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Κυριακή, 12 Νοεμβρίου 2017

Dengue hemorrhagic encephalitis: MRI

History: 39 years male, known case of dengue with NS1 positive with altered sensorium.

MRI findings

Multiple ill defined, irregular, mild to moderately enhancing  mixed signal intensity lesions seen involving both thalami, pons, posterior midbrain, both frontoparietal  pariventricular white matter regions ( right thalamus & pons more than rest) with restricted diffusion   /reduced ADC values / patchy bright signal s on T1 / blooming on SW ( pons more than rest) with mass effect on 4thventricle / mild proximal ventriculomegaly / moderate patchy meningeal  enhancement. Rest of the brain parenchyma & major dural  venous  sinuses  normal. Findings are likely suggestive of meningoencepalitis of dengue etiology, in view of history.

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Discussion by Dr MGK Murthy, Dr GA Prasad

  1. Dengue virus is a single-stranded RNA virus of the Flavivirus genus classified into four serotypes. Neurological manifestations, commonly seen with serotypes 2 and 3.
  2. Neurological manifestation in dengue hemorrhagic fever usually results from multisystem dysfunction secondary to liver failure, cerebral hypoperfusion, electrolyte imbalance, shock, cerebral edema, and hemorrhage related to vascular leak.  Presentation as viral encephalitis is rare as the virus is non-neurotrophic.
  3. Patients can  present with -  stroke, mononeuropathies, polyneuropathies, Guillain-Barre syndrome (GBS), myelitis, meningitis, acute disseminated encephalomyelitis (ADEM), encephalopathy, encephalitis, neuromyelitis optica, and optic neuritis.
  4. Presence of dengue virus and anti-dengue IgM antibodies in patient's CSF with encephalitis suggests the possibility of direct cerebral invasion through infected macrophages.
  5. Clinical differentials can be differentiated by MRI  -

  •          Japanese encephalitis – bilateral thalamic and basal ganglia involvement .
  •          Herpes encephalitis- bilateral temporal and basifrontal lobes lesions.
  •         Chikungunya encephalitis - white matter lesions with restricted diffusion without hemorrhage or basal ganglia involvement.
  •         Changes of ADEM in dengue fever are similar to Dengue  encephalitis on MRI and may not be possible to differentiate on MRI always.


There is no specific treatment for dengue encephalitis & treatment is mainly supportive.
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Monitoring of uranium concentrations in water samples collected near potentially hazardous objects in North-West Tajikistan

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Publication date: January 2018
Source:Journal of Environmental Radioactivity, Volume 181
Author(s): P. Zoriy, M. Schläger, K. Murtazaev, J. Pillath, M. Zoriy, B. Heuel-Fabianek
The water contamination near ecologically problematic objects was investigated between 2009 and 2014 in North-West Tajikistan as a part of a joint project between Forschungszentrum Jülich and Khujand State University. The main part of this work was the determination of uranium in water samples collected near the Degmay tailings dump, the Taboshar pit lake and the Syr Darya river. More than 130 water samples were collected and analyzed to monitor the uranium concentration near the investigated areas. Two different mass spectrometers and an ion chromatograph were used for element concentration measurements. Based on the results obtained, the uranium influence of the Degmay tailings on the rivers Khoja-Bakyrgan-Say and Syr Darya and surrounding water was not found. The uranium concentration in water samples was monitored for a lengthy period at seven locations Great differences in the uranium concentration in waters collected in 2010, 2011, 2012, 2013 for each location were not observed. Drinking water samples from the region of North-West Tajikistan were analyzed and compared with the World Health Organization's guidelines. Seven out of nine drinking water samples near Taboshar exceeded the WHO guideline value for uranium concentrations (30 μg/L). The average uranium concentration of water samples from Syr Darya for the period from 2009 to 2014 was determined to be 20.1 (±5.2) μg/L. The uranium contamination of the Syr Darya was determined from the western border to the eastern border and the results are shown in this paper.



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Generalized Hybrid One-Step Block Method Involving Fifth Derivative for Solving Fourth-Order Ordinary Differential Equation Directly

A general one-step three-hybrid (off-step) points block method is proposed for solving fourth-order initial value problems of ordinary differential equations directly. A power series approximate function is employed for deriving this method. The approximate function is interpolated at while its fourth and fifth derivatives are collocated at all points ,, in the interval of approximation. Several fourth-order initial value problems of ordinary differential equations are then solved to compare the performance of the proposed method with the derived methods. The analysis of the method reveals that the method is consistent and zero stable concluding that the method is also convergent. The numerical results demonstrate the superiority of the new method over the existing ones in terms of error.

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The Seduction of Curves revives old ideas about maths and beauty

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René Thom's mathematical theorems passed their sell-by date in the 1970s, but applied to the human form, will they captivate a new generation?

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Model Equations for Three-Dimensional Nonlinear Water Waves under Tangential Electric Field

We are concerned with gravity-capillary waves propagating on the surface of a three-dimensional electrified liquid sheet under a uniform electric field parallel to the undisturbed free surface. For simplicity, we make an assumption that the permittivity of the fluid is much larger than that of the upper-layer gas; hence, this two-layer problem is reduced to be a one-layer problem. In this paper, we propose model equations in the shallow-water regime based on the analysis of the Dirichlet-Neumann operator. The modified Benney-Luke equation and Kadomtsev-Petviashvili equation will be derived, and the truly three-dimensional fully localized traveling waves, which are known as “lumps” in the literature, are numerically computed in the Benney-Luke equation.

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Commute Equilibrium for Mixed Networks with Autonomous Vehicles and Traditional Vehicles

Recent development of autonomous vehicle (AV) provides new travel opportunities for citizens, and traditional vehicles (TVs) will still be used for a long time. Therefore, it is highly possible that both AVs and TVs will be used as travel modes in a city. In a transportation system with both AVs and TVs, the traffic pattern is worthy of studying. This paper investigates user equilibrium traffic pattern based on the traditional bottleneck model considering AVs and TVs. For both TVs and AVs, travel costs include queuing delay and schedule delay. However, they also have different components of travel costs; more specifically, for AVs, passengers have to pay a riding fare, and, for TVs, travelers encounter a walking time cost after parking their cars. For different combinations of travel demands and riding fare of AVs, analytical solutions of three different user equilibrium traffic patterns are obtained. Finally, numerical examples are provided to demonstrate the usefulness of the analytical models. Sensitivity analyses are examined to show the impacts of AV’s time-dependent fee and trip-based fixed fee on the traffic pattern and travel costs.

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Model Equations for Three-Dimensional Nonlinear Water Waves under Tangential Electric Field

We are concerned with gravity-capillary waves propagating on the surface of a three-dimensional electrified liquid sheet under a uniform electric field parallel to the undisturbed free surface. For simplicity, we make an assumption that the permittivity of the fluid is much larger than that of the upper-layer gas; hence, this two-layer problem is reduced to be a one-layer problem. In this paper, we propose model equations in the shallow-water regime based on the analysis of the Dirichlet-Neumann operator. The modified Benney-Luke equation and Kadomtsev-Petviashvili equation will be derived, and the truly three-dimensional fully localized traveling waves, which are known as “lumps” in the literature, are numerically computed in the Benney-Luke equation.

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Optimization of Pesticide Spraying Tasks via Multi-UAVs Using Genetic Algorithm

Task allocation is the key factor in the spraying pesticides process using unmanned aerial vehicles (UAVs), and maximizing the effects of pesticide spraying is the goal of optimizing UAV pesticide spraying. In this study, we first introduce each UAV’s kinematic constraint and extend the Euclidean distance between fields to the Dubins path distance. We then analyze the two factors affecting the pesticide spraying effects, which are the type of pesticides and the temperature during the pesticide spraying. The time window of the pesticide spraying is dynamically generated according to the temperature and is introduced to the pesticide spraying efficacy function. Finally, according to the extensions, we propose a team orienteering problem with variable time windows and variable profits model. We propose the genetic algorithm to solve the above model and give the methods of encoding, crossover, and mutation in the algorithm. The experimental results show that this model and its solution method have clear advantages over the common manual allocation strategy and can provide the same results as those of the enumeration method in small-scale scenarios. In addition, the results also show that the algorithm parameter can affect the solution, and we provide the optimal parameters configuration for the algorithm.

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Our Africa #PalliativeCare course is back up and running! Start the course of 20 free e-learning modules today!… https://t.co/eg2CbLwDJn

Our Africa #PalliativeCare course is back up and running! Start the course of 20 free e-learning modules today!… https://t.co/eg2CbLwDJn

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quality of care; +26 new citations

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



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CRP is linked to disease activity, impact and response to treatment in patients with chronic spontaneous urticaria

Abstract

Background

Elevated levels of C-reactive protein (CRP), a sensitive marker of inflammation, have been consistently reported in chronic spontaneous urticaria. Here, we retrospectively analyzed data from 1,253 CSU patients from two centers to answer the following questions: 1) What is the prevalence of elevated levels of CRP in CSU? 2) Why do CSU patients show elevated levels of CRP? 3) Are elevated CRP levels relevant?

Methods

Serum levels of CRP were measured by the nephelometric method. We collected information regarding various laboratory tests including ESR, CBC with differential, D-dimer, fibrinogen, C3, C4, IL-6 etc. For most patients, we also collected data on age, gender, duration of CSU, presence of angioedema, activity (UAS at the time of blood sampling and for 7 days), quality of life (CU-Q2oL and/or DLQI), comorbidities and possible causes of CSU, and autologous serum skin test (ASST) response. The efficacy of second generation antihistamines was evaluated at the day of blood collecting.

Results

One third of CSU patients had elevated levels of CRP. Higher levels of CRP were associated with ASST positivity (p=0.009) and arterial hypertension (p=0.005), but not with other possible causes or comorbidities of CSU. CRP correlated with urticaria activity (p<0.001), quality of life impairment (p=0.026), inflammatory and coagulation markers (p<0.001). CRP levels were significantly higher in non-responders to antihistamines as compared to responders (p<0.001).

Conclusion

Elevated levels of CRP are common and relevant in CSU patients. The assessment of CRP levels may help to optimize the management of patients with CSU.

This article is protected by copyright. All rights reserved.



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Brain Sciences, Vol. 7, Pages 150: Digital Platforms in the Assessment and Monitoring of Patients with Bipolar Disorder

Brain Sciences, Vol. 7, Pages 150: Digital Platforms in the Assessment and Monitoring of Patients with Bipolar Disorder

Brain Sciences doi: 10.3390/brainsci7110150

Authors: Arvind Rajagopalan Pooja Shah Melvyn Zhang Roger Ho

This paper aims to review the application of digital platforms in the assessment and monitoring of patients with Bipolar Disorder (BPD). We will detail the current clinical criteria for the diagnosis of BPD and the tools available for patient assessment in the clinic setting. We will go on to highlight the difficulties in the assessment and monitoring of BPD patients in the clinical context. Finally, we will elaborate upon the impact that diital platforms have made, and have the potential to make, on healthcare, mental health, and specifically the management of BPD, before going on to evaluate the benefits and drawbacks of the use of such technology.



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In Vivo Evaluation of Galla chinensis Solution in the Topical Treatment of Dermatophytosis

Aim. Dermatophytosis is one of the main fungal diseases in humans and animals all over the world. Galla chinensis, a traditional medicine, has various pharmacological effects. The goal of this study was to evaluate the treatment effect of Galla chinensis solution (GCS) on dermatophytosis-infected dogs (Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophytes, resp.). Methods. The treatment effects of GCS were evaluated by mycological cure rates and clinical score comprised of three indices, including inflammation, hair loss, and lesion scale. Results. The results showed that, in the three models of dermatophytosis, GCS significantly () improved skin lesions and fungal eradication. GCS (10% and 5%) had higher efficacy compared to the positive control (Tujingpi Tincture). The fungal eradication efficacy exceeds 85% after treatment with GCS (10%, 5%, and 2.5%) on day 14. Conclusion. The GCS has antidermatophytosis effect in dogs, which may be a candidate drug for the treatment of dermatophytosis.

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Vibration and Control in Structures under Single and Multiple Hazards



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Adaptive Steganalysis Based on Selection Region and Combined Convolutional Neural Networks

Digital image steganalysis is the art of detecting the presence of information hiding in carrier images. When detecting recently developed adaptive image steganography methods, state-of-art steganalysis methods cannot achieve satisfactory detection accuracy, because the adaptive steganography methods can adaptively embed information into regions with rich textures via the guidance of distortion function and thus make the effective steganalysis features hard to be extracted. Inspired by the promising success which convolutional neural network (CNN) has achieved in the fields of digital image analysis, increasing researchers are devoted to designing CNN based steganalysis methods. But as for detecting adaptive steganography methods, the results achieved by CNN based methods are still far from expected. In this paper, we propose a hybrid approach by designing a region selection method and a new CNN framework. In order to make the CNN focus on the regions with complex textures, we design a region selection method by finding a region with the maximal sum of the embedding probabilities. To evolve more diverse and effective steganalysis features, we design a new CNN framework consisting of three separate subnets with independent structure and configuration parameters and then merge and split the three subnets repeatedly. Experimental results indicate that our approach can lead to performance improvement in detecting adaptive steganography.

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Parameterization of LSB in Self-Recovery Speech Watermarking Framework in Big Data Mining

The privacy is a major concern in big data mining approach. In this paper, we propose a novel self-recovery speech watermarking framework with consideration of trustable communication in big data mining. In the framework, the watermark is the compressed version of the original speech. The watermark is embedded into the least significant bit (LSB) layers. At the receiver end, the watermark is used to detect the tampered area and recover the tampered speech. To fit the complexity of the scenes in big data infrastructures, the LSB is treated as a parameter. This work discusses the relationship between LSB and other parameters in terms of explicit mathematical formulations. Once the LSB layer has been chosen, the best choices of other parameters are then deduced using the exclusive method. Additionally, we observed that six LSB layers are the limit for watermark embedding when the total bit layers equaled sixteen. Experimental results indicated that when the LSB layers changed from six to three, the imperceptibility of watermark increased, while the quality of the recovered signal decreased accordingly. This result was a trade-off and different LSB layers should be chosen according to different application conditions in big data infrastructures.

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Phase Noise Effect on MIMO-OFDM Systems with Common and Independent Oscillators

The effects of oscillator phase noises (PNs) on multiple-input multiple-output (MIMO) orthogonal frequency division multiplexing (OFDM) systems are studied. It is shown that PNs of common oscillators at the transmitter and at the receiver have the same influence on the performance of (single-stream) beamforming MIMO-OFDM systems, yet different influences on spatial multiplexing MIMO-OFDM systems with singular value decomposition (SVD) based precoding/decoding. When each antenna is equipped with an independent oscillator, the PNs at the transmitter and at the receiver have different influences on beamforming MIMO-OFDM systems as well as spatial multiplexing MIMO-OFDM systems. Specifically, the PN effect on the transmitter (receiver) can be alleviated by having more transmit (receive) antennas for the case of independent oscillators. It is found that the independent oscillator case outperforms the common oscillator case in terms of error vector magnitude (EVM).

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Improved Road-Network-Flow Control Strategy Based on Macroscopic Fundamental Diagrams and Queuing Length in Connected-Vehicle Network

Connected-vehicles network provides opportunities and conditions for improving traffic signal control, and macroscopic fundamental diagrams (MFD) can control the road network at the macrolevel effectively. This paper integrated proposed real-time access to the number of mobile vehicles and the maximum road queuing length in the Connected-vehicles network. Moreover, when implementing a simple control strategy to limit the boundary flow of a road network based on MFD, we determined whether the maximum queuing length of each boundary section exceeds the road-safety queuing length in real-time calculations and timely adjusted the road-network influx rate to avoid the overflow phenomenon in the boundary section. We established a road-network microtraffic simulation model in VISSIM software taking a district as the experimental area, determined MFD of the region based on the number of mobile vehicles, and weighted traffic volume of the road network. When the road network was tending to saturate, we implemented a simple control strategy and our algorithm limits the boundary flow. Finally, we compared the traffic signal control indicators with three strategies: no control strategy, boundary control, and boundary control with limiting queue strategy. The results show that our proposed algorithm is better than the other two.

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Prognostic Impact of Cirrhosis in Patients with Intrahepatic Cholangiocarcinoma following Hepatic Resection

Background. Prognostic impact of cirrhosis in patients with intrahepatic cholangiocarcinoma (ICC) upon hepatic resection remains unclear due to lack of studies in the literature. Methods. A total of 106 resected patients with ICC were reviewed, including 25 patients (23.6%) with cirrhosis and 81 noncirrhotic patients (76.4%). Subgroups of cirrhotic patients with and without hepatitis B virus (HBV) infection were studied. Results. The impact of cirrhosis on the overall survival (OS) (hazard ratio [HR], 0.901; 95% confidence interval [CI], 0.510 to 1.592; ) and the relapse-free survival (RFS) (HR, 0.889; 95% CI, 0.509 to 1.552; ) revealed no statistical significance. Furthermore, HBV-associated cirrhotic patients and the other cirrhotic patients demonstrated no statistical difference on survival outcomes (1 yr OS, 60.0% versus 70.0%; 5 yr OS, 10.0% versus 0%; ; 1 yr RFS, 53.3% versus 30.0%; 5 yr RFS, 10.0% versus 0%; ). In patients with cirrhosis, tumor size larger than 5 cm was found to be the foremost factor that was independently associated with poor prognosis. Conclusion. The presence of liver cirrhosis did not significantly affect prognosis of patients with ICC after resection. Downstaging modality may be in need for patients with ICC underlying cirrhosis, which remains to be validated in future studies.

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Multivalued Discrete Tomography Using Dynamical System That Describes Competition

Multivalued discrete tomography involves reconstructing images composed of three or more gray levels from projections. We propose a method based on the continuous-time optimization approach with a nonlinear dynamical system that effectively utilizes competition dynamics to solve the problem of multivalued discrete tomography. We perform theoretical analysis to understand how the system obtains the desired multivalued reconstructed image. Numerical experiments illustrate that the proposed method also works well when the number of pixels is comparatively high even if the exact labels are unknown.

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Icariin Prevents IL-1β-Induced Apoptosis in Human Nucleus Pulposus via the PI3K/AKT Pathway

Purpose. To explore the effect and possible mechanism of icariin, a prenylated flavonol glycoside derived from the Chinese herb Epimedium sagittatum that was applied to IL-1β pretreated human nucleus pulposus (NP) cells. Methods. Human NP cells were isolated from intervertebral discs of patients with scoliosis and lumbar spondylolisthesis. The cells were divided into five groups: A (blank control); B (20 ng/ml IL-1β); C (20 ng/ml IL-1β + 20 μM icariin); D (20 μM icariin + 20 ng/ml IL-1β + 25 μM LY294002); E (20 ng/ml IL-1β + 25 μM LY294002). For each of the five groups, the CCK8, apoptosis rates, ROS rates, and JC-1 rates were determined and an electron micrograph was performed. Different expression levels of apoptosis proteins and proteins in the PI3K/AKT pathway were detected via western blot. Results. We found that the damage effects on human nucleus pulposus cells from 20 ng/ml of IL-1β exposure were attenuated by icariin. When the PI3K/AKT pathway was blocked by LY294002, a specific inhibitor of this pathway, the protective effect of icariin was impaired. In summary, icariin might be a protective traditional Chinese medicine, which prevents inflammation-induced degeneration of intervertebral discs partly through the PI3K/AKT pathway.

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Imaging of the thyroid and parathyroid using a cardiac cadmium zinc telluride camera: Phantom studies.

Imaging of the thyroid and parathyroid using a cardiac cadmium zinc telluride camera: Phantom studies.

J Nucl Med Technol. 2017 Nov 10;:

Authors: Miyazaki Y, Kato Y, Imoto A, Fukuchi K

Abstract
Purpose: Cadmium zinc telluride (CZT) detectors have recently been introduced to the field of clinical nuclear cardiology. However, the feasibility of using them for organs other than the heart remains unclear. The aim of this study was to evaluate the potential of a cardiac CZT camera to acquire thyroid and parathyroid images. We used custom-made phantoms and the currently available standard protocols for CZT, instead of a sodium-iodine scintillation (NaI) camera. Materials and Methods: Thyroid phantoms with or without parathyroid adenomas were made from agar using radiopharmaceuticals ((99m)Tc or (123)I) and imaged using CZT and NaI cameras. Using the CZT camera data, we prepared maximum intensity projection (MIP) images and planar equivalent (PE) images. Image counts were compared to those from the NaI camera, and the radioactivity of the phantoms was measured. For parathyroid imaging, three different protocols with the NaI camera were tested using MIP images. Results: For thyroid imaging, MIP could provide images as clear as those obtained from the NaI camera. The radioactivity and image counts correlated better for the PE images than the MIP images, especially for (123)I images. We succeeded in obtaining clear parathyroid adenoma images from MIP images using all three protocols. Conclusion: A cardiac CZT camera can effectively perform qualitative and quantitative assessments of the thyroid and parathyroid organs.

PMID: 29127244 [PubMed - as supplied by publisher]



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Geometric and dosimetric accuracy of dynamic tumor tracking during volumetric-modulated arc therapy using a gimbal mounted linac

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Publication date: Available online 11 November 2017
Source:Radiotherapy and Oncology
Author(s): Tomohiro Ono, Yuki Miyabe, Kunio Takahashi, Mami Akimoto, Nobutaka Mukumoto, Yoshitomo Ishihara, Mitsuhiro Nakamura, Takashi Mizowaki, Masahiro Hiraoka
PurposeThe aim was to examine the feasibility of a dynamic tumor-tracking volumetric modulated arc therapy (DTT-VMAT) technique using a gimbal-mounted linac and assess its positional, mechanical and dosimetric accuracy.Materials and methodsDTT-VMAT was performed using a surrogated signal-based technique. The positional tracking accuracy was evaluated as the difference between the predicted and detected target positions for various wave patterns. Mechanical accuracy measurements included gantry, multileaf collimator (MLC) and gimbal positions. The differences between the command and the measured positions were evaluated for various wave patterns. Dosimetric verification was performed using Gafchromic EBT3 films in the benchmark phantom and two clinical cases.ResultsThe root mean square error (RMSE) of the positional accuracy was within 0.31 mm. The RMSE of mechanical accuracy was within 0.14° for the gantry, 0.11 ± 0.02 mm for the MLC and 0.13 mm for the gimbal positions. The passing rate of the 3%/3 mm gamma index was greater than 83.3% and 91.2% for the benchmark phantom and two clinical cases, respectively.ConclusionsThe positional, mechanical and dosimetric accuracy of DTT-VMAT were evaluated. DTT-VMAT with a gimbal-mounted linac had sufficient accuracy and presents a new strategy for treatment of several tumors with respiratory motion.



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IJMS, Vol. 18, Pages 2399: In Situ Synthesis of Silver Nanoparticles in a Hydrogel of Carboxymethyl Cellulose with Phthalated-Cashew Gum as a Promising Antibacterial and Healing Agent

IJMS, Vol. 18, Pages 2399: In Situ Synthesis of Silver Nanoparticles in a Hydrogel of Carboxymethyl Cellulose with Phthalated-Cashew Gum as a Promising Antibacterial and Healing Agent

International Journal of Molecular Sciences doi: 10.3390/ijms18112399

Authors: Ana Lustosa Antônia de Jesus Oliveira Patrick Quelemes Alexandra Plácido Francilene da Silva Irisdalva Oliveira Miguel de Almeida Adriany Amorim Cristina Delerue-Matos Rita de Oliveira Durcilene da Silva Peter Eaton José de Almeida Leite

Silver nanoparticles have been shown to possess considerable antibacterial activity, but in vivo applications have been limited due to the inherent, but low, toxicity of silver. On the other hand, silver nanoparticles could provide cutaneous protection against infection, due to their ability to liberate silver ions via a slow release mechanism, and their broad-spectrum antimicrobial action. Thus, in this work, we describe the development of a carboxymethyl cellulose-based hydrogel containing silver nanoparticles. The nanoparticles were prepared in the hydrogel in situ, utilizing two variants of cashew gum as a capping agent, and sodium borohydride as the reducing agent. This gum is non-toxic and comes from a renewable natural source. The particles and gel were thoroughly characterized through using rheological measurements, UV-vis spectroscopy, nanoparticles tracking analysis, and transmission electron microscopy analysis (TEM). Antibacterial tests were carried out, confirming antimicrobial action of the silver nanoparticle-loaded gels. Furthermore, rat wound-healing models were used and demonstrated that the gels exhibited improved wound healing when compared to the base hydrogel as a control. Thus, these gels are proposed as excellent candidates for use as wound-healing treatments.



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An anatomic study on the attachment of the joint capsule to the tibia in the lateral side of the knee.

An anatomic study on the attachment of the joint capsule to the tibia in the lateral side of the knee.

Surg Radiol Anat. 2017 Nov 10;:

Authors: Nasu H, Nimura A, Sugiura S, Fujishiro H, Koga H, Akita K

Abstract
PURPOSE: The purpose of the current study was to examine the width, area, and histological characteristics of the capsular attachment to the tibia in the lateral side of the knee.
METHODS: A total of 27 knees were used in this study. The joint capsule of the knee was peeled away from the tibia and the width of the capsular attachment to the tibia was measured by two independent observers using a caliper. Interclass correlation coefficients for each value were calculated to evaluate the validity of the measurement. The capsular attachment to the tibia of the seven knees was histologically analyzed using Masson's trichrome staining.
RESULTS: At the posterior border of Gerdy's tubercle, the capsular attachment was wide; the average width was 8.6 mm (SD 3.0). Toward the posterolateral aspect of the knee, the capsular attachment gradually tapered. Finally, the capsular attachment was linear at the apex of the head of the fibula. Histological analysis at the posterior border of Gerdy's tubercle revealed developed uncalcified fibrocartilage on the capsular attachment. In contrast, at the apex of the head of the fibula, the joint capsule was adhered to the capsule of the proximal tibiofibular joint. Fibrous connective tissue was directly attached to the calcified fibrocartilage.
CONCLUSIONS: The attachment width of the knee joint capsule at the lateral side varied according to location. We consider that this finding on the capsular attachment will facilitate an understanding of the pathology or mechanism of diseases on the lateral side of the knee joint.

PMID: 29127471 [PubMed - as supplied by publisher]



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Rectus abdominis muscle innervation: an anatomical study with surgical implications in diep flap harvesting.

Rectus abdominis muscle innervation: an anatomical study with surgical implications in diep flap harvesting.

Surg Radiol Anat. 2017 Nov 10;:

Authors: Stecco C, Azzena GP, Macchi V, Porzionato A, Behr A, Rambaldo A, Tiengo C, De Caro R

Abstract
PURPOSE: To improve the current knowledge of rectus abdominis innervation, so as to identify a safe area where the vascular pedicle should be dissected to reduce the risk of nerve damage during deep inferior epigastric perforator (DIEP) flap harvesting.
METHODS: Ten abdominal wall dissections were performed. Perforating arteries were identified and classified into nerve-related perforators and non-nerve-related perforators depending on the presence of nerve branches crossing vessels. The width of rectus abdominis and the distance between perforators and lateral edge of rectus abdominis muscle were measured. In contralateral hemi-abdomen, full-thickness specimens were sampled for microscopical analysis.
RESULTS: Nerves enter the rectus sheath piercing the lateral edge (60% of cases) or the posterolateral surface of the sheath (40% of cases). They enter the rectus abdominis muscle at a mean distance of 4.3 cm from the lateral margin of the sheath. Within rectus abdominis, nerves have a mean thickness of 200.3 µm and split into 2-4 sensitive and 2-4 muscular branches. Close relationship between muscular branches and deep inferior epigastric artery perforators were shown. The mean distance between nerve-related perforators and the lateral edge of the rectus abdominis was of 3.26 ± 0.88 cm. The mean distance between non-nerve-related perforators and the lateral edge of the rectus abdominis was of 6.26 ± 0.90 cm.
CONCLUSIONS: To spare nerves and reduce donor-site complications, a perforator located beyond an imaginary line of 3.26 ± 0.88 cm far from the lateral edge of rectus abdominis muscle should be included in the DIEP flap.

PMID: 29127470 [PubMed - as supplied by publisher]



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The right intercostobronchial trunk: anatomical study in respect of posterior intercostal artery origin and its clinical application.

The right intercostobronchial trunk: anatomical study in respect of posterior intercostal artery origin and its clinical application.

Surg Radiol Anat. 2017 Nov 10;:

Authors: Kocbek L, Rakuša M

Abstract
PURPOSE: The right bronchial artery usually arises from the descending thoracic aorta as a common trunk with the right intercostal artery and forms the right intercostobronchial trunk. Both, the third right posterior intercostal artery and the right intercostobronchial trunk, are described as the most constant vessels. The focus of the study was to determine the characteristics of the right intercostobronchial trunk regarding the origins of the posterior intercostal arteries from the thoracic aorta.
METHODS: Posterior intercostal arteries and the right bronchial arteries were dissected in 43 human cadavers, preserved after Thiel's embalming method with intraarterial infusion of red colored latex.
RESULTS: Postmortem examination gave valued information on the right intercostobronchial trunk present in 58% of cases. The right intercostobronchial trunk was mapped and new classification regarding the origin of the posterior intercostal arteries from the thoracic aorta suggested type A, B and C, the latter ones into subtypes 1 and 2. Type A was proportional to the origin level of the PIA and its corresponding intercostal space. Size of outer diameter at the origin did not indicate the right bronchial artery branch. In subtype 2 of type B the proximal posterior intercostal artery diameter that gave off right bronchial artery was thicker than distal one.
CONCLUSIONS: The right bronchial artery originates from the second to the fifth posterior intercostal artery forming the right intercostobronchial trunk. Various origin and types of origin, diameter and course of the right intercostobronchial trunk described and analyzed in the study offer valuable information on the procedures involving the right intercostobronchial trunk.

PMID: 29127469 [PubMed - as supplied by publisher]



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Anxiety sensitivity and sleep disturbance: Investigating associations among patients with co-occurring anxiety and substance use disorders.

Anxiety sensitivity and sleep disturbance: Investigating associations among patients with co-occurring anxiety and substance use disorders.

J Anxiety Disord. 2017 Nov 07;53:9-15

Authors: Dixon LJ, Lee AA, Gratz KL, Tull MT

Abstract
Sleep disturbance is a common problem among individuals with anxiety and substance use disorders (SUD). Anxiety sensitivity (AS) is elevated in patients with anxiety disorders and SUD and has been linked to sleep-related problems, including insomnia and somnolence (i.e., daytime sleepiness). We examined the unique roles of AS cognitive, physical, and social concerns in sleep disturbance among a sample of 99 residential SUD patients with anxiety disorders. Clinical levels of insomnia or somnolence were evidenced by 53.5% of the sample. Consistent with predictions, AS physical concerns was significantly associated with insomnia, and AS cognitive concerns was significantly related to insomnia and somnolence. Hierarchical linear regression models were conducted to test the association of AS cognitive and physical concerns with insomnia and somnolence symptoms while controlling for relevant factors. AS cognitive concerns accounted for unique variance, above and beyond withdrawal symptoms, anxiety, and depressive symptoms, in the model examining insomnia symptoms (B=0.30, SE=0.13, p=0.023). Results suggest that AS cognitive concerns may represent an important transdiagnostic mechanism underlying sleep disturbance among individuals with dual diagnosis.

PMID: 29127882 [PubMed - as supplied by publisher]



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Budesonide facilitates weaning from mechanical ventilation in difficult-to-wean very severe COPD patients: Association with inflammatory mediators and cells.

Budesonide facilitates weaning from mechanical ventilation in difficult-to-wean very severe COPD patients: Association with inflammatory mediators and cells.

J Crit Care. 2017 Oct 31;44:161-167

Authors: Hashemian SM, Mortaz E, Jamaati H, Bagheri L, Mohajerani SA, Garssen J, Movassaghi M, Barnes PJ, Hill NS, Adcock IM

Abstract
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes.
OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients.
MATERIALS AND METHODS: We recruited 55 difficult-to-wean COPD patients (Stage 4) within the ICU of the Masih Daneshvari Hospital. Subjects were randomly assigned to receive inhaled budesonide (0.5mg/day) or placebo (normal saline). Dynamic compliance and BAL cytokines were measured.
RESULTS: Budesonide significantly reduced the number of days on MV (days-to-weaning=4.6±1.6days) compared to that seen in the control group (7.2±2.7days, p=0.014). Dynamic compliance was significantly improved in the budesonide group on days 3 (p=0.018) and 5 (p=0.011) The levels of CXCL-8 and IL-6 diminished on days 3-5 after start of budesonide (p<0.05).
CONCLUSION: In COPD patients on MV, nebulized budesonide was associated with reduced BAL CXCL8 and IL-6 levels and neutrophil numbers as well as an improvement in ventilatory mechanics and facilitated weaning.

PMID: 29127842 [PubMed - as supplied by publisher]



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Interventions for treating collagenous colitis.

Interventions for treating collagenous colitis.

Cochrane Database Syst Rev. 2017 Nov 11;11:CD003575

Authors: Kafil TS, Nguyen TM, Patton PH, MacDonald JK, Chande N, McDonald JW

Abstract
BACKGROUND: Collagenous colitis is a cause of chronic diarrhea. This updated review was performed to identify therapies for collagenous colitis that have been assessed in randomized controlled trials (RCTs).
OBJECTIVES: The primary objective was to assess the benefits and harms of treatments for collagenous colitis.
SEARCH METHODS: We searched CENTRAL, the Cochrane IBD Group Specialized Register, MEDLINE and EMBASE from inception to 7 November 2016.
SELECTION CRITERIA: We included RCTs comparing a therapy with placebo or active comparator for the treatment of active or quiescent collagenous colitis.
DATA COLLECTION AND ANALYSIS: Data were independently extracted by two authors. The primary outcome was clinical response or maintenance of response as defined by the included studies. Secondary outcome measures included histological response, quality of life and the occurrence of adverse events. Risk ratios (RR) and 95% confidence intervals (CI) were calculated for dichotomous outcomes. The Cochrane risk of bias tool was used to assess bias. The overall quality of the evidence was assessed using the GRADE criteria.
MAIN RESULTS: Twelve RCTs (476 participants) were included. These studies assessed bismuth subsalicylate, Boswellia serrata extract, mesalamine, cholestyramine, probiotics, prednisolone and budesonide therapy. Four studies were low risk of bias. One study assessing mesalamine and cholestyramine was judged to be high risk of bias due to no blinding. The other studies had an unclear risk of bias for random sequence generation (five studies) allocation concealment (six studies), blinding (one study), incomplete outcome data (one study) and selective outcome reporting (one study). Clinical response occurred in 100% (4/4) of patients who received bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks) compared to 0% (0/5) of patients who received placebo (1 study; 9 participants; RR 10.80, 95% CI 0.75 to 155.93; GRADE = very low). Clinical response occurred in 44% (7/16) of patients who received Boswellia serrata extract (three 400 mg/day capsules for 8 weeks) compared to 27% (4/15) of patients who received placebo (1 study; 31 participants; RR 1.64, 95% CI 0.60 to 4.49; GRADE = low). Clinical response occurred in 80% (24/30) of budesonide patients compared to 44% (11/25) of mesalamine patients (1 study; 55 participants; RR 1.82, 95% CI 1.13 to 2.93; GRADE = low). Histological response was observed in 87% (26/30) of budesonide patients compared to 44% (11/25) of mesalamine patients (1 study, 55 participants; RR 1.97, 95% CI 1.24 to 3.13; GRADE = low). There was no difference between the two treatments with respect to adverse events (RR 0.69, 95% CI 0.43 to 1.10; GRADE = low), withdrawals due to adverse events (RR 0.09, 95% CI 0.01 to 1.65; GRADE = low) and serious adverse events (RR 0.12, 95% CI 0.01 to 2.21; GRADE = low). Clinical response occurred in 44% (11/25) of mesalamine patients (3 g/day) compared to 59% (22/37) of placebo patients (1 study; 62 participants; RR 0.74, 95% CI 0.44 to 1.24; GRADE = low). Histological response was observed in 44% (11/25) and 51% (19/37) of patients receiving mesalamine and placebo, respectively (1 study; 62 participants; RR 0.86, 95% CI 0.50 to 1.47; GRADE = low). There was no difference between the two treatments with respect to adverse events (RR 1.26, 95% CI 0.84 to 1.88; GRADE = low), withdrawals due to adverse events (RR 5.92, 95% CI 0.70 to 49.90; GRADE = low) and serious adverse events (RR 4.44, 95% CI 0.49 to 40.29; GRADE = low). Clinical response occurred in 63% (5/8) of prednisolone (50 mg/day for 2 weeks) patients compared to 0% (0/3) of placebo patients (1 study, 11 participants; RR 4.89, 95% CI 0.35 to 68.83; GRADE = very low). Clinical response occurred in 29% (6/21) of patients who received probiotics (2 capsules containing 0.5 x 10(10) CFU each of L. acidophilus LA-5 and B. animalis subsp. lactis strain BB-12 twice daily for 12 weeks) compared to 13% (1/8) of placebo patients (1 study, 29 participants, RR 2.29, 95% CI 0.32 to 16.13; GRADE = very low). Clinical response occurred in 73% (8/11) of patients who received mesalamine (800 mg three times daily) compared to 100% (12/12) of patients who received mesalamine + cholestyramine (4 g daily) (1 study, 23 participants; RR 0.74, 95% CI 0.50 to 1.08; GRADE = very low). Clinical response occurred in 81% (38/47) of patients who received budesonide (9 mg daily in a tapering schedule for 6 to 8 weeks) compared to 17% (8/47) of placebo patients (3 studies; 94 participants; RR 4.56, 95% CI 2.43 to 8.55; GRADE = low). Histological response was higher in budesonide participants (72%, 34/47) compared to placebo (17%, 8/47) (RR 4.15, 95% CI 2.25 to 7.66; GRADE = low). Clinical response was maintained in 68% (57/84) of budesonide patients compared to 20% (18/88) of placebo patients (3 studies, 172 participants, RR 3.30 95% CI 2.13 to 5.09; GRADE = low). Histological response was maintained in 48% (19/40) of budesonide patients compared to 15% (6/40) of placebo patients (2 studies; 80 participants; RR 3.17, 95% CI 1.44 to 6.95; GRADE = very low). No difference was found between budesonide and placebo for adverse events (5 studies; 290 participants; RR 1.18, o95% CI 0.92 to 1.51; GRADE = low), withdrawals due to adverse events (5 studies, 290 participants; RR 0.97, 95% CI 0.43 to 2.17; GRADE = very low) or serious adverse events (4 studies, 175 participants; RR 1.11, 95% CI 0.15 to 8.01; GRADE = very low). Adverse effects reported in the budesonide studies include nausea, vomiting, neck pain, abdominal pain, excessive sweating and headache. Adverse effects reported in the mesalamine studies included nausea and skin rash. Adverse effects in the prednisolone study included abdominal pain, headache, sleep disturbance, mood change and weight gain.
AUTHORS' CONCLUSIONS: Low quality evidence suggests that budesonide may be effective for inducing and maintaining clinical and histological response in patients with collagenous colitis. We are uncertain about the benefits and harms of therapy with bismuth subsalicylate, Boswellia serrata extract, mesalamine with or without cholestramine, prednisolone and probiotics. These agents and other therapies require further study.

PMID: 29127772 [PubMed - as supplied by publisher]



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Asthma, GERD and Obesity: Triangle of Inflammation.

Asthma, GERD and Obesity: Triangle of Inflammation.

Indian J Pediatr. 2017 Nov 11;:

Authors: Gupta S, Lodha R, Kabra SK

Abstract
There is increasing prevalence of both asthma and obesity in children globally in recent years. Various epidemiological studies link obesity as a risk factor for asthma and suggest a possible causal association. Obesity asthma phenotype is considered as distinct in view of greater severity and poor asthma control. Various mechanisms underlying this phenotype have been suggested including mechanical effects of obesity and systemic inflammation, but still the exact mechanism is unclear. Also, the comorbidities like gastroesophageal reflux disease (GERD) and sleep disordered breathing (SDB) lead to inflammation in airways and contribute to asthma obesity association. A better understanding of mechanisms by which obesity and GERD lead to inflammation in airways and increase the risk of asthma may provide insight towards targeted treatment approach of these patients.

PMID: 29127618 [PubMed - as supplied by publisher]



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Relationships between low-grade peripheral inflammation and psychotropic drugs in schizophrenia: results from the national FACE-SZ cohort.

Relationships between low-grade peripheral inflammation and psychotropic drugs in schizophrenia: results from the national FACE-SZ cohort.

Eur Arch Psychiatry Clin Neurosci. 2017 Nov 10;:

Authors: Fond G, Resseguier N, Schürhoff F, Godin O, Andrianarisoa M, Brunel L, Bulzacka E, Aouizerate B, Berna F, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Faget C, Gabayet F, Lançon C, Llorca PM, Mallet J, Misdrahi D, Passerieux C, Rey R, Schandrin A, Urbach M, Vidailhet P, Boyer L, Leboyer M, FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group

Abstract
Low-grade inflammation has repeatedly been associated with schizophrenia (SZ) and in particular with cognitive impairment. Female gender, overweight and tobacco smoking have been suggested as risk factors to increase inflammation while preclinical inconsistent findings have been found regarding the association with psychotropic drugs. The aim of this study was to explore if psychotropic drugs were associated with inflammation in SZ and to determine which psychotropic drug was associated with inflammation in stable SZ subjects while considering clinical confounding factors. Participants were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment, including recording of current treatment. High-sensitivity CRP (hs-CRP) was measured for each participant as a proxy to define peripheral low-grade inflammation. The zero-inflated Poisson regression model estimated the relationship between low-grade inflammation and psychotropic drug. Four hundred and five stabilized, community-dwelling SZ subjects (mean age = 32.6 years, 74% male gender) have been included. In total, 148 participants (36.5%) were found with undetectable blood hs-CRP level. The probability of having an undetectable CRP was associated with a lower body mass index (p < 0.0001) and no cyamemazine add-on antipsychotic therapy (p = 0.001). The other 257 participants (63.5%) were found to have low-grade inflammation (hs-CRP > 0 mg/L). Low-grade inflammation was significantly associated with female gender (p = 0.004), higher body mass index (p < 0.0001), current tobacco smoking (p < 0.0001), clomipramine (p = 0.04), quetiapine (p < 0.0001) and hypnotic (p = 0.0006) consumption while decreased hs-CRP blood levels was associated with aripiprazole (p = 0.004) and valproate/valpromide (p = 0.03) consumption. The present study suggests that some psychotropic drugs (quetiapine, cyamemazine, clomipramine) may be associated with increased peripheral low-grade inflammation in SZ patients while others (aripiprazole, valproate) may be associated with decreased peripheral low-grade inflammation. These results should be replicated in SZ and non-SZ populations and the biological underpinnings should be further explored.

PMID: 29127503 [PubMed - as supplied by publisher]



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Personalized health in a public health perspective.

Personalized health in a public health perspective.

Int J Public Health. 2017 Nov 10;:

Authors: Evangelatos N, Satyamoorthy K, Brand A

PMID: 29127448 [PubMed - as supplied by publisher]



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Brief targeted memory reactivation during the awake state enhances memory stability and benefits the weakest memories.

Brief targeted memory reactivation during the awake state enhances memory stability and benefits the weakest memories.

Sci Rep. 2017 Nov 10;7(1):15325

Authors: Tambini A, Berners-Lee A, Davachi L

Abstract
Reactivation of representations corresponding to recent experience is thought to be a critical mechanism supporting long-term memory stabilization. Targeted memory reactivation, or the re-exposure of recently learned cues, seeks to induce reactivation and has been shown to benefit later memory when it takes place during sleep. However, despite recent evidence for endogenous reactivation during post-encoding awake periods, less work has addressed whether awake targeted memory reactivation modulates memory. Here, we found that brief (50 ms) visual stimulus re-exposure during a repetitive foil task enhanced the stability of cued versus uncued associations in memory. The extent of external or task-oriented attention prior to re-exposure was inversely related to cueing benefits, suggesting that an internally-orientated state may be most permissible to reactivation. Critically, cueing-related memory benefits were greatest in participants without explicit recognition of cued items and remained reliable when only considering associations not recognized as cued, suggesting that explicit cue-triggered retrieval processes did not drive cueing benefits. Cueing benefits were strongest for associations and participants with the poorest initial learning. These findings expand our knowledge of the conditions under which targeted memory reactivation can benefit memory, and in doing so, support the notion that reactivation during awake time periods improves memory stabilization.

PMID: 29127388 [PubMed - in process]



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Diagnostic value of blood-derived microRNAs for schizophrenia: results of a meta-analysis and validation.

Diagnostic value of blood-derived microRNAs for schizophrenia: results of a meta-analysis and validation.

Sci Rep. 2017 Nov 10;7(1):15328

Authors: Liu S, Zhang F, Wang X, Shugart YY, Zhao Y, Li X, Liu Z, Sun N, Yang C, Zhang K, Yue W, Yu X, Xu Y

Abstract
There is an increasing interest in searching biomarkers for schizophrenia (SZ) diagnosis, which overcomes the drawbacks inherent with the subjective diagnostic methods. MicroRNA (miRNA) fingerprints have been explored for disease diagnosis. We performed a meta-analysis to examine miRNA diagnostic value for SZ and further validated the meta-analysis results. Using following terms: schizophrenia/SZ, microRNA/miRNA, diagnosis, sensitivity and specificity, we searched databases restricted to English language and reviewed all articles published from January 1990 to October 2016. All extracted data were statistically analyzed and the results were further validated with peripheral blood mononuclear cells (PBMNCs) isolated from patients and healthy controls using RT-qPCR and receiver operating characteristic (ROC) analysis. A total of 6 studies involving 330 patients and 202 healthy controls were included for meta-analysis. The pooled sensitivity, specificity and diagnostic odds ratio were 0.81 (95% CI: 0.75-0.86), 0.81 (95% CI: 0.72-0.88) and 18 (95% CI: 9-34), respectively; the positive and negative likelihood ratio was 4.3 and 0.24 respectively; the area under the curve in summary ROC was 0.87 (95% CI: 0.84-0.90). Validation revealed that miR-181b-5p, miR-21-5p, miR-195-5p, miR-137, miR-346 and miR-34a-5p in PBMNCs had high diagnostic sensitivity and specificity in the context of schizophrenia. In conclusion, blood-derived miRNAs might be promising biomarkers for SZ diagnosis.

PMID: 29127368 [PubMed - in process]



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Molecular cloning and characterization of the SIFamide precursor and receptor in a hymenopteran insect, Bombus terrestris.

Molecular cloning and characterization of the SIFamide precursor and receptor in a hymenopteran insect, Bombus terrestris.

Gen Comp Endocrinol. 2017 Nov 07;:

Authors: Lismont E, Mortelmans N, Verlinden H, Broeck JV

Abstract
SIFamides (SIFa) are a family of neuropeptides that are highly conserved among arthropods. In insects, this peptide is mainly expressed in four medial interneurons in the pars intercerebralis and affects sexual behavior, sleep regulation and pupal mortality. Furthermore, an influence on the hatching rate has been observed. The first SIFa receptor (SIFR) was pharmacologically characterized in Drosophila melanogaster and is homologous to the vertebrate gonadotropin-inhibitory hormone (GnIH) receptor (NPFFR). In this study, we pharmacologically characterized the SIFR of the buff-tailed bumblebee Bombus terrestris. We demonstrated an intracellular increase in calcium ions and cyclic AMP (cAMP) upon ligand binding with an EC50 value in the picomolar and nanomolar range, respectively. In addition, we studied the agonistic properties of a range of related and modified peptides. By means of quantitative real time PCR (qPCR), we examined the relative transcript levels of Bomte-SIFa and Bomte-SIFR in a variety of tissues.

PMID: 29127004 [PubMed - as supplied by publisher]



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The influence of sleep on human hypothalamic-pituitary-adrenal (HPA) axis reactivity: A systematic review.

The influence of sleep on human hypothalamic-pituitary-adrenal (HPA) axis reactivity: A systematic review.

Sleep Med Rev. 2017 Oct 18;:

Authors: van Dalfsen JH, Markus CR

Abstract
Inadequate sleep is highly prevalent and known to decline both physical- and mental health. Literature suggests that altered functioning of the hypothalamic-pituitary-adrenal (HPA) axis might underlie this association. This assumption is mainly based on changes in basal neuroendocrine activity and it is of equal importance to elucidate whether sleep may also influence HPA stress responsiveness. The present review provides a complete outline of recent human studies that have investigated how different aspects of sleep influence cortisol reactivity to laboratory stress. From the available data it can be concluded that both objective and subjective decrements in sleep quality potentiate the stress reactivity of the HPA axis. On the contrary, normal variations in sleep duration do not seem to influence cortisol stress responsiveness whereas excessive daytime sleepiness is associated with a blunting of the cortisol response. Given its well-established health consequences, sensitization of the HPA axis might well be a crucial component linking inadequate sleep to stress-related pathology.

PMID: 29126903 [PubMed - as supplied by publisher]



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Properties of tonic episodes of masseter muscle activity during waking hours and sleep in subjects with and without history of orofacial pain.

Properties of tonic episodes of masseter muscle activity during waking hours and sleep in subjects with and without history of orofacial pain.

J Prosthodont Res. 2017 Nov 07;:

Authors: Mude AH, Kawakami S, Kato S, Minagi S

Abstract
PURPOSE: To provide a scientific data related to the tonic activity of masseter muscle in subjects with and without history of orofacial pain during their normal daily life.
METHODS: Thirty-three subjects were divided into two groups, a pain history group (PHG) and a non-pain history group (non-PHG), based on their responses to the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire. After excluding four subjects with incomplete recordings, full-day masseter muscle surface EMGs of 29 subjects (10 men, 19 women; mean age 24.1 years) were analyzed. Tonic episode (TE) was defined as continuous EMG activity with a duration at least 2s with intensities above twice the baseline noise level. TEs were classified into 6 strength categories (<7.5%, 7.5-10%, 10-15%, 15-25%, 25-40% and >40% of the maximum voluntary clenching (MVC)). The mean duration of activity observed in the non-PHG+2 SD was adopted as a cutoff for identifying sustained TE.
RESULTS: During waking hours, the incidence of sustained TEs was significantly higher in the PHG than in the non-PHG (p<0.05). The incidence and total duration of sustained TEs were significantly higher in the PHG than in the non-PHG at intensities of 7.5-10% MVC, 10-15% MVC, and 15-25% MVC (p<0.05). No significant difference was observed during sleep.
CONCLUSIONS: Within the limitations of this study, it would be concluded that sustained TEs may have a correlation with orofacial pain and the intensity range of 7.5-25% MVC would be an important range for future clenching studies.

PMID: 29126811 [PubMed - as supplied by publisher]



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[Vascular dysfunction in obstructive sleep apnoea: Implication of microparticules].

[Vascular dysfunction in obstructive sleep apnoea: Implication of microparticules].

Rev Pneumol Clin. 2017 Nov 07;:

Authors: Trzepizur W, Priou P, Meslier N, Urban T, Martínez MC, Andriantsitohaina R, Gagnadoux F

Abstract
Obstructive sleep apnea (OSA) is associated with increased cardiovascular diseases, including myocardial infarction and stroke and promotes cardiovascular risk factors including diabetes and hypertension. OSA has also been proposed to have a direct proatherogenic effects. Recent studies have investigated the role of microparticles (MPs) in the atherogenic process. MPs are small plasma membrane vesicles that can be released by a variety of vascular or blood cells and that contain membrane and cytosolic elements. Case-control studies have suggested that OSA is associated with an increase in circulating platelet-, endothelial- and leukocyte-derived MPs. MPs from OSA patients injected to mice have also been shown to induce vascular inflammation and endothelial dysfunction. In this article, we provide an overview of the main characteristics of MPs expressed in OSA and their potential role in the atherogenic process.

PMID: 29126756 [PubMed - as supplied by publisher]



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A 53-Year-Old Man With a Bronchial Mass and Multiple Bone Lesions.

A 53-Year-Old Man With a Bronchial Mass and Multiple Bone Lesions.

Chest. 2017 Nov;152(5):e115-e119

Authors: Cherian SV, Estrada-Y-Martin RM, Billah S, Weissferdt A

Abstract
CASE PRESENTATION: A 53-year-old man was admitted with complaints of back pain of 3 months' duration along with numbness and weakness in his left upper and lower extremities. He denied any respiratory complaints or anorexia but did report an 11 kg weight loss over the last 3 months. He had no other significant medical history and denied any history of cigarette smoking or recreational drug use. Family history was significant for prostate cancer in his father.

PMID: 29126536 [PubMed - in process]



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Response.

Response.

Chest. 2017 Nov;152(5):1090-1091

Authors: Kohler M, Schwarz EI

PMID: 29126524 [PubMed - in process]



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Prediction of drowsiness events in night shift workers during morning driving.

Prediction of drowsiness events in night shift workers during morning driving.

Accid Anal Prev. 2017 Nov 07;:

Authors: Liang Y, Horrey WJ, Howard ME, Lee ML, Anderson C, Shreeve MS, O'Brien CS, Czeisler CA

Abstract
The morning commute home is an especially vulnerable time for workers engaged in night shift work due to the heightened risk of experiencing drowsy driving. One strategy to manage this risk is to monitor the driver's state in real time using an in vehicle monitoring system and to alert drivers when they are becoming sleepy. The primary objective of this study is to build and evaluate predictive models for drowsiness events occurring in morning drives using a variety of physiological and performance data gathered under a real driving scenario. We used data collected from 16 night shift workers who drove an instrumented vehicle for approximately two hours on a test track on two occasions: after a night shift and after a night of rest. Drowsiness was defined by two outcome events: performance degradation (Lane-Crossing models) and electroencephalogram (EEG) characterized sleep episodes (Microsleep Models). For each outcome, we assessed the accuracy of sets of predictors, including or not including a driver factor, eyelid measures, and driving performance measures. We also compared the predictions using different time intervals relative to the events (e.g., 1-min prior to the event through 10-min prior). By examining the Area Under the receiver operating characteristic Curve (AUC), accuracy, sensitivity, and specificity of the predictive models, the results showed that the inclusion of an individual driver factor improved AUC and prediction accuracy for both outcomes. Eyelid measures improved the prediction for the Lane-Crossing models, but not for Microsleep models. Prediction performance was not changed by adding driving performance predictors or by increasing the time to the event for either outcome. The best models for both measures of drowsiness were those considering driver individual differences and eyelid measures, suggesting that these indicators should be strongly considered when predicting drowsiness events. The results of this paper can benefit the development of real-time drowsiness detection and help to manage drowsiness to avoid related motor-vehicle crashes and loss.

PMID: 29126462 [PubMed - as supplied by publisher]



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Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report.

Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report.

Head Face Med. 2017 Nov 10;13(1):20

Authors: Tomonari H, Takada H, Hamada T, Kwon S, Sugiura T, Miyawaki S

Abstract
BACKGROUND: We describe the case of a 16-year-old female patient with micrognathia, temporomandibular joint (TMJ) ankylosis, and obstructive sleep apnea, who was treated with mandibular distraction osteogenesis (DO) combined with sliding genioplasty, using skeletal anchorage.
CASE PRESENTATION: We first performed interpositional arthroplasty, in which an interposition of fascia temporalis and surrounding fat tissue was inserted into the defect after bilateral condylectomy, increasing the maximum mouth opening from 5.0 to 32.0 mm. Subsequently, orthodontic treatment and advancement of the mandible were carried out by mandibular DO, using miniscrews and miniplates. Finally, sliding genioplasty was performed to bring the tip of the mandible forward. The total amount of mandibular advancement at the menton was 16.0 mm. An improved facial appearance and good occlusion were eventually achieved, and the apnea-hypopnea index decreased from 37.1 to 8.7. There was no obvious bone resorption or pain in the temporomandibular region, limited mouth opening (maximum mouth opening: 33.0 mm), myofascial pain or headache, downward rotation of the mandible, or lateral shift of mandibular position evident at 5 years and 6 months after mandibular DO.
CONCLUSION: Mandibular DO using skeletal anchorage with intermaxillary elastics is useful for preventing extrusion of the upper and lower anterior teeth, thereby preventing rotation of the mandible. In addition, mandibular DO combined with sliding genioplasty is effective at improving both dentofacial deformities and impaired respiratory function.

PMID: 29126455 [PubMed - in process]



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The factors associated with geriatric depression in rural China: stratified by household structure.

The factors associated with geriatric depression in rural China: stratified by household structure.

Psychol Health Med. 2017 Nov 10;:1-11

Authors: Gong F, Zhao D, Zhao Y, Lu S, Qian Z, Sun Y

Abstract
Depressive symptoms and empty nest phenomenon of rural elderly people are both important public health issues, which should not be ignored. We aimed to estimate the prevalence of depressive symptoms and related factors of the empty nest elderly in rural China. We recruited 3182 eligible subjects and gathered data by face-to-face interview. Multivariate logistic regression models were used to explore the related factors of depressive symptoms. The present study showed that the prevalence of depressive symptoms significantly differed between empty nest old adults and non-empty nesters (24.1% vs. 19.0%). The elderly living alone had highest OR of depressive symptoms. Depressive symptoms of empty nest elderly was associated with sleep quality, economic status, pain, social support and ADL. While it was associated with gender, economic status, pain and PSMS in non-empty nest group. Number of chronic disease showed significant associations with depressive symptoms in the elderly living alone. Subjective support, support utilization and pain were positively associated with depressive symptoms in the elderly living with spouse. Sleep quality, economic status and ADL were common factors. Depressive symptoms obviously prevail among empty nest elderly than non-empty nesters. It reminded us that complementary social support from family and society is essential.

PMID: 29126351 [PubMed - as supplied by publisher]



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Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome.

Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome.

JAMA. 2017 Nov 11;:

Authors: Chapman AR, Lee KK, McAllister DA, Cullen L, Greenslade JH, Parsonage W, Worster A, Kavsak PA, Blankenberg S, Neumann J, Söerensen NA, Westermann D, Buijs MM, Verdel GJE, Pickering JW, Than MP, Twerenbold R, Badertscher P, Sabti Z, Mueller C, Anand A, Adamson P, Strachan FE, Ferry A, Sandeman D, Gray A, Body R, Keevil B, Carlton E, Greaves K, Korley FK, Metkus TS, Sandoval Y, Apple FS, Newby DE, Shah ASV, Mills NL

Abstract
Importance: High-sensitivity cardiac troponin I testing is widely used to evaluate patients with suspected acute coronary syndrome. A cardiac troponin concentration of less than 5 ng/L identifies patients at presentation as low risk, but the optimal threshold is uncertain.
Objective: To evaluate the performance of a cardiac troponin I threshold of 5 ng/L at presentation as a risk stratification tool in patients with suspected acute coronary syndrome.
Data Sources: Systematic search of MEDLINE, EMBASE, Cochrane, and Web of Science databases from January 1, 2006, to March 18, 2017.
Study Selection: Prospective studies measuring high-sensitivity cardiac troponin I concentrations in patients with suspected acute coronary syndrome in which the diagnosis was adjudicated according to the universal definition of myocardial infarction.
Data Extraction and Synthesis: The systematic review identified 19 cohorts. Individual patient-level data were obtained from the corresponding authors of 17 cohorts, with aggregate data from 2 cohorts. Meta-estimates for primary and secondary outcomes were derived using a binomial-normal random-effects model.
Main Outcomes and Measures: The primary outcome was myocardial infarction or cardiac death at 30 days. Performance was evaluated in subgroups and across a range of troponin concentrations (2-16 ng/L) using individual patient data.
Results: Of 11 845 articles identified, 104 underwent full-text review, and 19 cohorts from 9 countries were included. Among 22 457 patients included in the meta-analysis (mean age, 62 [SD, 15.5] years; n = 9329 women [41.5%]), the primary outcome occurred in 2786 (12.4%). Cardiac troponin I concentrations were less than 5 ng/L at presentation in 11 012 patients (49%), in whom there were 60 missed index or 30-day events (59 index myocardial infarctions, 1 myocardial infarction at 30 days, and no cardiac deaths at 30 days). This resulted in a negative predictive value of 99.5% (95% CI, 99.3%-99.6%) for the primary outcome. There were no cardiac deaths at 30 days and 7 (0.1%) at 1 year, with a negative predictive value of 99.9% (95% CI, 99.7%-99.9%) for cardiac death.
Conclusions and Relevance: Among patients with suspected acute coronary syndrome, a high-sensitivity cardiac troponin I concentration of less than 5 ng/L identified those at low risk of myocardial infarction or cardiac death within 30 days. Further research is needed to understand the clinical utility and cost-effectiveness of this approach to risk stratification.

PMID: 29127948 [PubMed - as supplied by publisher]



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Photo- and chemocatalytic oxidation of dyes in water.

Photo- and chemocatalytic oxidation of dyes in water.

J Environ Manage. 2017 Nov 08;206:507-515

Authors: Du WN, Chen ST

Abstract
Three commonly used dyes, Acid Red-114 (AR-114), Reactive Black-5 (RB-5), and Disperse Black EX-SF (DB-EX-SF), were treated in a pH-neutral liquid with ultraviolet (UV) light by two reactive methods: photocatalysis with titanium dioxide (TiO2), and/or chemocatalysis with hydrogen peroxide (H2O2) as the oxidant and various ferrous-based electron mediators as catalysts. Important factors for dye oxidation were determined through bifactorial experiments. The optimum combinations and doses of the three key reagents, namely TiO2, H2O2, and EDTA-Fe, were also determined. The degradation kinetics of the studied dyes at their optimum doses reveal that the oxidation reactions are pseudo-first-order in nature, and that certain dyes are selectively degraded more by one method than the other. The overall results suggest that co-treatment using more than one oxidative method is beneficial for the treatment of wastewater from dyeing processes.

PMID: 29127922 [PubMed - as supplied by publisher]



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Greywater characterization and generation rates in a peri urban municipality of a developing country.

Greywater characterization and generation rates in a peri urban municipality of a developing country.

J Environ Manage. 2017 Nov 08;206:498-506

Authors: Oteng-Peprah M, de Vries NK, Acheampong MA

Abstract
The quantity and quality of combined greywater from houses with in-house water supply and houses that rely on external sources of a peri-urban area in a developing country were determined. Data for quantity of greywater was collected from 36 households while 180 samples of greywater were collected from 60 households between December 2016 and February 2017. The results indicate that, average water consumption from households with in-house access was 82.51 ± 12.21 Lc(-1)d(-1) while households which rely on external sources was 36.64 ± 4.31 Lc(-1)d(-1) with return factors of 74.16% and 88.57% respectively. Quality analysis also showed significant differences between greywater from the two sources with most of the quality parameters exceeding the regulatory limit. The ratio between biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) ranged between 0.22 and 0.59 for greywater from in-house sources and 0.23-0.62 for external sources indicating low biodegradability of the greywater. The nutrients recorded exceeded the trigger levels for eutrophication while significant levels of microorganisms such as E. Coli and Salmonella spp. were also detected in both streams. Direct reuse of greywater for irrigation was found to be unsuitable based on the salinity and sodium hazard analysis. Principal component analysis of the data indicated that the characteristics of the combined greywater in the study area is influenced by cooking and cleaning practices, personal hygiene, biodegradability, frequency of water use before disposal and sanitary practices in the bathroom. The greywater discharged is detrimental to the environment and poses a health risk to humans and livestock. There is therefore the need for authorities involved to prioritize greywater management and treatment in peri-urban areas of developing countries.

PMID: 29127921 [PubMed - as supplied by publisher]



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Minding the Gap: Reconciling Human and Technical Perspectives on the IoT for Healthy Ageing

There are two distinct bodies of literature on the Internet of Things, one that derives from a technical perspective, while the other comes from a human perspective. From a technical perspective, sensors can automatically detect physical activity, thus enabling elderly people to live independently, while sensors in essence check that they are active, remind them to take their pills, and so on. From a human perspective, people seek control over their lives, good health, social connection, and a sense of well-being that comes from having purpose and feeling competent in daily routines. So are technologies meant to enable users to stay in control of their lives and manage their relations and preferred routines, or do they undermine it, making elderly people feel subjects of surveillance and incompetent, disrupting their daily arrangements? And is there a middle path that we might take in design that creates innovative technologies that are aesthetic in form and function and empowering to use? In this paper, we offer a framework and examples of designs that bridge these perspectives.

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Are Fusion Transcripts in Relapsed/Metastatic Head and Neck Cancer Patients Predictive of Response to Anti-EGFR Therapies?

Prediction of benefit from combined chemotherapy and the antiepidermal growth factor receptor cetuximab is a not yet solved question in head and neck squamous cell carcinoma (HNSCC). In a selected series of 14 long progression-free survival (PFS) and 26 short PFS patients by whole gene and microRNA expression analysis, we developed a model potentially predictive of cetuximab sensitivity. To better decipher the “omics” profile of our patients, we detected transcript fusions by RNA-seq through a Pan-Cancer panel targeting 1385 cancer genes. Twenty-seven different fusion transcripts, involving mRNA and long noncoding RNA (lncRNA), were identified. The majority of fusions (81%) were intrachromosomal, and 24 patients (60%) harbor at least one of them. The presence/absence of fusions and the presence of more than one fusion were not related to outcome, while the lncRNA-containing fusions resulted enriched in long PFS patients (). The CD274-PDCD1LG2 fusion was present in 7/14 short PFS patients harboring fusions and was absent in long PFS patients (). Among the short PFS patients, those harboring this fusion had the worst outcome () and increased K-RAS activation (). The associations between HNSCC patient’s outcome following cetuximab treatment and lncRNA-containing fusions or the CD274-PDCD1LG2 fusion deserve validation in prospective clinical trials.

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Chloroform Extract of Artemisia annua L. Relaxes Mouse Airway Smooth Muscle

Artemisia annua L. belongs to the Asteraceae family, which is indigenous to China. It has valuable pharmacological properties, such as antimalarial, anti-inflammatory, and anticancer properties. However, whether it possesses antiasthma properties is unknown. In the current study, chloroform extract of Artemisia annua L. (CEAA) was prepared, and we found that CEAA completely eliminated acetylcholine (ACh) or high K+-elicited (80 mM) contractions of mouse tracheal rings (TRs). Patch-clamp technique and ion channel blockers were employed to explore the underlying mechanisms of the relaxant effect of CEAA. In whole-cell current recording, CEAA almost fully abolished voltage-dependent Ca2+ channel (VDCC) currents and markedly enhanced large conductance Ca2+-activated K+ (BK) channel currents on airway smooth muscle cells (ASMCs). In single channel current recording, CEAA increased the opening probability but had no effect on the single channel conductance of BK channels. However, under paxilline-preincubated (a selective BK channel blocker) conditions, CEAA only slightly increased BK channel currents. These results indicate that CEAA may contain active components with potent antiasthma activity. The abolished VDCCs by CEAA may mainly contribute to the underlying mechanism through which it acts as an effective antiasthmatic compound, but the enhanced BK currents might play a less important role in the antiasthmatic effects.

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The Effects of Natural Chinese Medicine Aconite Root, Dried Ginger Rhizome, and Coptis on Rectal and Skin Temperatures at Acupuncture Points

The 4 properties of Chinese materia medica refer to cold, hot, warm, and cool. In the present study, the effects of the Coptis, the prepared aconite root, and dried ginger rhizome were compared with regard to the rectal and skin temperature changes of the related body surface acupuncture points (Dazhui, Zhiyang, Mingmen, Zhongwan, and Shenque). The investigation aimed to explore the thermal sensitive points, which can reflect the cold and hot properties of the Chinese herbs. This study showed that the prepared aconite root and dried ginger rhizome exhibited a warming effect on the body temperature, whereas the warming sensitive points were Zhongwan, Shenque, Dazhui, and Zhiyang. Coptis exhibited both a warming and a cooling effect on the body temperature, and the cooling sensitive point was Dazhui. The concomitant effect of these three Chinese herbs on the regulation of the body temperature was reflected by Dazhui. However, there are still some limitations and one-sidedness. For instance, the cold and hot property of some herbs cannot be fully reflected through relevant acupoints on the conception and governor vessels. More detecting sites such as ears and internal organs will be selected for further exploration of Chinese herbs’ cold and hot property.

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Chemical Characterization and Biological Activities of Essential Oil Obtained from Mint Timija Cultivated under Mineral and Biological Fertilizers

Cultivation of mint timija (Mentha suaveolens subsp. timija (Briq.) Harley) constitutes a promising solution to the conservation and sustainable utilization of this Moroccan endemic and threatened species. Optimized agronomic practices require mineral and/or biological fertilizer applications. The aim of this study was to determine the effects of application of a complete (N, P, and K) mineral fertilizer and vesicular arbuscular mycorrhizae (VAM) inoculation on the composition, antioxidant, and insecticidal properties of mint timija essential oils (EOs). The GC-MS analyses identified 27 components representing more than 99.9% of the total oils. Menthone (40.7–49.3%), pulegone (31.3–36.5%), and isomenthone (2.5–4.4%) were found to be the main constituents. Cultivation of mint timija with mineral fertilizer and VAM inoculation induced an increase in menthone content and a parallel decrease of pulegone. Both treatments enhanced the antioxidant activity of the investigated EOs in all assays (IC50 ranged from 2.34 ± 0.03 mg/mL to 6.82 ± 0.25 mg/mL), while no significant difference in the toxicities of these oils against Tribolium confusum du Val. has been observed. Overall, we conclude that cultivation using complete mineral fertilizer and VAM inoculation could be useful in modulating the chemical composition and enhancing the antioxidant activity of the EO of this endemic Moroccan species.

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Copanlisib: First Global Approval.

Copanlisib: First Global Approval.

Drugs. 2017 Nov 10;:

Authors: Markham A

Abstract
Bayer are developing copanlisib (Aliqopa™)-a pan-class I phosphoinositide 3-kinase (PI3K) inhibitor-as a treatment for various haematological and solid malignancies. The US FDA has granted copanlisib accelerated approval for the treatment of adults with relapsed follicular lymphoma who have received at least two prior systemic therapies based on the results of a phase II trial. Phase III trials are underway evaluating copanlisib as treatment for relapsed/refractory diffuse large B-cell lymphoma and in combination with rituximab or rituximab-based chemotherapy or standard immunochemotherapy in patients with relapsed indolent B-cell non-Hodgkin's lymphoma. Phase I/II studies are underway in relapsed or refractory peripheral T-cell or NK/T-cell lymphoma, advanced cholangiocarcinoma, hormone receptor-positive HER2-negative stage I-IV breast cancer, HER2-positive breast cancer and recurrent and/or metastatic head and neck squamous cell carcinomas harbouring a PI3KCA mutation/amplification and/or a PTEN loss. This article summarizes the milestones in the development of copanlisib leading to this first approval for relapsed follicular lymphoma.

PMID: 29127587 [PubMed - as supplied by publisher]



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Influence of coupler size on revision rate and timing of revision after free flap tissue transfer in the head and neck.

Influence of coupler size on revision rate and timing of revision after free flap tissue transfer in the head and neck.

Eur Arch Otorhinolaryngol. 2017 Nov 10;:

Authors: Kisser U, Adderson-Kisser C, Baumeister P, Reiter M

Abstract
OBJECTIVE: Microvascular coupler devices have been proven an effective alternative to standard hand-sutured anastomoses in reconstructive surgery. Until now, the influence of the coupler size on the revision rate after free flap tissue transfer in head and neck surgery has not been investigated. Neither has its influence on the timing of venous revisions.
MATERIALS AND METHODS: A retrospective mono-center cohort study was performed in order to analyze the influence of coupler size on timing and revision rate of microvascular procedures.
RESULTS: 437 patients who had undergone surgery between 2009 and 2015 were included. The statistical analysis of coupler size and revision rate due to venous complications showed a significant reduction of more than 40% in the revision rate for each additional mm in the coupler size. We observed revisions due to venous congestion until the fourth day postoperatively within our cohort. However, when the coupler size used was ≥ 3 mm, no venous congestion occurred later than 12 h after surgery.
CONCLUSION: The quantitative effects of coupler size on the revision rate in head and neck reconstruction were demonstrated for the first time. We recommend spending extra time and effort on dissecting the largest possible vein in order to be able to choose the largest possible coupler size for the venous anastomosis. As a consequence of our findings, we limit our postoperative monitoring for patients with a coupler ≥ 3 mm to 24 h, as later venous congestions are very unlikely.

PMID: 29127507 [PubMed - as supplied by publisher]



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Correspondence: Reply to 'Revisiting the theoretical cell membrane thermal capacitance response'.

Correspondence: Reply to 'Revisiting the theoretical cell membrane thermal capacitance response'.

Nat Commun. 2017 Nov 10;8(1):1432

Authors: Shapiro MG, Homma K, Villarreal S, Richter CP, Bezanilla F

PMID: 29127286 [PubMed - in process]



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Injuries in female and male elite taekwondo athletes: a 10-year prospective, epidemiological study of 1466 injuries sustained during 250 000 training hours.

Injuries in female and male elite taekwondo athletes: a 10-year prospective, epidemiological study of 1466 injuries sustained during 250 000 training hours.

Br J Sports Med. 2017 Nov 10;:

Authors: Park KJ, Song BB

Abstract
OBJECTIVES: We aimed to determine the injury patterns associated with training activities in elite South Korean taekwondo athletes training for the Olympic Games.
METHODS: We collected data prospectively from 2007 to 2016 at the Korea National Training Center in Seoul, South Korea. A sports injury was defined as acute or chronic musculoskeletal signs and symptoms due to taekwondo activities during training sessions. Athletes were assessed by an on-site sports medicine specialist. The elite taekwondo athletes were stratified according to sex, weight class (flyweight, featherweight, welterweight and heavyweight), injury location (body region and site) and injury severity (mild or level I, requiring treatment for 1-3 days; moderate or level II, requiring treatment for 4-7 days; or severe or level III, requiring treatment for ≥8 days).
RESULTS: Athlete exposure was 56 160 training sessions that took 249 600 hours. 1466 injuries were recorded in 283 athletes, with an average of 4.6 injuries per athlete annually. Of these, more than half (56%) were mild injuries, with most injuries occurring in the lower extremities (65.5%), followed by injuries to the trunk (16%), upper extremities (14%) and head and neck area (4%). Among these athletes, women had higher injury rates in the featherweight and welterweight categories (P≤0.0001), but there were no sex differences in other weight categories. In general, female athletes and male athletes experienced a comparable risk of injury (relative ratio: 1.55; 95% CI 0.89 to 2.68).
CONCLUSION: In elite South Korean taekwondo athletes, most injuries occur in the lower extremities and were graded as minor. Injury severity depended on weight class.

PMID: 29127266 [PubMed - as supplied by publisher]



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Abrikossoff's tumour on the upper limb: a rare presentation.

Abrikossoff's tumour on the upper limb: a rare presentation.

BMJ Case Rep. 2017 Nov 09;2017:

Authors: Costa Almeida CE, Caroço T, Silva M, Albano MN

Abstract
Abrikossoff's tumour or granular cell tumour is a rare entity. Most common locations are the head and neck, with only a few cases reported on the upper limbs. A 55-year-old man with a nodular lesion on the left arm resorted to surgery consultation. Nodule was firm, mobile, painless and non-ulcerated. Total excision using a Limberg flap procedure was performed. Following 3 months of follow-up, the patient is fine. Abrikossoff's tumour is frequently presented in the second to sixth decade of life as an ulcerated nodule with progressive growth. Malignant form is rare, with metastases occurring in up to 3% of patients. Excision must be accomplished with free margins. Recurrence is rare. Abrikossoff's tumour on the upper limbs is rare. Although benignity is the rule, doctors must be aware of the possibility of harbouring a cancer. Surgery is the treatment of choice.

PMID: 29127127 [PubMed - in process]



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