Πληροφορίες

Η φωτογραφία μου
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com, https://plus.google.com/communities/115462130054650919641?sqinv=VFJWaER0c2NCRl9ERzRjZWhxQmhzY09kVV84cjRn , ,https://plus.google.com/u/0/+AlexandrosGSfakianakis , https://www.youtube.com/channel/UCQH21WX8Qn5YSTKrlJ3OrmQ , https://www.youtube.com/channel/UCTREJHxB6yt4Gaqs4-mLzDA , https://twitter.com/g_orl?lang=el, https://www.instagram.com/alexandrossfakianakis/,

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Τετάρτη, 12 Απριλίου 2017

Head, neck cancer screenings at Naval Hospital Camp Lejeune - Camp Lejeune Globe


Head, neck cancer screenings at Naval Hospital Camp Lejeune
Camp Lejeune Globe
Other types of tumors arising from the salivary glands in the face and neck, and the nose and sinus cavities are also included in this group. April is Head and Neck Cancer Awareness Month and Naval Hospital Camp Lejeune Ear, Nose, Throat Clinic is open ...

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Expression in Escherichia coli of cysteine protease inhibitors from cowpea (Vigna unguiculata): The crystal structure of a single-domain cystatin gives insights on its thermal and pH stability

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): José Edvar Monteiro Júnior, Napoleão Fonseca Valadares, Humberto D’Muniz Pereira, Fábio Henrique Dyszy, Antônio José da Costa Filho, Adriana Ferreira Uchôa, Adeliana Silva de Oliveira, Cristina Paiva da Silveira Carvalho, Thalles Barbosa Grangeiro
Two cysteine proteinase inhibitors from cowpea, VuCys1 and VuCys2, were produced in E. coli ArcticExpress (DE3). The recombinant products strongly inhibited papain and chymopapain as well as the midgut proteases from Callosobruchus maculatus larvae, a bruchid that uses cysteine proteases as major digestive enzymes. Heat treatment at 100°C for up to 60min or incubation at various pH values caused little reduction in the papain inhibitory activity of both inhibitors. Moreover, minor conformational variations, as probed by circular dichroism spectroscopy, were observed after VuCys1 and VuCys2 were subjected to these treatments. The crystal structure of VuCys1 was determined at a resolution of 1.95Å, revealing a domain-swapped dimer in the asymmetric unit. However, the two lobes of the domain-swapped dimer are positioned closer to each other in VuCys1 in comparison to other similar cystatin structures. Moreover, some polar residues from opposite lobes recruit water molecules, forming a hydrogen bond network that mediates contacts between the lobes, thus generating an extended open interface. Due to the closer distance between the lobes, a small hydrophobic core is also formed, further stabilizing the folded domain-swapped dimer. These structural features might account for the extraordinary thermal and pH stability of VuCys1.



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Characterisation of the fumarate hydratase repertoire in Trypanosoma cruzi

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Ricardo A.P. de Pádua, Ali Martin Kia, Antonio J. Costa-Filho, Shane R. Wilkinson, M. Cristina Nonato
Nifurtimox and benznidazole represent the only treatments options available targeting Chagas disease, the most important parasitic infection in the Americas. However, use of these is problematic as they are toxic and ineffective against the more severe stages of the disease. In this work, we used a multidisciplinary approach to characterise the fumarases from Trypanosoma cruzi, the causative agent of Chagas Disease. We showed this trypanosome expresses cytosolic and mitochondrial fumarases that via an iron-sulfur cluster mediate the reversible conversion of fumarate to S-malate. Based on sequence, biochemical properties and co-factor binding, both T. cruzi proteins share characteristics with class I fumarases, enzymes found in bacteria and some other protozoa but absent from humans, that possess class II isoforms instead. Gene disruption suggested that although the cytosolic or mitochondrial fumarase activities are individually dispensable their combined activity is essential for parasite viability. Finally, based on the mechanistic differences with the human (host) fumarase, we designed and validated a selective inhibitor targeting the parasite enzyme. This study showed that T. cruzi fumarases should be exploited as targets for the development of new chemotherapeutic interventions against Chagas disease.



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Role of the C-terminal and chitin insertion domains on enzymatic activity of endochitinase ChiA74 of Bacillus thuringiensis

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Estefania O. Juárez-Hernández, Luz E. Casados-Vázquez, Dennis K. Bideshi, R. Salcedo-Hernández, José E. Barboza-Corona
ChiA74 has modular structure that includes a secretion signal peptide (sp) sequence, and catalytic (CD), chitin insertion (CID), fibronectin type-III (FnIII) and chitin binding (CBD) domains. We described for the first time the existence of a putative CID in ChiA74. Mature ChiA74 lacking its sp sequence (rChiA74Δsp, ∼70kDa) and two truncated versions, rChiA74Δsp-60, rChiA74Δsp-50 lacking, respectively, CBD and CDB-FnIII were produced. rChiA74Δsp and rChiA74Δsp-60 are unstable and were processed to generate stable proteins of ∼50kDa. With colloidal chitin, rChiA74Δsp and rChiA74Δsp-50 had higher activity than rChiA74Δsp-60. rChiA74Δsp showed similar ability to bind chitin than rChiA74Δsp-50. The catalytic efficiencies (kcat/Km) of rChiA74Δsp and rChiA74Δsp-50 were higher, ∼ 21-fold than rChiA74Δsp-60, using chitin as the substrate. Optimal activity was detected at pH 7 and 40°C. Data suggest that the CBD in ChiA74 is important for binding to chitin, but not necessary as the presence of a CID together with the CD in a stable truncated version (i.e. ChiA74Δsp-50) has similar affinity and hydrolytic activity as the mature enzyme. The CID of ChiA74 showed identities of ∼ 55% with CIDs of other chitinases such as those from B. circulans and B. licheniformis, respectively, and conserved residues important for interacting with chitin.



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Characterizations and hepatoprotective effect of polysaccharides from Mori Fructus in rats with alcoholic-induced liver injury

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Xin Zhou, Qingfang Deng, Huaguo Chen, Enming Hu, Chao Zhao, Xiaojian Gong
Crude polysaccharides of Mori Fructus (MFPs) were found to have anti-inflammatory antioxidant, and immuno-enhancing activities. However, the structure of the polysaccharides was ambiguous and its holistic hepatic protection evaluation was defective. This study was conducted to illustrate the characterization of MFPs, and evaluate its hepatoprotective activities. The results found that MFPs contained 67.93±1.18% carbohydrates, 31.03±0.54% uronic acid, and little protein and sulfate. The average molecular weight was ranging from 112.2kDa to 181.9kDa. Monosaccharide component analysis indicated that MFPs was mainly composed of glucose, galacturonic acid, rhamnose and galactose. Both the acute and subacute alcoholic-induced liver injury animal models were adopted to evaluate the MFPs’s hepatoprotective activity. After administration of MFPs, both serological indexes (aspartate aminotransferase and alanine aminotransferase) and hepatic indicators (glutathione, superoxide dismutase, glutathione peroxidase and malondialdehyde) were improved by comparing with the non-MFPs group. The hepatic histopathology results also showed a prominent lipid degeneration and microvesicular steatosis attenuation in the MFPs groups. These outstanding hepatic protecting activities of MFPs might be related to its activation of ethanol dehydrogenase, elimination of free radicals and/or inhibition of lipid peroxidation capacities. MFPs could be important active substances for preventing and remedying liver injury.



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Optimization of Glycyrrhiza polysaccharide liposome by response surface methodology and its immune activities

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Yi Wu, Lei Yi, Entao Li, Youying Li, Yan Lu, Peijuan Wang, Honglei Zhou, Jiaguo Liu, Yuanliang Hu, Deyun Wang
Glycyrrhiza polysaccharide liposome (GPSL) was prepared by reverse-phase evaporation method and optimized with response surface methodology. As a result, the optimum preparation conditions were as follows: the ratio of soybean phosphatide to Glycyrrhiza polysaccharide (GPS) of 24:1, temperature of drug incubation of 46°C, the ultrasound time of 16min. Confirmation experiments and transmission electron micrograph (SEM) exhibited the entrapment efficiency of liposome as 78.33±0.25%, with spherical shape and uniform sizes. Furthermore, proliferation assay, allogeneic mixed lymphocyte reaction and supernatant cytokines of chBM-DCs were performed by MTT and ELISA methods to investigate the immune-modulating effects of GPSL and GPS. The results showed that GPSL could significantly promote the proliferation of immature chBM-DCs, enhance the ability of mature chBM-DCs to induce T-cell proliferation and modulate the mature chBM-DCs to secret cytokines such as IL-2, IFN-γ and IL-10. These evidences indicated that the immune-modulating activity of GPS was significantly improved after encapsulated with liposome.



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Sample letter of recommendation job



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LaTeX Templates » Awesome Resume/CV and Cover Letter

Collection of free Cover Letter Samples you can use to attach your resume or CV. The best cover letter writing guide, with examples and and professional tips.

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Writing the Thesis Statement Sentence

3. Creating a Thesis Statement & Outline is a thesis statement? A thesis statement is usually a sentence that states your argument to the reader.

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Seven Qualities of a Good Leader - GROCO

Leadership is an important aspect of almost any industry. Most people would often think that leadership is only important in industries that are related to business

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Bibliographical essay - mu

Bibliographic Essay on Pauline Cushman William J. Christen Material Published before 1893 Sarmiento published his 373 page book about her life within a year of

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Religious Liberty Essay Scholarship Contest | Baptist

Creative Communication Enter our writing contests. Students get published, win prizes, teachers earn school supplies

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SEAMCAT Download

ECO Frequency Information System. EFIS is the tool to fulfill EC Decision 2007/344/EC on the harmonised availability of information regarding spectrum use in Europe

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Proofreading Jobs Online -- Complete Beginner's Guide

: Polished Paper offers professional English language editing and proofreading services designed to meet all of your needs.

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Essay Writing Service For Smashing Performance

American University, Academic Support Center, Writing Lab, updated 2009 TEN STEPS FOR WRITING RESEARCH PAPERS There are ten steps involved in writing a research paper:

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SparkNotes: Hiroshima

John Hersey's 1946 piece exploring how six survivors experienced the atomic bombing of Hiroshima, Japan, and its aftermath.

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Detail essay on terrorism government

Terrorism essaysTerrorism is an international problem in This was a general agreement of the American government, Continue reading this essay Continue reading

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SparkLife – The Spark

How To Write a Thesis Statement What is a Thesis Statement? Almost all of us—even if we don’t do it consciously—look early in an essay for a one- or two

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Starbucks' New Strategy: 7-Step Plan For 5-Year Growth

Meet children where they are, as individuals and as a group Support each child in attaining challenging and achievable goals that contribute to his or her ongoing

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Economic Glossary - EconEdLink

Homework 2016 - 2017 School Year. Fitness for Life Make-up days - Friday during each lunch, Saturday morning at Wright Park. We will meet in front of the greenhouse

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Student Success Strategies: Dealing With an Initial Bad Grade

Sweating over another paper? You could be having fun instead. Order essay writing services here and become the real master of your time

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Constitution of the Republic of Ghana

I need some help with creating an appendix for my thesis. I have about 10 figures which need to be in the appendix. I have a good appendix with the following code

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Interactive CV - Robby Leonardi | hey@

A Day in the Life of a Front End Developer (An-Ni Wang)

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SparkNotes: The Crucible: Study Questions & Essay Topics

Suggested essay topics and study questions for Arthur Miller's The Crucible. Perfect for students who have to write The Crucible essays.

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SparkNotes: Melville Stories: Benito Cereno (Part I)

In Benito Cereno, the narrator is Amasa Delano, the captain of a Massachusetts whaling ship. When the story begins, Captain Delano and his ship, the Bachelor's

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Http:

This article originally appears in the May 2016 issue of ELLE, available digitally on April 5, on newsstands in select cities starting April 6, and nationwide on

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Factors affecting smartphone adoption for accessing information in medical settings

Abstract

Objectives

This study aimed to acquire knowledge about the factors affecting smartphone adoption for accessing information in medical settings in Iranian Hospitals.

Methods

A qualitative and quantitative approach was used to conduct this study. Semi-structured interviews were conducted with 21 medical residents and interns in 2013 to identify determinant factors for smartphone adoption. Afterwards, nine relationships were hypothesised. We developed a questionnaire to test these hypotheses and to evaluate the importance of each factor. Structural equation modelling was used to analyse the causal relations between model parameters and to accurately identify determinant factors.

Results

Eight factors were identified in the qualitative phase of the study, including perceived usefulness, perceived ease of use, training, internal environment, personal experience, social impacts, observability and job related characteristics. Among the studied factors, perceived usefulness, personal experience and job related characteristics were significantly associated with attitude to use a smartphone which accounted for 64% of the variance in attitude. Perceived usefulness had the strongest impact on attitude to use a smartphone.

Conclusion

The factors that emerged from interviews were consistent with the Technology Acceptance Model (TAM) and some previous studies. TAM is a reliable model for understanding the factors of smartphone acceptance in medical settings.



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Complement factor C4 activation in patients with hereditary angioedema

Publication date: Available online 12 April 2017
Source:Clinical Biochemistry
Author(s): Anne Aabom, Anette Bygum, Claus Koch
ObjectivesLow complement factor C4 is usually considered a valuable screening tool for patients with the potentially life-threatening Hereditary Angioedema with C1-inhibitor (C1-INH) deficiency (C1-INH-HAE). However, there are patients with C1-INH-HAE presenting with normal C4 levels. This means, that C1-INH-HAE may potentially be overlooked, if screening is performed only by measurement of C4. It has been suggested that measurement of C4 activation products is better suited to avoid false negative results. Our aim was to investigate whether total antigenic C4 or non-functional C4c is a better measure of the increased C4 activation in C1-INH-HAE patients.Design and methodsTwo different monoclonal antibodies (mAb) to human C4 were produced: one had specificity for the β-chain of C4 and would thus react with both functional and non-functional C4, and the other was developed against the factor I cleavage site on the α3-domain of C4 and was thus specific for activated, non-functional C4c. With these mAb we investigated plasma from 19 Danish C1-INH-HAE patients in three different enzyme-linked immunosorbent assays (ELISAs): a total antigenic C4 assay, a functional C4 assay and an assay measuring non-functional C4c.ResultsThe amount of total antigenic C4 varied considerably between patients and 2 patients had total antigenic C4 levels in the normal area. Functional C4 was low in all C1-INH-HAE patients. A C4c/C4 ratio showed that around half the C4 measured in patients was non-functional and captured all C1-INH-HAE patients.ConclusionsThis study shows that the C4c/C4 ratio seems to be a better diagnostic measure than total antigenic C4 alone. Our findings underline that screening with total antigenic C4 implies a risk of overlooking C1-INH-HAE patients.



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Paediatric Laboratory Medicine- some reflections on the sub-specialty

Publication date: Available online 11 April 2017
Source:Clinical Biochemistry
Author(s): V.L. Grey, T.P. Loh, M. Metz, T. Lang, M. Hersberger




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Effects of preanalytical factors on hemoglobin measurement: A comparison of two HemoCue® point-of-care analyzers

Publication date: Available online 12 April 2017
Source:Clinical Biochemistry
Author(s): Ralph D. Whitehead, Ming Zhang, Maya R. Sternberg, Rosemary L. Schleicher, Bakary Drammeh, Carine Mapango, Christine M. Pfeiffer
BackgroundIn field studies, hemoglobin (Hb) is often measured using a battery-operated, portable HemoCue® hemoglobinometer.MethodsWe compared the performance of 2 HemoCue® models (Hb-201+ and Hb-301) and investigated effects of preanalytical factors on Hb results by simulating unfavorable field conditions.ResultsThe Hb-301 produced 2.6% higher results compared to the Hb-201+. Hb had to be measured within 1min of filling the Hb-301 cuvette to avoid artificially elevated concentrations (1.3% per min). The Hb-301 cuvettes withstood elevated temperature (37°C) and humidity (72%) for 3weeks, while the Hb-201+ cuvettes degraded within 10min under those conditions. Both cuvette types withstood elevated temperature for 3weeks. Properly-collected venous and capillary blood produced comparable results. Pooled capillary blood produced comparable results to the second and third but not the fourth drop of blood (3.3% lower). Blood could be stored for ≤4days at 10–30°C before Hb-201+ measurement, but only for 1day at 10–23°C before Hb-301 measurement (≤1% change in Hb).ConclusionsHigher Hb results obtained with the Hb-301 may influence the interpretation of anemia prevalence in health surveys. While the Hb-301 performed better in high humidity conditions, the Hb-201+ provided more user flexibility regarding delayed Hb reading.



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Renal Cell Carcinoma Metastatic to the Gallbladder



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Flame Retardants Tied to Thyroid Cancer Risk - WebMD


YOU.co.za

Flame Retardants Tied to Thyroid Cancer Risk
WebMD
TUESDAY, April 11, 2017 (HealthDay News) -- Flame retardants used in many home furnishings may boost the risk for thyroid cancer, researchers report. "Thyroid cancer is the fastest increasing cancer in the U.S., with most of the increase in new cases ...
Fireproof chemicals in sofas linked to thyroid cancerYOU.co.za
Ask Dr. Nandi: Your sofa could be causing this cancerWXYZ

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Head, neck cancer screenings at Naval Hospital Camp Lejeune - Camp Lejeune Globe


Head, neck cancer screenings at Naval Hospital Camp Lejeune
Camp Lejeune Globe
Risk factors for head and neck cancer include tobacco use– both smoked and smokeless - and alcohol. Due to the overall decrease in smoking in the United States since the 1980s, the incidence of vocal cord (larynx) cancer has steadily decreased over the ...

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Antitumor activity and pharmacologic characterization of the depsipeptide analog as a novel HDAC/PI3K dual inhibitor

Abstract

Histone deacetylase (HDAC)/phosphatidylinositol 3-kinase (PI3K) dual inhibition is a promising strategy for the treatment of intractable cancers because of the advantages of overcoming potential resistance and exhibiting synergistic effects. Therefore, development of an HDAC/PI3K dual inhibitor is reasonably attractive. Romidepsin (FK228, depsipeptide) is a potent HDAC inhibitor. We have previously reported that depsipeptide and its analogs have an additional activity as PI3K inhibitors and are defined as HDAC/PI3K dual inhibitors. Subsequently, we identified FK-A11 as the most potent analog and reported its biochemical, biological, and structural properties as an HDAC/PI3K dual inhibitor. In this study, we demonstrated in vitro and in vivo efficacy of FK-A11 in HT1080 fibrosarcoma and PC3 prostate cancer cell xenograft mouse models. FK-A11 showed in vivo antitumor activity by both intravenous and intraperitoneal administration in a dose-dependent manner. In both xenograft models, FK-A11 showed superior antitumor effects compared to other depsipeptide analogs in accordance with in vitro anti-cell proliferation effects and the potency of HDAC/PI3K dual inhibition. In addition, we showed evidence of HDAC/PI3K dual inhibition accompanying antitumor efficacy in xenograft tumor tissues by immunohistochemistry. We also detailed pharmacokinetic characterization of FK-A11 in mice. These findings will be essential for guiding further preclinical and clinical studies.

This article is protected by copyright. All rights reserved.



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Anti-tumor effect of FAK inhibitor PF562271 against human osteosarcoma in vitro and in vivo

Abstract

Focal adhesion kinase (FAK) overexpression is related to the invasive and metastatic property in different kind of cancers. Target therapy by inhibiting FAK has achieved promising effect in some cancer treatment, but its effect in human osteosarcoma has not yet well studied. In present study, we analyzed the anti-tumor efficacy of PF562271, a FAK inhibitor, against osteosarcoma in vitro and vivo. p-FAK (Y397) was highly expressed in primary human osteosarcoma tumor samples and was associated with osteosarcoma prognosis and lung metastasis. PF562271 greatly suppressed the proliferation, colony formation in human osteosarcoma cell lines. In addition, treatment of osteosarcoma cell lines with PF562271 induced apoptosis and down-regulated the activity of AKT/mTOR pathway. Furthermore, PF562271 impaired tube formation ability of endothelial cells in vitro. Finally, oral administration of PF562271 in mice dramatically reduced tumor volume, weight and angiogenesis of osteosarcoma xenografts in vivo. These results indicate that FAK inhibitor PF562271 can potentially be effectively used for the treatment of osteosarcoma.

This article is protected by copyright. All rights reserved.



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Role of hepatic resection in patients with intermediate-stage hepatocellular carcinoma: a multicenter study from Japan

Summary

Transarterial chemoembolization (TACE) is recommended for patients with intermediate-stage (Barcelona Clinic Liver Cancer (BCLC) criteria B, BCLC-B) hepatocellular carcinoma (HCC). However, patients with BCLC-B HCC can differ in background factors related to hepatic function as well as tumor size and number. In the present study, we clarified the role of hepatic resection in patients with BCLC-B HCC. A total of 489 BCLC-B HCC patients with Child-Pugh class A disease initially treated with hepatic resection or TACE were included. In patients after propensity score matching (n=264), hepatic resection (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.35–0.91) was independently associated with survival in the multivariate analysis. We then divided patients into 2 groups based on the results of statistical analysis. There were 170 patients treated with resection and 319 with TACE. Child-Pugh score and number of tumors (cut-off, 3 tumors) were independently associated with type of HCC treatment in the multivariate analysis. We then divided patients in Group A (Child-Pugh score of 5 and ≤3 tumors; n=186) and Group B (Child-Pugh score of 6 or ≥4 tumors; n=303). In Group A, cumulative survival was significantly higher in the hepatic resection group than in the TACE group (p=0.014). In Cox proportional hazards models, hepatic resection (HR, 0.38; 95% CI, 0.23–0.64) was independently associated with survival in Group A patients. In Group B, treatment status was not associated with overall survival. Hepatic resection should be considered in patients with a Child-Pugh score of 5 and ≤3 tumors, despite having BCLC-B HCC.

This article is protected by copyright. All rights reserved.



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The nuclear 28S gene fragment D3 as species marker in oribatid mites (Acari, Oribatida) from German peatlands

Abstract

To make oribatid mites an applicable tool in monitoring programs it is necessary to find a molecular species marker that allows distinct, rapid and easy species identification. In previous studies, the common barcoding sequence COI showed to be too variable to serve as species marker in oribatid mites. The aim of the present study is to evaluate the potential use of the D3 region of the nuclear 28S rDNA gene for species identification. Therefore, we generated a reference DNA library of 28S D3 to identify specimens of the Oribatida from Germany, with focus on species occurring in peatlands being one of the most endangered habitats in Europe. New DNA sequences were obtained from 325 individuals and 64 species (58 genera, 34 families). By adding 28S D3-sequences from GenBank we altogether analysed 385 sequences from 89 German species, 32 of them restricted to peatlands and further 42 occurring in peatlands occasionally, representing 46 and 33% of the oribatids in German peatlands, respectively. P-distances were measured between species within families as well as for intraspecific divergence. 28S D3 showed low intraspecific genetic p-distances between 0 and 0.5%, interspecific distances within families varied between 0 and 9.7%. Most species pairs within families were further separated by one to four indels in addition to substitutions. Altogether, 93% of all analysed species are clearly delineated by 28S D3. Our study emphasises that 28S D3 rDNA is a useful barcode for the identification of oribatid mite specimens and represents an important step in building-up a comprehensive barcode library to allow metabarcoding analyses of environmental peatland samples for Oribatida in Germany as well as in Central Europe.



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Increased activities of peroxidase and polyphenol oxidase enhance cassava resistance to Tetranychus urticae

Abstract

In order to study the function of peroxidase (POD) and polyphenol oxidase (PPO) in cassava resistance to spider mites, we tested the changes of transcription levels and activities of these two protective enzymes in both cassava and Tetranychus urticae (=T. cinnabarinus) during the interaction. The results showed that after damage of the mite-susceptible cassava cultivar BRA900 by T. urticae for 1 and 8 days, the transcription levels of MePOD and MePPO and the activities of POD and PPO showed no significant difference compared with those in undamaged leaves. However, the corresponding transcription levels and activities in 1- and 8-day-damaged leaves of mite-resistant cassava cultivar C1115 increased to a significant level of approximately twofold. When T. urticae fed on BRA900 for 1 and 8 days, the transcription levels of TcPPO and TcPOD and the activities of PPO and POD showed no significant difference compared with those before feeding. However, the corresponding transcription levels and activities of these two protective enzymes in T. urticae feeding on C1115 significantly decreased by about half. This study preliminarily validates the function of POD and PPO in cassava resistance to T. urticae, and provides candidate gene resource for molecular breeding of spider mite-resistant cassava.



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Molecular and morphological identification of a human biting tick, Amblyomma testudinarium (Acari: Ixodidae), in Taiwan

Abstract

Genetic identity and morphological features of a human biting tick, Amblyomma testudinarium, were determined for the first time in Taiwan. Morphological features of adult male and female ticks of Am. testudinarium were observed and photographed by a stereo- microscope. The genetic identity was analyzed by comparing the sequences of mitochondrial 16S ribosomal DNA gene obtained from 18 strains of ticks representing 10 species of Amblyomma, and four outgroup species of Dermacentor and Rhipicephalus ticks. Nine major clades could be easily distinguished by neighbour-joining analysis and were congruent by maximum-parsimony method. All these Am. testudinarium ticks collected from Taiwan and Japan were genetically affiliated to a monophyletic group with highly homogeneous sequence (99.8–100% similarity), and can be discriminated from other species of Amblyomma and other genera of ticks (Dermacentor and Rhipicephalus) with a sequence divergence ranging from 6.9 to 23.9%. Moreover, intra- and inter-species analysis based on the genetic distance (GD) values indicated a lower level (GD < 0.003) within the same lineage of Am. testudinarium ticks collected from Taiwan and Japan, as compared with other lineage groups (GD > 0.108) of Amblyomma ticks, as well as outgroup (GD > 0.172) species. Our results provide the first distinguished features of adult Am. testudinarium ticks and the first genetic identification of Am. testudinarium ticks collected from humans in Taiwan. Seasonal prevalence, host range, and vectorial capacity of this tick species in Taiwan need to be further clarified.



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Acaricidal and sublethal effects of a Chenopodium -based biopesticide on the two-spotted spider mite (Acari: Tetranychidae)

Abstract

Acaricidal and sublethal effects of the biopesticide Requiem®EC (containing an essential oil extract of Chenopodium ambrosioides near ambrosioides) on the two-spotted spider mite, Tetranychus urticae Koch, were evaluated in laboratory bioassays. The biopesticide was applied to bean leaves or leaf discs using a Potter spray tower. Acaricidal activity against eggs and immatures was evaluated in successive acute toxicity bioassays. Concentration-mortality data were subjected to probit analysis and the following LC50 values (ml/l) were calculated: 2.47 (eggs), 0.71 (larvae), 1.13 (protonymphs), 2.23 (female deutonymphs), and 6.02 (female teleiochrysalises). In adult bioassay, in which pre-ovipositional females were treated with a series of concentrations (0.31–10 ml/l), a run-off effect ranging 4–80% (after 24 h) and 8–93% (after 72 h) was observed. In two-choice bioassay, T. urticae females preferred the untreated halves of leaves over the halves treated with 1.25–10 ml/l biopesticide and they laid significantly more eggs on the untreated halves in the first 24 h and summed over 72 h. The indices of repellency and oviposition deterence ranged 11.2–77.3 and 14.8–87.9%, respectively. In age-stage two-sex life table bioassay, the females that hatched from eggs treated with 2.5 ml/l biopesticide and reached adulthood on treated leaf surface showed a significantly reduced the intrinsic rate of increase (r = 0.222), compared to the control (r = 0.317). The reduction of population growth was mainly due to a reduced preadult survival rate (0.42 ± 0.04) and extended juvenile developmental time (9.27 ± 0.11 days), compared to the control (0.93 ± 0.03 and 7.70 ± 0.06 days, respectively).



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Estimating heat wave-related mortality in Europe using singular spectrum analysis

Abstract

Estimating the impact of heat waves on human mortality is key when it comes to the design of effective climate change adaptation measures. As the usual approach—relying on detailed health data in form of hospital records—is not feasible for many countries, a different methodology is needed. This work presents such an approach. Based on singular spectrum analysis and using monthly mortality rates—partly ranging back to 1960—it derives excess mortality estimates for 27 European countries. Excess mortality is then regressed against a heat wave measure in order to assess the health impacts of extreme heat. The analysis demonstrates that many European countries are severely affected by heat waves: On average, 0.61%—and up to 1.14% in case of Portugal—of all deaths are caused by extreme heat events. This finding confirms the understanding that climate change is a major environmental risk to public health: In the 27 examined European countries, over 28,000 people die every year due to exposure to extreme heat.



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Surgical Technique: Treatment of Distal Humerus Nonunions

Abstract

Background

Open reduction and internal fixation of distal humerus fractures is standard of care with good to excellent outcome for most patients. However, nonunions of the distal humerus still occur. These are severely disabling problems for the patient and a challenge for the treating physician. Fortunately, a combination of standard nonunion techniques with new plate designs and fixation methods allow even the most challenging distal humeral nonunion to be treated successfully.

Questions/Purposes

The purpose of this manuscript is to describe our current technique in treating distal humeral nonunion as it has evolved over the last four decades. We have now follow-up on 62 treated patients.

Methods

A few key steps are essential to obtain bone healing while regaining or preserving elbow motion. These include careful planning, extensile exposure, release of the ulnar nerve, capsular release and mobilization of the distal fragment, debridement, and finally stable fixation after alignment with application of bone graft.

Results

The vast majority of distal humeral nonunions can be treated successfully with open reduction and internal fixation.

Conclusion

Important components of the treatment plan are careful preoperative planning, extensile approach, debridement, and solid fixation with—locking—plates and liberal use of bone graft.



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Food labeling issues in patients with severe food allergies: solving a hamlet-like doubt.

Purpose of review: We review the laws on labeling in the international community, the difficulties they pose to the food manufacturers to prepare the food labels and the methodologies to determine the concentration of potential allergens in foods. Recent findings: European Food Safety Authority and International Life Sciences Institute Europe are evaluating strategies to identify the threshold level of allergen that can trigger a reaction in individuals. The most used techniques to detect the presence of protein in food are Enzyme-linked immunosorbent assay, polymerase chain reaction and real time polymerase chain reaction. Researchers are now trying to apply proteomics to estimate the amount of protein within the food. In order to protect the health of consumers, the Codex Alimentarius Commission updates constantly the list of allergens. In response to these regulations, some industries have also added some precautionary allergen labeling (PAL). It was generally agreed that PAL statements needed to be visible, simple, and safe. It was suggested that PAL be standardized, an action that would occur if the 'Voluntary Incidental Trace Allergen Labelling' process was made mandatory. Summary: So far, no laboratory technique is able to reassure the consumers about the composition of foods found on the packaging. International authorities produced increasingly stringent laws, but more is still to do. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Task-optimal auditory attention set restored as fast in older as in younger adults after distraction

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Publication date: Available online 12 April 2017
Source:Biological Psychology
Author(s): Márta Volosin, Zsófia Anna Gaál, János Horváth
The present study investigated how fast younger and older adults recovered from a distracted attentional state induced by rare, unpredictable sound events. The attentional state was characterized by the auditory N1 event-related potential (ERP), which is enhanced for sound events in the focus of attention. Younger (19-26 years) and older (62-74 years) adults listened to continuous tones containing rare pitch changes (glides) and short gaps. Glides and gaps could be separated in 150ms, 250ms, 650ms or longer and the task was gaps detection while ignoring glides. With longer glide-gap separations similar N1 enhancements were observable in both groups suggesting that the duration of the distracted sensory state was not affected by aging. Older adults responded, however, slower at short glide-gap separations which indicated that distraction at subsequent levels of processing may have nonetheless more impact in older than in younger adults.



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Hip and Knee Arthroplasty in Osteoarthritis

Opinion statement

Osteoarthritis (OA) of the hip and knee continues to increase in prevalence with the increasing age of our population. This condition is characterized by joint pain, stiffness, and limitations in activities of daily living. Management options are initially aimed at preventing the progression of disease and delaying the need for total joint arthroplasty (TJA). This includes nonoperative measures, as well as surgical interventions, including arthroscopy, osteotomy, and arthrodesis. However, once patients fail alternative therapy, TJA is indicated. Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are highly effective procedures at reducing pain and improving functional status. Patients report high satisfaction rates after TJA and experience minimal complications. Moreover, these procedures are cost effective. Significant research into patient-specific implants (PSI) and computer-navigation-assisted surgery shows improved component positioning; however, further research is needed to determine the clinical effect of this innovation. Wear rates in both TKA and THA have improved significantly over the past decade, with highly cross-linked ultra-high molecular-weight polyethylene showing promising results. New minimally invasive surgical techniques are also showing excellent short-term results, but long-term data is still lacking. Overall, hip and knee OA is a debilitating condition that can be effectively managed with TKA or THA. Indications continue to expand for these procedures and innovation continues to aim for improved outcomes.



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Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture [Research]

A single bout of low-frequency electroacupuncture (EA) causing muscle contractions increases whole-body glucose uptake in insulin-resistant rats. We explored the underlying mechanism of this finding and whether it can be translated into clinical settings. Changes in glucose infusion rate (GIR) were measured by euglycemic–hyperinsulinemic clamp during and after 45 min of low-frequency EA in 21 overweight/obese women with polycystic ovary syndrome (PCOS) and 21 controls matched for age, weight, and body mass index (experiment 1) and in rats receiving autonomic receptor blockers (experiment 2). GIR was higher after EA in controls and women with PCOS. Plasma serotonin levels and homovanillic acid, markers of vagal activity, decreased in both controls and patients with PCOS. Adipose tissue expression of pro-nerve growth factor (NGF) decreased, and the mature NGF/proNGF ratio increased after EA in PCOS, but not in controls, suggesting increased sympathetic-driven adipose tissue metabolism. Administration of α-/β-adrenergic receptor blockers in rats blocked the increase in GIR in response to EA. Muscarinic and dopamine receptor antagonist also blocked the response but with slower onset. In conclusion, a single bout of EA increases whole-body glucose uptake by activation of the sympathetic and partly the parasympathetic nervous systems, which could have important clinical implications for the treatment of insulin resistance.—Benrick, A., Kokosar, M., Hu, M., Larsson, M., Maliqueo, M., Marcondes, R. R., Soligo, M., Protto, V., Jerlhag, E., Sazonova, A., Behre, C. J., Højlund, K., Thorén, P., Stener-Victorin, E. Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture.



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Nuclear complex of glyceraldehyde-3-phosphate dehydrogenase and DNA repair enzyme apurinic/apyrimidinic endonuclease I protect smooth muscle cells against oxidant-induced cell death [Research]

Atherosclerotic plaque destabilization is the major determinant of most acute coronary events. Smooth muscle cell (SMC) death contributes to plaque destabilization. Here, we describe a novel antiapoptotic mechanism in vascular SMC that involves interaction of nuclear glyceraldehyde-3-phosphate dehydrogenase (GAPDH) with apurinic/apyrimidinic endonuclease 1 (Ape1), the major oxidized DNA repair enzyme. GAPDH down-regulation potentiated H2O2-induced DNA damage and SMC apoptosis. Conversely, GAPDH overexpression decreased DNA damage and protected SMCs against apoptosis. Ape1 down-regulation reversed the resistance of GAPDH-overexpressing cells to DNA damage and apoptosis, which indicated that Ape1 is indispensable for GAPDH-dependent protective effects. GAPDH bound Ape1 in the SMC nucleus, and blocking (or oxidation) of GAPDH active site cysteines suppressed GAPDH/Ape1 interaction and potentiated apoptosis. GAPDH up-regulated Ape1 via a transcription factor homeobox protein Hox-A5–dependent mechanism. GAPDH levels were reduced in atherosclerotic plaque SMCs and this effect correlated with oxidative stress and SMC apoptosis. Thus, we demonstrated that nuclear GAPDH/Ape1 interaction preserved Ape1 activity, reduced DNA damage, and prevented SMC apoptosis. Suppression of SMC apoptosis by maintenance of nuclear GAPDH/Ape1 interactions may be a novel therapy to increase atherosclerotic plaque stability.—Hou, X., Snarski, P., Higashi, Y., Yoshida, T., Jurkevich, A., Delafontaine, P., Sukhanov, S. Nuclear complex of glyceraldehyde-3-phosphate dehydrogenase and DNA repair enzyme apurinic/apyrimidinic endonuclease I protect smooth muscle cells against oxidant-induced cell death.



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The role of CB1 in intestinal permeability and inflammation [Research]

The endocannabinoid system has previously been shown to play a role in the permeability and inflammatory response of the human gut. The goal of our study was to determine the effects of endogenous anandamide (AEA) and 2-arachidonoyl glycerol (2-AG) on the permeability and inflammatory response of intestinal epithelium under normal, inflammatory, and hypoxic conditions. Human intestinal mucosa was modeled using Caco-2 cells. Human tissue was collected from planned colorectal resections. Accumulation of AEA and 2-AG was achieved by inhibiting their metabolizing enzymes URB597 (a fatty acid amide hydrolase inhibitor) and JZL184 (a monoacylglycerol lipase inhibitor). Inflammation and ischemia were simulated with TNF-α and IFN- and oxygen deprivation. Permeability changes were measured by transepithelial electrical resistance. The role of the CB1 receptor was explored using CB1 knockdown (CB1Kd) intestinal epithelial cells. Endocannabinoid levels were measured using liquid chromatography–mass spectrometry. Cytokine secretion was measured using multiplex and ELISA. URB597 and JZL184 caused a concentration-dependent increase in permeability via CB1 (P < 0.0001) and decreased cytokine production. Basolateral application of JZL184 decreased permeability via CB1 (P < 0.0001). URB597 and JZL184 increased the enhanced (worsened) permeability caused by inflammation and hypoxia (P < 0.0001 and P < 0.05). CB1Kd cells showed reduced permeability response to inflammation (P < 0.01) but not hypoxia. 2-AG levels were increased in response to inflammation and hypoxia in Caco-2 cells. In human mucosal tissue, inflammation increased the secretion of granulocyte macrophage-colony stimulating factor, IL-12, -13, and -15, which was prevented with ex vivo treatment with URB597 and JZL184, and was inhibited by a CB1 antagonist. The results of this study show that endogenous AEA and 2-AG production and CB1 activation play a key modulatory roles in normal intestinal mucosa permeability and in inflammatory and hypoxic conditions.—Karwad, M. A., Couch, D. G., Theophilidou, E., Sarmad, S., Barrett, D. A., Larvin, M., Wright, K. L., Lund, J. N., O’Sullivan, S. E. The role of CB1 in intestinal permeability and inflammation.



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Avian blastoderm dormancy arrests cells in G2 and suppresses apoptosis [Research]

In most avian species, the early embryo suspends development when the ambient temperature is too low; the resultant dormant state is called cold torpor. However, very little is known about dormant avian embryos at the cellular level. To investigate the molecular processes that occur in the chicken blastoderm during cold torpor, we performed transcriptome analysis and investigated cellular responses in dormant embryos. In embryos stored at low temperature, we observed up-regulation of genes and proteins related to endoplasmic reticulum stress and stress-activated protein kinase signaling. In addition, the proportion of early apoptotic cells rose dramatically during torpor, whereas the proportion of late apoptotic cells was unchanged. Cell cycle analysis revealed that mitotic arrest occurred at the G2 phase in a DNA damage–independent manner and that the arrest was alleviated after incubation at 37°C. Our data suggest that the dormant avian embryo tolerates cold stress by inducing stress-tolerance pathways, inhibiting late apoptosis, and triggering cell cycle arrest at the G2 phase.—Ko, M. H., Hwang, Y. S., Rim, J. S., Han, H. J., Han, J. Y. Avian blastoderm dormancy arrests cells in G2 and suppresses apoptosis.



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Learning and Training: Statistics and Myths

focusing on reaction, learning, behavior and results techniques for evaluating training programs by donald l. kirkpatrick (june, 1960) this series of articles is based on

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Wizkids | Dedicated to creating games driven by imagination

Here are some of the main causes and effects of deforestation.

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Watchmen (2009) - Rotten Tomatoes

Free comparison papers, essays, and research papers. These results are sorted by most relevant first (ranked search). You may also sort these by color rating or

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Fast Food Vs. Healthy Foods | Healthy Eating | SF Gate

If you’ve ever been to the ., you might notice that the fast food restaurants over there are a little bit different, and slightly healthier than they are here.

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Definition essay writing help, ideas, topics, examples

Definition of Expository Writing. Expository writing is writing that seeks to explain, illuminate or 'expose' (which is where the word 'expository' comes from).

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Bowdoin College Writing Guide - Patrick Rael

Students are told from the first time they receive instruction in English composition that their introductory paragraphs should accomplish two tasks:

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Marriage Advice - Stories, Tips, Lessons | The Huffington Post

Robert Marshall's novel, A Separate Reality, was released last fall from Carroll & Graf. A visual artist as well as a writer, he lives in New York City.

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Samsung Galaxy S5 LTE-A G901F Android smartphone. Announced 2014, August. Features 3G, ″ Super AMOLED capacitive touchscreen, 16 MP camera, Wi-Fi, GPS, Bluetooth.

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Mechanism-based selection of stabilization strategy for amorphous formulations: Insights into crystallization pathways

Publication date: Available online 12 April 2017
Source:Journal of Controlled Release
Author(s): Khadijah Edueng, Denny Mahlin, Per Larsson, Christel A.S. Bergström
We developed a step-by-step experimental protocol using differential scanning calorimetry (DSC), dynamic vapour sorption (DVS), polarized light microscopy (PLM) and a small-scale dissolution apparatus (μDISS Profiler) to investigate the mechanism (solid-to-solid or solution-mediated) by which crystallization of amorphous drugs occurs upon dissolution. This protocol then guided how to stabilize the amorphous formulation. Indapamide, metolazone, glibenclamide and glipizide were selected as model drugs and HPMC (Pharmacoat 606) and PVP (K30) as stabilizing polymers. Spray-dried amorphous indapamide, metolazone and glibenclamide crystallized via solution-mediated nucleation while glipizide suffered from solid-to-solid crystallization. The addition of 0.001%–0.01% (w/v) HPMC into the dissolution medium successfully prevented the crystallization of supersaturated solutions of indapamide and metolazone whereas it only reduced the crystallization rate for glibenclamide. Amorphous solid dispersion (ASD) formulation of glipizide and PVP K30, at a ratio of 50:50% (w/w) reduced but did not completely eliminate the solid-to-solid crystallization of glipizide even though the overall dissolution rate was enhanced both in the absence and presence of HPMC. Raman spectroscopy indicated the formation of a glipizide polymorph in the dissolution medium with higher solubility than the stable polymorph. As a complementary technique, molecular dynamics (MD) simulations of indapamide and glibenclamide with HPMC was performed. It was revealed that hydrogen bonding patterns of the two drugs with HPMC differed significantly, suggesting that hydrogen bonding may play a role in the greater stabilizing effect on supersaturation of indapamide, compared to glibenclamide.

Graphical abstract

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PEGylation rate influences peptide-based nanoparticles mediated siRNA delivery in vitro and in vivo

Publication date: Available online 12 April 2017
Source:Journal of Controlled Release
Author(s): Gudrun Aldrian, Anaïs Vaissière, Karidia Konate, Quentin Seisel, Eric Vivès, Frédéric Fernandez, Véronique Viguier, Coralie Genevois, Franck Couillaud, Héléne Démèné, Dina Aggad, Aurélie Covinhes, Stéphanie Barrère-Lemaire, Sébastien Deshayes, Prisca Boisguerin
Small interfering RNAs (siRNAs) present a strong therapeutic potential because of their ability to inhibit the expression of any desired protein. Recently, we developed the retro-inverso amphipathic RICK peptide as novel non-covalent siRNA carrier. This peptide is able to form nanoparticles (NPs) by self-assembling with the siRNA resulting in the fully siRNA protection based on its protease resistant peptide sequence. With regard to an in vivo application, we investigated here the influence of the polyethylene glycol (PEG) grafting to RICK NPs on their in vitro and in vivo siRNA delivery properties.A detailed structural study shows that PEGylation did not alter the NP formation (only decrease in zeta potential) regardless of the used PEGylation rates. Compared to the native RICK:siRNA NPs, low PEGylation rates (≤20%) of the NPs did not influence their cellular internalization capacity as well as their knock-down specificity (over-expressed or endogenous system) in vitro. Because the behavior of PEGylated NPs could differ in their in vivo application, we analyzed the repartition of fluorescent labeled NPs injected at the one-cell stage in zebrafish embryos as well as their pharmacokinetic (PK) profile after administration to mice. After an intra-cardiac injection of the PEGylated NPs, we could clearly determine that 20% PEG-RICK NPs reduce significantly liver and kidney accumulation. NPs with 20% PEGylation constitutes a modular, easy-to-handle drug delivery system which could be adapted to other types of functional moieties to develop safe and biocompatible delivery systems for the clinical application of RNAi-based cancer therapeutics.

Graphical abstract

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Targeted drug distribution in tumor extracellular fluid of GD2-expressing neuroblastoma patient-derived xenografts using SN-38-loaded nanoparticles conjugated to the monoclonal antibody 3F8

Publication date: Available online 12 April 2017
Source:Journal of Controlled Release
Author(s): Carles Monterrubio, Sonia Paco, Nagore G. Olaciregui, Guillem Pascual-Pasto, Monica Vila-Ubach, Maria Cuadrado-Vilanova, M. Mar Ferrandiz, Helena Castillo-Ecija, Romina Glisoni, Nataliya Kuplennik, Achim Jungbluth, Carmen de Torres, Cinzia Lavarino, Nai-Kong V. Cheung, Jaume Mora, Alejandro Sosnik, Angel M. Carcaboso
Neuroblastoma is a pediatric solid tumor with high expression of the tumor associated antigen disialoganglioside GD2. Despite initial response to induction therapy, nearly 50% of high-risk neuroblastomas recur because of chemoresistance. Here we encapsulated the topoisomerase-I inhibitor SN-38 in polymeric nanoparticles (NPs) surface-decorated with the anti-GD2 mouse mAb 3F8 at a mean density of seven antibody molecules per NP. The accumulation of drug-loaded NPs targeted with 3F8 versus with control antibody was monitored by microdialysis in patient-derived GD2-expressing neuroblastoma xenografts. We showed that the extent of tumor penetration by SN-38 was significantly higher in mice receiving the targeted nano-drug delivery system when compared to non-targeted system or free drug. This selective penetration of the tumor extracellular fluid translated into a strong anti-tumor effect prolonging survival of mice bearing GD2-high neuroblastomas in vivo.

Graphical abstract

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Membrane permeation of arginine-rich cell-penetrating peptides independent of transmembrane potential as a function of lipid composition and membrane fluidity

Publication date: Available online 12 April 2017
Source:Journal of Controlled Release
Author(s): Rike Wallbrecher, Tobias Ackels, R. Alis Olea, Marco J. Klein, Lucie Caillon, Jürgen Schiller, Petra H. Bovée-Geurts, Toin H. van Kuppevelt, Anne S. Ulrich, Marc Spehr, Merel J.W. Adjobo-Hermans, Roland Brock
Cell-penetrating peptides (CPPs) are prominent delivery vehicles to confer cellular entry of (bio-) macromolecules. Internalization efficiency and uptake mechanism depend, next to the type of CPP and cargo, also on cell type. Direct penetration of the plasma membrane is the preferred route of entry as this circumvents endolysosomal sequestration. However, the molecular parameters underlying this import mechanism are still poorly defined. Here, we make use of the frequently used HeLa and HEK cell lines to address the role of lipid composition and membrane potential. In HeLa cells, at low concentrations, the CPP nona-arginine (R9) enters cells by endocytosis. Direct membrane penetration occurs only at high peptide concentrations through a mechanism involving activation of sphingomyelinase which converts sphingomyelin into ceramide. In HEK cells, by comparison, R9 enters the cytoplasm through direct membrane permeation already at low concentrations. This direct permeation is strongly reduced at room temperature and upon cholesterol depletion, indicating a complex dependence on membrane fluidity and microdomain organisation. Lipidomic analyses show that in comparison to HeLa cells HEK cells have an endogenously low sphingomyelin content. Interestingly direct permeation in HEK cells and also in HeLa cells treated with exogenous sphingomyelinase is independent of membrane potential. Membrane potential is only required for induction of sphingomyelinase-dependent uptake which is then associated with a strong hyperpolarization of membrane potential as shown by whole-cell patch clamp recordings. Next to providing new insights into the interplay of membrane composition and direct permeation, these results also refute the long-standing paradigm that transmembrane potential is a driving force for CPP uptake.

Graphical abstract

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Enhancing tissue permeability with MRI guided preclinical focused ultrasound system in rabbit muscle: From normal tissue to VX2 tumor

Publication date: Available online 12 April 2017
Source:Journal of Controlled Release
Author(s): Yao Sun, Xiaobing Xiong, Darpan Pandya, Youngkyoo Jung, Akiva Mintz, Satoru Hayasaka, Thaddeus J. Wadas, King C.P. Li
High Intensity Focused Ultrasound (HIFU) is an emerging noninvasive, nonionizing physical energy based modality to ablate solid tumors with high power, or increase local permeability in tissues/tumors in pulsed mode with relatively low power. Compared with traditional ablative HIFU, nondestructive pulsed HIFU (pHIFU) is present in the majority of novel applications recently developed for enhancing the delivery of drugs and genes. Previous studies have demonstrated the capability of pHIFU to change tissue local permeability for enhanced drug delivery in both mouse tumors and mouse muscle. Further study based on bulk tissues in large animals and clinical HIFU system revealed correlation between therapeutic effect and thermal parameters, which was absent in the previous mouse studies. In this study, we further investigated the relation between the therapeutic effect of pHIFU and thermal parameters in bulky normal muscle tissues based on a rabbit model and a preclinical HIFU system. Correlation between therapeutic effect and thermal parameters was confirmed in our study on the same bulk tissues although different HIFU systems were used. Following the study in bulky normal muscle tissues, we further created bulky tumor model with VX2 tumors implanted on both hind limbs of rabbits and investigated the feasibility to enhance tumor permeability in bulky VX2 tumors in a rabbit model using pHIFU technique. A radiolabeled peptidomimetic integrin antagonist, 111In-DOTA-IA, was used following pHIFU treatment in our study to target VX2 tumor and serve as the radiotracer for follow-up single-photon emission computed tomography (SPECT) scanning. The results have shown significantly elevated uptake of 111In-DOTA-IA in the area of VX2 tumors pretreated by pHIFU compared with the control VX2 tumors not being pretreated by pHIFU, and statistical analysis revealed averaged 34.5% enhancement 24h after systematic delivery of 111In-DOTA-IA in VX2 tumors pretreated by pHIFU compared with the control VX2 tumors.

Graphical abstract

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Bioengineered robust hybrid hydrogels enrich the stability and efficacy of biological drugs

Publication date: Available online 12 April 2017
Source:Journal of Controlled Release
Author(s): Moon Soo Gil, Jinhwan Cho, Thavasyappan Thambi, V.H. Giang Phan, Inchan Kwon, Doo Sung Lee
Biological drugs are exquisitely tailored components offering the advantages of high specificity and efficacy that are considered safe for treating diseases. Nevertheless, the effectiveness of biological drugs is limited by their inherent short biological half-life and poor stability in vivo. Herein, we engineered a novel delivery platform based on hybrid injectable hydrogels, in which pH- and temperature-responsive biodegradable copolymers were site-specifically coupled to the sulfhydryl group of human serum albumin, which effectively enhances the stability and circulation half-life of the biological drug, recombinant uricase enzyme (Uox). The albumin ligand conjugated to the Uox allowed specific-binding of the enzyme within the protein shell, and the synthetic polymers effectively shield the protein-enzyme complex. Such close confinement exhibits strong resistance towards various physical, chemical and therapeutically relevant stressors such as temperature, pH and proteases. Subcutaneous administration of Uox-loaded bioengineered hybrid hydrogel improved the pharmacokinetics by prolonging its circulation half-life. As a consequence, the bioengineered hybrid hydrogel normalized the serum uric acid level in hypoxanthine/potassium oxonate-induced hyperuricemia mice, and no obvious side effects were observed in the major organs. The characteristic of the bioengineered hydrogel networks applicable to a variety of biological drugs by simple mixing that unlock the possibility of adapting biological drugs to therapeutic applications.

Graphical abstract

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Beneficial effects of glutathione supplementation during vitrification of mouse oocytes at the germinal vesicle stage on their preimplantation development following maturation and fertilization in vitro

Publication date: Available online 12 April 2017
Source:Cryobiology
Author(s): Adel R. Moawad, Seang Lin Tan, Teruko Taketo
Oocyte cryopreservation is imperative for assisted reproductive technologies (ART). Although cryopreservation of oocytes at the Metaphase II has been widely used, immature oocytes at the germinal vesicle stage (GV-oocytes) need to be cryopreserved in certain situations such as cancer patients; however, the success rate of embryonic development from the GV-oocytes remains low largely due to the requirement for in vitro maturation (IVM). Our aim was to investigate the effects of glutathione (GSH) supplementation during vitrification and warming of mouse GV-oocytes on the preservation of developmental competence. GV-oocytes within cumulus oocyte complexes (COCs) were collected from C57BL/6J (B6) and (B6.DBA)F1 mouse strains and subjected to vitrification and warming, followed by IVM. The vitrification, warming or IVM medium was supplemented with GSH at 0–4.0 mM. In vitro matured oocytes were then fertilized in vitro and cultured in KSOMaa up to 4 days. The first cleavage and blastocyst development were evaluated morphologically, and their rates were statistically analysed by one-way ANOVA followed by Tukey's multiple comparisons test. The difference was considered significant at P < 0.05. The results showed that GSH supplementation in the IVM medium exhibited no or rather inhibitory effects on the first cleavage or blastocyst development in both mouse strains except that 1 mM GSH increased the blastocyst development rate in B6. By contrast, 1 mM GSH supplementation during vitrification and warming increased the blastocyst development rate in both mouse strains, more efficiently in B6 than (B6.DBA)F1. In conclusion, GSH supplementation during vitrification and warming of GV-oocytes protects the oocytes from freezing-inflicted loss of developmental competence.



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Writing Algebraic Equations - Math Goodies

A summary of Solving Word Problems in 's Applications of Solving Equations. Learn exactly what happened in this chapter, scene, or section of Applications of Solving

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Creating Research Paper Note Cards

How to Organize a Research Paper using Notecards. How do I organize my research? Use notecards! (3x5 index cards) put quotation marks around it and note the

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10 Tips for Writing the College Application Essay | Best

Why Kitchen Painters We provide a long term remodelling solution using your current kitchen cabinetry. Give your cabinets a brand new look without the major expense

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Luxury Hotels and Resorts | The Ritz-Carlton

Ritz-Carlton Reserve Hotels; The Ritz-Carlton Residences and Destination Clubs; Upcoming Locations; Hotel does not participate in The Ritz-Carlton Rewards Program

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Finishing the Essay

Noplag for Schools, Colleges, Universities. Create classes & assignments. Add students and instructors. Check & grade papers online. Get early access

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Cold Case Murder of Righteous Brothers Singer’s Ex-Wife

The Philadelphia homicide squad's lone female detective finds her calling when she's assigned cold cases -- older crimes that have never been solved.

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Greenville County Sheriff’s Office | Greenville County SC

Sheriff Jared Miller and the Wakulla County Sheriff's Office is calling on all Facebook Detectives and asking for your help in the following case: Detectives in the

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Math Problem Solving - Free Worksheets - RHL School

Math series Solving math word problems. There are two steps to solving math word problems: Translate the wording into a numeric equation that combines smaller

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Who Was Moses? - Biblical Archaeology Society

The Good Samaritan parable is one of the most beloved gospel stories for young and old alike. The story is told in Luke 10:29–37: A man going from Jerusalem to

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Read, I, Pencil | Library of Economics and Liberty

Ваш сайт на www. . Создайте свой сайт при помощи наших сервисов: Готовые сайты на

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Blackboard Learn

Category : MBA HR Projects download from |, Free HRM Project Report | HR Project Report MBA / BBA, HR Surveys, Projects on HR Policy, HR in

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Career Planning Is A Lifelong Process Education Essay

Though my career goals were important to me, I decided that time with my family was more important. I reached my short term goal of a key carrier.

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What is a government? definition and meaning

Booker T. Washington Delivers the 1895 Atlanta Compromise Speech. On September 18, 1895, African-American spokesman and leader Booker T. Washington spoke before a

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Algebra test generator. Unlimited practices. Sharpen your

SoftTech Engineers Pvt Ltd specializes in Construction ERP Software, providing Work & Procurement Management and e-governance in India, UAE, Africa.

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Book Trailers for Readers - How to make a book trailer

VoiceThread Universal lets you browse threads and hear comments in pages specially designed for screen readers. Click here to go to VoiceThread Universal

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Free Math Worksheets Generator - Math Facts

Math Worksheet Generator: Our math worksheet generator lets you create your own math worksheets. Make your own customized worksheet in seconds!

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Search - Chaminade College Preparatory

PTC Mathcad is math software that allows you to solve, analyze and share your most vital engineering calculations.

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PageInsider - Information about all domains

Colorado High School Sports Scores and Statistics Schedules, scores, results, standings, leaders and more. Read our welcome announcement; Skip down to today's game

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10 Best Sites To Watch Free Movies Online | Without

makes it easy for you to create a website and grow your business online with ecommerce, marketing, SEO and A/B testing solutions all in one place.

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Regional Radiation Therapy Impacts Outcome for Node-Positive Cutaneous Melanoma

Background: Regional radiation therapy (RT) has been shown to reduce the risk of regional recurrence with node-positive cutaneous melanoma. However, risk factors for regional recurrence, especially in the era of sentinel lymph node biopsy (SLNB), are less clear. Our goals were to identify risk factors associated with regional recurrence and to determine whether a radiosensitivity index (RSI) gene expression signature (GES) could identify patients who experience a survival benefit with regional RT. Methods: A single-institution, Institutional Review Board–approved study was performed including 410 patients treated with either SLNB with or without completion lymph node dissection (LND; n=270) or therapeutic LND (n=91). Postoperative regional RT was delivered to the involved nodal basin in 83 cases (20.2%), to a median dose of 54 Gy (range, 30–60 Gy) in 27 fractions (range, 5–30). Primary outcomes were regional control and overall survival by RSI GES status. Results: Median follow-up was 69 months (range, 13–180). Postoperative regional RT was associated with a reduced risk of regional recurrence among all patients on univariate (5-year estimate: 95.0% vs 83.3%; P=.036) and multivariate analysis (hazard ratio[HR], 0.15; 95% CI, 0.05–0.43; P<.001). Among higher-risk subgroups, regional RT was associated with a lower risk of regional recurrence among patients with clinically detected lymph nodes (n=175; 5-year regional control: 94.1% vs 69.5%; P=.003) and extracapsular extension (ECE) present (n=138; 5-year regional control: 96.7% vs 62.2%; P<.001). Among a subset of radiated patients with gene expression data available, a low RSI GES (radiosensitive) tumor status was associated with improved survival compared with a high RSI GES (5-year: 75% vs 0%; HR, 10.68; 95% CI, 1.24–92.14). Conclusions: Regional RT was associated with a reduced risk of regional recurrence among patients with ECE and clinically detected nodal disease. Gene expression data show promise for better predicting radiocurable patients in the future. In the era of increasingly effective systemic therapies, the value of improved regional control potentially takes on greater significance.



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NCCN News



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Implementation of Systemic Hedgehog Inhibitors in Daily Practice as Neoadjuvant Therapy

The most common cancer in both men and women is basal cell carcinoma (BCC). Although most primary and recurrent BCCs have high cure rates with standard therapies, advanced BCCs present a greater treatment challenge, especially in cosmetically and functionally sensitive areas. In patients unable to undergo surgery or radiation therapy, hedgehog inhibitors can be used neoadjuvantly to reduce tumor size, decreasing the extent and complexity of any subsequent surgery and providing either a cure or palliation. The goal of this review is to summarize the pharmacology, efficacy, and safety of systemic hedgehog inhibitors, as well as their role in daily practice as neoadjuvant therapy. Relevant English-language literature was identified and evaluated based on results from database searches of PubMed. Terms searched included, but were not limited to, "vismodegib," "Erivedge," "sonidegib," "DE225," "BCC," and "neoadjuvant treatment." Additional literature was identified from the reference lists of previously identified articles. The authors' personal experience in treating advanced BCC using hedgehog inhibitors has been incorporated into the recommendations made herein.



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Politics as Usual--Not!



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The 21-Gene Recurrence Score Assay for Node-Positive, Early-Stage Breast Cancer and Impact of RxPONDER Trial on Chemotherapy Decision-Making: Have Clinicians Already Decided?

Background: The 21-gene recurrence score (RS) assay is retrospectively validated for assessing prognosis and benefit from chemotherapy in hormone receptor–positive, early-stage breast cancer (EBC) with low RS. We hypothesized that oncologists have already incorporated the RS assay for decision-making in higher-risk, node-positive disease, despite the lack of prospective data and contrary to NCCN Guideline recommendations. This study provides the first analysis of trends and differences in RS use and therapeutic implications in a population-based data set of patients with node-positive EBC. It also assesses the impact of the RxPONDER trial on clinicians' chemotherapy recommendations. Methods: Node-positive EBC cases diagnosed during 2010 through 2012 and included in the National Cancer Data Base were used. Multivariate logistic regression was used to estimate test use and impact on chemotherapy recommendations. Results: The RS assay was ordered for 16.5% of the 80,405 identified patients. Of all variables, the RS assay had the strongest association with chemotherapy recommendation, with adjusted odds ratios (AORs) of 19 for scores >30. Odds of chemotherapy recommendation were significantly lower for the group who received the test (AOR, 0.21; 95% CI, 0.20–0.22). When divided based on the cutoff point of 25 adopted by the RxPONDER trial, those with an RS of 18 to 25 had significantly lower odds of chemotherapy recommendation compared with those with an RS of 26 to 30 (AOR, 0.32; 95% CI, 0.26–0.40). Test use was lower for blacks, community centers, uninsured/governmentally insured patients, higher tumor grade, larger tumor size, and more nodes involved. Chemotherapy recommendation was higher for patients of younger age, with private insurance, and with higher tumor grade, size, and number of nodes involved. Black patients had significantly higher RS (AOR, 1.37; 95% CI, 1.25–1.79). Conclusions: The RS assay influences clinicians' chemotherapy recommendation in node-positive EBC. Clinicians are using the inclusion criteria of the RxPONDER trial before its final release. Black patients have higher RS, likely representing worse biology. Significant differences exist in test use and clinical implications based on race, insurance, and facility.



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Therapeutic Response of Metastatic Colorectal Cancer Harboring a KRAS Missense Mutation After Combination Chemotherapy With the EGFR Inhibitor Panitumumab

Over the past decade, subset analyses of retrospective and prospective clinical studies have determined that KRAS-mutated metastatic colorectal cancers do not respond effectively to inhibition of epidermal growth factor receptor (EGFR) with the EGFR-targeting monoclonal antibodies cetuximab or panitumumab. Within the past few years, the scope of tested variants in the KRAS oncogene has expanded significantly, and testing of all RAS family genes has become more widely available in clinical laboratories. Expert consensus guidelines have recommended not using EGFR inhibitors in patients with KRAS-mutated tumors. However, with increasing identification of low-prevalence variants, it is conceivable that some RAS mutations do not provide equivalent resistance to EGFR inhibition compared with the most prevalent mutations at codons 12, 13, and 61. This report describes a case of a patient with metastatic colon cancer harboring the p.A59T variant of KRAS, with objective radiographic response (36% decrease per RECIST 1.1) and carcinoembryonic antigen biomarker response to panitumumab therapy given with FOLFIRI chemotherapy. We propose that A59T represents one potential exception to the guidelines that KRAS mutant tumors fail to respond to therapy with EGFR inhibitors, altering the paradigm of using this generalized approach.



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Oncology Research Program



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NCCN Guidelines Insights: Breast Cancer, Version 1.2017

These NCCN Guidelines Insights highlight the important updates/changes to the surgical axillary staging, radiation therapy, and systemic therapy recommendations for hormone receptor–positive disease in the 1.2017 version of the NCCN Guidelines for Breast Cancer. This report summarizes these updates and discusses the rationale behind them. Updates on new drug approvals, not available at press time, can be found in the most recent version of these guidelines at NCCN.org.



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Paving the Way for Dose Banding of Chemotherapy: An Analytical Approach

Background: In an interdepartmental cooperation, we investigated the feasibility and benefits of implementing dose banding of chemotherapy at our medical center. Based on this concept, chemotherapy doses are clustered into bands of similar dosage levels, thereby allowing the preproduction of frequently used standard doses of drugs, with sufficient physicochemical stability. Although established practice in the United Kingdom, there is little published evidence of its introduction elsewhere. Methods: We performed an analysis of local prescribing practice (22,310 chemotherapies) and identified gemcitabine, 5-fluorouracil, and carboplatin, among various others, as cytotoxic drugs suitable for dose banding. Results: First, we determined the physicochemical stability of the selected chemotherapy drugs during 12-weeks' storage by performing pH analysis and visual examination for color change or particles. No relevant changes were identified. Gemcitabine was selected for quantitative high-performance liquid chromatography analysis and we were able to show that ≥95% remained after 12 weeks' storage, in accordance with international guidelines. To simulate a worst case scenario, we performed microbiological stability testing of simulated cytotoxic compounding by replacing the cytotoxic drug with liquid media. Samples were incubated over defined storage time points (3, 6, and 12 weeks) and evaluated using the direct inoculation method. For the container integrity test, we deposited the samples into highly contaminated broth for 1 hour. Microbiological stability was demonstrated in both tests for the full storage period. Conclusions: Our data show that 12-weeks' storage of selected cytotoxic products is feasible from a microbiological perspective. Sterility of prepared products was maintained under extreme storage conditions. Gemcitabine content was in accordance with international guidelines after 12-weeks' storage. These results support the introduction of dose-banded gemcitabine products with the predicted advantages of optimized pharmacy workflow and reduced patient waiting times. We highlight the need for further research and consensus on the performance of purity analyses in dose-banded drug products.



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Infusion-Compatible Antibiotic Formulations for Rapid Administration to Improve Outcomes in Cancer Outpatients With Severe Sepsis and Septic Shock: The Sepsis STAT Pack

Background: Patients with cancer are at high risk for severe sepsis and septic shock (SS/SSh), and a delay in receiving effective antibiotics is strongly associated with mortality. Delays are due to logistics of clinic flow and drug delivery. In an era of increasing antimicrobial resistance, combination therapy may be superior to monotherapy for patients with SS/SSh. Patients and Methods: At the Seattle Cancer Care Alliance, we implemented the Sepsis STAT Pack (SSP) program to simplify timely and effective provision of empiric antibiotics and other resuscitative care to outpatients with cancer with suspected SS/SSh before hospitalization. Over a 49-month period from January 1, 2008, through January 31, 2012, a total of 162 outpatients with cancer received the intervention. A retrospective cohort study was conducted to determine outcomes, including mortality and adverse events associated with the use of a novel care bundle designed for compatibility of broad-spectrum antibiotics and other supportive care administered concurrently via rapid infusion at fixed doses. Results: Of 162 sequential patients with cancer and suspected SS/SSh who received the SSP, 71 (44%) were diagnosed with SS/SSh. Median age was 53 years and 65% were men; 141 (87%) had hematologic malignancies, 77 (48%) were transplant recipients, and 80 (49%) were neutropenic. Median time to completion of antibiotics was 111 minutes (interquartile range, 60–178 minutes). A total of 71 patients (44%) had bacteremia and 17% of 93 isolates were multidrug-resistant. Possibly related nephrotoxicity occurred in 7 patients, and 30-day mortality occured in 6 of 160 patients (4%), including 3 of 71 (4%) with SS/SSh. Risk of developing SSh or death within 30 days increased 18% (95% CI, 4%–34%) for each hour delay to completion of antibiotics (P=.01). Conclusions: Rapidly administered combination antibiotics and supportive care delivered emergently to ambulatory patients with cancer with suspected SS/SSh was well-tolerated and associated with excellent short-term survival.



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Non-Small Cell Lung Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology

This selection from the NCCN Guidelines for Non–Small Cell Lung Cancer (NSCLC) focuses on targeted therapies and immunotherapies for metastatic NSCLC, because therapeutic recommendations are rapidly changing for metastatic disease. For example, new recommendations were added for atezolizumab, ceritinib, osimertinib, and pembrolizumab for the 2017 updates.



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Trends in the Incidence and Outcomes of Hospitalized Cancer Patients With Clostridium difficile Infection: A Nationwide Analysis

Background: Patients with cancer have several risk factors for Clostridium difficile infection (CDI), but the impact of CDI on outcomes in this population needs elucidation. We analyzed the incidence of CDI and its impact on outcomes in patients with cancer using the National Hospital Discharge Survey (NHDS) database from 2001 to 2010. Methods: Diagnosis codes were used to identify patients with cancer and CDI events. Demographics, diagnoses, length of stay (LOS), and discharge information were abstracted. Multivariate linear and logistic regression models with weighted analysis were conducted to study CDI incidence and CDI-associated outcomes. Analyses were performed using SAS version 9.4. Results: During the 10-year study period, 20.1 million discharges had a cancer diagnosis. CDI developed in 1.09% of patients with cancer versus 0.77% of patients without cancer (adjusted odds ratio [aOR], 1.28; 95% CI, 1.28–1.29; P<.001). The incidence of CDI in patients with cancer increased during the 10-year study period (64.7 per 10,000 discharges in 2001–2002 to 109.1 in 2009–2010; P<.001). In multivariable analysis, compared with patients with cancer without CDI, patients with cancer and CDI had a longer mean LOS (5.67 days; 95% CI, 5.39–5.94) and higher rates of in-hospital mortality (aOR, 1.18; 95% CI, 1.16–1.20) and discharge to a care facility (aOR, 1.74; 95% CI, 1.72–1.75; all P<.001). Conclusions: In this national database, CDI incidence increased significantly in patients with cancer over the study period and was associated with prolonged hospitalization, increased mortality, and discharge to a care facility. Despite increased attention, CDI remained a serious infection and merits appropriate prevention and management.



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Why a One Size Fits All Approach to RAS Might Not Fit Colorectal Cancer



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Aluminium resistant, plant growth-promoting bacteria induce overexpression of Aluminium stress related genes in Arabidopsis thaliana and increase the ginseng tolerance against Aluminium stress

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Publication date: Available online 12 April 2017
Source:Microbiological Research
Author(s): Mohamed El-Agamy Farh, Yeon-Ju Kim, Johan Sukweenadhi, Priyanka Singh, Deok-Chun Yang
Panax ginseng is an important cash crop in the Asian countries due to its pharmaceutical effects, however the plant is exposed to various abiotic stresses, lead to reduction of its quality. One of them is the Aluminum (Al) accumulation. Plant growth promoting bacteria which able to tolerate heavy metals has been considered as a new trend for supporting the growth of many crops in heavy metal occupied areas. In this study, twelve bacteria strains were isolated from rhizosphere of diseased Korean ginseng roots located in Gochang province, Republic of Korea and tested for their ability to grow in Al-embedded broth media. Out of them, four strains (Pseudomonas simiae N3, Pseudomonas fragi N8, Chryseobacterium polytrichastri N10, and Burkholderia ginsengiterrae N11-2) were able to grow. The strains could also show other plant growth promoting activities e.g. auxins and siderophores production and phosphate solubilization. P. simiae N3, C. polytrichastri N10, and B. ginsengiterrae N11-2 strains were able to support the growth of Arabidopsis thaliana stressed by Al while P. simiae N3 could not. Plants inoculated with P. simiae N3, C. polytrichastri N10, and B. ginsengiterrae N11-2 showed higher expression level of Al stress related genes, AtAIP, AtALS3 and AtALMT1, compared to non-bacterized plants. Expression profiles of the genes reveal the induction of external mechanism of Al resistance by P. simiae N3 and B. ginsengiterrae N11-2 and internal mechanism by C. polytrichastri N10. Korean ginseng seedlings treated with these strains showed higher biomass, particularly the foliar part, higher chlorophyll content than non-bacterized Al stressed seedlings. According to the present results, these strains can be used in the future for the cultivation of ginseng in Al persisted locations.



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Overlap Syndrome

Abstract

Purpose of Review

This paper aims to critically evaluate recent literature on the epidemiology, pathophysiology, and management of overlap syndrome (OS).

Recent Findings

The prevalence of OS is much higher in patients with either chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea (OSA) (8.1%–65.9%) than in the general population (1–2%). Maladaptive neural, inflammatory, cardiovascular, and autonomic responses are intensified with the coexistence of both conditions, leading to worse diurnal and nocturnal respiratory function. Careful analysis of the oximetry and capnography findings during polysomnography can detect concomitant sleep-related hypoxemia/hypoventilation. Observational studies report salutary effects of CPAP on gas exchange, COPD exacerbation, sexual dysfunction, and mortality.

Summary

COPD or OSA patients should be routinely screened for the presence of OS, since CPAP therapy can improve clinical outcomes. Future studies should investigate the pathophysiological interactions resulting from combined risk factors (smoking and obesity), the impact of oxygen on clinical outcomes, and the role of other positive airway pressure modalities.



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Traumatic Brain Injury in Combat Trauma

Abstract

Purpose of Review

With more than 2 million American military personnel deployed and 350,000 traumatic brain injuries since 2001, civilian and military health care providers must recognize the impact and unique considerations for managing combat-related traumatic brain injuries. Here, we will review the etiology and manifestations of combat-related traumatic brain injuries with further discussion of acute management and aeromedical evacuation in the deployed setting.

Recent Findings

Traumatic brain injuries have emerged as the signature wound of the recent wars. Previously, lethal assaults on the human body are now routinely survivable due to improvements in protective equipment and battlefield medicine. Management centers on increased recognition and screening for TBI, and advanced imaging techniques are not routinely recommended at this time.

Summary

Unlike other physical injuries, traumatic brain injuries can occur in the absence of other physical wounds, making them more difficult to detect. Traumatic brain injuries have several short- and long-term manifestations and consequences that are important to recognize as healthcare providers.



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