Schillaci O

Abstract
In May, 2017 some representatives of the Italian nuclear medicine and neurological communities spontaneously met to discuss the issues emerged during the first two years of routine application of amyloid PET with fluorinated radiopharmaceuticals in the real world. The limitations of a binary classification of scans, the possibility to obtain early images as a surrogate marker of regional cerebral bloos flow, the need for (semi-)quantification and, thus, the opportunity of ranking brain amyloidosis, the correlation with Aβ42 levels in the cerebrospinal fluid, the occurrence and biological meaning of uncertain/boderline scans, the issue of incidental amyloidosis, the technical pittfalls leading to false negative/positive results, the position of the tool in the diagnostic flow- chart in the national reality, are the main topics that have been discussed. Also, a card to justify the examination to be filled by the dementia specialist and a card for the nuclear medicine physician to report the exam in detail have been approved and are available in the web, which should facilitate the creation of a national register, as previewed by the 2015 intersocietal recommendation on the use of amyloid PET in Italy. The content of this discussion could stimulate both public institutions and companies to support further research on these topics.

PMID: 29697220 [PubMed - as supplied by publisher]

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2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography in primary extranodal lymphomas: treatment response evaluation and prognosis.

2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography in primary extranodal lymphomas: treatment response evaluation and prognosis.

Q J Nucl Med Mol Imaging. 2018 Apr 24;:

Authors: Salvatore B, Fonti R, De Renzo A, Pellegrino S, Ferrara IL, Mainolfi CG, Marano L, Selleri C, Pane F, Del Vecchio S, Pace L

Abstract
BACKGROUND: We evaluated the role of [18F]FDG PET/CT in tumor response assessment and prognosis of Primary Extranodal Lymphoma (PEL) patients.
METHODS: We examined retrospectively, 56 PEL patients: 31 with aggressive diffuse large B cell lymphoma (DLBCL) and 25 with indolent lymphoma (20 mucosa-associated lymphoid tissue lymphoma-MALT and 5 follicular lymphoma). All patients had undergone [18F]FDG PET/CT at diagnosis (PET-I) and 50 of them also after therapy (PET-II). Moreover, 52 patients were subjected to a mean follow-up period of 76 months.
RESULTS: PET-I was positive in 50 (89%) patients (mean SUVmax 10.3±6.7). In the assessment of tumor response, according to Lugano classification, 45 patients showed complete metabolic response (CMR), 4 patients had partial metabolic response (PMR) and 1 had progressive metabolic disease (PMD). Based on 66% ΔSUVmax cut-off, among CMR patients, 41 showed a ΔSUVmax>66% whereas among nonresponders, 4 patients showed a ΔSUVmax<66%. At follow-up, univariate analysis showed that age, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Progression Free Survival (PFS) (p<0.05), while, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Overall Survival (OS) (p<0.05). At multivariate analysis only Lugano classification was retained in the model for prediction of both PFS (p<0.05) and OS (p<0.05). By Kaplan-Meier analysis and log- rank testing both PFS and OS were significantly better in patients in CMR as compared to patients in PMR or PMD according to Lugano classification (p<0.01).
CONCLUSIONS: [18F]FDG PET/CT represents a useful tool in the detection of disease response and in the evaluation of outcome in PEL patients.

PMID: 29697219 [PubMed - as supplied by publisher]

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Total FDG lesion number on PET/CT predicts survival of esophageal carcinoma patients with recurrence following curative surgery.

Total FDG lesion number on PET/CT predicts survival of esophageal carcinoma patients with recurrence following curative surgery.

Q J Nucl Med Mol Imaging. 2018 Apr 24;:

Authors: Kim SJ, Hyun SH, Moon SH, Cho YS, Yi HK, Shim YM, Choi JY, Kim BT, Lee KH

Abstract
BACKGROUND: Total lesion number is a prognostic determinant in recurrent esophageal cancer, but this requires multiple tests. Here, we investigated the prognostic value of total FDG lesion number obtained from a single PET/CT study.
METHODS: Subjects were 153 esophageal squamous cell carcinoma patients with loco-regional or distant recurrence following curative surgery. FDG PET/CT performed within 30 days was inspected for abnormal FDG uptake lesions using a SUVmax of 3.0 as threshold for significance. Prognostic associations were assessed by Cox proportional hazards regression and Kaplan-Meier analysis.
RESULTS: PET/CT showed significant local FDG lesions in 49.0%, regional lesions in 78.4%, and distant lesions in 44.4% of patients. Among 73 patients with loco-regional recurrence, 54 had 0-3 and 19 had ≥4 FDG lesions. Among 80 patients with distant recurrence, 31 had 0-3 and 49 had ≥4 FDG lesions. During a median follow-up of 11.8 mo, 99 deaths occurred. Univariate variables associated with poor survival included ≥4 FDG lesions and no treatment for loco-regional recurrence and no treatment for distant recurrence. Kaplan Meier analysis showed worse survival for ≥4 than 0-3 FDG lesions in patients with loco-regional recurrence (15.6 vs. 32.1 mo; P = 0.009), but not in those with distant recurrence. Significant independent predictors of poor survival were ≥4 FDG lesions and no treatment for loco-regional recurrence and no treatment for distant recurrence.
CONCLUSIONS: Total FDG lesion number assessed by PET/CT is a significant independent prognostic factor in esophageal cancer patients with loco-regional recurrence following curative surgery.

PMID: 29697218 [PubMed - as supplied by publisher]

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Blood-brain barrier transport kinetics of NOTA-modified proteins: the somatropin case.

Blood-brain barrier transport kinetics of NOTA-modified proteins: the somatropin case.

Q J Nucl Med Mol Imaging. 2018 Apr 24;:

Authors: Bracke N, Janssens Y, Wynendaele E, Tack L, Maes A, van de Wiele C, Sathekge M, De Spiegeleer B

Abstract
BACKGROUND: Chemical modifications such as PEG, polyamine and radio labeling on proteins can alter their pharmacokinetic behaviour and their blood-brain barrier (BBB) transport characteristics. NOTA, i.e. 1,4,7-triazacyclononane-1,4,7-triacetic acid, is a bifunctional chelating agent that has attracted the interest of the scientific community for its high complexation constant with metals like gallium. Until now, the comparative BBB transport characteristics of NOTA-modified proteins versus unmodified proteins are not yet described.
METHODS: Somatropin (i.e. recombinant human growth hormone), NOTA-conjugated somatropin and gallium-labelled NOTA-conjugated somatropin were investigated for their brain penetration characteristics (multiple time regression and capillary depletion) in an in vivo mice model to determine the blood-brain transfer properties.
RESULTS: The three compounds showed comparable initial brain influx, with Kin = 0.38 ± 0.14 μL/(g×min), 0.36 ± 0.16 μL/(g×min) and 0.28 ± 0.18 μL/(g×min), respectively. Capillary depletion indicated that more than 80% of the influxed compounds reached the brain parenchyma. All three compounds were in vivo stable in serum and brain during the time frame of the experiments.
CONCLUSIONS: Our results show that modification of NOTA as well as gallium chelation onto proteins, in casu somatropin, does not lead to a significantly changed pharmacokinetic profile at the blood-brain barrier.

PMID: 29697217 [PubMed - as supplied by publisher]

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Overview on current treatment standards in high-grade gliomas.

Overview on current treatment standards in high-grade gliomas.

Q J Nucl Med Mol Imaging. 2018 Apr 26;:

Authors: Pellerino A, Franchino F, Soffietti R, Rudà R

Abstract
High-grade gliomas (HGGs) are the most common primary tumors of the Central Nervous System, which include anaplastic gliomas (grade III) and glioblastomas (GBM, grade IV). Surgery is the mainstay of treatment in HGGs in order to achieve a histological and molecular characterization, as well as relieve neurological symptoms and improve seizure control. Combinations of some molecular factors, such as IDH 1-2 mutations, 1p/19q codeletion and MGMT methylation status, allow to classify different subtypes of gliomas and identify patients with different outcome. The standard of care in HGGs consists in a combination of radiotherapy and chemotherapy with alkylating agents. Despite this therapeutic approach, tumor recurrence occurs in HGGs, and new surgical debulking, reirradiation or second-line chemotherapy are needed. Considering the poor results in terms of survival, several clinical trials have explored the efficacy and tolerability of antiangiogenic agents, targeted therapies against Epidermal Growth Factor Receptor (EGFR) and different immunotherapeutic approaches in recurrent and newly-diagnosed GBM, including immune checkpoint inhibitors (ICIs), and cell- or peptide-based vaccination with unsatisfactory results in term of disease control. In this review we describe the major updates in molecular biology of HGGs according to 2016 WHO Classification, the current management in newly-diagnosed and recurrent GBM and grade III gliomas, and the results of the most relevant clinical trials on targeted agents and immunotherapy.

PMID: 29696949 [PubMed - as supplied by publisher]

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Role of amino acid PET in HGGs: limitations and perspectives.

Role of amino acid PET in HGGs: limitations and perspectives.

Q J Nucl Med Mol Imaging. 2018 Apr 26;:

Authors: Verger A, Arbizu J, Law I

Abstract
Positron emission tomography (PET) using radiolabelled amino acids was recently recommended by the Response Assessment in Neuro-Oncology (RANO) working group as an additional tool in the diagnostic assessment of brain tumours. The aim of this review is to summarise available literature data on the role of amino-acid PET imaging in high-grade gliomas (HGGs), with regard to diagnosis, treatment planning and follow-up of these tumours. Indeed, amino acid PET applications are multiple throughout the evolution of HGGs. However, certain limitations such as lack of specificity, uncertain value for grading and prognostication or the limited data for treatment monitoring should to be taken into account, the latter of which are further developed in this review. Notwithstanding these limitations, amino acid PET is becoming increasingly accessible in many nuclear medicine centres. Larger prospective cohort prospective studies are thus needed in order to increase the clinical value of this modality and enable its extended use to the largest number of patients.

PMID: 29696948 [PubMed - as supplied by publisher]

https://ift.tt/2Fnuo05

The role of amino acid PET in the light of the new WHO classification 2016 for brain tumors.

The role of amino acid PET in the light of the new WHO classification 2016 for brain tumors.

Q J Nucl Med Mol Imaging. 2018 Apr 26;:

Authors: Suchorska B, Albert NL, Bauer EK, Tonn JC, Galldiks N

Abstract
INTRODUCTION: Since its introduction in 2016, the revision of the World Health Organization (WHO) classification of central nervous system tumours has already changed the diagnostic and therapeutic approach in glial tumors. Blurring the lines between entities formerly labelled as "high-grade" or "low-grade", molecular markers define distinct biological subtypes with different clinical course. This new classification raises the demand for non-invasive imaging methods focussing on depicting metabolic processes.
EVIDENCE ACQUISITION: We performed a review of current literature on the use of amino acid PET (AA-PET) for obtaining diagnostic or prognostic information on glioma in the setting of the current WHO 2016 classification.
EVIDENCE SYNTHESIS: So far, only a few studies have focussed on combining molecular genetic information and metabolic imaging using AA-PET. The current review summarizes the information available on "molecular grading" as well as prognostic information obtained from AA-PET and delivers an insight into a possible interrelation between metabolic imaging and glioma genetics.
CONCLUSIONS: Within the framework of molecular characterization of gliomas, metabolic imaging using AA-PET is a promising tool for non-invasive characterisation of molecular features and to provide additional prognostic information. Further studies incorporating molecular and metabolic features are necessary to improve the explanatory power of AA-PET in glial tumors.

PMID: 29696947 [PubMed - as supplied by publisher]

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Conventional and advanced magnetic resonance imaging in patients with high grade glioma.

Conventional and advanced magnetic resonance imaging in patients with high grade glioma.

Q J Nucl Med Mol Imaging. 2018 Apr 26;:

Authors: Pope WB, Brandal G

Abstract
Magnetic resonance imaging is integral to the care of patients with high grade gliomas. Anatomic detail can be acquired with conventional structural imaging, but newer approaches also add capabilities to interrogate image-derived physiologic and molecular characteristics of central nervous system neoplasms. These advanced imaging techniques are increasingly employed to generate biomarkers that better reflect tumor burden and therapy response. The following is an overview of current strategies based on advanced magnetic resonance imaging that are used in the assessment of high grade glioma patients with an emphasis on how novel imaging biomarkers can potentially advance patient care.

PMID: 29696946 [PubMed - as supplied by publisher]

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The effect of chewing-gum on dose rate of salivary gland in differentiated thyroid carcinoma patients treated with radioiodine.

The effect of chewing-gum on dose rate of salivary gland in differentiated thyroid carcinoma patients treated with radioiodine.

Q J Nucl Med Mol Imaging. 2018 Apr 26;:

Authors: Haghighatafshar M, Nowshad R, Etemadi Z, Ghaedian T

Abstract
BACKGROUND: Although, different methods have been suggested on reducing salivary gland radiation after radioiodine administration, an effective preventive or therapeutic measure is still debateful. To the best of our knowledge this is the second study that aimed to evaluate the effect of chewing-gum as a sialagogue on the radioiodine content of salivary gland, and radioiodine- induced symptoms of salivary gland dysfunction.
METHODS: Twenty two patients who were referred to radioiodine therapy were randomized into chewing-gum (group A) and control (group B) groups. Anterior and posterior planar images including both head and neck were obtained 2, 6, 12, 24 and 48 hours after the administration of radioiodine in all patients and round regions of interest (ROI) were drawn for both left and right parotid glands with a rectangular ROI in the region of cerebrum as the background. All patients were followed once, 6 months after radioiodine administration via a phone call for subjective evaluation of symptoms related to salivary gland damage.
RESULTS: There was no significant difference between the two groups regarding the mean age, gender and initial iodine activity. The geometric mean of background-corrected count per administrated dose and acquisition time was calculated for bilateral parotid glands. This normalized parotid count showed a significant reduction in net parotid count in both groups during the first 48 hours after the radioiodine administration. However, no significant difference was found between the groups according to the amount and pattern of dose reduction in this time period.
CONCLUSIONS: This study revealed that chewing-gum had no significant effect on the radioiodine content of parotid glands during the first 48 hours after radioiodine administration. Also, no significant difference was found in the incidence of relevant symptoms after 6 months comparing both groups.

PMID: 29696945 [PubMed - as supplied by publisher]

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PM2.5 and gaseous pollutants in New York State during 2005–2016: Spatial variability, temporal trends, and economic influences

Publication date: June 2018
Source:Atmospheric Environment, Volume 183
Author(s): Stefania Squizzato, Mauro Masiol, David Q. Rich, Philip K. Hopke
Over the past decades, mitigation strategies have been adopted both by federal and state agencies in the United States (US) to improve air quality. Between 2007 and 2009, the US faced a financial/economic crisis that lowered activity and reduced emissions. At the same time, changes in the prices of coal and natural gas drove a shift in fuels used for electricity generation. Seasonal patterns, diel cycles, spatial gradients, and trends in PM2.5 and gaseous pollutants concentrations (NOx, SO2, CO and O3) monitored in New York State (NYS) from 2005 to 2016 were examined. Relationships between ambient concentrations, changes in NYS emissions retrieved from the US EPA trends inventory, and economic indicators were studied. PM2.5 and primary gaseous pollutants concentrations decreased across NYS. By 2016, PM2.5 and SO2 attained relatively homogeneous concentrations across the state. PM2.5 concentrations decreased significantly at all sites. Similarly, SO2 concentrations declined at all sites within this period, with the highest slopes observed at the urban sites. Reductions in NOx emissions likely contributed to summertime average ozone reductions. NOx and VOCs controls reduced O3 peak concentrations as seen in significant relationships between the annual O3 4^th-highest daily maximum 8-h concentrations and estimated NOx emissions at rural and suburban sites (r² ∼ 0.7). Spring maxima were not reduced with most sites showing insignificant slopes or significant positive slopes (e.g., +2.6% y⁻¹ and +2% y⁻¹, at CCNY and PFI, respectively). Increases in autumn and winter ozone concentrations were found (e,g., 6.6 ± 0.4% y⁻¹ on average in New York City). Significant relationships were observed between PM2.5, primary pollutants, and economic indicators. Overall, a decrease in electricity generation with coal, and the simultaneous increase in natural gas consumption for power generation, led to a decrease in PM2.5 and gaseous pollutants concentrations.

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Comprehensive measurements of atmospheric OH reactivity and trace species within a suburban forest near Tokyo during AQUAS-TAMA campaign

Publication date: July 2018
Source:Atmospheric Environment, Volume 184
Author(s): Sathiyamurthi Ramasamy, Yoshihide Nagai, Nobuhiro Takeuchi, Shohei Yamasaki, Koki Shoji, Akira Ida, Charlotte Jones, Hiroshi Tsurumaru, Yuhi Suzuki, Ayako Yoshino, Kojiro Shimada, Yoshihiro Nakashima, Shungo Kato, Shiro Hatakeyama, Kazuhide Matsuda, Yoshizumi Kajii
Total OH reactivity, which gives the instantaneous loss rate of OH radicals due to reactive species, is an invaluable technique to understand regional air quality, as it gives the overall reactivity of the air mass, the fraction of each trace species reactive to OH, the fraction of missing sinks, O3 formation potential, etc. Total OH reactivity measurement was conducted in a small suburban forest located ∼30 km from Tokyo during the air quality study at field museum TAMA (AQUAS-TAMA) campaign in early autumn 2012 and summer 2013. The average measured OH reactivities during that autumn and summer were 7.4 s⁻¹ and 11.4 s⁻¹, respectively. In summer, isoprene was the major contributor, accounting for 28.2% of the OH reactivity, as a result of enhanced light-dependent biogenic emission, whereas NO2 was major contributor in autumn, accounting for 19.6%, due to the diminished contribution from isoprene as a result of lower solar strength. Higher missing OH reactivity 34% was determined in summer, and linear regression analysis showed that oxygenated VOCs could be the potential candidates for missing OH reactivity. Lower missing OH reactivity 25% was determined in autumn and it was significantly reduced (11%) if the interference of peroxy radicals to the measured OH reactivity were considered.

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Modeling biogenic secondary organic aerosol (BSOA) formation from monoterpene reactions with NO3: A case study of the SOAS campaign using CMAQ

Publication date: July 2018
Source:Atmospheric Environment, Volume 184
Author(s): Momei Qin, Yongtao Hu, Xuesong Wang, Petros Vasilakos, Christopher M. Boyd, Lu Xu, Yu Song, Nga Lee Ng, Athanasios Nenes, Armistead G. Russell
Monoterpenes react with nitrate radicals (NO3), contributing substantially to nighttime organic aerosol (OA) production. In this study, the role of reactions of monoterpenes + NO3 in forming biogenic secondary organic aerosol (BSOA) was examined using the Community Multiscale Air Quality (CMAQ) model, with extended emission profiles of biogenic volatile organic compounds (BVOCs), species-specific representations of BSOA production from individual monoterpenes and updated aerosol yields for monoterpene + NO3. The model results were compared to detailed measurements from the Southern Oxidants and Aerosol Study (SOAS) at Centreville, Alabama. With the more detailed model, monoterpene-derived BSOA increased by ∼1 μg m⁻³ at night, accounting for one-third of observed less-oxidized oxygenated OA (LO-OOA), more closely agreeing with observations (lower error, stronger correlation). Implementation of a multigenerational oxidation approach resulted in the model capturing elevated OA episodes. With the aging model, aged semi-volatile organic compounds (ASVOCs) contributed over 60% of the monoterpene-derived BSOA, followed by SOA formation via nitrate radical chemistry, making up to 34% of that formed at night. Among individual monoterpenes, β-pinene and limonene contributed most to the monoterpene-derived BSOA from nighttime reactions.

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Development of non-linear models predicting daily fine particle concentrations using aerosol optical depth retrievals and ground-based measurements at a municipality in the Brazilian Amazon region

Publication date: July 2018
Source:Atmospheric Environment, Volume 184
Author(s): Karen dos Santos Gonçalves, Mirko S. Winkler, Paulo Roberto Benchimol-Barbosa, Kees de Hoogh, Paulo Eduardo Artaxo, Sandra de Souza Hacon, Christian Schindler, Nino Künzli
Epidemiological studies generally use particulate matter measurements with diameter less 2.5 μm (PM2.5) from monitoring networks. Satellite aerosol optical depth (AOD) data has considerable potential in predicting PM2.5 concentrations, and thus provides an alternative method for producing knowledge regarding the level of pollution and its health impact in areas where no ground PM2.5 measurements are available. This is the case in the Brazilian Amazon rainforest region where forest fires are frequent sources of high pollution. In this study, we applied a non-linear model for predicting PM2.5 concentration from AOD retrievals using interaction terms between average temperature, relative humidity, sine, cosine of date in a period of 365,25 days and the square of the lagged relative residual. Regression performance statistics were tested comparing the goodness of fit and R² based on results from linear regression and non-linear regression for six different models. The regression results for non-linear prediction showed the best performance, explaining on average 82% of the daily PM2.5 concentrations when considering the whole period studied. In the context of Amazonia, it was the first study predicting PM2.5 concentrations using the latest high-resolution AOD products also in combination with the testing of a non-linear model performance. Our results permitted a reliable prediction considering the AOD-PM2.5 relationship and set the basis for further investigations on air pollution impacts in the complex context of Brazilian Amazon Region.

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Evolution of the spatiotemporal pattern of PM2.5 concentrations in China – A case study from the Beijing-Tianjin-Hebei region

Publication date: June 2018
Source:Atmospheric Environment, Volume 183
Author(s): Dan Yan, Yalin Lei, Yukun Shi, Qing Zhu, Li Li, Zhien Zhang
Atmospheric haze pollution has become a global concern because of its severe effects on human health and the environment. The Beijing-Tianjin-Hebei urban agglomeration is located in northern China, and its haze is the most serious in China. The high concentration of PM2.5 is the main cause of haze pollution, and thus investigating the temporal and spatial characteristics of PM2.5 is important for understanding the mechanisms underlying PM2.5 pollution and for preventing haze. In this study, the PM2.5 concentration status in 13 cities from the Beijing-Tianjin-Hebei region was statistically analyzed from January 2016 to November 2016, and the spatial variation of PM2.5 was explored via spatial autocorrelation analysis. The research yielded three overall results. (1) The distribution of PM2.5 concentrations in this area varied greatly during the study period. The concentrations increased from late autumn to early winter, and the spatial range expanded from southeast to northwest. In contrast, the PM2.5 concentration decreased rapidly from late winter to early spring, and the spatial range narrowed from northwest to southeast. (2) The spatial dependence degree, by season from high to low, was in the order winter, autumn, spring, summer. Winter (from December to February of the subsequent year) and summer (from June to August) were, respectively, the highest and lowest seasons with regard to the spatial homogeneity of PM2.5 concentrations. (3) The PM2.5 concentration in the Beijing-Tianjin-Hebei region has significant spatial spillovers. Overall, cities far from Bohai Bay, such as Shijiazhuang and Hengshui, demonstrated a high-high concentration of PM2.5 pollution, while coastal cities, such as Chengde and Qinhuangdao, showed a low-low concentration.

https://ift.tt/2Hy5X62

Bidirectional juxtacrine ephrinB2/Ephs signaling promotes angiogenesis of ECs and maintains self-renewal of MSCs

Publication date: July 2018
Source:Biomaterials, Volume 172
Author(s): Cen Cao, Ying Huang, Qingming Tang, Chenguang Zhang, Lei Shi, Jiajia Zhao, Li Hu, Zhewen Hu, Yun Liu, Lili Chen
Co-transplantation of endothelial cells (ECs) and mesenchymal stem cells (MSCs) is an important strategy for repairing complex and large bone defects. However, the ways in which ECs and MSCs interact remain to be fully clarified. We found that forward ephrinB2/Ephs signaling from hBMSCs to hUVECs promoted the tube formation of hUVECs by activating the PI3K/AKT/mTOR pathway. Reverse ephrinB2/Ephs signaling from hUVECs to hBMSCs promoted the proliferation and maintenance of hBMSCs self-renewal via upregulation of OCT4, SOX2, and YAP1. Subcutaneous co-transplantation of ECs and MSCs in nude mice confirmed that forward ephrinB2/Ephs signaling could increase the cross-sectional area of blood vessels in the transplanted area, and reverse ephrinB2/Ephs signaling could maintain the self-renewal of transplanted hBMSCs in vivo. Based on these results, ephrinB2/Ephs bidirectional juxtacrine regulation between ECs and MSCs plays a pivotal role in improving the healing of bone defects by promoting angiogenesis and achieving a sufficient number of MSCs.

Graphical abstract

https://ift.tt/2rb39AT

Ventricular Tachycardia Ablation in Patients With Implantable Cardioverter Defibrillators Should No Longer Be a Therapy of Last Resort.

Author: Kanagasundram, Arvind N. MD; John, Roy M. MBBS, PhD; Stevenson, William G. MD

Page: 1885-1887

https://ift.tt/2Kmf3AH

Cardiorespiratory Fitness, Coronary Artery Calcium, and Cardiovascular Disease Events in a Cohort of Generally Healthy Middle-Age Men: Results From the Cooper Center Longitudinal Study.

Author: Radford, Nina B. MD; DeFina, Laura F. MD; Leonard, David PhD; Barlow, Carolyn E. PhD; Willis, Benjamin L. MD, MPH; Gibbons, Larry W. MD; Gilchrist, Susan C. MD, MS; Khera, Amit MD, MSc; Levine, Benjamin D. MD

Page: 1888-1895

https://ift.tt/2FnqioJ

Fitness, Exercise, and Coronary Calcification.

Author: Thompson, Paul D. MD

Page: 1896-1898

https://ift.tt/2KkZTLH

Risk of Dementia in Adults With Congenital Heart Disease: Population-Based Cohort Study.

Author: Bagge, Carina N. BSc; Henderson, Victor W. MD, MS; Laursen, Henning B. MD, DMSc; Adelborg, Kasper MD, PhD; Olsen, Morten MD, PhD; Madsen, Nicolas L. MD, MPH

Page: 1912-1920

https://ift.tt/2Fnq0OF

Improving 1-Year Outcomes of Infrainguinal Limb Revascularization: Population-Based Cohort Study of 104 000 Patients in England.

Author: Heikkila, Katriina PhD; Mitchell, David C. MS; Loftus, Ian M. MD; Johal, Amundeep S. PhD; Waton, Sam BSc; Cromwell, David A. PhD

Page: 1921-1933

https://ift.tt/2KlFgiO

Inhibition of JAK-STAT Signaling Suppresses Pathogenic Immune Responses in Medium and Large Vessel Vasculitis.

Author: Zhang, Hui MD, PhD; Watanabe, Ryu MD, PhD; Berry, Gerald J. MD; Tian, Lu PhD; Goronzy, Jorg J. MD, PhD; Weyand, Cornelia M. MD, PhD

Page: 1934-1948

https://ift.tt/2FofkPC

Cardiovascular Magnetic Resonance in Acute ST-Segment-Elevation Myocardial Infarction: Recent Advances, Controversies, and Future Directions.

Author: Bulluck, Heerajnarain MBBS, PhD; Dharmakumar, Rohan PhD; Arai, Andrew E. MD; Berry, Colin MBCHB, PhD; Hausenloy, Derek J. MD, PhD

Page: 1949-1964

https://ift.tt/2KnKrOS

Precision Obesity Care on the Horizon.

Author: Kuehn, Bridget M.

Page: 1965-1966

https://ift.tt/2Fof6rK

Highlights From the Circulation Family of Journals.

Author:

Page: 1967-1972

https://ift.tt/2KlFczA

Letter by Jin-shan and Xue-bin Regarding Article, "Chronic Myocardial Infarction: Where Is It Located?".

Author: Jin-shan, He MD; Xue-bin, Li MD

Page: 1976

https://ift.tt/2KhHkbg

Response by Goldwasser et al to Letter Regarding Article, "Chronic Myocardial Infarction: Where Is It Located?".

Author: Goldwasser, Diego MD; Elizari, Marcelo MD; Bayes de Luna, Antonio MD, PhD

Page: 1977-1978

https://ift.tt/2FnbVRa

Letter by Gazmuri and Karmazyn Regarding Article, "Activation and Inhibition of Sodium-Hydrogen Exchanger Is a Mechanism That Links the Pathophysiology and Treatment of Diabetes Mellitus With That of Heart Failure".

Author: Gazmuri, Raul J. MD, PhD; Karmazyn, Morris PhD

Page: 1979-1980

https://ift.tt/2KkZPLX

Response by Packer to Letter Regarding Article, "Activation and Inhibition of Sodium-Hydrogen Exchange Is a Mechanism That Links the Pathophysiology and Treatment of Diabetes Mellitus With That of Heart Failure".

Author: Packer, Milton MD

Page: 1981-1982

https://ift.tt/2FlQUGp

Letter by Grocott Regarding Article, "Sodium Glucose Cotransporter-2 Inhibition in Heart Failure: Potential Mechanisms, Clinical Applications, and Summary of Clinical Trials".

Author: Grocott, Hilary P. MD

Page: 1983

https://ift.tt/2Kk5GRG

Response by Lytvyn et al to Letter Regarding Article, "Sodium Glucose Cotransporter-2 Inhibition in Heart Failure: Potential Mechanisms, Clinical Applications, and Summary of Clinical Trials".

Author: Lytvyn, Yuliya PhD *,,; Bjornstad, Petter MD *,; Udell, Jacob A. MD, MPH; Lovshin, Julie A. PhD, MD; Cherney, David Z.I. MD, PhD

Page: 1984-1985

https://ift.tt/2FocKZY

Letter by d'Aloja et al Regarding Article, "Competitive Sport Participation Among Athletes With Heart Disease: A Call for a Paradigm Shift in Decision Making".

Author: d'Aloja, Ernesto MD, PhD; Chighine, Alberto MD; Gabiati, Letizia MD

Page: 1986-1987

https://ift.tt/2KnPmQa

A Work Flow to Build and Validate Patient Specific Left Atrium Electrophysiology Models from Catheter Measurements

Publication date: Available online 27 April 2018
Source:Medical Image Analysis
Author(s): Cesare Corrado, Steven Williams, Rashed Karim, Gernot Plank, Mark O'Neill, Steven Niederer
Biophysical models of the atrium provide a physically constrained framework for describing the current state of an atrium and allow predictions of how that atrium will respond to therapy. We propose a work flow to simulate patient specific electrophysiological heterogeneity from clinical data and validate the resulting biophysical models. In 7 patients we recorded the atrial anatomy with an electroanatomical mapping system (St Jude Velocity); we then applied an S1-S2 electrical stimulation protocol from the coronary sinus (CS) and the high right atrium (HRA) whilst recording the activation patterns using a PentaRay catheter with 10 bipolar electrodes at 12 ± 2 sites across the atrium. Using only the activation times measured with a PentaRay catheter and caused by a stimulus applied in the CS with a remote catheter we fitted the four parameters for a modified Mitchell-Schaeffer model and the tissue conductivity to the recorded local conduction velocity restitution curve and estimated local effective refractory period. Model parameters were then interpolated across each atrium. The fitted model recapitulated the S1-S2 activation times for CS pacing giving a correlation ranging between 0.81 and 0.98. The model was validated by comparing simulated activations times with the independently recorded HRA pacing S1-S2 activation times, giving a correlation ranging between 0.65 and 0.96. The resulting work flow provides the first validated cohort of models that capture clinically measured patient specific electrophysiological heterogeneity.

Graphical abstract

https://ift.tt/2vSBJ8m

Role of Epidermal Growth Factor Receptor (EGFR) Inhibitors and Radiation in the Management of Brain Metastases from EGFR Mutant Lung Cancers

AbstractThe growth of genotype‐directed targeted therapies, such as inhibitors of the epidermal growth factor receptor (EGFR), has revolutionized treatment for some patients with oncogene‐addicted lung cancer. However, as systemic control for these patients has improved, brain metastases remain an important source of morbidity and mortality. Traditional treatment for brain metastases has been radiotherapy, either whole‐brain radiation or stereotactic radiosurgery. The growing availability of drugs that can cross the blood‐brain barrier and have activity in the central nervous system (CNS) has led to many studies investigating whether targeted therapy can be used in combination with or in lieu of radiation. In this review, we summarize the key literature about the incidence and nature of EGFR‐mutant brain metastases (EGFR BMs), the data about the activity of EGFR inhibitors in the CNS, and whether they can be used as front‐line therapy for brain metastases. Although initial use of tyrosine kinase inhibitors for EGFR BMs can often be an effective treatment strategy, multidisciplinary evaluation is critical, and prospective studies are needed to clarify which patients may benefit from early radiotherapy.Implications for Practice.Management of brain metastases in epidermal growth factor receptor (EGFR) mutant lung cancer is a common clinical problem. The question of whether to start initial therapy with an EGFR inhibitor or radiotherapy (either whole‐brain radiotherapy or stereotactic radiosurgery) is controversial. The development of novel EGFR inhibitors with enhanced central nervous system (CNS) penetration is an important advance in the treatment of CNS disease. Multidisciplinary evaluation and evaluation of extracranial disease status are critical to choosing the best treatment option for each patient.

https://ift.tt/2r5dmyx

Immuno‐Oncology Biomarkers for Gastric and Gastroesophageal Junction Adenocarcinoma: Why PD‐L1 Testing May Not Be Enough

AbstractPurpose.The treatment of patients with advanced gastric and gastroesophageal junction (G/GEJ) adenocarcinomas has been transformed by the U.S. Food and Drug Administration approval of pembrolizumab. Tumor and adjacent tissue must stain positively for the programmed cell death ligand 1 (PD‐L1) protein by companion diagnostic testing. However, some patients with PD‐L1‐negative tumors also benefit from pembrolizumab. High microsatellite instability (MSI) and tumor mutational load (TML) are positive predictive biomarkers for immune checkpoint inhibition (ICI) in other tumors. We sought to identify more patients who could benefit from ICI using alternative PD‐L1 thresholds, MSI, and TML.Methods.Tumor specimens underwent next‐generation sequencing (NGS) and PD‐L1 testing using immunohistochemistry. NGS was used to determine TML and MSI.Results.We profiled 581 G/GEJ adenocarcinoma specimens. PD‐L1 staining was scored for intensity (0, none; 1+, weak; 2+, moderate; 3+, strong). Using 2+ staining at a 5% threshold, 9.3% of tumors were PD‐L1 positive, and using 1+ staining at 1%, 16.2% were PD‐L1 positive. 6.9% of tumors had high MSI. High TML (≥17 mutations per megabase) was seen in 6.9%, and medium TML (≥7) was seen in 56.5% of tumors. Thirty (5.2%) PD‐L1‐negative tumors at the 1+, 1% threshold had high TML or high MSI. Primary tumors had higher rates of high TML (8.8% vs. 3.9%; p = .0377) and high MSI (8.5% vs. 3.9%; p = .0471) than metastases.Conclusion.PD‐L1 testing alone fails to detect patients who may benefit from ICI. Lower PD‐L1 thresholds and TML testing should be considered in future clinical trials.Implications for Practice.Pembrolizumab is approved by the U.S. Food and Drug Administration for patients with refractory gastric and gastroesophageal cancers if the tumor and adjacent tissue stain positively for the programmed cell death ligand 1 (PD‐L1) protein by companion diagnostic testing. Tumor mutational load, microsatellite instability (MSI), and alternative PD‐L1 testing thresholds may serve as predictive biomarkers for response to immune checkpoint inhibition, and standard PD‐L1 testing will not identify all patients who may benefit from this therapy.

https://ift.tt/2HvierD

Emerging Gene Fusion Drivers in Primary and Metastatic Central Nervous System Malignancies: A Review of Available Evidence for Systemic Targeted Therapies

AbstractPrimary and metastatic tumors of the central nervous system present a difficult clinical challenge, and they are a common cause of disease progression and death. For most patients, treatment consists primarily of surgery and/or radiotherapy. In recent years, systemic therapies have become available or are under investigation for patients whose tumors are driven by specific genetic alterations, and some of these targeted treatments have been associated with dramatic improvements in extracranial and intracranial disease control and survival. However, the success of other systemic therapies has been hindered by inadequate penetration of the drug into the brain parenchyma. Advances in molecular characterization of oncogenic drivers have led to the identification of new gene fusions driving oncogenesis in some of the most common sources of intracranial tumors. Systemic therapies targeting many of these alterations have been approved recently or are in clinical development, and the ability to penetrate the blood‐brain barrier is now widely recognized as an important property of such drugs. We review this rapidly advancing field with a focus on recently uncovered gene fusions and brain‐penetrant systemic therapies targeting them.Implications for Practice.Driver gene fusions involving receptor tyrosine kinases have been identified across a wide range of tumor types, including primary central nervous system (CNS) tumors and extracranial solid tumors that are associated with high rates of metastasis to the CNS (e.g., lung, breast, melanoma). This review discusses the systemic therapies that target emerging gene fusions, with a focus on brain‐penetrant agents that will target the intracranial disease and, where present, also extracranial disease.

https://ift.tt/2r6krPp

Influence of temperature fluctuations on one-stage deammonification systems in northern cold region

Abstract

Cold and fluctuant temperatures are still a bottleneck for the application of one-stage deammonification in mainstream anammox (anaerobic ammonium oxidation). In this study, to simulate the practical but critical operational condition under rapidly fluctuant temperatures between April and May in cold northern area, two deammonification reactors with anammox granular sludge and nitritation flocculent sludge were tested under the cold shock with temperature fluctuations (11–18 °C). Under the controlled temperature (32 °C), good performances were obtained in both reactors. However, after the cold shock (ca. 13 °C), both reactors deteriorated similarly. The ammonia removal efficiencies decreased by half, while total nitrogen (TN) removal efficiencies decreased by two thirds. Nitrite accumulated in both reactors, while nitrate production was not disturbed although its contributions from nitrite oxidizing bacteria (NOB) increased. In the stage with increasing wastewater temperatures (17.5 ± 2.2 °C), several operational conditions were tested to recover the performances, including limited dissolved oxygen, long hydraulic retention time (HRT), high nitrogen loading with elevated pH, and low NH₄⁺–N (60 mg/L), which did not significantly improve the performances, while the phenomena of heterotrophic nitrate reduction dramatically improved the nitrogen removal performances under limited aeration. During the cold temperature shock, insufficient anammox activity, and nitrate overproduction were the main problems.

https://ift.tt/2HyhbU4

The importance of allergic disease in public health: an iCAALL statement

https://ift.tt/2FobtSJ

A novel assessment and treatment approach to patients with Hashimoto’s encephalopathy

Summary

Hashimoto's encephalopathy (HE) is rarely reported with only a few hundred cases published. Diagnosis is made in patients with an appropriate clinical picture and high antithyroperoxidase (anti-TPO) antibodies after infectious, toxic and metabolic causes of encephalopathy have been excluded. There is little objective data on the neurocognitive impairment in patients with HE and their improvement with treatment. We present the case of a 28-year-old woman with HE. Approach to management was novel as objective neuropsychological assessment was used to assess her clinical condition and response to treatment. Intravenous immunoglobulin (IVIg) as the first-line treatment instead of steroids. She responded well. The case illustrates that a different approach is required for the diagnosis and treatment of HE. A new diagnostic criteria is proposed that includes neurocognitive assessment, serum and CSF antibodies, an abnormal EEG and exclusion of other causes of encephalopathy. Furthermore, treatment should be tailored to the patient.

Learning points:

Neurocognitive assessment should be carried out to assess the extent of brain involvement in suspected Hashimoto's encephalopathy pre- and post- treatment.

Treatment of Hashimoto's encephalopathy should be tailored to the patient.

Unifying diagnostic criteria for Hashimoto's encephalopathy must be established.

https://ift.tt/2HWie3q

Patients Screening Positive for Body Dysmorphic Disorder Show No Significant Health-Related Quality of Life Gain after Functional Septorhinoplasty at a Tertiary Referral Center

Facial plast Surg
DOI: 10.1055/s-0038-1632400

Body dysmorphic disorder (BDD) is a psychiatric disorder defined by an excessive concern about one's physical appearance, especially regarding slight or imagined abnormities of the body. This study was conducted to compare postoperative quality of life (QOL) changes after primary septorhinoplasty among patients screening positive and those screening negative for BDD. Two common instruments for the screening of BDD were used namely the Dysmorphic Concern Questionnaire (DCQ) and the BDD Concern Questionnaire (BDDQ). For the determination of QOL changes, three validated screening instruments were used. The Functional Rhinoplasty Outcome Inventory (FROI-17) and the Rhinoplasty Outcomes Evaluation (ROE) were used as disease-specific instruments and the Short Form 36 Health Survey (SF-36) was used as a general instrument. All patients completed the FROI-17, the ROE, and the SF-36 preoperatively and 60 months postoperatively. The BDD questionnaires were singularly obtained 60 months after surgery. The authors identified 9.8% of our patients with a possible BDD diagnosis. The patients screening positive for BDD showed significantly lower ROE scores postoperatively, compared with those screening negative for BDD. QOL gains detected by the disease-specific instruments (ROE and FROI-17) were only significant in the non-BDD group. No significant QOL gains were detectable with the FROI-17, the ROE, and the SF-36 in the BDD group. In patients screening negative for BDD, QOL, as measured with the SF-36, improved significantly in five categories: physical functioning, role-functioning physical, bodily pain, general health, and social functioning. Patients screening positive for BDD did not improve in any categories of the general SF-36 questionnaire. Instead, their score in the "mental health" category was significantly lower 5 years after their surgery compared with preoperatively. Patients retrospectively screening positive for BDD in our cohort did not improve in QOL postoperatively. Alternative nonsurgical treatments such as cognitive behavioral treatment and/or selective serotonin reuptake inhibitors have been reported to be effective and should be considered as the treatment of choice. Some studies suggest that a smaller subgroup of BDD patients may benefit from functional rhinoplasty. Further research and larger long-term prospective outcome studies are needed to understand the influence of BDD symptoms on postoperative satisfaction and QOL changes after septorhinoplasty.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents | Abstract | Full text

https://ift.tt/2HYyYHg

Complications of Polydioxanone Foil Use in Nasal Surgery: A Case Series

Facial plast Surg
DOI: 10.1055/s-0038-1632399

Polydioxanone (PDS) foil is widely recognized as a septal cartilage replacement during rhinoplasties and is thought to be completely resorbable and biodegradable. Since its United States Food and Drug Administration approval in 2010, PDS foil has drawn significant enthusiasm and many surgeons consider it an ideal implantable biomaterial as reflected in numerous studies highlighting its benefits. However, scant literature exists highlighting relevant complications of PDS plates that may potentially lead to cavalier overuse. This descriptive case series assesses the outcomes of PDS foil usage in three patients seen for septoplasty at two independent institutions over the past 5 years. Our results demonstrate that PDS plate usage can lead to septal cartilage loss and resultant saddle nose deformıty associated with prolonged postoperative edema and inflammation. To our knowledge, this is the largest case series of this reported phenomenon.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents | Abstract | Full text

https://ift.tt/2HyPtGI

Second Hand Smoke exposure increased the need for inhaled corticosteroids in children with asthma

Exposure to tobacco smoke (ETS) has been associated with increased risk for severity of asthma in children [1,2]. The question to be addressed is whether children with asthma with high environmental tobacco exposure would respond as well to inhaled corticosteroids as those with lower ETS exposure. Urine cotinine is a sensitive and specific biomarker for measuring the exposure to tobacco smoke. The aim of the study was to assess whether the high exposure to tobacco smoke measured by urine cotinine level can influence the daily dose of inhaled corticosteroids needed to achieve asthma control in exposed children.

https://ift.tt/2Hx4vk7

Development of a tool predicting severity of allergic reaction during peanut challenge

Reliable prognostic markers for predicting severity of allergic reactions during oral food challenges (OFC) have not been established.

https://ift.tt/2r4RaVm

"Vestn Otorinolaringol"[jour]; +19 new citations

19 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Vestn Otorinolaringol"[jour]

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PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

https://ift.tt/2HxEOAa

Changes in Type I and Type II Collagen Expression in Rat Mandibular Condylar Cartilage Associated with Aging and Dietary Loading.

Changes in Type I and Type II Collagen Expression in Rat Mandibular Condylar Cartilage Associated with Aging and Dietary Loading.

J Oral Facial Pain Headache. 2018 Apr 25;:

Authors: Orajärvi M, Laaksonen S, Hauru R, Mursu E, Jonaviciute E, Voipio HM, Raustia A, Pirttiniemi P

Abstract
AIMS: To evaluate the usefulness of diet board feeding as a model for temporomandibular joint (TMJ) research, characterize dietary loading-related morphometric changes in the mandibular condylar cartilage of aging rats, and investigate changes in type I and type II collagen expression in different age, sex, and diet groups.
METHODS: Material was collected from a study that examined the effects of 1-year and 2-year diet board feeding on rats. In diet board feeding, rats must gnaw wood to reach their food, leading to a higher masticatory workload. The material analyzed was comprised of 150 TMJ samples from 75 Hsd:Sprague Dawley rats grouped according to feeding method (diet board [experimental group] or ad libitum [control group]), sex, and experiment length (1 or 2 years). The rats were sacrificed at the age of 15 or 26 months (15-M rats or 26-M rats). From the TMJ samples, 5-μm-thick sections were cut parallel to the sagittal plane of the mandibular condyle. Histomorphometric analysis of the thickness of the condylar cartilage and the number of cartilage cells was performed after toluidine blue staining. Immunohistochemical staining included type I and type II collagen antigens. Differences in the thickness of the cellular layer and the number of cells in the condylar cartilage were analyzed by means of a repeated-measures analysis of variance (ANOVA) model, and differences in the type of collagen with a one-way random-effects ANOVA model.
RESULTS: Condylar cartilage was significantly thicker in the 15-M diet board-fed rats than in the 15-M control rats and in the 26-M rats than in the 15-M rats. The number of cells was larger in the 26-M female rats than in the 26-M male rats. Type I collagen expression was significantly higher in the 15-M diet board-fed female rats than in the 15-M controls. Type II collagen showed increased expression in older rats compared to younger rats.
CONCLUSION: Condylar cartilage is sensitive to the interplay between loading, aging, and sex of middle-aged and older rats. High loading of condylar cartilage increased the thickness of cartilage in younger rats.

PMID: 29697719 [PubMed - as supplied by publisher]

https://ift.tt/2HDDUhC

Efficacy of Low-Level Laser Therapy in the Treatment of Temporomandibular Myofascial Pain: A Systematic Review and Meta-Analysis.

Efficacy of Low-Level Laser Therapy in the Treatment of Temporomandibular Myofascial Pain: A Systematic Review and Meta-Analysis.

J Oral Facial Pain Headache. 2018 Apr 25;:

Authors: Munguia FM, Jang J, Salem M, Clark GT, Enciso R

Abstract
AIMS: To conduct a systematic review and meta-analysis to determine the efficacy of low-level laser therapy (LLLT) in treating temporomandibular myofascial pain in adults compared to laser placebo.
METHODS: Randomized, placebo-controlled studies were identified by a search on March 2, 2016 and updated on February 9, 2017 in the PubMed, Web of Science, and Cochrane Library databases. Three of the authors assessed the studies for risk of bias. Outcomes included pain reduction on a visual analog scale (VAS) and interincisal opening.
RESULTS: The initial search strategy yielded 142 unduplicated references assessed independently by three review authors. After evaluation, this number was reduced to eight relevant studies for inclusion in this review. Of these eight studies, four were at unclear risk of bias and four were at high risk. In a meta-analysis, pain intensity was significantly reduced after treatment in the group that received LLLT as compared to laser placebo (an average of 2.2 units on a scale of 0 to 10) (P = .005) and an average of 2.4 units 3 to 4 weeks later (P = .022). Pooled results showed a significant increase in interincisal opening at 1 month after treatment (P = .012), but not when the treatment was completed (P = .079).
CONCLUSION: The findings from this systematic review showed that LLLT seems to be effective in reducing pain in patients with temporomandibular myofascial pain with moderate-quality evidence. However, due to the high heterogeneity, small number, and high risk of bias of the included studies, the results are not definitive, and further well-designed studies are needed.

PMID: 29697718 [PubMed - as supplied by publisher]

https://ift.tt/2HXuX5X

Analgesic Effects of Intranasal Ketamine in Rat Models of Facial Pain.

Analgesic Effects of Intranasal Ketamine in Rat Models of Facial Pain.

J Oral Facial Pain Headache. 2018 Apr 25;:

Authors: Claudino R, Nones C, Araya E, Chichorro J

Abstract
AIMS: To assess the analgesic effect of intranasal administration of S-ketamine in different rat models of facial pain.
METHODS: Nociceptive responses induced by formalin injected into the upper lip and facial hyperalgesia induced by capsaicin or carrageenan injected into the upper lip were used to evaluate the analgesic effect of intranasal ketamine in acute facial pain models in rats (n = 173). The effect of intranasal ketamine on heat and mechanical hyperalgesia induced by constriction of the infraorbital nerve (CION) was also evaluated. In addition, locomotor activity in the open field test was assessed after intranasal ketamine administration. Two-way repeated measures analysis of variance followed by Bonferroni post hoc correction were used to analyze all data.
RESULTS: Intranasal ketamine (0.5 mg/kg) failed to modify the first phase of the orofacial formalin test, but reduced the second phase by about 40%. Intranasal ketamine also reduced the facial heat hyperalgesia induced by capsaicin and carrageenan. In the CION model, intranasal ketamine at 0.5 mg/kg reversed the heat hyperalgesia and at 1 mg/kg attenuated the mechanical hyperalgesia 4 and 14 days after the surgery, respectively. The open field test did not reveal locomotor deficits in rats treated with intranasal ketamine.
CONCLUSION: This study has demonstrated that intranasal ketamine produces analgesic effects in inflammatory and neuropathic facial pain models and may represent an adjuvant in the treatment of such conditions, especially when rapid pain relief is needed.

PMID: 29697717 [PubMed - as supplied by publisher]

https://ift.tt/2KkaiYn

Prevalence of Posterior Disc Displacement of the Temporomandibular Joint in Patients with Temporomandibular Disorders: Systematic Review and Meta-Analyses.

Prevalence of Posterior Disc Displacement of the Temporomandibular Joint in Patients with Temporomandibular Disorders: Systematic Review and Meta-Analyses.

J Oral Facial Pain Headache. 2018 Apr 25;:

Authors: Afroz S, Naritani M, Hosoki H, Takechi K, Okayama Y, Matsuka Y

Abstract
AIMS: To assess the prevalence of posterior disc displacement (PDD) in patients with temporomandibular disorders (TMD) through a systematic review of the literature and meta-analysis, as well as to assess features associated with PDD such as chief complaint, signs and symptoms, morphologic condyle and disc alterations, and PDD management.
METHODS: A systematic literature search was performed in the US National Library of Medicine's PubMed/MEDLINE and Cochrane Library databases to identify all peer-reviewed, English-language manuscripts related to PDD. A critical appraisal checklist provided by the Joanna Briggs Institute for studies reporting prevalence data was used to assess the quality of the included manuscripts. A meta-analysis was conducted using software MetaXL 5.3 (EpiGear International Pty Ltd) add-in for Microsoft Excel. Pooled prevalence and 95% confidence intervals (CIs) were calculated using the software. Heterogeneity of the included studies was assessed using the Higgins I2 test and Cochran's Q (with P value; < .05 was considered significant).
RESULTS: A total of 21 articles were selected for qualitative data synthesis: 2 case reports, 14 observational studies, and 5 studies that reported PDD in various conditions. Quantitative data analysis was performed for the 14 observational studies, of which 13 reported prevalence with respect to the number of joints affected and 9 reported prevalence with respect to the number of patients affected. The overall pooled prevalence of PDD for the number of joints affected was 0.7% (95% CI: 0.005 to 0.008). The pooled prevalence of PDD for the number of patients was 0.9% (95% CI: 0.007 to 0.011). PDD was found to be associated with osseous changes, including changes in the morphology of the condyle, disc, and articular eminence; osseous abnormalities (erosion, osteophytes); and joint effusion.
CONCLUSION: This meta-analysis showed a very low prevalence rate of PDD in TMD patients. The limited literature did not allow conclusions to be drawn about the PDD-related features.

PMID: 29697716 [PubMed - as supplied by publisher]

https://ift.tt/2Kj8b6N

Nuclear progestin receptor (Pgr) knockouts resulted in subfertility in male tilapia (Oreochromis niloticus)

Publication date: Available online 27 April 2018
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Xuelian Fang, Limin Wu, Lanying Yang, Lingyun Song, Jing Cai, Feng Luo, Jing Wei, Linyan Zhou, Deshou Wang
It was documented that 17α, 20β-dihydroxy-4-pregnen-3-one (DHP), a fish specific progestin, might play critical roles in spermatogenesis, sperm maturation and spermiation partially through activating nuclear receptor (Pgr). However, no direct evidence is available to demonstrate the functions of DHP in fish spermatogenesis. To further elucidate the roles of DHP in teleosts, we generated a pgr homozygous mutant line in XY Nile tilapia (Oreochromis niloticus). Pgr gene mutation resulted in the development of a smaller, thinner testis and a lower GSI compared with normal testis. Pgr gene knockout led to irregular arrangement of spermatogenic cysts, decline of sperm count and sperm motility. Significant decrease of spermatocytes and spermatozoa was observed, which was further proved by the PCNA and Ph3 staining. Real-time PCR analysis demonstrated that mutation of pgr gene resulted in a significant up-regulation of steroidogenesis-related genes of cyp17a, cyp11b2, StAR, scc, 20β-HSD, and sf1, and down-regulation of fshb, fshr, oct4, sycp3, cdk1, prm, cyclinB1, cyclinB2 and cdc25 genes. Furthermore, both Immunohistochemistry and Western blotting experiments revealed a remarkable increase of Cyp17a1, Cyp17a2 and Cyp11b2 expressions in the pgr^−/− testis. EIA measurement showed that an evident increase of 11-KT level was found in the pgr^−/− XY fish. There was a significant increase in the mortality of offspring when crossing pgr^−/− XY fish with wild type XX fish. Increased TUNEL staining and enhanced apoptosis maker gene (bax) expressions were also observed. Taken together, our data suggested that DHP-activated physiology via pgr is crucial for the fertility in the XY tilapia.

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Delineating the regulation of estrogen and androgen receptor expression by sex steroids during rat spermatogenesis

Publication date: Available online 27 April 2018
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Anita Kumar, Kushaan Dumasia, Sharvari Deshpande, Sanketa Raut, N.H. Balasinor
Estrogen receptors (ERα and β) and androgen receptor (AR) regulate various critical processes during spermatogenesis. Since spermatogenesis is very sensitive to hormonal stimuli and perturbations, it is important to understand the regulation of expression of these receptors by sex steroid hormones. Although many studies have reported deregulation of steroid receptors on endocrine disruption, there is no consensus on the regulation of their expression by steroid hormones during spermatogenesis, and a lack of clear understanding of the mechanism of regulation. Here, we evaluated the receptor expressions in a well-established exogenous estradiol administration model. We then investigated the mechanisms by which the individual receptors regulate their expression by binding to the respective hormone response elements upstream of these receptor genes. By further employing in vitro and in vivo models of ER and AR stimulation or antagonism, we delineated their regulation in a receptor subtype-specific manner. Our results indicate that ERα positively regulates expression of both the ERs; whereas, ERβ and AR negatively regulate expression of both ERβ and AR by direct binding to upstream regulatory regions. The perturbations in the levels of steroid receptors could be an important factor contributing to spermatogenic defects and male sub-fertility after estradiol and ER agonist treatment. Our study delineates the direct contribution of the individual steroid receptors in the regulation of their own expression.

https://ift.tt/2FnqnZw

"In Vivo"[jour]; +37 new citations

37 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"In Vivo"[jour]

These pubmed results were generated on 2018/04/27

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The palatal septal cartilage implantation for snoring and obstructive sleep apnea

Patients with snoring and obstructive sleep apnea frequently have nasal and palatal obstruction. The objective of this study was to investigate the safety and feasibility of a palatal septal cartilage implant (SCI) for snoring and obstructive sleep apnea.

https://ift.tt/2I1ZuPY

Consideration of methods for identifying mite allergens

House dust mites are small arthropods that produce proteins—found in their feces, body parts, and eggs—that are major triggers of human allergies worldwide. The goal of this review is to describe the current m...

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The impact of occupational exposure to traffic-related air pollution among professional motorcyclists from Porto Alegre, Brazil, and its association with genetic and oxidative damage

Abstract

Vehicles play an important role in modern life; however, they also generate hazards. Occupational exposed subjects are in long-term contact with harmful products, which sets these professionals in a susceptible group to air pollutant damage. The aims of this study were to quantify individual exposure to pollutant gases and chemical elements and to evaluate oxidative and genetic damage in professional motorcyclists and office workers. We recruited professional motorcyclists and office workers from Porto Alegre, Brazil, between January and December 2016. Individual exposure to air pollutants was assessed by passive monitoring. Fingernail trace elements were determined by using inductively coupled plasma mass spectrometry. Oxidative stress biomarkers were quantified spectrophotometrically, and genotoxicity was evaluated by micronuclei assay. Individual exposure to NO₂ and O₃, trace element content (Sb, Pt, As, Cd, V, Mn, and Co), oxidative stress factors, and genetic damage were statistically higher in professional motorcyclists (p < 0.05). Moreover, NO₂ and O₃ levels showed very strong positive correlation with plasmatic lipid peroxidation (p < 0.001 and r = 0.8849 and 0.8995) and strong positive correlation with micronuclei frequency (p < 0.001 and r = 0.7683 and 0.7280). Results suggest that professional motorcyclists are at high risk due to long-term air pollution exposure, which implies in the onset of several harmful effects and worsening of pre-existent diseases.

https://ift.tt/2r3XYCH

Neonicotinoid detection in wild turkeys ( Meleagris gallopavo silvestris ) in Ontario, Canada

Abstract

The use of neonicotinoid insecticides in agriculture is now recognized for the health risks it poses to non-target wildlife, with associated honey bee mortality especially concerning. Research directed toward the presence and effects of these pesticides on terrestrial vertebrates that consume neonicotinoid-coated seeds, such as wild turkeys (Meleagris gallopavo silvestris), is lacking. This study used liquid chromatography attached to a tandem mass spectrometer to assess the liver from 40 wild turkeys for neonicotinoid and other pesticide residues and compared detected levels of these contaminants across the southern Ontario, Canada. Nine (22.5%) wild turkeys had detectible levels of neonicotinoid residues—clothianidin in eight, and thiamethoxam in three. Two (5.0%) of these turkeys had detectable levels of both clothianidin and thiamethoxam. Fuberidazole was detected in two (5.0%) wild turkeys. The highest level of thiamethoxam detected was 0.16 ppm, while clothianidin was detected at 0.12 ppm, and fuberidazole at 0.0094 ppm. Knowledge of exposure in free-ranging wildlife is critical for better understanding the effects of neonicotinoids on wildlife health; thus, these data help establish baseline data for southern Ontario wild turkeys and provide context for reference values in future analyses.

https://ift.tt/2HzbIQU

Interhemispheric alpha-band hypoconnectivity in children with autism spectrum disorder

Publication date: 1 August 2018
Source:Behavioural Brain Research, Volume 348
Author(s): Abigail Dickinson, Charlotte DiStefano, Yin-Ying Lin, Aaron Wolfe Scheffler, Damla Senturk, Shafali Spurling Jeste
• Diverse genetic and environmental etiologies converge onto circuit level brain dysfunction in autism spectrum disorder (ASD), manifesting at a macroscopic level as aberrant neural connectivity. Previous studies have described atypical patterns of decreased short range and increased long range connectivity in ASD [1]. However, it remains unclear whether group level features of circuit dysfunction are consistently present across the range of cognitive function seen in the autism spectrum.• The dynamics of neural oscillations in the alpha range (6–12 Hz) are exquisitely sensitive to healthy development of functional and structural connectivity. Alpha-band coherence, measured with high temporal-precision electroencephalography (EEG) therefore represents an ideal tool for studying neural connectivity in developmental populations.• Here we examined spontaneous alpha phase coherence in a heterogeneous sample of 59 children with ASD and 39 age matched typically developing children. Using a data driven approach, we conducted an unbiased examination of all possible atypical connectivity patterns across all cortical regions.• Long-range hypoconnectivity was present in children with ASD compared to typically developing children, with temporal interhemispheric connectivity showing the largest difference between the two groups.• Decreased long range alpha coherence distinguishes a heterogeneous group of ASD children from typically developing children. Interhemispheric temporal hypoconnectivity represents a fundamental functional difference in children with ASD across a wide cognitive and age range that may reflect white matter disturbances or increased signal variability at temporal sites in ASD.

https://ift.tt/2JAAn3R

Effects of the NMDA receptor antagonists dizocilpine and Ro 63-1908 on delay-discounting and risky decision-making in a gambling task

Publication date: 1 August 2018
Source:Behavioural Brain Research, Volume 348
Author(s): Guy A. Higgins, Leo B. Silenieks, Cam MacMillan, Fiona D. Zeeb, Sandy Thevarkunnel
Previous studies demonstrated that NMDA receptor antagonists such as dizocilpine (MK801) and the GluN2B NMDA antagonist Ro 63–1908 promote impulsive action (motor impulsivity). The effects of these treatments on impulsive choice and decision-making is less well characterized. Two experiments were undertaken. In the first experiment, given evidence for delay order as a factor in choice selection, the effect of dizocilpine was examined in a delay discounting task with separate groups of male Long-Evans rats trained to a schedule of either ascending (i.e. 0–40 s), or descending delays (i.e. 40–0 s). Under the ascending-delay schedule, dizocilpine (0.03–0.06 mg/kg SC) reduced discounting, yet on the descending-delay schedule discounting was increased. Subgrouping rats according to discounting rate under vehicle pretreatment were consistent with a treatment-induced choice perseveration. In a second experiment, male Long-Evans rats were trained to a gambling task (rGT). Neither dizocilpine (0.01–0.06 mg/kg SC) nor Ro 63–1908 (0.1–1 mg/kg SC) shifted choice from the advantageous to the disadvantageous options. However dizocilpine, and marginally Ro 63–1908, increased choice of the least risky, but suboptimal option. This effect was most evident in rats that initially preferred the disadvantageous options. Consistent with previous studies, both treatments increased measures of motor impulsivity. These results demonstrate that dizocilpine has effects on discounting dependent on delay order and likely reflective of perseveration. On the rGT task, neither dizocilpine nor Ro 63–1908 promoted risky choice, yet both NMDA receptor antagonists increased impulsive action.

https://ift.tt/2JwRYtC

A refined rat primary neonatal microglial culture method that reduces time, cost and animal use

Publication date: Available online 27 April 2018
Source:Journal of Neuroscience Methods
Author(s): Marieta Georgieva, Alasdair Leeson-Payne, Maria Dumitrascuta, Ann Rajnicek, Marzia Malcangio, Wenlong Huang
BackgroundPrimary microglial cultures have been used extensively to facilitate the development of therapeutic strategies for a variety of CNS disorders including neurodegeneration and neuropathic pain. However, existing techniques for culturing these cells are slow and costly.New MethodHere, we report a refined protocol based on our previously published methods described by Clark et al., which reduces in the time, reagents and the number of animals used for each culture whilst yielding high number and excellent quality microglial cells.ResultsOur refined protocol offers an isolation of > 96% microglia from a mixed glial culture after only four days of incubation. It results in a high yield of microglia, in excess of one million cells per cortex with predominantly resting morphology and a low level of cell activation.Comparison with Existing Method(s)Compared to conventional procedures our refined protocol requires only one third of the time to prepare high quality microglial cultures, cuts the cost more than four-fold, and significantly reduces the number of animals used per culture.ConclusionOur consistent, reliable, and time/cost effective microglial culture protocol is crucial for efficient in vitro screening of potential therapeutics. By dramatically reducing the culture time from 2 weeks to just 4 days and increasing the laboratory research output it has implications for the Reduction, Refinement and Replacement policies endorsed by many government funding agencies and animal research regulatory bodies.

https://ift.tt/2Hwdp1n

Recovery of early neural spikes from stimulation electrodes using a DC-coupled low gain high resolution data acquisition system

Publication date: Available online 27 April 2018
Source:Journal of Neuroscience Methods
Author(s): Hyunjun Jung, Jintae Kim, Yoonkey Nam
BackgroundNeural responses to electrical stimulation provide valuable information to probe and study the network function. Especially, recording neural responses from the stimulated site provides improved neural interfacing method. However, it is difficult to measure short-delayed responses at the stimulated electrode due to the saturation of the amplifier after stimulation which is called "stimulus artifact". Despite the advances in handling stimulation artifacts, it is still very challenging to deal with the artifacts if one tries to stimulate and recording from the same electrode.New methodIn this paper, we developed a system consisting of 24 bit ADC and low gain DC-amplifier which allows us to record the entire responses including saturation-free stimulus artifact and neural responses with excellent resolution.ResultsOur approach showed saturation free recording after stimulation, which makes it possible to recover neural spike as early as in 2 ms at the stimulating electrode with digital elimination methods.Comparison with Existing methods With our system we could record neural signals after stimulation that was difficult with high gain and high pass filtered recording system due to amplifier saturation.ConclusionsOur new system can enhance interface performance with its higher robustness and with simple system configuration.

https://ift.tt/2JysPyV

APIC Masthead

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5

https://ift.tt/2Kj6TZK

Information for Readers

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5

https://ift.tt/2JyBLnE

Validity of administrative data in identifying complex surgical site infections from a population-based cohort after primary hip and knee arthroplasty in Alberta, Canada

Publication date: Available online 27 April 2018
Source:American Journal of Infection Control
Author(s): Elissa Rennert-May, Braden Manns, Stephanie Smith, Shannon Puloski, Elizabeth Henderson, Flora Au, Kathryn Bush, John Conly
BackgroundSurgical site infections (SSIs) are a substantial burden to healthcare systems in North America. Administrative data is one method though which these may be identified, but the accuracy of using such data is uncertain.MethodsWe followed a population-based cohort of patients who received primary hip/knee arthroplasty in Alberta, Canada, for whom a comprehensive Infection Prevention and Control (IPC) prospective surveillance methodology was used to track SSIs. Patients were also followed using International Classification of Diseases, Tenth Revision (ICD-10) codes. We assessed the sensitivity/specificity and positive/negative predictive values of ICD-10 codes compared to IPC surveillance.ResultsBetween April 1, 2012, and March 31, 2015, 24,512 people received hip/knee arthroplasty. Of these, 258 (1.05%) had a complex SSI found by IPC surveillance. Sensitivity and specificity of ICD-10 codes in identifying complex SSIs after hip/knee arthroplasty were 85.3% (95% confidence interval [CI] 80.3%-89.4%) and 99.5% (95% CI 99.4%-99.6%), respectively. Positive and negative predictive values were 63.6% (95% CI 58.3%-68.7%) and 99.8% (95% CI 99.8%-99.9%), respectively.DiscussionAdministrative data have reasonable testing characteristics for identifying complex SSIs after arthroplasty. For centers without prospective surveillance programs, this could be useful in identifying hospitals with frequent complex SSIs after arthroplasty.ConclusionsA comprehensive IPC surveillance program is superior at detecting SSIs after arthroplasty.

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Information for Authors

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5

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Newly revised guide to clinically important microbes—available in print and digital formats

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5

https://ift.tt/2KlWixe

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5

https://ift.tt/2Jxu29q

Exploring the nurses' role in antibiotic stewardship: A multisite qualitative study of nurses and infection preventionists

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5
Author(s): Eileen J. Carter, William G. Greendyke, E. Yoko Furuya, Arjun Srinivasan, Alexa N. Shelley, Aditi Bothra, Lisa Saiman, Elaine L. Larson
BackgroundThere is a growing recognition of the need to partner with nurses to promote effective antibiotic stewardship. In this study, we explored the attitudes of nurses and infection preventionists toward 5 nurse-driven antibiotic stewardship practices: 1) questioning the need for urine cultures; 2) ensuring proper culturing technique; 3) recording an accurate penicillin drug allergy history; 4) encouraging the prompt transition from intravenous (IV) to oral (PO) antibiotics; and 5) initiating an antibiotic timeout.MethodsNine focus groups and 4 interviews with 49 clinical nurses, 5 nurse managers, and 7 infection preventionists were conducted across 2 academic pediatric and adult hospitals.ResultsNurse-driven antibiotic stewardship was perceived as an extension of the nurses' role as patient advocate. Three practices were perceived most favorably: questioning the necessity of urinary cultures, ensuring proper culturing techniques, and encouraging the prompt transition from IV to PO antibiotics. Remaining recommendations were perceived to lack relevance or to challenge traditionally held nursing responsibilities. Prescriber and family engagement were noted to assist the implementation of select recommendations. Infection preventionists welcomed the opportunity to assist in providing nurse stewardship education.ConclusionsNurses appeared to be enthusiastic about participating in antibiotic stewardship. Efforts to engage nurses should address knowledge needs and consider the contexts in which nurse-driven antibiotic stewardship occurs.

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Health care system leaders' perspectives on infection preventionist and registered nurse engagement in antibiotic stewardship

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Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5
Author(s): Mary Lou Manning, Monika Pogorzelska-Maziarz
BackgroundInfection preventionists (IPs) and registered nurses (RNs) have an important role to play in antibiotic stewardship programs (ASPs). Recent articles highlight their potential roles in practice, research, education, and policy; however, little is known about their actual ASP engagement. Leaders often have early knowledge of emerging trends and evolving health care worker roles.MethodsA survey was developed using the Centers for Disease Control and Prevention's Core Elements of Hospital Antibiotic Stewardship Programs to assess health care system infection prevention and control leaders' perceptions of IP and RN engagement in hospital ASPs.ResultsThirty-five leaders representing all regions of the United States completed the survey. Their organizations tended to have significant ASP leadership support, but lacked ASP policies indicating IP and RN roles and responsibilities. IPs were more likely than RNs to be members of the ASP team and have greater ASP knowledge. Neither discipline was conducting patient education related to proper use of antibiotics, but this was identified as a future ASP role. The 2017 Joint Commission Antimicrobial Stewardship Standard was accelerating ASP implementation.ConclusionsIPs and RNs are well-positioned to assume greater roles in ASPs, especially in educating patients about the safe and proper use of antibiotics. However, their roles must be clearly identified, defined, and quantified. In so doing, knowledge and skill gaps can be identified and specific educational programs developed to advance their successful engagement in ASPs.

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Frequent contamination of nursing scrubs is associated with specific care activities

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5
Author(s): Kerri A. Thom, Daniel Escobar, Mallory A. Boutin, Min Zhan, Anthony D. Harris, J. Kristie Johnson
BackgroundThe objective of this article is to assess health care worker (HCW) and patient care factors associated with bacterial contamination of scrubs.MethodsWe performed a cohort study of critical care HCWs. Participants were given 4 sets of new scrubs; each set was sampled 8 times during the 8-month study period on random days in the last 4 hours of the shift. Total colony counts and presence of prespecified pathogenic bacteria were assessed. Generalized estimating equation was used to identify factors associated with contamination.ResultsThere were 720 samples obtained from 90 HCWs; 30% of samples were contaminated with pathogenic bacteria. Multivariate analysis showed that providing care for patients with wounds (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.17-2.62; P < .01) or giving a bath (OR, 1.46; 95% CI, 0.96-2.22; P = .07) was associated with higher odds of scrub contamination. A second model showed the average log colony count of bacterial contamination of scrubs was higher when a bath was given (log colony count difference, 0.21; P = .05) but lower among HCWs assigned to care for at least 1 patient on contact precautions (log colony count difference, 0.28; P < .01).ConclusionsHCW attire was frequently contaminated with bacteria. Providing care for patients with wounds or giving a bath were associated with scrub contamination by pathogenic bacteria. However, the amount of contamination was lower among HCWs who were assigned to care for patients on contact precautions.

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Dynamics of intraoperative Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter transmission

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5
Author(s): Brent Hadder, Hetal M. Patel, Randy W. Loftus
BackgroundOur primary objective was to examine anesthesia work area reservoir isolation of Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter spp (KAPE) pathogens. This is a retrospective analysis of a randomized, prospective, and observational study involving 3 academic medical centers.MethodsPatients included adults undergoing general anesthesia. Gram-negative isolates (N = 2,682) were collected from anesthesia work area reservoirs in 274 randomly selected operating room case pairs. Nine hundred and forty-five isolates were included in this study. Chi square tests were used to examine the association of anesthesia work area reservoirs with KAPE genera isolation.ResultsAcinetobacter pathogens were more likely to be isolated from anesthesia provider hands (risk ratio [RR], 1.07; 95% confidence interval [CI], 1.04-1.10; corrected P = .004) and less likely to be isolated from patients (RR, 0.2; 95% CI, 0.08-0.50; corrected P < .0001). Enterobacter pathogens were more likely to be isolated from patients (RR, 3.34; 95% CI, 1.92-5.81; corrected P = 0.001) and less likely to be isolated from provider hands (RR, 0.89; 95% CI, 0.83-0.97; corrected P = .007).ConclusionsAnesthesia provider hands are important reservoirs for Acinetobacter spp, whereas patient skin surfaces are key reservoirs for Enterobacter spp. Future work should examine the impact of a multimodal program in controlling the intraoperative spread of Acinetobacter and Enterobacter pathogens.

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Erratum

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5

https://ift.tt/2KjivMd

Sustained reduction in rates of hospital-onset Clostridium difficile infection using an automated electronic health record protocol

Publication date: May 2018
Source:American Journal of Infection Control, Volume 46, Issue 5
Author(s): Jad Antoine Khoury, William W. Sistrunk, Frances Hixson, Mary Duncan, Ann Perry, Amanda Varble, Alex M. Bryant
BackgroundAn automated protocol was designed within our electronic medical record (EMR) to help curb the Clostridium difficile problem at our institution. The protocol will identify patients at high risk for C difficile, improve the timing of testing of patients infected on admission, and enhance the appropriateness of C difficile testing throughout the patient's hospitalization.MethodsAdmitted patients with 2 of the following 3 criteria were labeled as high risk for C difficile: admission to a medical institution in the preceding 90 days, administration of antibiotics in the preceding 90 days, or a history of C difficile. High-risk patients with diarrhea in the first 3 days of admission are identified in the EMR, and prompt testing for C difficile is done. After day 3, if diarrhea develops, a series of questions is presented to help test the appropriate patients for C difficile.ResultsA statistically significant reduction in rates of hospital-onset C difficile was achieved after implementation of the protocol.ConclusionsImplementation of an automated protocol for targeted testing of high-risk patients for C difficile was successful at reducing rates of hospital-onset C difficile by improving timing and appropriateness of testing.

https://ift.tt/2JAtDmz

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 27 Απριλίου 2018

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