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pubmed_48_25232
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Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. A drug class review is now published monthly with The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, call The Formulary at 800-322-4349. The December 2015 monograph topics are rolapitant, insulin degludec, flibanserin, coagulation factor IX (recombinant), and grazoprevir/elbasvir. The Safety MUE is on rolapitant.
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10.1310/hpj5011-1025
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pubmed_510_4632
|
Twenty two patients (19 females) with focal nodular hyperplasia were seen between 1973 and 1989. Five were children, and all the adults were aged under 42 years (median 33 years). Fourteen patients (64%) were symptomatic on presentation. Twelve of the 14 adult women had taken the oral contraceptive pill. Twelve patients, nine of whom were symptomatic, underwent hepatic resection shortly after presentation. There were no deaths or major complications, and all remain well on follow up. Four patients underwent either hepatic artery embolisation or ligation. After an interval of six to 10 years they were asymptomatic and only one has histological evidence of residual focal nodular hyperplasia. Of five patients initially treated conservatively, two were asymptomatic and have remained so for three and 13 years. One of the three symptomatic patients became symptom free after stopping the contraceptive pill. The management of focal nodular hyperplasia requires a flexible approach. Lesions which are asymptomatic can be observed with regular ultrasound and treated if they enlarge or become symptomatic. Symptomatic patients who present while taking the contraceptive pill can also have a trial of conservative treatment. Other symptomatic patients, including those who previously took the pill, are best treated by surgical resection, and, where this is not possible, by embolisation.
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10.1136/gut.32.5.524
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pubmed_306_8819
|
BACKGROUND
The objective of this exploratory study was to identify patient-related predictors of communication preferences in patients with chronic low back pain for various dimensions of patient-physician communication (patient participation and orientation, effective and open communication, emotionally supportive communication, communication about personal circumstances).
METHODS
Eleven rehabilitation centers from various parts of Germany participated in collection of data between 2009 and 2011. A total of 701 patients with chronic low back pain were surveyed at the start of rehabilitation. The patient questionnaire captured communication preferences, pain impact, pain intensity, and psychologic variables (fear avoidance beliefs, illness coherence, control beliefs, communication self-efficacy, and personality characteristics). The rehabilitation physicians filled out a documentation sheet containing information on diagnosis, inability to work, duration of the illness, and comorbidity at the beginning and end of rehabilitation. Hierarchical regression analyses were performed.
RESULTS
On average, effective, open, and patient-centered communication was very important for patients with back pain, emotionally supportive communication was important, and communication about personal circumstances was somewhat important. The variance in communication preferences explained by the predictors studied here was 8%-19%. Older patients showed a lower preference for patient-centered and open communication, but a higher preference for communication about personal circumstances. Patients with psychologic risk factors (eg, fear avoidance beliefs), extroverted patients, and patients with high self-efficacy in patient-physician interaction generally had higher expectations of the physician's communicative behavior.
CONCLUSION
Providers should take into consideration the fact that patients with back pain have a strong need for effective, open, and patient-centered communication. A flexible approach to communication needs appears to be especially important for communication about emotional and personal circumstances, because the patients differ most clearly in this respect. Personal characteristics provided only initial clues to possible preferences; for more precision, an individual assessment (by means of questionnaires or discussion) is needed.
|
10.2147/PPA.S50695
|
pubmed_587_17169
|
In MCF-7 cells, TNF alpha induces a G1 arrest with an increased expression of p21/Waf1, an activation of NF-kappa B and an accumulation of p53. NF-kappa B and p53 are two transcriptional factors known to activate p21/Waf1 gene expression. Here we show that p53 inhibition has no effect on p21/Waf1 mRNA accumulation following TNF alpha treatment. In contrast, inactivation of NF-kappa B inhibits p21/Waf1 expression without affecting G1 arrest. The fact that p21/Waf1 gene expression is still stimulated when p53 is inactivated strongly suggests that TNF alpha induces accumulation of an inactive form of p53 protein. This assumption was further supported by the following observations: (i) the p53 DNA-binding activity to its consensus sequence was not stimulated following TNF alpha treatment, (ii) phosphorylation at Ser-15, -20 or -392 was not detected in response to TNF alpha, (iii) the transcription rate of Ddb2, another p53 target gene, was not stimulated by TNF alpha. Finally, the accumulation of p53 in the nuclei of TNF alpha-treated MCF-7 cells was concomitant with an increase in p53 mRNA level, suggesting a regulation at the transcription level.
|
10.1038/sj.cdd.4400983
|
pubmed_957_7814
|
Purpose
The purpose of this study was to determine the extent and prevalence of daily PA and the sedentary behavior during inactive spare-time among young Saudis and their effect on overweight and obesity.
Methods
A total of 357 students completed all stages of this study. They included 282 boys aged 11.95 ± 0.73 years (213 children aged 11.62 ± 0.506 years and 69 adolescents aged 13.16 ± 0.373 years) and 75 girls (16 children aged 11.94 ± 0.236 years and 59 adolescents aged 13.47 ± 0.626 years). For each participant, height and weight were measured, and BMI was calculated. A questionnaire asking about daily PA and sedentary habits during the previous 7 days was also used. Multiple comparisons were performed to test for differences between groups by sex and age category, and stepwise multiple regression analysis was used to determine which variables significantly affected BMI.
Results
The overall prevalence of overweight and obesity was 17.02 and 28.37% in boys and 9.33 and 0% in girls, respectively. The patterns of PA were changing within elements and between sexes. Both groups of boys were more active than girls during breakfast and lunch periods (p < 0.001 for all). A significant difference in favor of boys was also observed between the two groups of boys and the group of adolescent girls regarding after-school physical activity (p < 0.05 for all). Prepubescent boys reported being generally less active during the previous 7 days than their female counterparts and adolescent peers. Sedentary behaviors did not differ between all groups. Playing video games and using laptops were the parameters significantly associated with BMI.
Conclusions
This study noted that the prevalence of overweight and obesity was more pronounced in boys than in girls. However, boys were more active but had the same degree of sedentary behavior as girls. Physical activity across the days of weekly, video games, and laptop use were the parameters that most affected BMI.
|
10.3389/fspor.2022.963144
|
pubmed_354_17921
|
This cross-sectional research aimed to explore the associated factors with participation in the quality improvement processes in Kalasin hospital, Kalasin province, Thailand. The 412 samples were randomized selection and the created questionnaire was applied to collect their opinion. The results showed that level of participation in quality improvement, which called HA of hospital health professionals at high level (average = 3.52, S.D. = 0.86). In aspect of internal factors of samples, positions and role of responsibility were significantly related with quality improvement. Job motivation and support from the organization were positively correlated with participation of HA activities with statistical significance level. Finding can be suggest that the hospital need to support their staff in aspect of focus on patient, human resources development and patient care process. Including to support and staff encouragement to high level of participant all quality improvement quality.
|
10.3233/SHTI190071
|
pubmed_1048_22113
|
BACKGROUND
Patients with chronic kidney disease (CKD) undergoing coronary angiography (CA), adequate hydration and minimizing volume of contrast media (CM) are class 1b recommendations for preventing contrast induced nephropathy (CIN). Current data are insufficient to justify specific recommendations about isoosmolar vs. low-osmolar contrast media by the ACCF/AHA/SCAI guidelines.
METHODS
Randomized trials comparing IOCM to LOCM in CKD stage 3 and above patients undergoing CA, and reporting incidence of CIN (defined by a rise in creatinine of 25% from baseline) were included in the analysis. The secondary outcome of the study was the incidence of serum creatinine increase by >1mg/dl.
RESULTS
A total of 2839 patients were included in 10 trials, in which 1430 patients received IOCM and 1393 received LOCM. When compared to LOCM, IOCM was not associated with significant benefit in preventing CIN (OR=0.72, [CI: 0.50-1.04], P=0.08, I2=59%). Subgroup analysis revealed non-significant difference in incidence of CIN based on baseline use of N-acetylcystine (NAC), diabetes status, ejection fraction, and whether percutaneous coronary intervention vs coronary angiography alone was performed. The difference between IOCM and LOCM was further attenuated when restricted to studies with larger sample size (>250 patients) (OR=0.93; [CI: 0.66-1.30]) or when compared with non-ionic LOCM (OR=0.79, [CI: 0.52-1.21]).
CONCLUSION
In patients with CKD stage 3 and above undergoing coronary angiography, use of IOCM showed overall non-significant difference in incidence of CIN compared to LOCM. The difference was further attenuated when IOCM was compared with non-ionic LOCM.
|
10.1016/j.ijcard.2016.11.170
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pubmed_137_11617
|
The toxigenesis of non-proteolytic C. botulinum , types B, E, and F, in a variety of fresh fish stored between 4 and 30°C for up to 60 days was evaluated in a five year study. Muscle homogenates and fillets were inoculated with 104-10-2 spores from multiple strain pools, then modified atmosphere (MA) packaged under vacuum, 100% CO2, or 70% CO2 and 30% N2. Our conclusions are based on all data generated in 927 experiments comprising 18,700 samples. The earliest lag times (LT), i.e. sampling period prior to observation of toxicity, among all experiments conducted at 30, 20, 16, 12, 8, and 4°C, were 0.5, 1, 2, 3, 3, and 18 d, respectively. The LT across experiments was significantly affected by temperature (p<0.00001), inoculum level (p<0.00001), fish type (p<0.0001), spore pool (0.0001), and MA (p<0.02). The LT was not affected by homogenization of the fish muscle. We established a general formula that provides the most conservative model for the prediction of LT. This formula yielded calculated LT's that were very close to observed data and models based on individual experiments. Temperature explained 74.6% of experimental variation in the final multiple linear regression model (r2=0.883). The spore inoculum level accounted for 7.4%, while other factors explained <3% together. The utility of the model is demonstrated by its ability to predict the time before toxigenesis in qualitative studies of C. botulinum toxicity in inoculated fish stored under different MA's, reported in the international literature.
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10.4315/0362-028X-53.2.131
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pubmed_63_10332
|
Gastrointestinal disturbances (particularly diarrhea) are often induced in response to cancer treatments such as chemotherapy or radiation. Oral chemotherapeutic agents can induce diarrhea by damaging the intestinal lining. Two common oral drugs used in cancer treatment that are known to have gastrointestinal side effects are capecitabine and lapatinib. In this brief communication, the authors discuss a case study of a stage IV breast cancer patient whose chemotherapy-induced diarrhea was treated successfully with a multispecies combination of probiotics. This is a unique study in which grade 3 chemotherapy-induced diarrhea (characterized by 7-9 stools per day and associated with incontinence and abdominal cramping) was treated with only a multispecies combination of probiotics. Probiotics have been used to treat diarrhea in patients with irritable bowel syndrome, ulcerative colitis, pouchitis, and Crohn's disease. More recently, probiotics have been used to treat chemotherapy-induced diarrhea in colon cancer patients. This case study demonstrates that the probiotics can also be used to treat severe cases of chemotherapy-induced diarrhea in breast cancer patients. The use of different probiotics in gastrointestinal diseases is an increasingly important area of study, and more research into this area is needed. This study demonstrates that probiotics should be considered for advanced breast cancer patients with chemotherapy-induced diarrhea.
|
10.1177/0148607109332004
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pubmed_1136_7917
|
Active surveillance (AS) is an alternative to total prostatectomy (TP) in managing low-risk prostate cancer (PC). Our aim is to compare urologist reimbursement for managing low-risk PC by AS or TP. The urologist's reimbursement for TP includes the fee for the procedure and follow-up visits. For AS, our protocol involves digital rectal examination (DRE) and PSA testing every 3 months for first 2 years and every 6 months thereafter. Transrectal ultrasound (TRUS)-guided biopsies are performed yearly. Some urologists recommend spacing the biopsies by 1-3 years. Medicare reimbursement values were used. The urologist reimbursements for a follow-up visit, prostate biopsy, open TP and robotic TP are $72, $595, $1905 and $2939, respectively. We also corrected for a 15% chance of having TP after being on AS. The cumulative reimbursements from open TP and following the patient up to 10 years are approximately $2121 (1 year), $2265 (2 years), $2697 (5 years) and $3057 (10 years). For robotic TP, the urologist reimbursements are $3155 (1 year), $3259 (2 years), $3731 (5 years) and $4091 (10 years). For AS, the urologist reimbursements are $883 (1 year), $1766 (2 years), $4269 (5 years) and $7964 (10 years). The urologist reimbursement from AS and TP become nearly equal between 3 and 4 years follow-up, subsequently AS attains higher reimbursement.
|
10.1038/pcan.2010.34
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pubmed_725_4192
|
The blood/brain barrier prevents the passive diffusion of proteins and metabolites from cerebral blood vessels into tissue spaces around neuronal and glial cells. To provide nutrients for these cells, transport mechanisms must exist and indeed have been demonstrated for metabolites. We now show that monoclonal antibodies against rat and human transferrin receptors label blood capillaries in the brain but not in other tissues. In the rat this labelling occurs after injection of antibody into the blood, thus the receptors seem to be accessible at the endothelial surface. It is possible that transferrin receptors are expressed on these cells to allow transport of transferrin (and thus iron) into brain tissues.
|
10.1038/312162a0
|
pubmed_827_23744
|
Seven Japanese patients on maintenance hemodialysis who were comorbid with mild depression were medicated with 50 mg/day fluvoxamine maleate for 28 days. Effectiveness was obtained in four out of seven patients (57%). The plasma fluvoxamine concentrations were examined in three patients. The plasma fuvoxamine concentration decreased by 22% by hemodialysis. There is a tendency for the dialyzed rate of fluvoxamine to become lower if the plasma albumin concentration is higher. The half-life of fluvoxamine was possibly shortened more in the patient with hypoalbuminaemia. The plasma fluvoxamine concentration reached a steady state 8 days after the start of medication and thereafter. The time required to reach steady state was lengthened when compared with the results in normal Japanese volunteers.
|
10.1111/j.1440-1819.2003.01206.x
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pubmed_518_22098
|
Juvenile rainbow trout, on 3% of body weight daily ration, were exposed to 0 (control) or 3 microg/L Cd (as Cd(NO3)2*4H2O) in moderately hard (140 mg/L as CaCO3), alkaline (95 mg/L as CaCO3, pH 8.0) water for 30 days. Particular attention focused on Cd burden in tissues (gills, liver, kidney, and whole body) and induction of metallothionein (MT) in gills, liver, and kidney during chronic Cd exposure. Mortality in Cd-exposed fish was minimal ( approximately 10%), and no growth effects occurred over the 30-day exposure. Cd accumulated in a time-dependent fashion to 9 times (gills), 3 times (liver), 20 times (kidney), 2 times (carcass), and 2 times (whole body) control levels by 30 days; absolute concentrations were in the order kidney > gill > liver > whole body > carcass. Tissue (gills, liver, and kidney) Zn and Cu burdens were not altered by chronic exposure to 3 microg/L Cd. MT concentrations in all tissues increased over the 30 days of Cd exposure, but the increases were much less than those of Cd on a molar binding site basis. Absolute MT concentrations were in the order liver > kidney > gill, but relative increases were greatest in kidney (fourfold), followed by gills (twofold) and liver (1.3-fold). MT levels were sufficient to bind all Cd in gill, liver, and kidney under control conditions, and after chronic Cd exposure remained sufficient in liver and kidney, but not in gills. Total metal levels (Cd + Zn + Cu) greatly exceeded MT binding capacity in all tissues under all conditions.
|
10.1007/s002440010273
|
pubmed_1025_7412
|
BACKGROUND
Osteosarcoma (OS) is the most frequent bone tumor in children and adolescents. Tumor antigens are encoded by genes that are expressed in many types of solid tumors but are silent in normal tissues, with the exception of placenta and male germ-line cells. It has been proposed that antigen tumors are potential tumor markers.
OBJECTIVES
The premise of this study is that the identification of novel OS-associated transcripts will lead to a better understanding of the events involved in OS pathogenesis and biology.
METHODS
We analyzed the expression of a panel of seven tumor antigens in OS samples to identify possible tumor markers. After selecting the tumor antigen expressed in most samples of the panel, gene expression profiling was used to identify osteosarcoma-associated molecular alterations. A microarray was employed because of its ability to accurately produce comprehensive expression profiles.
RESULTS
PRAME was identified as the tumor antigen expressed in most OS samples; it was detected in 68% of the cases. Microarray results showed differences in expression for genes functioning in cell signaling and adhesion as well as extracellular matrix-related genes, implying that such tumors could indeed differ in regard to distinct patterns of tumorigenesis.
CONCLUSIONS
The hypothesis inferred in this study was gathered mostly from available data concerning other kinds of tumors. There is circumstantial evidence that PRAME expression might be related to distinct patterns of tumorigenesis. Further investigation is needed to validate the differential expression of genes belonging to tumorigenesis-related pathways in PRAME-positive and PRAME-negative tumors.
|
10.1007/s00776-011-0106-7
|
pubmed_1033_13886
|
Small intestinal submucosa (SIS) has been used for reinforcement of other tissues in the body with success and has been shown to act as a bioabsorbable tissue scaffold that promotes and assists healing. The effectiveness of using porcine SIS as a tissue scaffold for reinforcement of rotator cuff repair is unclear. This study evaluates both clinical and magnetic resonance imaging (MRI) follow-up at 6 months in patients with large and massive rotator cuff tears treated with open repair and SIS reinforcement or interpositional grafting. Eleven consecutive patients who underwent open rotator cuff repair with SIS augmentation for large or massive tears were selected retrospectively, and their charts were reviewed. Magnetic resonance images were then obtained at least 6 months after the index procedure. Patients were evaluated clinically and with a questionnaire, and an American Shoulder and Elbow Surgeons shoulder score was calculated. Results showed retear on MRI in 10 of 11 patients with recurrence of large, retracted tears. One repair remained intact by MRI evaluation at 10 months. Clinically, there was no statistically significant difference between preoperative and postoperative shoulder scores by use of a paired t test analysis (P =.70). Five patients had worse scores postoperatively. We concluded that, though SIS xenografting may be effective in other areas of the body for tendon healing, its use in reinforcement of large and massive rotator cuff repairs seems to be ineffective and does not improve clinical outcome.
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10.1016/j.jse.2004.03.005
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pubmed_30_6300
|
The clonal origin of thyroid tumors in female mice heterozygous for a deficiency of the X-linked enzyme glucose-6-phosphate dehydrogenase (G6PD) was studied. Tumor phenotype was demonstrated by enzyme histochemistry. Because monophenotypia is not synonymous with monoclonality, a method to estimate the degree of mingling of the two cellular phenotypes in normal tissue was devised. Twenty-five point three percent of 624 randomly chosen pairs of adjacent follicular cells were of unlike phenotype, suggesting that if tumors were derived from 2 or more cells at least a quarter would express polyphenotypia. Four hundred fifty-three thyroid lesions induced in 20 GPDX (enzyme-deficient) mice, 20 C3H (normal) mice, and 48 heterozygous (C3HxGPDX) mice by radiation and long-term goitrogen treatment were studied. One hundred twenty-eight adenomas (sharply defined or encapsulated hypercellular lesions) were found in heterozygotes; 108 (84%) were monophenotypic, and 20 (16%) were largely monophenotypic with degenerate areas or included normal cells. None were clearly polyphenotypic. Seventy-five nodules (circumscribed but not encapsulated, largely normocellular lesion with prominent stroma) were found in heterozygotes; 25 (33%) only were monophenotypic. It is concluded that thyroid adenomas are monoclonal and nodules polyclonal. The variegated pattern of polyphenotypia in the nodules together with their prominent stromal component leads to the suggestion that there is a causative role for the stroma in their generation.
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pubmed_30_6300
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pubmed_417_5272
|
We have previously reported that the binding site repertoires of heterodimers formed between retinoid X receptor (RXR) and either retinoic acid receptor (RAR) or thyroid hormone receptor (TR) bound to response elements consisting of directly repeated PuG(G/T)TCA motifs spaced by 1-5 bp [direct repeat (DR) elements 1-5] are highly similar to those of their corresponding DNA binding domains (DBDs). We have now mapped the dimerization surfaces located in the DBDs of RXR, RAR and TR, which are responsible for cooperative interaction on DR4 (RXR and TR) and DR5 (RXR and RAR). The D-box of the C-terminal CII finger of RXR provides one of the surfaces which is specifically required for the formation of the heterodimerization interfaces on both DR4 and DR5. Heterodimerization with the RXR DBD on DR5 specifically requires the tip of the RAR CI finger as the complementary surface, while a 7 amino acid sequence encompassing the 'prefinger region', but not the TR CI finger, is specifically required for efficient dimerization of TR and RXR DBDs on DR4. Importantly, DBD swapping experiments demonstrate not only that the binding site repertoires of the full-length receptors are dictated by those of their DBDs, but also that the formation of distinct dimerization interfaces between the DBDs are the critical determinants for cooperative DNA binding of these receptors to specific DRs.
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10.1002/j.1460-2075.1994.tb06395.x
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pubmed_58_14233
|
BACKGROUND
In the absence of trauma, hematologic disease and anti-platelet use, no attention has been paid to elucidate the mechanism of ecchymosis. It has taken our attention that ecchymosis on lower limb might be a sign of varicose vein. Accordingly, we aimed to analyze and describe the frequency of leg symptoms and presence of ecchymosis in patients with varicose vein.
MATERIALS AND METHODS
Four hundred and ninety four patients who had been diagnosed as having varicose vein or chronic venous insufficiency either by clinical examination or Doppler ultrasonography were included in the study. Leg symptoms were defined as pain, itching, muscle cramps, throbbing, and swelling. Ulcers, pigmentations and ecchymosis were recorded as signs of varicose vein. Ecchymosis was defined as a hemorrhagic lesions, larger than >3 mm on the skin of lower extremities, forming a flat, rounded or irregular, blue or purplish patch.
RESULTS
Leg pain was the most common symptom in our study population. Ecchymosis was observed in 24 patients (5%). Logistic regression analysis showed that ecchymosis was significantly and positively associated with muscle cramps (Odds ratio: 5.82, p = 0.001) and female gender (Odds ratio: 5.17 p = 0,019 but negatively associated with age (Odds ratio: 0.94, p = 0.004).
CONCLUSION
We have documented for the first time that the frequency of ecchymosis and its association with muscle cramps in a relatively large patient population with peripheral varicose vein or chronic venous insufficiency. Ecchymosis on lower limbs should be considered as a novel sign of varicose vein.
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10.3233/CH-170320
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pubmed_116_4144
|
We report a single center's preliminary clinical experience of the Sentinel (Angeion, Minneapolis, MN) implantable cardioverter defibrillator (ICD), which employs novel technologies that offer the potential for significant reduction in ICD size. Thirty-three patients have received Sentinel ICDs with a mean follow-up of 450 (range 150-1023) days. Device shock therapy has been used to defibrillate/cardiovert 43 spontaneous episodes of malignant ventricular arrhythmia and 510 episodes of hemodynamically well tolerated ventricular arrhythmia have been pace-terminated (pace-termination failed in 6 episodes with subsequent delivery of appropriate shock therapy). There has been no arrhythmic death in this patient population. There have been 9 inappropriate shocks in 6 patients (in 2 patients for atrial fibrillation which had satisfied the algorithm detection criteria for high zone ventricular arrhythmia, in 3 for sinus tachycardia [rate greater than 180 beats per min] and in 1 due to device capacitor malfunction). Device replacement has been required for component malfunction in 3 patients. There have been no other major complications. Follow-up time to date is short and longterm device efficacy and performance remain unproven. However, our early clinical experience suggests that the innovations used to manufacture the Sentinel ICD have facilitated reduction in ICD size without compromising therapeutic efficacy.
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10.1023/a:1009760605033
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pubmed_660_17384
|
INTRODUCTION
The Rapid Alert System was established by the European Union (EC Regulation 178/2002 Art.50, paragraph 1) for food intended for human consumption and for animal feed, with the aim of ensuring the protection of public, animal and environmental health. The purpose of the Rapid Alert System for Food and Feed (RASFF) is to provide the control authorities with the means of exchanging information on the measures taken to ensure food safety. This system allows for a rapid intervention following the discovery of food or feed already placed on the market and which represent, directly or indirectly, a serious risk for human, animal or environmental health.
METHODS
Our work intends to examine all alert and information notified to the Hygiene Department of Food and Nutrition of what was formerly NA3 LHU in the last 5 years (2008-2012), and is now Naples 2 North LHU, bearing in mind that, according to regional law 16/2008 (10), the Local Health Units in Campania have been redefined. The types of risk regarding the food subject of the alerts received are: chemical, physical and biological. Food frauds (adulteration, counterfeiting, sophistication and alteration) and the poor state of preservation were considered separately.
RESULTS
Out of 146 cases of non-conformity reported, 87 involved chemical risk, 28 biological risk and 17 included foreign bodies; there were also 7 food frauds and 1 case of poor state of preservation. As for the origin, the food subject of non-conformity were for the most part (61,64%) of national origin, while 34.24% came from abroad. Of these, about 66% were of non-EU origin.
CONCLUSIONS
The experience gained during the period from 2008 to 2012 allows us to state that the information flow has been improved allowing local services that have been assigned the control to act more rapidly. A critical issue sometimes remains concerning the completeness of the given data, above all regarding the type of risk that, when well reported, provides a valuable contribution to the success of a comprehensive and responsible risk management programme. The encouraging fact that emerges from this study, however, is that, despite the premises made about the characteristics of the area examined, the number of alerts we received involving production sites located in the area of the LHU jurisdiction is less than what we might have expected.
|
10.7416/ai.2014.1993
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pubmed_186_25229
|
OBJECTIVE
To investigate the relationship between the etiology, laboratory findings and prognosis of secondary HPS, so as to enhance the understanding of the secondary HPS and the related factors affecting prognosis, reduce the misdiagnosis and to understand the factors that affect the prognosis.
METHODS
The etiology, laboratory findings and prognosis of 61 patients with secondary HPS were analyzed retrospectively.
RESULTS
Univariate analysis showed that TG, FIB, SF, ANC, ALB, TBIL, ALT, LDH were significantly different between the 2 groups of the patients with secondary HPS. Multiariate factor analysis showed that the LDH and the etiology affected the prognosis of the patients with secondary HPS. The prognosis of the patients with elevated LDH, viral infection, especially EB virus infection, tumor and unknown causes might be poor.
CONCLUSIONS
The etiology and clinical characteristics of prognosis are diverse. The cause needs to be identified as soon as possible. The prognosis should be judged according to LDH and other indicators. Then, targeted therapy should be used to control the disease in the short time.
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10.7534/j.issn.1009-2137.2016.02.051
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pubmed_167_20284
|
Prospective research studies answer clinical questions via randomized control studies or prospective cohort studies. Bias is defined as any deviation from the truth when interpreting data. Broadly speaking, bias is categorized into 3 categories: selection bias, information bias, and confounding bias. Furthermore, misinterpretation of presented statistics in research studies causes acceptance of conclusions which may not necessarily be true. This paper identifies sources of bias in prospective research and instructions to avoid bias.
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10.1097/BSD.0000000000000767
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pubmed_72_27
|
Fusarium wilt, caused by a soilborne pathogen Fusarium oxysporum f. sp. lilii, is the major disease of lily (Lilium L.). In order to isolate the genes differentially expressed in a resistant reaction to F. oxysporum in L. regale Wilson, a cDNA library was constructed with L. regale root during F. oxysporum infection using the suppression subtractive hybridization (SSH), and a total of 585 unique expressed sequence tags (ESTs) were obtained. Furthermore, the gene expression profiles in the incompatible interaction between L. regale and F. oxysporum were revealed by oligonucleotide microarray analysis of 585 unique ESTs comparison to the compatible interaction between a susceptible Lilium Oriental Hybrid 'Siberia' and F. oxysporum. The result of expression profile analysis indicated that the genes encoding pathogenesis-related proteins (PRs), antioxidative stress enzymes, secondary metabolism enzymes, transcription factors, signal transduction proteins as well as a large number of unknown genes were involved in early defense response of L. regale to F. oxysporum infection. Moreover, the following quantitative reverse transcription PCR (QRT-PCR) analysis confirmed reliability of the oligonucleotide microarray data. In the present study, isolation of differentially expressed genes in L. regale during response to F. oxysporum helped to uncover the molecular mechanism associated with the resistance of L. regale against F. oxysporum.
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10.7868/s0026898414060147
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pubmed_26_15020
|
Pegfilgrastim (PEGFIL) has been found to be comparable to daily filgrastim (FIL) in managing chemotherapy-induced neutropenia. In the present study, we evaluated the ability of PEGFIL to mobilize stem cells in 38 consecutive patients with lymphoproliferative diseases (multiple myeloma, n = 18; lymphomas, n = 15; chronic lymphocytic leukemia, n = 5). Patients were mobilized using PEGFIL (6-18 mg as a single dose) during 2005-2006; 32 then received high-dose chemotherapy followed by autologous stem cell transplantation. PEGFIL-mobilized patients were matched by age, disease, and treatment line at a ratio of 1:2 to historical FIL-mobilized controls. The primary study endpoint was the blood CD34(+) concentration at onset of leukapheresis. Leukapheresis began a median of 10 days from the beginning of mobilization chemotherapy in both groups. At the onset of leukapheresis, median blood CD34(+) cell counts did not differ significantly in the FIL group compared with the PEGFIL group (79 x 10(6)/L vs 64 x 10(6)/L, respectively; p = 0.44). In the different disease categories, the respective CD34(+) cell counts after FIL and PEGFIL mobilization were 72 x 10(6)/L vs 123 x 10(6)/L (p = 0.08) in myeloma, 51 x 10(6)/L vs 62 x 10(6)/L (p = 0.6) in lymphomas, and 27 x 10(6)/L vs 30 x 10(6)/L (p = 0.62) in CLL, respectively. The target CD34(+) cell yield was harvested with one leukapheresis in 53% of PEGFIL-mobilized patients. Engraftment after autografting did not differ significantly in the two groups. Stem cell mobilization with a single dose of PEGFIL was, therefore, comparable to that achieved using daily FIL in patients with lymphoproliferative diseases. PEGFIL is a more practical way to mobilize stem cells than daily FIL.
|
10.1007/s00277-008-0675-5
|
pubmed_60_13141
|
BACKGROUND
Neuroendocrine carcinoma (NEC) of the paranasal sinuses is rare, accounting for 5% of sinonasal malignancies. The purpose of this study was to assess prognostic factors and survival rates for sinonasal NEC.
METHODS
A retrospective review of patients with NEC treated from 1990 to 2004 was performed. Patient demographics, TNM classification, treatment modality, recurrences, and survival were evaluated.
RESULTS
NEC was identified in 28 patients; the most common primary site was the ethmoid sinuses. Most patients presented with advanced tumors; few had regional or distant metastasis. Local recurrence rate was 21%. Five-year overall survival (OS) and disease-specific survival (DSS) rates were 65% and 78%, respectively. Response to chemotherapy predicted for improved survival, although no differences in outcomes were noted between definitive management strategies.
CONCLUSION
NEC of the paranasal sinuses is an exceedingly rare malignancy of the paranasal sinuses. Our data suggests definitive management with surgery or radiotherapy offers durable control. The response to chemotherapy may predict for overall outcomes.
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10.1002/hed.21940
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pubmed_785_17901
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BACKGROUND Cystic fibrosis (CF) is an autosomal recessive disease caused by a CF trans-membrane regulator (CFTR) defect. Its prevalence is 1:2500 in Caucasians, 1:15300 among African Americans and is rare in Southeast Asia. The present study aims to review demographic data, clinical manifestations and laboratory findings of Iranian children diagnosed with CF who referred to a Children's Hospital Medical Center in Tehran, Iran during a ten-year period. METHODS In a retrospective study from 1991-2000, all hospitalized patients with documented CF were reviewed. Diagnosis was based on clinical findings and sweat chloride levels above 60 mEq/L. RESULTS A total of 233 patients [females: 91 (39.1%), males: 142 (60.9%)] were enrolled. The onset of symptoms was before the first month of life in 12.1%, between 1-6 months of age in 75.1%, and between 6-12 months of age in 6.9% of patients. Consanguinity of parents was present in 42.5% of patients. Respiratory (81.5%) and gastrointestinal (73.4%) symptoms, in addition to growth retardation were the most common presentations Eighty-eight percent of patients weighted below the fifth percentile. Of the 207 chest radiographs performed, the most frequent finding was hyper-aeration associated with pneumonia. Among 138 patients in whom barium swallows were performed, 102 (74%) had gastroesophageal reflux. A total of 27 patients expired, mostly from respiratory failure (96.3%). CONCLUSION CF is not a rare disease in Iran. We suggest early diagnosis and appropriate maintenance therapy for improving morbidity and mortality amongst CF patients.
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pubmed_785_17901
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pubmed_79_71
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The multiplication of M. tuberculosis, var. bovis inoculated into the cornea of mice was studied by staining the whole cornea at various stages after inoculation. Four groups of animals were studied: untreated animals, animals treated with cortisone, animals previously immunized with the same bovine strain, and immunized animals treated with cortisone.In the untreated immunized group little or no multiplication occurred. In the other three groups multiplication did occur and was about the same for the first week after inoculation. After this stage, cortisone-treated animals, whether previously immunized or not, showed increased multiplication and massive cord formation, as compared with untreated animals in which little further multiplication was seen. The cortisone treatment had thus completely suppressed immunity. The significance of these results is discussed.
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10.1111/j.1476-5381.1957.tb00127.x
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pubmed_594_9197
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Recent data suggest that cells from species as diverse as yeast and mammals may use similar mechanisms to detect changes in nutrient concentration. Here we review recent advances in understanding how glucose regulates gene transcription in mammals.
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10.1152/physiologyonline.2000.15.3.149
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pubmed_836_10505
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Cardiopulmonary resuscitation (CPR) is the appropriate intervention to sustain respiratory and circulatory functions in patients with diseases that are potentially reversible; while CPR is unequivocally inappropriate for patients with terminal diseases when there is a consensus of medical opinion that is no reasonable likelihood of meaningful survival. In practical application patients and their families seek guidance based on understanding. CPR when employed without expectations of benefit, will be likely to further compromise neurological function, produce iatrogenic injury, and add discomfort to the dying patient. The decision not to resuscitate remains a reasoned medical judgement. In some condition, transferring the patient with terminal diseases to an alternate physician or institution is ultimately respectful both for the patient and of physician.
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pubmed_836_10505
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pubmed_32_18033
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Homicide is the number one cause of death among African American youth, both male and female. Largely to blame for Black-on-Black violence is the sense of alienation our youth feel from society. To counter this phenomenon of violence it is essential to empower youth. Through education and community-based programs we can draw them away from the materialistic to the realistic. By banding together as mentors to our youth we can provide them with a sense of history and heritage, and thereby equip them with the self-identity originating from self-respect.
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10.1353/hpu.2010.0612
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pubmed_1013_18997
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BACKGROUND
There is a paucity of data on anesthesia-related outcomes for endovascular treatment (EVT) in the extended window (>6 hours from ischemic stroke onset). We compared functional and safety outcomes between local anesthesia (LA) without sedation, conscious sedation (CS) and general anesthesia (GA).
METHODS
Patients who underwent EVT in the early (<6 hours) and extended time windows using LA, CS, or GA between October 2015 and March 2020 were included from a UK national stroke registry. Multivariable analyses were performed, adjusted for age, sex, baseline stroke severity, pre-stroke disability, EVT technique, center, procedural time and IV thrombolysis.
RESULTS
A total of 4337 patients were included, 3193 in the early window (1135 LA, 446 CS, 1612 GA) and 1144 in the extended window (357 LA, 134 CS, 653 GA). Compared with GA, patients treated under LA alone had increased odds of an improved modified Rankin Scale (mRS) score at discharge (early: adjusted common (ac) OR=1.50, 95% CI 1.29 to 1.74, p=0.001; extended: acOR=1.29, 95% CI 1.01 to 1.66, p=0.043). Similar mRS scores at discharge were found in the LA and CS cohorts in the early and extended windows (p=0.21). Compared with CS, use of GA was associated with a worse mRS score at discharge in the early window (acOR=0.73, 95% CI 0.45 to 0.96, p=0.017) but not in the extended window (p=0.55). There were no significant differences in the rates of symptomatic intracranial hemorrhage or in-hospital mortality across the anesthesia modalities in the extended window.
CONCLUSION
LA without sedation during EVT was associated with improved functional outcomes compared with GA, but not CS, within and beyond 6 hours from stroke onset. Prospective studies assessing anesthesia-related outcomes in the extended time window are warranted.
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10.1136/neurintsurg-2022-018846
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pubmed_68_418
|
Myasthenia gravis (MG) is an antibody-mediated muscle disease in which any skeletal muscle can be affected. MG may produce numerous symptoms and signs. To doctors and patients, it may seem like lung disease, stroke, heart disease, or the effects of emotional stress. This article explores the "territory" between MG and diseases of the heart and lungs as well as the other neuromuscular diseases.
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pubmed_68_418
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pubmed_216_19734
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Although sterols constitute one of the most important molecular species in cells, the reasons for their structure-function relationships in lipid membranes are not well understood. The main objective of this work is to elucidate the recently suggested possibility that the ordering and condensing effects of sterols on phospholipid membranes are related to the smoothness of a sterol. We focus on cholesterol, which has two methyl groups attached to its beta-face, and compare its properties to those of demethylated cholesterol (Dchol), from which the two methyl groups have been removed. Atomic-scale molecular dynamics simulations of lipid membranes comprised of saturated lipids and sterols, either cholesterol or Dchol, provide compelling evidence that despite its smoother structure, the ordering and condensing effects of Dchol are less effective than those of cholesterol. The ordering capability of both cholesterol and Dchol is highly asymmetric with respect to their ring structure, but whereas cholesterol favors the alpha-face, Dchol favors the beta-face. The origin and implications of this difference are analyzed in detail. The picture that emerges from this study supports a view that the two methyl groups at the steroid ring system of cholesterol play an important role in cholesterol-lipid interactions by reducing sterol tilt in the bilayer and hence allowing for an optimal orientation for cholesterol.
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10.1529/biophysj.106.095497
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pubmed_719_12897
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Nanostructured carbonated hydroxyapatite (nCHA) is a promising biomaterial for bone tissue engineering due to its chemical properties, similar to those of the bone mineral phase and its enhanced in vivo bioresorption. However, the biological effects of nCHA nanoparticles on cells and tissues are not sufficiently known. This study assessed the impact of exposing pre-osteoblasts to suspensions with high doses of nCHA nanoparticles with high or low crystallinity. MC3T3-E1 pre-osteoblasts were cultured for 1 or 7 days in a culture medium previously exposed to CHA nanoparticles for 1 day. Control groups were produced by centrifugation for removal of bigger nCHA aggregates before exposure. Interaction of nanoparticles with the culture medium drastically changed medium composition, promoting Ca, P, and protein adsorption. Transmission Electron microscopy revealed that exposed cells were able to internalize both materials, which seemed concentrated inside endosomes. No cytotoxicity was observed for both materials, regardless of centrifugation, and the exposure did not induce alterations in the release of pro-and anti-inflammatory cytokines. Morphological analysis revealed strong interactions of nCHA aggregates with cell surfaces, however without marked alterations in morphological features and cytoskeleton ultrastructure. The overall in vitro biocompatibility of nCHA materials, regardless of physicochemical characteristics such as crystallinity, encourages further studies on their clinical applications.
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10.1002/jbm.a.36709
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pubmed_937_19771
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Unintentional subdural block, while attempting epidural block, is known as a complication. The authors used a catheter which had happened to be introduced into the subdural space, for clinical anesthesia and postoperative pain relief. For a 75-year-old male patient, gastrectomy was scheduled under epidural anesthesia. Epidural puncture was at the T 7 and T 8 interspace using loss of resistance method with saline under fluoroscopic guidance. We examined the catheter position by injecting iopamidol and confirmed subdural catheterization by subsequent computed tomography. After obtaining informed consent and agreement from the patient, "subdural anesthesia" was conducted. Ten ml of 0.5% bupivacaine was injected with 20 mg ephedrine as an initial dose. Twenty min after the injection, pin pricking revealed that analgesia had extended from the C 5 to S 1 dermatoms. Consciousness was clear and blood pressure was stable. Then, surgery was started. Since blood pressure tended to fall down gradually, we injected 40 mg of ephedrine subcutaneously 45 min after the subdural injection. At a 2 hours interval from the initial subdural injection, 5 ml of 0.5% bupivacaine was additionally injected. Respiration was stable throughout the surgery and the surgery was finished uneventfully. Analgesic level was from C 5 through S 3 at the end of surgery. Bupivacaine 0.25% was continuously infused at a rate of 2 ml.h-1 for 7 days for postoperative pain relief. The patient never complained of pain during the period. This report demonstrates that subdural block has a potential capability as an anesthesia for laparotomy as far as it is managed properly.
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pubmed_937_19771
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pubmed_313_21512
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Attempting to predict future is dangerous. This is particularly true in medical science where change is a result of chance discoveries. Currently, practicing psychiatrists are aware of deficiencies in psychiatric practice. However, we have a number of genuine reasons for optimism and excitement. Genetics, novel treatment approaches, new investigative techniques, large-scale treatment trials, and research in general medicine and neurology will give better insights in psychiatric disorders and its management. Psychiatric services in rural India can be reached by telemedicine. There are some threat perceptions which require solving and remedying. Subspecialties in psychiatry are the need of the hour. There is also a requirement for common practice guidelines. Mental Health Care Bill, 2013, requires suitable amendments before it is passed in the Indian Parliament. Research in psychiatry is yet to be developed as adequate resources are not available.
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10.4103/0973-1229.193069
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pubmed_446_5563
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The aim of this study in Medina city in 2009 was to identify key role players who influence the healthcare system and to assess their views regarding the improvement of the quality of health care in Saudi Arabia. In a qualitative, cross-sectional study data were collected from focus group discussions and analysed using a content analysis approach. Key role players were chosen based on their previous experience in providing feedback in health care-related areas: representatives from organizations, interest groups, departments, the media, other governmental organizations and members of the public who actively worked with the Department of Health. The topics discussed were: health and community; health and media; planning for health; female staff views; role of the private health sector; and the role of other governmental agencies. The discussions highlighted the importance of improvement of health facility infrastructure, the implementation of staff training and education, the initiation of quality assurance and safety standards and the extension of the scope of primary care and community health educational programmes.
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pubmed_446_5563
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pubmed_370_8012
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Phencyclidine (PCP) given to male Wistar rats produced hyperactivity and various stereotypic motor behaviors. Methadone, apomorphine, and naloxone were tested for their effects on PCP-induced stereotypy. Methadone (0.5 mg/kg) had no effect on the hyperactivity produced by PCP, but significantly attenuated PCP-induced stereotypy when given both before and after PCP. Low doses of apomorphine were equally effective as methadone in attenuating PCP-induced stereotypy. However, when naloxone was given after methadone or apomorphine to PCP-treated rats, the full PCP-induced stereotypy was again observed. Naloxone pretreatment on doses up to 20 mg/kg was not effective in antagonizing PCP-induced behavioral effects. Methadone and apomorphine antagonism of PCP-induced stereotypy may be mediated by opiate receptors. The results of this study and observations from human studies collectively suggest the possible effectiveness of opiates in treating PCP-induced and functional psychoses.
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10.1007/BF00433500
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pubmed_190_2609
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Human amniotic membrane (HAM) has biological properties which are useful for wound healing. HAM is notably one of the therapeutic alternatives for venous leg ulcer care. Indeed, a prospective clinical study has demonstrated that cryopreserved HAM transplantation for leg ulcer is feasible, safe and has beneficial effects: 80 % of the patients had a significant clinical response. Nevertheless, at the end of the 3-month follow-up period, only 20 % of the ulcers were totally closed. The aim of this work was to create and characterize a model of epidermized HAM. The method of HAM desepithelialization was validated by histology, immunohistochemistry and scanning electron microscopy. Then, de-epithelialized HAM was seeded with primary keratinocytes. After 21 days of culture, 15 at the air-liquid interface, the model obtained was analyzed histologically and by immunohistochemistry. The amniotic basement membrane was preserved during enzymatic desepithelialization of HAM. Primary keratinocytes proliferated on HAM: the model obtained showed involucrin expression and had a good basement membrane. As re-epithelialization is an important step for ulcer closure, a model of epidermized HAM could be used to speed up the healing of such wounds.
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10.1007/s10561-014-9427-z
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pubmed_345_20833
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BACKGROUND
Extended-spectrum β-lactamase (ESBL)-producing pathogens represent increasing challenges to physicians because of rising prevalence, high mortality, and challenging treatment. Identifying high risks and early appropriate therapy is critical to favorable outcomes.
METHODS
This is a 5-year retrospective case-case-control study performed at the Detroit Medical Center on adult patients with bloodstream infection (BSI) caused by ESBL-producing and non-ESBL-producing Escherichia coli or Klebsiella pneumoniae, each compared with uninfected controls. Data were collected from December 2004-August 2009. Multivariate analysis was performed using logistic regression.
RESULTS
Participants included 103 patients with BSI caused by ESBL-producing pathogens and 79 patients with BSI caused by pathogens that did not produce ESBLs. The mean age of patients in the ESBL group was 67 years; of the patients, 51% were men, 77% were black, and 38% (n = 39) died in hospital. The mean age of patients in the non-ESBL group was 58 years; of the patients, 51% were men, 92% were black, and 22% (n = 17) died in hospital. On multivariate analysis, predictors of BSI caused by ESBL-producing pathogens included central venous catheter (odds ratio [OR], 29.4; 95% confidence interval [CI], 3.0-288.3), prior β-lactam-/β-lactamase-inhibitor therapy (OR, 28.1; 95% CI, 1.99-396.5), and prior cefepime therapy (OR, 22.7; 95% CI, 2.7-192.4). The only risk factor for BSI caused by non-ESBL-producing pathogens was urinary catheter insertion (OR, 18.2; 95% CI, 3.3-100.3).
CONCLUSION
Prior antimicrobial therapy, particularly with β-lactam, was the strongest unique risk factor for BSI caused by ESBL-producing E coli or K pneumoniae.
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pubmed_345_20833
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pubmed_59_230
|
During the 1970s and 1980s Jay Winter published a series of highly influential articles on the demographic impact of the First World War, culminating in his study of The Great War and the British People in 1986. Winter argued that the war led to a dramatic improvement in average living standards, and that the survival chances of most sections of the civilian population improved more rapidly than they might have done if peace had been maintained. This paper seeks to test the strength of Winter's hypothesis in three main ways. Section I examines the arguments which Winter himself put forward to support his view that the war led to a systematic erosion of pre-war differentials in infant mortality. Section III utilizes evidence relating to children's heights to examine the extent to which the war led to improvements in children's 'nutritional status'. The paper's overall conclusion is that the war did not lead to any dramatic improvements in civilian health; the overall impression to be gained from an analysis of wartime health statistics is one of continuity rather than change.
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10.1093/shm/6.3.343
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pubmed_754_4645
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A monoclonal antibody (E11) was produced by immunization of mice with intact human cells of monocyte lineage. Despite the finding that E11 did not inhibit rosettes with C3b-coated sheep erythrocytes (EC3b), several lines of evidence indicated that E11 was specific for complement receptor type one (CR1). All monocytes, neutrophils, lymphocytes and erythrocytes that reacted with E11 formed EC3b rosettes. The E11 antigen on these cells was shown to be a molecule of 222 +/- 10 kDa. Treatment of lymphocytes, monocytes, and neutrophils with E11 followed by fluorescein-coupled F(ab')2 anti-mouse-IgG at 37 degrees C in buffer lacking sodium azide, led to capping or apparent endocytosis of the E11 antigen and a diminution in CR1 activity of 88%, 59% and 25%, respectively. This same treatment had no detectable effect on monocyte or neutrophil CR3 activity (EC3bi rosettes). Furthermore, with E11-capped lymphocytes, the residual EC3b rosetting was capped directly over the E11-fluorescence cap, whereas EC3d,g rosetting (CR2 specific) was undiminished and distributed evenly around the circumference of cells containing E11-fluorescence caps. Finally, the binding of E11 to cells was inhibited by the prior treatment of these cells with a well characterized rabbit polyclonal anti-CR1. These data indicated that E11 was specific for a site in CR1 that was distal from the C3b-binding site, so that E11 was unable to block CR1 activity. E11 proved to be useful for identifying CR1 on various cells in tissue sections, and for quantitating CR1 on erythrocytes and neutrophils. Erythrocytes and neutrophils from normal individuals were found to bind an average of 610 and 4.6 X 10(4) 125I-labeled E11 molecules per cell. When E11 was visualized in tissues by immunoperoxidase staining, the cells that apparently contained the greatest amounts of CR1 were dendritic reticulum cells and kidney podocytes. The E11 reactive dentritic reticulum cells were characteristic of both follicular and diffuse follicular center cell tumors. Lymphocytes from patients with chronic lymphocytic leukemia (CLL) characteristically expressed little E11, confirming earlier studies that CLL cells lacked CR1 activity detected by EAC1-3b rosette formation. Because normal B cells have been shown to express CR1 at a very early stage of maturation, the absence of CR1 on CLL cells is discordant with the immature nature of CLL cells defined by immunoglobulin expression.
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10.1002/eji.1830140307
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pubmed_373_5448
|
The Instrument Development Project of the Alzheimer's Disease Cooperative Study (ADCS) evaluated new assessments in five domains: (a) cognitive function; (b) clinical global change; (c) activities of daily living; (d) behavioral symptoms, and (e) cognition in severely impaired patients. These new instruments demonstrate excellent discrimination between normal controls and patient groups and show adequate validity and reliability. Stability of measurement and sensitivity to longitudinal change were also demonstrated in each of these areas. Examination of several domain-specific questions also contributed new information on the measurement of cognitive function with different subtasks across AD severity levels, the stability of clinical ratings of global change, and the applicability of behavioral assessment across severity levels. The success of this project enhances the state of the art in the measurement of efficacy in AD clinical trials and also provides a basis for future research on improving AD outcome measures.
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pubmed_373_5448
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pubmed_1043_2204
|
A mechanical electrode inserter was used to allow reproducible electromyographic (emg) electrode insertions. The electrical activity provoked by the mechanical insertion was recorded and quantitatively analyzed in the anterior tibialis, the extensor hallucis longus, and the extensor digitorum brevis of unimpaired human subjects. No statistically significant differences were found among these muscles in the total duration of sharp spike activity or in the duration of sharp spike activity following cessation of needle electrode movement. There was a statistically significant reduction in the total duration of mechanically-provoked electrical activity in the extensor digitorum brevis when compared to the anterior tibialis using the technique employed in this study. There was a statistically significant increase in time following the onset of needle electrode movement until the initiation of sharp spike activity in the extensor hallucis longus as compared to the anterior tibialis. Abnormalities are present in the extensor digitorum brevis muscle of clinically unimpaired subjects. Endplate spikes can be recorded as positive-shaped potentials in the endplate zones of muscle. Nonreproducible positive-shaped potentials of unknown etiology are seen to occur singly or in pairs following insertional activity in normal muscle. When examining muscle for the early evidence of provokable positive sharp wave and fibrillation potentials, care must be taken not to mistake normal characteristics of insertional activity for pathological abnormalities.
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pubmed_1043_2204
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pubmed_418_12978
|
MicroRNAs (miRNAs) are conserved small non coding RNAs, which are typically 22-24 nucleotides long and play an important role in post transcription regulation andin various biological processes in both animals and plants. Ocimum basilicum is an important medicinal plant having different bioactive compounds eugenol and essential oils that possess numerous therapeutic properties. However, only a few miRNAs of Ocimum basilicum and its function have been studied till date. The present study focusses on the identification of miRNA from expressed sequenced tags by carrying out computational approaches based on the homology search method. A total of 10 potential miRNAs with 8 different families were predicted in O.basilicum. Furthermore, the psRNA target server was used to predict cross kingdom target genes on human transcriptome for identification ofpotential miRNAs. Eight miRNA families were found to modulate the 87 human target genes which were associated with RAS/MAPK signalling cascade, cardiomyopathy, HIV, breast cancer, lung cancer, Alzheimer's diseases and several neurological disorders. Moreover, O.basilicum miRNAs regulate the key human target genes having significance in various diseases and important biological networks with 10 hub nodes interactions. Thus this study gives the pave for further studies to explore the potential of miRNA mediated cross kingdom regulation and treatment of various diseases including cancer.
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10.1007/s11033-019-04759-x
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pubmed_755_1140
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We describe a version of the standard tick drag-flag modified for use in close-growing and tangled vegetation, as well as under ornamental shrubbery and fallen branches. Two major features of the sweep are: (1) it allows the user to remain upright with the flag parallel to the ground, thus sampling effectively beneath low and fallen branches and around shrubs, as well as capturing host-seeking ticks in advance of the operator; and (2) the use of a flannel rubberized-laminate fabric (crib sheet) for the flag that is snag-proof and highly durable in dense and thorny vegetation. In simultaneous 100-m samples, the sweep was as effective as the 1-m standard tick drag for capturing nymphs of the deer tick, Ixodes dammini Spielman, Clifford, Piesman & Corwin, where understory vegetation was sparse, but was twice as effective in dense vegetation, capturing significantly more I. dammini nymphs. The sweep also captured nymphs of the American dog tick, Dermacentor variabilis (Say); rabbit tick, Haemaphysalis leporispalustris (Packard); and lone star tick, Amblyomma americanum (L.).
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10.1093/jmedent/29.2.352
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pubmed_122_21156
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Cancer cells are required to rewire existing metabolic pathways to support their abnormal proliferation. We have previously shown that, unlike glucose-addicted cancers, Kaposi's sarcoma-associated herpesvirus (KSHV)-transformed cells depend on glutamine rather than glucose for energy production and amino acid and nucleotide syntheses. High-level consumption of glutamine is tightly regulated and often coupled with the citrulline-nitric oxide (NO) cycle. We have found that KSHV infection accelerates nitrogen efflux by upregulating the expression of argininosuccinate synthase 1 (ASS1), a key enzyme in the citrulline-NO cycle. KSHV utilizes multiple microRNAs to upregulate ASS1 expression. Depletion of either ASS1 or inducible nitric oxide synthase (iNOS) in KSHV-transformed cells suppresses growth proliferation, abolishes colony formation in soft agar, and decreases NO generation. Furthermore, by maintaining intracellular NO levels, ASS1 expression facilitates KSHV-mediated activation of the STAT3 pathway, which is critical for virus-induced transformation. These results illustrate a novel mechanism by which an oncogenic virus hijacks a key metabolic pathway to promote growth transformation and reveal a potential novel therapeutic target for KSHV-induced malignancies.IMPORTANCE We have previously shown that Kaposi's sarcoma-associated herpesvirus (KSHV)-transformed cells depend on glutamine rather than glucose for energy production and amino acid and nucleotide syntheses. In this study, we have further examined how the KSHV-reprogramed metabolic pathways are regulated and discovered that KSHV hijacks the citrulline-nitric oxide (NO) cycle to promote growth proliferation and transformation. Multiple KSHV-encoded microRNAs upregulate argininosuccinate synthase 1 (ASS1), a key enzyme in the citrulline-NO cycle. ASS1 is required for KSHV-induced proliferation, colony formation in soft agar, and NO generation of KSHV-transformed cells, which also depends on inducible nitric oxide synthase. By maintaining intracellular NO levels, ASS1 mediates KSHV activation of the STAT3 pathway, which is essential for KSHV-induced abnormal cell proliferation and transformation. These results illustrate a novel mechanism by which an oncogenic virus hijacks a key metabolic pathway to promote growth transformation and reveal a potential novel therapeutic target for KSHV-induced malignancies.
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10.1128/JVI.01599-18
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pubmed_34_17571
|
BACKGROUND
Recent evidence suggests that oxidative stress may be an instigator of the metabolic syndrome, and adiponectin, an adipocyte-derived polypeptide, may modulate oxidative stress, ameliorating the atherosclerotic process.
AIM
Oxidative stress is increased in hemodialysis (HD) patients. We hypothesize that a relationship between plasma levels of adiponectin and markers of inflammation and oxidative stress exists.
METHODS AND RESULTS
In 124 HD patients, plasma adiponectin levels and three separate oxidative stress markers, tumor necrosis factor-alpha as well as high-sensitivity C-reactive protein (hsCRP) were determined. Plasma adiponectin was significantly and negatively correlated with serum hsCRP (r = -0.247, p = 0.008) and plasma malondialdehyde (MDA) levels (r = -0.326; p < 0.001). Multiple regression analyses suggested that plasma MDA, serum HDL cholesterol levels and logarithmically transformed hsCRP were the variables independently associated with plasma adiponectin levels.
CONCLUSION
Plasma adiponectin was significantly associated with plasma MDA, serum HDL cholesterol levels and serum hsCRP levels. Our results suggest the possibility that plasma adiponectin may play a role in alleviating oxidative stress in HD patients.
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10.1159/000107509
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pubmed_345_25199
|
Gene knockout studies on Geobacter sulfurreducens (Gs) cells showed that the outer membrane cytochrome OmcF is involved in respiratory pathways leading to the extracellular reduction of Fe(III) citrate and U(VI) oxide. In addition, microarray analysis of OmcF-deficient mutant versus the wild-type strain revealed that many of the genes with decreased transcript level were those whose expression is upregulated in cells grown with a graphite electrode as electron acceptor. This suggests that OmcF also regulates the electron transfer to electrode surfaces and the concomitant electrical current production by Gs in microbial fuel cells. Extracellular electron transfer processes (EET) constitute nowadays the foundations to develop biotechnological applications in biofuel production, bioremediation and bioenergy. Therefore, the structural characterization of OmcF is a fundamental step to understand the mechanisms underlying EET. Here, we report the complete assignment of the heme proton signals together with (1)H, (13)C and (15)N backbone and side chain assignments of the OmcF, excluding the hydrophobic residues of the N-terminal predicted lipid anchor.
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10.1007/s12104-015-9611-5
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pubmed_509_6572
|
The indications for endonasal endoscopic approaches to diseases of the skull base and its adjacent structures have expanded considerably during the last decades. This is not only due to improved technical possibilities such as intraoperative navigation, the development of specialized instruments, and the compilation of anatomical studies from the endoscopic perspective but also related to the accumulating experience with endoscopic procedures of the skull base by multidisciplinary centers. Endoscopic endonasal operations permit new approaches to deeply seated lesions and are characterized by a reduced manipulation of neurovascular structures and brain parenchyma while at the same time providing improved visualization. They reduce the trauma caused by the approach, avoid skin incisions and minimize the surgical morbidity. Transnasal endoscopic procedures for the closure of small and large skull base defects have proven to be reliable and more successful than operations with craniotomies. The development of new local and regional vascularized flaps like the Hadad-flap have contributed to this. These reconstructive techniques are furthermore effectively utilized in tumor surgery in this region. This review delineates the classification of expanded endonasal approaches in detail. They provide access to lesions of the anterior, middle and partly also to the posterior cranial fossa. Successful management of these complex procedures requires a close interdisciplinary collaboration as well as continuous education and training of all team members.
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10.3205/cto000081
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pubmed_1111_10965
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Alpha-hexabromocyclododecane (α-HBCD) is an emerging persistent organic pollutant present in the hexabromocyclododecane (HBCD) commercial mixture. HBCD is used as an additive flame retardant in a wide variety of household consumer products. Three main stereoisomers, alpha (α), beta (β), and gamma (γ), comprise roughly 10, 10, and 80% of the mixture, respectively. Despite its small contribution to HBCD global production and usage, α-HBCD is the major stereoisomer found in wildlife and human tissues including breast milk and blood in North America, European Union, and Asia. No mammalian or human data are currently available regarding the toxicokinetics of α-HBCD. This study was conducted in an effort to fully characterize the absorption, distribution, metabolism, and elimination of α-HBCD following a single and repeated exposure with respect to dose, time, and route of administration in female C57BL/6 mice. Results indicate that ∼90% of the administered dose (3 mg/kg) was absorbed after oral exposure. Disposition was (1) dictated by lipophilicity, as adipose, liver, muscle, and skin were major depots and (2) was dose dependent with nonlinear accumulation at higher doses. Elimination, both whole-body and from individual tissues, was biphasic. α-HBCD-derived radioactivity was excreted in the feces as parent and metabolites, whereas urine only contained metabolites. Presence of polar metabolites in the blood and urine were a major factor in determining the rapid initial whole-body half-life after a single oral exposure. Initial half-lives were ∼1-3 days and much longer terminal half-lives of 17 days were observed, suggesting the potential for α-HBCD bioaccumulation. A 10-day repeated study supports α-HBCD bioaccumulation potential. Stereoisomerization previously observed after exposure to γ-HBCD was not seen after exposure of α-HBCD. The toxicokinetic behavior reported here has important implications for the extrapolation of toxicological studies of the commercial HBCD mixture to the assessment of risk of α-HBCD which is the major stereoisomer found in wildlife and people.
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10.1093/toxsci/kfr059
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pubmed_901_11760
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Two penicillins and 5 cephalosporins were evaluated for their ability to pass through the outer-membranes of Proteus morganii, Citrobacter freundii and Escherichia coli. Cefazolin, ceftezole and cephaloridine showed high permeability through the outer-membranes of these Gram-negative bacteria. Benzylpenicillin and cephalothin, on the contrary, showed low permeability. The outer-membrane permeability of ampicillin and cephalexin varied from species to species. C. freundii was found to have the highest barrier against both the penicillins and the cephalosporins, and E. coli appeared to have a low barrier against the cephalosporins. The hydrophobic character of the beta-lactam antibiotics, which was estimated by a reversed-phase thin-layer chromatography was closely related to the outer-membrane permeability. In general, the more hydrophilic antibiotic showed the higher outer-membrane permeability. However, cephaloridine, the most lipophilic compound among the antibiotics tested, showed good permeability.
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10.7164/antibiotics.32.59
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pubmed_512_16192
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Five novel 1H-pyrrolo[2,3-b]pyridine or 1H-pyrazolo[3,4-b]pyridine derivatives, with a methylene, sulfur, sulfoxide or cyclopropyl group as a linker, were designed, synthesized and biologically evaluated against c-Met and ALK. The development of these methods of compound synthesis may provide an important reference for the construction of novel 7-azaindole and 7-azaindazole derivatives with a single atom linker. The enzyme assay and cell assay in vitro showed that compound 9 displayed strong c-Met kinase inhibition with IC50 of 22.8nM, moderate ALK kinase inhibition, and strong cell inhibition with MKN-45 IC50 of 329nM and EBC-1 IC50 of 479nM. In order to find the better candidate compounds, compounds 8, 9 and 10 have been selected as tool compounds for further optimization.
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pubmed_512_16192
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pubmed_115_9039
|
A new lab-on-a-chip compatible binding assay platform is introduced. The platform combines dry-chemistry bioaffinity reagents and the recently introduced ArcDia TPX binding assay technique. The technique employs polymer microspheres as a solid phase reaction carrier, fluorescently labeled antibody conjugates, and detection of fluorescence emission from the surface of individual microspheres by two-photon excitation fluorescence. Signal response of the technique is independent of the reaction volume, thus the technique is particularly well suited for detection of bioaffinity reactions from miniature volumes. Performance of the new assay platform is studied by means of an immunometric assay of human alpha-fetoprotein (hAFP) in 384-plate format, and the results are compared to those of a corresponding wet-chemistry assay method. The results show that the ArcDia TPX detection technique can be combined with dry-chemistry reagents without compromises in assay performance. The microchip field has so far been characterized with a lack of microchip-compatible detection platforms which would allow cost-effective microchip design and sensitive bioaffinity detection. The presented detection technique is expected to provide a solution for this shortage.
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10.1039/b509333c
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pubmed_702_9392
|
PURPOSE
This study evaluated the effect of artificial saliva storage on the hardness, crack length, and fracture toughness of a glazed, polished, and bleached hydrothermal low-fusing glass-ceramic (Duceram LFC).
MATERIALS AND METHODS
Forty ceramic discs were constructed. The discs were assigned to four groups (n = 10) according to their surface finish: Gp1 -- Autoglaze, Gp2 -- Autoglaze/ground/diamond-polished, Gp3 -- Overglaze, Gp4 -- Overglaze/ground/diamond-polished. Each group was further divided into two subgroups forming eight total subgroups (n = 5). Subgroup A was unbleached; Subgroup B was bleached. Testing was performed before and after 21 days of artificial saliva storage. Data were presented as means and standard deviation (SD). ANOVA was used, along with Duncan's post hoc test for pairwise comparison between the means when ANOVA test was found significant (p< or = 0.05).
RESULTS
Surface treatments such as glazing, polishing, and bleaching, saliva storage, and the interaction between these variables had a statistically significant effect on mean values of microhardness, crack length, and fracture toughness of the specimens. There was a statistically significant increase in microhardness and fracture toughness mean values, while crack length values decreased after saliva storage. Polished specimens recorded the smallest crack lengths and fracture toughness, and highest hardness values before and after saliva storage. No difference in fracture toughness values was evident between glazed and polished specimens. Mean crack lengths decreased after saliva storage in all the tested specimens. Hardness values increased after saliva storage. The autoglazed group showed significantly higher fracture toughness, lower crack length, and microhardness than the overglazed group.
CONCLUSIONS
Surface finishing procedures and artificial saliva storage had a statistically significant effect on mean values of microhardness, crack length, and fracture toughness. This in vitro study suggests that fracture toughness of ceramics may be affected by different surface treatments such as glazing, polishing, bleaching, or a combination; however, in this study Duceram LFC proved its self-healing property after 3-week storage in artificial saliva.
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10.1111/j.1532-849X.2009.00448.x
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pubmed_310_21383
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Homeodomain proteins are a highly conserved class of DNA-binding proteins that are found in virtually every eukaryotic organism. The conserved mechanism that these proteins use to bind DNA suggests that there may be at least a partial DNA recognition code for this class of proteins. To test this idea, we have investigated the sequence-specific requirements for DNA binding and repression by the yeast alpha2 homeodomain protein in association with its cofactors, Mcm1 and Mata1. We have determined the contribution for each residue in the alpha2 homeodomain that contacts the DNA in the co-crystal structures of the protein. We have also engineered mutants in the alpha2 homeodomain to alter the DNA-binding specificity of the protein. Although we were unable to change the specificity of alpha2 by making substitutions at residues 47, 54, and 55, we were able to alter the DNA-binding specificity by making substitutions at residue 50 in the homeodomain. Since other homeodomain proteins show similar changes in specificity with substitutions at residue 50, this suggests that there is at least a partial DNA recognition code at this position.
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10.1074/jbc.M103097200
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pubmed_428_4354
|
To explore the effect of supplementing active peptide on recovering skeletal muscle injury after track and field exercises.
METHOD
choose 80 patients (contain teenagers) with skeletal muscle micro-injury after the track and field exercises from March 2015 to July 2016, divide them into two groups. Normal treatment of micro-injury of skeletal muscle is given to the control group while active peptide is supplemented to the experimental group based on normal treatment. Compare the two groups to find the differences in relevant indexes of skeletal muscle after track and field exercises.
RESULT
Patients with micro-injury of skeletal muscle after track and field exercises may have inflammation at the early stage, so they need a long time for recovery. Relevant indexes of the experimental group after the treatment of supplementing active peptide are better than those of the control group (P<0.05).
CONCLUSION
To supplement active peptide can promote the synthesis of protein, which is conducive to the recovery of micro-injury on skeletal muscle and reduce the extravasations of creatine kinase in the cell, so as to improve the patients' anti-fatigue ability and endurance level.
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pubmed_428_4354
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pubmed_1091_2293
|
BACKGROUND
Bona fide psychotherapy approaches are effective treatments for generalized anxiety disorder (GAD) compared to no-treatment conditions. Treatment manuals and protocols allow a relatively high degree of freedom for the way therapists implement these overall treatment packages and there is a systematic lack of knowledge on how therapists should customize these treatments. The present study experimentally examines two implementation strategies of customizing a bona fide psychotherapy approach based on a 16 session time-limited cognitive-behavioral therapy (CBT) protocol and their relation to the post-session and ultimate treatment outcomes.
METHODS
This trial contrasts two different implementation strategies of how to customize the in-session structure of a manual-based CBT-protocol for GAD. The patients will be randomly assigned to two implementation conditions: (1) a systematic focus on subtle changes lasting from 7 to 20 min at the check-in phase of every psychotherapy session and (2) a state-of-the-art (SOTA) check-in phase lasting several minutes mainly focused on the session goals. Potential therapist effects will be examined based on an ABAB crossed-therapist design. Treatment outcomes will be assessed at the following times: post-session outcomes, treatment outcome at post assessment and 6- as well as 12-month follow-up.
DISCUSSION
The proposed randomized clinical implementation trial addresses the clinically relevant question of how to customize a bona fide psychotherapy protocol experimentally contrasting two implementation strategies. Through the development and testing of the proposed implementation design, this trial has the potential to inform therapists about efficacious implementation strategies of how to customize a manual-based treatment protocol in respect to the timing of the in-session structure.
TRIAL REGISTRATION
This trial was registered at ClinicalTrials.gov ( NCT03079336 ) at March 14, 2017.
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10.1186/s12888-018-1666-2
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pubmed_768_14850
|
INTRODUCTION
The hypothesis derives from the field of female stress incontinence. Application of pressure on the anterior vaginal wall at midurethra with a hemostat restores the geometry of the vesicoureteral junction and continence.
METHODS
We applied unilateral midurethral pressure during a radiological investigation of a 15-year-old female patient who had undergone 2 surgeries for ureteric reflux.
RESULTS
On injection of the dye into the bladder, reflux was noted in the left ureter, and this disappeared within 2-3 seconds after pressure was applied on 2 successive occasions in the midurethral area of the vagina.
CONCLUSION
The hypothesis that a musculoelastic mechanism dependent on a competent pubourethral ligament may play a role in vesicoureteral valve closure appears to have been confirmed, at least in one case. Hopefully this observation will lead to further studies, and perhaps, new directions for therapy.
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10.5173/ceju.2012.01.art16
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pubmed_133_1934
|
OBJECTIVE
To assess the level of knowledge about hepatitis B of Vietnamese adolescents, a group at high risk for hepatitis B, and compare it to the knowledge of adolescents of other races and ethnicities.
METHODS
A sample of 2816 adolescents was surveyed in 1993 in 2 middle schools and 2 high schools in Worcester, Massachusetts, using a self-administered multilingual questionnaire.
RESULTS
Knowledge of hepatitis B was low overall. Vietnamese respondents were more likely than were other students to know that hepatitis B affects the liver (35.6% vs 22.6%). However, they were much less likely than were other students to correctly identify sex with an infected person as a risk factor for infection (13.7% vs 32. 8%). Independent predictors of this knowledge were: white race; older age; attending high school versus middle school; having been taught about hepatitis B in school; knowing the definition of hepatitis B; reporting better grades; having a family member with hepatitis B; and being more highly acculturated.
CONCLUSIONS
Adolescent knowledge about risk of infection was low in this study. Attention should be directed at providing health education on hepatitis B to adolescents, particularly to Vietnamese. Health care providers, community health educators, and others engaged in the effort to control and eradicate hepatitis B should be sensitive to the unique educational and cultural needs of high-risk southeast Asian adolescent populations.
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pubmed_133_1934
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pubmed_52_20436
|
For the pace of healthcare IT adoption to be accelerated, barriers such as the misalignment of financial incentives must be corrected. While adoption incentives are still in the formative stage, it is clear that mature incentives need to be sufficiently large to lead to adoption, emphasize outcomes rather than strictly use of IT, and require that hospitals put "skin in the game". Failure to develop these incentives will guarantee that the country will continue to experience low healthcare IT adoption rates. A collaborative effort by purchasers, providers, and government is the key to addressing the challenge of misaligned incentives.
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pubmed_52_20436
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pubmed_328_12294
|
Analysis of fluorescence fluctuation experiments by the mean-segmented Q (MSQ) method was recently used to successfully characterize the oligomeric state and mobility of proteins within the nuclear envelope (NE) of living cells. However, two significant shortcomings of MSQ were recognized. Non-ideal detector behavior due to dead-time and afterpulsing as well as the lack of error analysis currently limit the potential of MSQ. This paper presents time-shifted MSQ (tsMSQ), a new formulation of MSQ that is robust with respect to dead-time and afterpulsing. In addition, a protocol for performing error analysis on tsMSQ data is introduced to assess the quality of fit models and estimate the uncertainties of fit parameters. Together, these developments significantly simplify and improve the analysis of fluorescence fluctuation data taken within the NE. To demonstrate these new developments, tsMSQ was used to characterize the oligomeric state and mobility of the luminal domains of two inner nuclear membrane SUN proteins. The results for the luminal domain of SUN2 obtained through tsMSQ without correction for non-ideal detector effects agree with a recent study that was conducted using the original MSQ formulation. Finally, tsMSQ was applied to characterize the oligomeric state and mobility of the luminal domain of the germline-restricted SUN3.
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10.1016/j.ymeth.2018.09.008
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pubmed_1131_9268
|
BACKGROUND
Nodal skip metastasis (NSM) is common in esophageal carcinoma, even with different lymph node classification criteria. The prognostic impact of NSM in esophageal carcinoma has been unclear. Some studies found no impact on survival and others found a positive impact. This research was to further investigate the incidence of NSM in patients with thoracic esophageal squamous cell carcinoma (ESCC), and assess its prognostic value in thoracic ESCC.
METHODS
We retrospectively analyzed the clinical data of 340 consecutive patients with solitary lymph node metastasis who underwent esophagectomy with three-field lymph node dissection for ESCC at the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2013. The survivals of the patients with NSM or adjacent node metastasis were compared.
RESULTS
There were 216 patients with NSM, and 124 patients with adjacent node metastasis. The incidence of NSM in this cohort was 63.5%. No significant difference was found between the patients with NSM and the patients with adjacent node metastasis in age, sex, tumor location, pathologic T stage, histologic grade, tumor length, and the number of resected lymph nodes (all p > 0.05). Patients with NSM had 5-year cumulative survival of 29.2%, which was significantly worse than the 45.6% survival in those with adjacent node metastasis (p < 0.05).
CONCLUSION
In conclusion, NSM is associated with a relatively poor prognosis in thoracic ESCC.
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pubmed_1131_9268
|
pubmed_226_20682
|
Environmentally sustainable cement mortars containing wheat straw (Southern Italy, Apulia region) of different length and dosage and perlite beads as aggregates were prepared and characterised by rheological, thermal, acoustic, mechanical, optical and microstructural tests. A complete replacement of the conventional sand was carried out. Composites with bare straw (S), perlite (P), and with a mixture of inorganic and organic aggregates (P/S), were characterised and compared with the properties of conventional sand mortar. It was observed that the straw fresh composites showed a decrease in workability with fibre length decrease and with increase in straw volume, while the conglomerates with bare perlite, and with the aggregate mixture, showed similar consistency to the control. The thermal insulation of the straw mortars was extremely high compared to the sand reference (85-90%), as was the acoustic absorption, especially in the 500-1000 Hz range. These results were attributed to the high porosity of these composites and showed enhancement of these properties with decrease in straw length and increase in straw volume. The bare perlite sample showed the lowest thermal insulation and acoustic absorption, being less porous than the former composites, while intermediate values were obtained with the P/S samples. The mechanical performance of the straw composites increased with length of the fibres and decreased with fibre dosage. The addition of expanded perlite to the mixture produced mortars with an improvement in mechanical strength and negligible modification of thermal properties. Straw mortars showed discrete cracks after failure, without separation of the two parts of the specimens, due to the aggregate tensile strength which influenced the impact compression tests. Preliminary observations of the stability of the mortars showed that, more than one year from preparation, the conglomerates did not show detectable signs of degradation.
|
10.3390/ma15020453
|
pubmed_618_18115
|
This systematic review identifies the significance of the preceptor role in affecting new graduate nurse retention. Findings from 20 research studies provide support that nurse preceptors receiving continuing education and perceiving reward and recognition from the preceptor position positively affect new graduate nurse retention. Hospital administration, nurse managers, nurse educators, preceptors, and new graduate nurses each play a role in the successful implementation of a preceptor support system.
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10.1097/NND.0000000000000117
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pubmed_419_24814
|
Functional peptides, which are composed of proteinogenic natural amino acids, are expected to be used as biomaterials with minimal environmental impact. Synthesizing a functional peptide with a shorter amino acid sequence while retaining its function is a easy and economical strategy. Furthermore, shortening functional peptides helps to elucidate the mechanism of their functional core region. Truncated elastin-like peptides (ELPs) are peptides consisting of repetitive sequences, derived from the elastic protein tropoelastin, that show the thermosensitive formation of coacervates. In this study, to obtain shortened ELP analogues, we synthesized several (Phe-Pro-Gly-Val-Gly)n (FPGVG)n analogues with one or two amino acid residues deleted from each repeat sequence, such as the peptide analogues consisting of FPGV and/or FPG sequences. Among the novel truncated ELP analogues, the 16-mer (FPGV)4 exhibited a stronger coacervation ability than the 25-mer (FPGVG)5. These results indicated that the coacervation ability of truncated ELPs was affected by the amino acid sequence and not by the peptide chain length. Based on this finding, we prepared Cd2+-binding sequence-conjugated ELP analogue, AADAAC-(FPGV)4, and found that it could capture Cd2+. These results indicated that the 16-mer (FPGV)4 only composed of proteinogenic amino acids could be a new biomaterial with low environmental impact.
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10.1038/s41598-022-23940-0
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pubmed_613_3256
|
Flutamide (FLT) is a poorly soluble anticancer drug. Therefore, lyophilized dispersions (LDs) of FLT with polyvinylpyrrolidone (PVP) K30, polyethylene glycol (PEG) 6000, and pluronic F127 were prepared via lyophilization monophase solution technique with the aim of increasing its dissolution rate. FLT showed an A(L)-type phase solubility diagrams with PVP and PEG, whereas A(N)-type diagram was obtained with pluronic. The amount of residual tertiary butyl alcohol, determined by gas chromatography, was 0.015-0.021% w/w. Differential scanning calorimetry and X-ray diffractometry revealed that FLT-polymer 1:1 LDs were partially amorphous, whereas the 1:3 and 1:5 LDs were completely amorphous. After 6 months storage, polymers under study inhibited FLT recrystallization maintaining its amorphous form. The particle size of FLT-polymer LDs was between 0.81 and 2.13 μm, with a high surface area (268.43-510.82 m²/g) and porosity (354.01-676.23 e⁻³ mL/g). Also, the poor flow properties of FLT could be improved but to a limited extent. FLT dissolution was significantly enhanced with the fastest dissolution that was achieved using pluronic. After 30 min, about 66.52%, 78.23%, and 81.64% of FLT was dissolved from 1:5 FLT-PVP, PEG, and pluronic LDs, respectively, compared with only 13.45% of FLT. These data suggest that these polymers might be useful adjuncts in preparation and stabilization of amorphous immediate-release FLT LDs.
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10.3109/03639045.2010.539232
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pubmed_859_477
|
Non-small cell lung cancer (NSCLC) is one of the important causes of cancer-related mortality worldwide. Previous studies have demonstrated the crucial roles of mucosal-associated invariant T (MAIT) cells in regulating tumor immunity, while their roles in NSCLC remain largely unknown. The aim of this study is to evaluate clinical relevance of MAIT cells in blood and tumor tissues of patients with NSCLC. Here, we find that there is no significant difference in the frequency of circulating MAIT cells between NSCLC patients and healthy donors. However, the MAIT-frequency is significantly declined in lung tumor tissues compared to their peri-tumor counterparts, which relates to Tumor-Node-Metastasis (TNM) stage. The MAIT-frequency in lung tumor tissues is higher in node-negative patients compared to node-positive patients. Furthermore, tumor-infiltrating MAIT cells display a tissue-resident effector-memory phenotype and exhibit upregulated levels of exhaustion markers. The percentage of tissue-resident cells in MAIT tends to be higher in tumor tissues than in peri-tumor tissues. In addition, the percentage of IL-17A+ MAIT cells is significantly higher in lung tumor tissues than that in peri-tumor tissues. In summary, our results indicate the possible detrimental role of MAIT cells in the development and progression of NSCLC.
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10.1016/j.intimp.2022.109461
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pubmed_151_22029
|
Recent studies with children and adults have shown that the abilities of the Approximate Number System (ANS), which operates from early infancy and allows estimating the number of elements in a set without symbols, are trainable and transferable to symbolic arithmetic abilities. Here we investigated the brain correlates of these training effects, which are currently unknown. We trained two Groups of first grade children, one in performing nonsymbolic additions with dot arrays (Addition-Group) and another one in performing color comparisons of the same arrays (Color-Group). The training program was computerized, throughout seven sessions and had a pretest-posttest design. To evaluate cognitive gains, we measured math skills before and after the training. To measure the brain changes, we used electroencephalogram (EEG) recordings in the first and the last training sessions. We explored the changes in N1 and P2p, which are two electrophysiological components sensitive to nonsymbolic numeric computations. A passive Control-Group receiving no intervention also had their math skills evaluated. We found that the two training Groups had similarly gain in math skills, suggesting no specific transfer of the nonsymbolic addition training to math skills at the behavioral level. In contrast, at the brain level, we found that only in the Addition-Group the P2p amplitude significantly increased across sessions. Notably, the gain in P2p amplitude positively correlated with the gain in math abilities. Together, our results showed that first graders rapidly gained in math skills by different interventions. However, number-related brain networks seem to be particularly sensitive to nonsymbolic arithmetic training.
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10.3389/fnint.2018.00028
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pubmed_794_21278
|
Recent studies have provided molecular confirmation that a subset of yolk sac tumors is somatically derived. Somatically derived yolk sac tumors are typically diagnosed in older women and are often seen adjacent to epithelial proliferations (such as endometriosis or endometrioid carcinoma) with which they share mutations. Here, we present a case of a postmenopausal woman with a yolk sac tumor and endometriosis in the right ovary, endometriosis with glandular crowding and reactive changes in the left ovary, endometrial endometrioid carcinoma, and yolk sac tumor involving the serosa of the colon. Targeted next-generation sequencing of these five tumor components demonstrated identical mutations in PTEN (p.R130G), PIK3CA (p.G1049S), FGFR2 (p.S252W), and FBXW7 (p.R689Q), suggesting that all components arose from a common precursor. The endometrial endometrioid carcinoma harbored additional exclusive mutations involving PIK3CA (p.H1048R) and CTNNB1 (p.S37F).
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10.1097/PGP.0000000000000889
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pubmed_223_1717
|
Children of migrants develop and grow up with two languages, that of their family and that learnt at school, and within the two corresponding worlds. This transcultural situation entails a degree of vulnerability, and these children need to learn to reconcile the two worlds. In the setting of care, these different worlds and languages should be taken into account for what they are. This is an ethical requirement, and also a pragmatic approach, contributing to the efficacy of the care of these children. In this article we analyse the factors to take into account for all to provide adequate care for children of migrants, and we explore the modes of referral to specialised transcultural consultations if necessary.
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10.1016/S0038-0814(20)30056-6
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pubmed_200_14176
|
Multistage formation of fluoride upconversion agents from the related-semiconductor precursors provides a promising route for the fabrication of near-infrared (NIR) photocatalysts with high photocatalytic activities. Herein, the cotton templated CaTiO3 "semiconduction" precursors (C-CaTiO3) were used to synthesize the NIR photocatalyst of Er3+/Tm3+/Yb3+-(CaTiO3/CaF2/TiO2) (C-ETYCCT), and the functions of the Ca2+ source for CaF2 and the heterostructure formations were displayed by C-CaTiO3. The generated CaF2 acted as the host material for the lanthanide ions, and the heterostructures were constructed among anatase, rutile, and the remaining CaTiO3. The induced oxygen vacancies and Ti3+ ions enabled the samples to utilize most of the upconversion luminescence for photocatalysis. The NIR driven degradation rate of methyl orange (MO) over C-ETYCCT reached 52.34%, which was 1.6 and 2.5 times higher than those of Er3+/Tm3+/Yb3+-(CaTiO3/TiO2) (C-ETYCT) and Er3+/Tm3+/Yb3+-(CaTiO3/CaF2) (C-ETYCC), respectively. The degradation rates of MO and salicylic acid over C-ETYCCT with UV-vis-NIR light irradiation were also much higher than those of other samples, which were mainly results of the contributions of its high upconversion luminescence and the efficient electron-hole pair separation.
|
10.1021/acsami.5b05557
|
pubmed_30_1680
|
A consecutive series of 559 hospital survivors of acute myocardial infarction aged less than 66 years were studied; 93 were designated prospectively as low-risk because they were suitable for early submaximal exercise testing and had none of the following clinical or exercise test 'risk factors': (1) angina for at least one month prior to infarction; (2) symptomatic ventricular arrhythmias, or (3) recurrent ischaemic pain, both after the first 24 h of infarction; (4) cardiac failure; (5) cardiomegaly; and (6) an abnormal exercise test (angina, ST-depression or poor blood pressure response). Altogether 301 patients were exercised; their mortality over a median follow-up of 2.4 years was 10.2%, versus 24.6% in the 258 patients not exercised (P = 0.0005). Absence of clinical 'risk factors' alone, in the exercised patients, identified 156 with a mortality of 5.4% versus 15.6% in the 145 with at least one clinical 'risk factor' (P = 0.004). The fully defined low-risk group comprised 93 of the former patients who had neither clinical nor exercise test 'risk factors'. None of these patients died compared with 19 of those with at least one 'risk factor' (mortality = 14.7%; P = 0.002). Their respective rates of non-fatal reinfarction were similar and never exceeded 5% per annum. Therefore, simple clinical and exercise test criteria can positively identify low-risk patients after infarction in whom secondary prevention may be inappropriate.
|
10.1093/oxfordjournals.eurheartj.a062598
|
pubmed_486_2407
|
Acetaminophen (ACT) is commonly used as a counter painkiller and nowadays, it is increasingly present in the natural water environment. Although its concentrations are usually at the ppt to ppm levels, ACT can transform into various intermediates depending on the environmental conditions. Due to the complexity of the ACT degradation products and the intermediates, it poses a major challenge for monitoring, detection and to propose adequate treatment technologies. The main objectives of this review study were to assess (i) the occurrences and toxicities, (2) the removal technologies and (3) the transformation pathways and intermediates of ACT in four environmental compartments namely wastewater, surface water, ground water, and soil/sediments. Based on the review, it was observed that the ACT concentrations in wastewater can reach up to several hundreds of ppb. Amongst the different countries, China and the USA showed the highest ACT concentration in wastewater (≤300 μg/L), with a very high detection frequency (81-100%). Concerning surface water, the ACT concentrations were found to be at the ppt level. Some regions in France, Spain, Germany, Korea, USA, and UK comply with the recommended ACT concentration for drinking water (71 ng/L). Notably, ACT can transform and degrade into various metabolites such as aromatic derivatives or organic acids. Some of them (e.g., hydroquinone and benzoquinone) are toxic to human and other life forms. Thus, in water and wastewater treatment plants, tertiary treatment systems such as advanced oxidation, membrane separation, and hybrid processes should be used to remove the toxic metabolites of ACT.
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10.1016/j.chemosphere.2019.124391
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pubmed_777_14070
|
Development of allograft rejection continues to be the major determinant of morbidity and mortality postlung transplantation. We have recently demonstrated that a population of donor-derived mesenchymal stem cells is present in human lung allografts and can be isolated and expanded ex vivo. In this study, we investigated the impact of lung resident mesenchymal stem cells (LR-MSCs), derived from allografts of human lung transplant recipients, on T cell activation in vitro. Similar to bone marrow-derived MSCs, LR-MSCs did not express MHC II or the costimulatory molecules CD80 or CD86. In vitro, LR-MSCs profoundly suppressed the proliferative capacity of T cells in response to a mitogenic or an allogeneic stimulus. The immunosuppressive function of LR-MSCs was also noted in the absence of direct cell contact, indicating that LR-MSCs mediated their effect predominantly via a soluble mediator. LR-MSCs isolated from lung transplant recipients demonstrated PGE(2) secretion at baseline (385 +/- 375 pg/ml), which increased in response to IL-1beta (1149 +/- 1081 pg/ml). The addition of PG synthesis inhibitors (indomethacin and NS-398) substantially abrogated LR-MSC-mediated immunosuppression, indicating that PGE(2) may be one of the major soluble mediators impacting T cell activity. This is the first report to demonstrate that human tissue-derived MSCs isolated from an allogeneic environment have the potential to mediate immunological responses in vitro.
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10.4049/jimmunol.181.6.4389
|
pubmed_752_8754
|
Acinetobacter baumannii is a significant nosocomial pathogen often associated with extreme drug resistance (XDR). In Argentina, isolates of A. baumannii resistant to tetracyclines have accounted for more than 40% of drug-resistant isolates in some hospitals. We have previously reported the dispersion of the tet(B) resistance element associated with the ISCR2 transposase in epidemiologically unrelated A. baumannii isolates recovered from 1983 to 2011. This study extends this surveillance to 77 recent (2009-2013) XDR A. baumannii isolates with different levels of minocycline susceptibility. Isolates were examined by a pan-PCR assay, which showed six different amplification patterns, and specific PCRs were used for the confirmation of the the ΔISCR2-tet(B)-tet(R)-ISCR2 element. The tet(B) gene was present in 66 isolates and the ISCR2 element in 68 isolates; the tet(B) gene was associated with ISCR2 in all tet(B)-positive isolates. We conclude that this element is widespread in XDR A. baumannii isolates from Argentina and could be responsible for the emergence of tetracycline resistance in recent years.
|
10.1017/S0950268815002897
|
pubmed_335_22638
|
Non-reciprocal devices, which allow non-reciprocal signal routing, serve as fundamental elements in photonic and microwave circuits and are crucial in both classical and quantum information processing. The radiation-pressure-induced coupling between light and mechanical motion in travelling-wave resonators has been exploited to break the Lorentz reciprocity, enabling non-reciprocal devices without magnetic materials. Here, we experimentally demonstrate a reconfigurable non-reciprocal device with alternative functions as either a circulator or a directional amplifier via optomechanically induced coherent photon-phonon conversion or gain. The demonstrated device exhibits considerable flexibility and offers exciting opportunities for combining reconfigurability, non-reciprocity and active properties in single photonic devices, which can also be generalized to microwave and acoustic circuits.
|
10.1038/s41467-018-04187-8
|
pubmed_301_11903
|
Schwann cells aid in neuronal regeneration in the peripheral nervous system via guiding the regrowth of axons. In this study, we investigated the magnetic orientation of Schwann cells, and of a mixture of Schwann cells and collagen, after an 8-tesla magnetic field exposure. We obtained cultured Schwann cells from dissected sciatic nerves of neonatal rats. After 60 h of magnetic field exposure, Schwann cells oriented parallel to the magnetic fields. In contrast, the mixture of Schwann cells and collagen, Schwann cells oriented in the direction perpendicular to the magnetic field after 2 h of magnetic field exposure. In this case, Schwann cells aligned along the collagen fiber oriented by magnetic fields. The magnetic control of Schwann cell alignment is useful in medical engineering applications such as nerve regeneration.
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10.1016/s0304-3940(03)00719-5
|
pubmed_339_23502
|
This analytic (phase II) study aimed to investigate the hypothesis that the decline in serum melanoma-inhibiting activity (MIA) levels following initiation of treatment might have prognostic value. The mean serum lactate dehydrogenase (LDH), MIA and S100 levels in patients with malignant melanoma before treatment were higher than in the control group. Patients with visceral dissemination had much higher mean serum MIA levels than patients with nodal spread only. A regression model was constructed to analyse the prognostic factors in patients with advanced stage malignant melanoma. Therapy included surgical excision or lymph node dissection, hypofractionated radiotherapy, and immunotherapy or chemotherapy. Blood samples were collected within 24 h before the initiation of systemic treatment and two or three times more at 20-28 day intervals. Overall survival was investigated by univariate analysis, and correlation with clinical factors was compared using the log-rank test. Gender, primary tumour site, surgery, radiation therapy, serum S100 levels before systemic treatment and choice of chemotherapy were not correlated with the outcome. In addition to the stage of disease, low serum LDH levels before systemic treatment and a decline in serum MIA levels following initiation of systemic treatment predicted a favourable outcome. Metastasis to visceral organs was associated with higher serum MIA levels. Persistence of high serum MIA levels despite systemic treatment predicts an unfavourable prognosis.
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10.1097/00008390-200112000-00009
|
pubmed_595_11858
|
Many physiological functions rely on the precise maintenance of body calcium (Ca2+) and magnesium (Mg2+) balance, which is tightly regulated by the concerted actions of intestinal absorption, renal reabsorption, and exchange with bone. The kidney plays an important role in the homeostasis of divalent ions. Most Ca2+ and Mg2+ reabsorption occurs in the proximal tubules and the thick ascending limb of Henle's loop via a passive paracellular pathway. At the level of the distal convoluted tubule (DCT) and the connecting tubule (CNT), Ca2+ and Mg2+ are reabsorbed via an active transcellular route. Reabsorption of divalents in these latter segments is regulated in a Ca2+ and Mg2+-specific manner and determines the final excretion in the urine. Importantly, genetic studies, as well as molecular cloning strategies, recently identified epithelial ion channels as the gatekeepers of active Ca2+ and Mg2+ reabsorption. These channels are members of the transient receptor potential (TRP) superfamily. TRP vanilloid 5 (TRPV5) is responsible for the rate-limiting Ca2+ entry, and TRP melastatin 6 (TRPM6) constitutes the apical entry step in Mg2+ reabsorption. Dysregulation or malfunction of these influx pathways has been associated with renal Ca2+ and Mg2+ wasting. This review updates the current knowledge and the recent advances of Ca2+ and Mg2+ reabsorption and related disorders.
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10.1053/j.ackd.2006.01.002
|
pubmed_848_4271
|
The in vitro hydrolysis of two new classes of steroid acid esters synthesized from prednisolone as local anti-inflammatory steroids was investigated in rat, rabbit, and human plasma. One class was synthesized by incorporating methoxycarbonyl groups at the 16 position of prednisolone to produce 16 alpha-methoxycarbonyl prednisolone (P16CM) and its 17-deoxy analogue (DP16CM). The other class was synthesized by modifying the ketol side chain of prednisolone to produce methyl 20 alpha- and methyl beta-dihydroprednisolonate (P4 alpha and P4 beta). The P16CM and P4 beta were rapidly and completely hydrolyzed within 1 h of incubation in rat and rabbit plasma and within 4 h in human plasma. There was a marked species difference in the hydrolysis of DP16CM which occurred in the following order: rat greater than human greater than rabbit. The in vitro hydrolysis of P4 alpha was much slower than that of P4 beta; the process continued over 24 h in rat plasma. As expected, no change in the initial concentration of prednisolone was found over 120 h of incubation in rat plasma. This marked species difference in the hydrolysis of these steroid acid esters is probably related to the differences in the amounts, types, and activities of the hydrolyzing enzymes (e.g., esterases) in the plasma of the three species. From this study it can be concluded that the existence of an hydroxyl group at C-17 and the orientation of hydroxyl groups at C-20 play an important role in the systemic hydrolysis rate of the carboxy ester group on the steroid nucleus.
|
10.1002/jps.2600791015
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pubmed_22_3559
|
A patient in his 70s was diagnosed with sigmoid colon cancer[pT3pN1cM1(PUL1), pStage IV ]for which he underwent sigmoid colectomy and received S-1 adjuvant therapy for the lung metastases. The patient received a total of 10 courses of S- 1, administered orally on days 1-14 of a 21-day cycle. The lung metastases showed a complete response, and the patient completed the S-1 chemotherapy. No recurrence of lung metastases was detected up to 6 months later.
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pubmed_22_3559
|
pubmed_263_25665
|
Long-term treatment of Allium cepa seedlings with low concentration of hydroxyurea (HU) results in a disruption of cell cycle checkpoints, leading root apex meristem (RAM) cells to an abnormal organization of nuclear structures forming interphase (I) and mitotic (M) domains of chromatin at opposite poles of the nucleus. Thus far, both critical cell length and an uneven distribution of cyclin B-like proteins along the nuclear axis have been recognized as essential factors needed to facilitate the formation of biphasic interphase-mitotic (IM) cells. Two new aspects with respect to their emergence are investigated in this study. The first concerns a relationship between the polarity of increasing chromatin condensation (IM orientation) and the acropetal (base→apex) alignment of RAM cell files. The second problem involves the effects of auxin (IAA), on the frequency of IM cells. We provide evidence that there is an association between the advanced M-poles of the IM cell nuclei and the polarized accumulation sites of auxin efflux carriers (PIN2 proteins) and IAA. Furthermore, our observations reveal exclusion regions for PIN2 proteins in the microtubule-rich structures, such as preprophase bands (PPBs) and phragmoplast. The current and previous studies have prompted us to formulate a hypothetical mechanism linking PIN2-mediated unilateral localization of IAA and the induction of bipolar IM cells in HU-treated RAMs of A. cepa.
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pubmed_263_25665
|
pubmed_1032_5510
|
PURPOSE
To perform the final quality assurance of our fluoroscopic-based markerless tumor tracking for gated carbon-ion pencil beam scanning (C-PBS) radiotherapy using a rotating gantry system, we evaluated the geometrical accuracy and tumor tracking accuracy using a moving chest phantom with simulated respiration.
METHODS
The positions of the dynamic flat panel detector (DFPD) and x-ray tube are subject to changes due to gantry sag. To compensate for this, we generated a geometrical calibration table (gantry flex map) in 15° gantry angle steps by the bundle adjustment method. We evaluated five metrics: (a) Geometrical calibration was evaluated by calculating chest phantom positional error using 2D/3D registration software for each 5° step of the gantry angle. (b) Moving phantom displacement accuracy was measured (±10 mm in 1-mm steps) with a laser sensor. (c) Tracking accuracy was evaluated with machine learning (ML) and multi-template matching (MTM) algorithms, which used fluoroscopic images and digitally reconstructed radiographic (DRR) images as training data. The chest phantom was continuously moved ±10 mm in a sinusoidal path with a moving cycle of 4 s and respiration was simulated with ±5 mm expansion/contraction with a cycle of 2 s. This was performed with the gantry angle set at 0°, 45°, 120°, and 240°. (d) Four types of interlock function were evaluated: tumor velocity, DFPD image brightness variation, tracking anomaly detection, and tracking positional inconsistency in between the two corresponding rays. (e) Gate on/off latency, gating control system latency, and beam irradiation latency were measured using a laser sensor and an oscilloscope.
RESULTS
By applying the gantry flex map, phantom positional accuracy was improved from 1.03 mm/0.33° to <0.45 mm/0.27° for all gantry angles. The moving phantom displacement error was 0.1 mm. Due to long computation time, the tracking accuracy achieved with ML was <0.49 mm (=95% confidence interval [CI]) for imaging rates of 15 and 7.5 fps; those at 30 fps were decreased to 1.84 mm (95% CI: 1.79 mm-1.92 mm). The tracking positional accuracy with MTM was <0.52 mm (=95% CI) for all gantry angles and imaging frame rates. The tumor velocity interlock signal delay time was 44.7 ms (=1.3 frame). DFPD image brightness interlock latency was 34 ms (=1.0 frame). The tracking positional error was improved from 2.27 ± 2.67 mm to 0.25 ± 0.24 mm by the tracking anomaly detection interlock function. Tracking positional inconsistency interlock signal was output within 5.0 ms. The gate on/off latency was <82.7 ± 7.6 ms. The gating control system latency was <3.1 ± 1.0 ms. The beam irradiation latency was <8.7 ± 1.2 ms.
CONCLUSIONS
Our markerless tracking system is now ready for clinical use. We hope to shorten the computation time needed by the ML algorithm at 30 fps in the future.
|
10.1002/mp.13403
|
pubmed_822_912
|
Support for women during labor encompasses the continuous presence of a person who provides psychosocial, emotional, and physical support. Providing labor support to women in the intrapartum setting is a core midwifery competency and a clinical skill that midwifery students are expected to master. Instruction on labor support is a common objective in midwifery education intrapartum courses and skills labs, yet there is no standard for teaching this skill to midwifery students. Thus, in order to accomplish this objective, we created an interprofessional simulation on labor support that involves the use of a standardized patient, a written scenario, an interprofessional team of nursing and midwifery students, faculty observations, and a reflective debrief. The goals of the labor support simulation are to allow midwifery students the opportunity to practice intrapartum labor support techniques and interprofessional communication prior to entering the clinical setting. A postsimulation structured debrief allows for student learning and reflection. This article describes the design, planning, and implementation of this unique simulation experience. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
|
10.1111/jmwh.12373
|
pubmed_573_14085
|
We demonstrate coherent spectral beam combining and femtosecond pulse spectral synthesis using three parallel fiber chirped pulse amplifiers, each amplifying different ultrashort-pulse spectra. This proof-of-concept experiment opens a path to simultaneously overcome individual-amplifier energy and power limitations, as well as limitations on amplified pulse spectra due to the gain narrowing in a single fiber amplifier.
|
10.1364/OE.21.003897
|
pubmed_600_19334
|
Recent measurements of the positron energy spectrum obtained from inverse beta decay interactions of reactor electron antineutrinos show an excess in the 4 to 6 MeV region relative to current predictions. First-principles calculations of fission and beta decay processes within a typical pressurized water reactor core identify prominent fission daughter isotopes as a possible origin for this excess. These calculations also predict percent-level substructures in the antineutrino spectrum due to Coulomb effects in beta decay. Precise measurement of these substructures can elucidate the nuclear processes occurring within reactors. These substructures can be a systematic issue for measurements utilizing the detailed spectral shape.
|
10.1103/PhysRevLett.114.012502
|
pubmed_82_6719
|
OBJECTIVE
The purpose of this study was to examine the delayed effects of antivascular endothelial growth factor treatment on tumor growth and vascularity in a subcutaneous mouse tumor model of human glioblastoma.
METHODS
Antivascular endothelial growth factor antibody treatment was administered for a period of 6 weeks, to suppress tumor growth. To detect late vascular effects, tumor vascular parameters for treated tumors and control tumors were analyzed 4 weeks thereafter. By that time, tumors had grown to adequate sizes (diameter, 8-10 mm) for comparison with untreated control tumors. Vascular parameters were quantified by using an image-analysis system.
RESULTS
Vascular density was significantly lower in antivascular endothelial growth factor antibody-treated tumors, compared with control tumors of similar size. The vascular architecture of treated tumors was also distinctly different, compared with control tumors, showing larger but sparser vessel structures.
CONCLUSION
These findings suggest that antiangiogenic therapy may have a prolonged effect on the vascular architecture of certain tumors, resulting in enduring changes in the tumor vessels. Because tumor vasculature plays an important role in the sensitivity to various treatment modalities, these changes are likely to influence the responses of these tumors to further therapy.
|
10.1097/00006123-199809000-00094
|
pubmed_885_21577
|
We use umbrella sampling Monte Carlo and forward and reverse forward flux sampling (FFS) simulation techniques to compute the free energy barriers to evaporation of water confined between two hydrophobic surfaces separated by nanoscopic gaps, as a function of the gap width, at 1 bar and 298 K. The evaporation mechanism for small (1 × 1 nm(2)) surfaces is found to be fundamentally different from that for large (3 × 3 nm(2)) surfaces. In the latter case, the evaporation proceeds via the formation of a gap-spanning tubular cavity. The 1 × 1 nm(2) surfaces, in contrast, are too small to accommodate a stable vapor cavity. Accordingly, the associated free energy barriers correspond to the formation of a critical-sized cavity for sufficiently large confining surfaces, and to complete emptying of the gap region for small confining surfaces. The free energy barriers to evaporation were found to be of O(20kT) for 14 Å gaps, and to increase by approximately ~5kT with every 1 Å increase in the gap width. The entropy contribution to the free energy of evaporation was found to be independent of the gap width.
|
10.1021/jp308362h
|
pubmed_242_925
|
OBJECTIVE
To investigate whether workplace exposures to recognized lymphohematopoietic carcinogens were possibly related to cancers in six semiconductor-manufacturing workers.
METHODS
A job-exposure matrix was developed for chemical and physical process agents and anticipated by-products. Potential cumulative occupational exposures of the six cases were reconstructed. The role of workplace exposures in cancer was evaluated through quantitative risk assessment and by comparison with epidemiological literature.
RESULTS
Two workers were potentially exposed to agents capable of causing their diagnosed cancers. Reconstructed exposures were similar to levels in outdoor environments and lower than exposures associated with increased risks in epidemiological studies. Cancer risks were estimated to be less than 1 in 10,000 persons.
CONCLUSIONS
The development of cancer among the six workers was unlikely to be explained by occupational exposures to recognized lymphohematopoietic carcinogens.
|
10.1097/JOM.0000000000000413
|
pubmed_842_14762
|
BACKGROUND
Caudal anaesthesia is recommended for most surgical procedures of the lower part of the body, mainly below the umbilicus. It has been well established that a dorsal penile nerve block immediately after surgery decreases postoperative pain in children undergoing hypospadias repair. This study aimed to compare caudal or penile nerve block using bupivacaine in postoperative pain control in hypospadias repair in children.
PATIENTS AND METHODS
After local ethical committee approval and obtaining informed parental consent, 85 American society of Anesthesiologists status I and II patients, aged 6 months to 6 years old, undergoing hypospadias repair, were prospectively enrolled in this study. The patients were randomly divided into the following two groups: Caudal block was performed in 44 and penile block was performed in 41 patients. Cardiorespiratory systems data, analgesic requirement and complications were compared between the groups.
RESULTS
There were statistically significant haemodynamic (blood pressure and heart rate) alteration during operation in each group (P<0.01). The haemodynamic parameters were stable during operation in successful blocks in both groups. Caudal block success rate is 97.7%, whereas in penile block is 92.6%. Nineteen of 43 patients (44%) in caudal group and 29 of 41 patients (70%) in penile group received analgesia in the postoperative period and this difference was significant between the two groups (P = 0.025).
CONCLUSIONS
Without ultrasonography and with blind block, with anatomic landmarks only, the caudal block success rate is high and if there is no contraindication for caudal block, it is the best choice in children under 6 years old (or 25 kg) for hypospadias repair.
|
10.4103/0189-6725.91673
|
pubmed_93_18506
|
BACKGROUND
Coagulation disorders are frequently diagnosed, especially in hospitalized equidae, and result in increased morbidity and mortality. However, hemostatic reference intervals have not been established for donkeys yet.
OBJECTIVES
To determine whether the most common coagulation parameters used in equine practice are different between healthy donkeys and horses.
ANIMALS
Thirty-eight healthy donkeys and 29 healthy horses.
METHODS
Blood samples were collected to assess both coagulation and fibrinolytic systems by determination of platelet count, fibrinogen concentration, clotting times (prothrombin time [PT] and activated partial thromboplastin time [aPTT]), fibrin degradation products (FDP) and D-Dimer concentrations.
RESULTS
PT and aPTT in donkeys were significantly (P < .05) shorter than those of horses. In contrast, FDP and D-Dimer concentrations were significantly (P < .05) higher in donkeys than in horses.
CONCLUSIONS AND CLINICAL IMPORTANCE
The coagulation parameters most commonly determined in equine practice are different in donkeys compared with horses. Thus, the use of normal reference ranges reported previously for healthy horses in donkeys might lead to a misdiagnosis of coagulopathy in healthy donkeys, and unnecessary treatments in sick donkeys. This is the first report of normal coagulation profile results in donkeys, and further studies are warranted to elucidate the physiological mechanisms of the differences observed between donkeys and horses.
|
10.1111/j.1939-1676.2011.0748.x
|
pubmed_1063_23765
|
Functional studies suggest that promoter polymorphisms of the Prostaglandin D Receptor (PTGDR) gene can be involved in asthma. All-trans Retinoic acid (ATRA) has also been linked to allergic diseases. We have previously described the PTGDR promoter activation mediated by ATRA through response elements (RARE) at position -549T> C. In this study we aimed to analyze the effect of retinoic acid (RA) on the expression of PTGDR, the production of cytokines as well as to evaluate the binding of RA receptors to RA-Response Elements (RARE) sequences. A549 cells were transfected with vectors carrying different PTGDR haplotypes and treated with all-Trans Retinoic Acid (ATRA). PTGDR expression was measured by qPCR. Chromatin Immunoprecipitation assays (ChIP) were performed in ATRA stimulated KU812 cells and in PBMCs of patients carrying CTCT, CCCC or CCCT haplotypes. In addition, a broad panel of cytokines was analyzed by cytometric bead assay in A549 cells. The expression of PTGDR increased in A549 cells transfected with PTGDR-variants. The CCCC haplotype showed a significantly higher expression compared with CTCT. However, we found that RA up-regulated PTGDR expression through RARα mainly in the CTCT variant. Experiments on PBMCs from allergic patients carrying the -549T and -549C variant of the PTGDR promoter after ATRA and RAR antagonist administration confirmed the modulation of PTGDR by ATRA. The cytokine analysis showed that IL4 and IL6 levels were significantly increased in A549 cells transfected with PTGDR. In addition, ATRA treatment decreased the levels of IL4, IL6 and TNFα in A549 cells, whereas it increased IL4 and TNFα levels in PTGDR-transfected cells. We observed genetic differences in the regulation of PTGDR by ATRA that could contribute to the phenotypic differences observed in allergic patients. Our findings showed that RAR modulation by PTGDR might have an impact on Th2 responses, suggesting that RAR could be a potential therapeutic target in allergic inflammation.
|
10.1371/journal.pone.0215086
|
pubmed_541_10819
|
Denervation of skeletal muscle alters the expression of many genes, which may be important for establishing optimal conditions for reinnervation. Using the differential display technique we have attempted to discover neurally regulated genes in skeletal muscle. An mRNA that is up-regulated in denervated hind limb muscle was identified and cloned. The cDNA encodes an RNA-binding protein, which was discovered during the course of this work to be a nucleolar protein interacting with the fork-head associated domain of the proliferation marker protein Ki-67, and named NIFK. We show that the nifk gene is widely expressed in adult mouse tissues and that the expression is up-regulated in denervated hind limb muscle. No difference between expression in perisynaptic and extrasynaptic portions of muscle was observed. The widespread expression in adult tissues suggests that the NIFK protein has other functions in addition to its interaction with Ki-67, which is only expressed in proliferating cells.
|
10.1016/s1065-6995(03)00038-6
|
pubmed_476_11405
|
Overstated generalizability (external validity) is common in research. It may coexist with inflation of the magnitude and statistical support for effects and dismissal of internal validity problems. Generalizability may be secured before attempting replication of proposed discoveries or replication may precede efforts to generalize. These opposite approaches may decrease or increase, respectively, the use of inferential statistics with advantages and disadvantages.
|
10.1017/S0140525X21000054
|
pubmed_1096_14402
|
Cancer stem cells (CSCs) with enhanced tumorigenicity and chemoresistance are believed to be responsible for treatment failure and tumor relapse in ovarian cancer patients. However, it is still unclear how CSCs survive DNA-damaging agent treatment. Here, we report an elevated expression of DNA polymerase η (Pol η) in ovarian CSCs isolated from both ovarian cancer cell lines and primary tumors, indicating that CSCs may have intrinsically enhanced translesion DNA synthesis (TLS). Down-regulation of Pol η blocked cisplatin-induced CSC enrichment both in vitro and in vivo through the enhancement of cisplatin-induced apoptosis in CSCs, indicating that Pol η-mediated TLS contributes to the survival of CSCs upon cisplatin treatment. Furthermore, our data demonstrated a depletion of miR-93 in ovarian CSCs. Enforced expression of miR-93 in ovarian CSCs reduced Pol η expression and increased their sensitivity to cisplatin. Taken together, our data suggest that ovarian CSCs have intrinsically enhanced Pol η-mediated TLS, allowing CSCs to survive cisplatin treatment, leading to tumor relapse. Targeting Pol η, probably through enhancement of miR-93 expression, might be exploited as a strategy to increase the efficacy of cisplatin treatment.
|
10.1073/pnas.1421365112
|
pubmed_758_12100
|
Cytokine flow cytometry (CFC) is a general term that applies to flow cytometric analysis of cells using anticytokine antibodies as markers of activation. The most common version of this technique is the intracellular staining of cytokines in cells that have been fixed and permeabilized after short-term in vitro activation. When used with specific antigens, this technique allows for the quantitation of rare populations of antigen-specific T cells. In this chapter, specific methodology for such intracellular staining is elaborated, with emphasis on the effects of variables such as sample type, antigens, activation conditions, sample processing, and data acquisition and analysis.
|
10.1385/1-59259-773-4:095
|
pubmed_241_18189
|
Recently, a highly sensitive assay (FREELITE) capable of measuring serum immunoglobulin-free light chains (FLC) was developed. An abnormal kappa/lambda ratio supports the presence of clonal plasma cell expansion. Using this assay, we measured serum and urine samples of 178 healthy volunteers, 184 patients with polyclonal gamma-globulinemia and 150 patients with monoclonal gamma-globulinemia. The diagnostic sensitivity of the FLC assays for monoclonal gammopathies was 88.0% and the specificity for healthy volunteers and polyclonal gammopathies was 96.1%. The minimal detection sensitivity of this assay for serum FLC was 0.3 mg/l and was greater than 100-fold more sensitive than serum protein electrophoresis (SPE). The combination of FLC with SPE and immunoelectrophoresis identified 99% of patients with monoclonal gammopathies. Effective treatment often leads to a more rapid reduction of the involved FLC level relative to the intact immunoglobulin or total light chain concentration because the half-life of FLC is <6 hours. These observations suggest that FREELITE is useful for diagnosis, disease monitoring and assessment of response to treatment in patients with monoclonal gammopathies such as multiple myeloma and AL amyloidosis.
|
pubmed_241_18189
|
pubmed_922_9587
|
Ocular infection due to microbial contamination is one of the main risks associated with the wearing of contact lens, which demands novel straightforward strategies to find reliable solutions. This contribution reports the preparation, characterization and biological evaluation of soft contact lenses (CL) releasing nitric oxide (NO), as an unconventional antibacterial agent, under daylight exposure. A tailored NO photodonor (NOPD) was embedded into commercial CL leading to doped CL with an excellent optical transparency (transmittance = 100%) at λ ≥ 450 nm. The NOPD results homogeneously distributed in the CL matrix where it fully preserves the photobehavior exhibited in solution. In particular, NO release from the CL and its diffusion in the supernatant physiological solution is observed upon visible light illumination. The presence of a blue fluorescent reporting functionality into the molecular skeleton of the NOPD, which activates concomitantly to the NO photorelease, allows the easy monitoring of the NO delivery in real-time and confirms that the doped CL work under daylight exposure. The NO photoreleasing CL are well-tolerated in both dark and light conditions by corneal cells while being able to induce good growth inhibition of Staphylococcus aureus under visible light irradiation. These results may pave the way to further engineering of the CL with NOPD as innovative ocular devices activatable by sunlight.
|
10.3390/ijms20153735
|
pubmed_681_10398
|
INTRODUCTION
We report on our results of MIVAT operations.
METHOD
Nineteen Patients including 15 females and 4 males were operated with MIVAT, corresponding to 11 % of all patients undergoing an operation for benign goitre in our hospital. A single node of the thyroid gland within 30 mm and enlargement of a thyroid lobe up to 25 ml were the selection criteria. The median age was 34 years (range 16-61). We performed 2 thyroidectomies, 6 Hartley-Dunhill resections, 9 hemihyroidectomies and 2 enucleations. Eighteen patients (95 %) were followed-up postoperatively. The median follow-up period was 8 months (range 1 -21).
RESULTS
The median operation time was 83 min (range 60-124). The median preoperative thyroid gland volume was 25 ml (range 10-54) measured by ultrasound. The resected thyroid tissue ranged from 12 to 51 g (median 29 g). A statistical significant difference (P = 0.04 paired t-test) between the preoperative and postoperative estimated serum-calcium levels (2.31 vs. 2.25 mM) was observed. But both parameters were inside the physiological range. Paresis of the recurrent laryngeal nerve was not observed. 89 % of the patients rated the postoperative cosmetic result as very good and all patients would prefer this operation procedure once again.
CONCLUSION
The MIVAT procedure is a safe operation also in small groups with excellent cosmetic results postoperatively and a high acceptance by the patients.
|
10.1055/s-2003-41392
|
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