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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Παρασκευή, 17 Νοεμβρίου 2017

NICE Guidelines for Cervical Spine Evaluation in RTA

Presenting a short video about cervical spine evaluation in RTA according to NICE guidelines.

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Reply to: “Predelivery uterine artery embolization for placental anomalies: some clarifications”



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Computed Tomography Perfusion is a Useful Adjunct to Computed Tomography Angiography in the Diagnosis of Brain Death

Abstract

Background

In the diagnosis of brain death (BD), computed tomography angiography (CTA) results in some cases show intracranial filling, leading to diagnostic confusion. Because cerebral circulatory arrest commences at the capillary level, we hypothesized that computed tomography perfusion (CTP) would be a more sensitive approach than CTA; therefore, the aim of the study was to compare the sensitivities of CTP and CTA in the diagnosis of BD.

Material and Methods

Whole brain CTP was performed in patients in the intensive care unit diagnosed with BD and CTA was derived from CTP datasets. Cerebral blood flow (CBF) and volume (CBV) were calculated in all brain regions. The CTP findings were interpreted as being consistent with a diagnosis of BD (positive) when CBF and CBV in all regions of interest (ROIs) were below 10 ml/100 g/min and 1.0 ml/100 g, respectively. The CTA findings were interpreted using a 4-point grading system.

Results

A total of 50 patients were included in the study. The CTP results revealed CBF from 0.00 to 9.98 ml/100 g/min (mean, 1.98 ± 1.68 ml/100 g/min) and CBV from 0.00 to 0.99 ml/100 g (mean, 0.14 ± 0.12 ml/100 g) and were thus interpreted as positive in all 50 patients. In contrast, the CTA results suggested 7 negative cases, providing a sensitivity of 86%. The difference between the CTP and CTA sensitivity results for the diagnosis of BD was statistically significant (p = 0.006).

Conclusion

Whole brain CTP may potentially be a feasible and highly sensitive test for diagnosing BD: therefore, performing CTP in combination with CTA in cases when CTA results are negative for BD could increase the sensitivity of CTA.



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Calcified carotid artery atheromas in panoramic radiographs are associated with a first myocardial infarction: a case-control study.

Publication date: Available online 15 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): N. Gustafsson, J. Ahlqvist, U. Näslund, P. Wester, K. Buhlin, A. Gustafsson, E. Levring Jäghagen
ObjectiveThe aim of this case-control study was to investigate whether subjects with a first myocardial infarction (MI) had a higher prevalence of calcified carotid artery atheromas (CCAAs) in panoramic radiographs (PRs) than age, gender, and residential area matched controls without MIs.Study designSix hundred ninety-six cases with a first MI and 696 controls, were included in this sub-study of the Swedish multicentre PAROKRANK study. All subjects had PRs that were evaluated for CCAAs.ResultsThe prevalence of CCAAs detected by PR was 33.8% (235/696) in cases and 27.6% (192/696) in controls (odds ratio [OR]: 1.24, 95% CI: 1.04-1.44; p=0.012). Among males, 32.7% (184/562) of cases and 26.5% (149/562) of controls displayed CCAAs in PRs (OR: 1.24, 95% CI: 1.03-1.48; p=0.022). Among both genders, bilateral CCAAs were significantly more common among cases than among controls (p=0.002).ConclusionCases, i.e. subjects with recent MIs, had a significantly higher prevalence of CCAAs in PRs compared to controls, i.e. subjects without MIs. This difference between groups was more pronounced for bilateral CCAAs. These findings supported the contention that CCAA detection could serve as a risk indicator for future MIs.



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Considerations in the diagnosis of oral hairy leukoplakia – an institutional experience

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Publication date: Available online 15 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Andres Flores-Hidalgo, Si On Lim, Alice E. Curran, Ricardo J. Padilla, Valerie Murrah
ObjectiveWe report the 10-year experience with oral hairy leukoplakia (OHL) at the Division of Oral and Maxillofacial Pathology at the University of North Carolina at Chapel Hill.Study DesignAll the associated hematoxylin and eosin (H&E) and EBV encoding region in-situ hybridization (EBER ISH) slides of OHL cases between January 1, 2008 and February 1, 2017 were retrieved and reviewed. Collected demographics, clinical presentation, medical and social history were reviewed and reported.ResultsSix ISH-confirmed OHL cases showed predilection for the lateral tongue. There were three females and three males. The mean age was 50.5 years, with a range of 29 -70 years. One patient had known HIV-positive status prior to the biopsy. Three patients had reported a history of heavy smoking. Other medical conditions reported were history of breast cancer, a long history of corticosteroid inhalers use for asthma treatment, high cholesterol, diabetes and hypertension.ConclusionThese findings demonstrate the need to include OHL as a potential entity in the differential diagnosis of leukoplakic tongue lesions, regardless of the HIV status. Also, the presence of OHL in patient can promote the investigation of various explanations of EBV infection including immunosuppression due to HIV infection or chronic steroid use.



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Comparison between peri-implant bone level changes of implants placed during and 3 months after iliac bone grafting

Publication date: Available online 15 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Emre Tosun, Canseda Avağ, Özgür Başlarlı, Serkan Kiriş, Anıl Öztürk, Murat Akkocaoğlu
ObjectiveThe aim of this study was to compare the peri-implant bone level changes of implants placed during and 3 months after bone grafting from the iliac crest.Study DesignA total of 103 implants were placed; 42 during the grafting, and 61 three months after the grafting procedure. All patients were grafted with iliac bone from the anterior superior iliac crest. Bone resorption was evaluated with cone-beam computed tomography, in all patients, at their last control visit. Periodontal health was assessed via the gingival and plaque indices and pocket depths around the dental implants.ResultsMean bone resorption values at the buccal, lingual, mesial, and distal sides of the implants were 1.08 mm, 0.36 mm, 0.30 mm, and 0.25 mm in the delayed group, and 1.87 mm, 1.25 mm, 0.92 mm, and 1.23 mm in the simultaneous group, respectively; the differences between the groups were significant. There were no significant between-group differences in the gingival or plaque indices, or pocket depths. The mean follow-up period was 29 months.ConclusionFor reconstructing atrophic jaws, bone grafting from the iliac crest and implant placement after 3 months is a reliable technique with a high success rate and less bone resorption.



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Performance of five different displays in the detection of artificial incipient and recurrent caries-like lesions

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Publication date: Available online 15 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Shawn Chancy Countryman, Saulo Leonardo Sousa Melo, Manuella Dias Furtado Belem, Francisco Haiter-Neto, Marcos A. Vargas, Veeratrishul Allareddy
ObjectivesTo assess whether auto-calibrating medical-grade monitors perform better than off-the-shelf monitors and tablet computers in detecting artificial incipient and recurrent caries-like lesions.Materials & Methods60 extracted teeth (30 premolars and 30 molars) were selected. All molars received class II amalgam and composite restorations. A 7mm2 area on the crowns of half of the teeth was demineralized. Phantoms consisting of four teeth were created. Three observers using a five-point scale evaluated digital periapical radiographs for the presence of caries on five displays: two auto-calibrating medical-grade monitors, two tablets, and an off-the-shelf monitor. Sensitivity, specificity, accuracy, and ROC data were calculated and verified through ANOVA and Tukey tests. Cohen's kappa assessed observer agreements.ResultsIntraobserver agreement ranged from 0.347-0.612 (molars) and 0.617-0.811 (premolars). Interobserver agreement ranged from 0.239-0.559 (molars) and 0.657-0.858 (premolars). The performances of tablets and the off-the-shelf monitor were similar to medical monitors when the same tooth groups were compared. Medical monitors presented fewer statistically significant differences when different lesions where compared within the same display and restorative material.ConclusionEvaluations of similar lesions were not significantly different between the 3 types of displays. However, the auto-calibrating medical-grade monitors performed better when incipient and recurrent lesions were compared.



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Use of integra in oral reconstruction: a case series

Publication date: Available online 15 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): L. Rúa Gonzálvez, L. de Villalaín Álvarez, A. Novoa Gómez, J.C. de Vicente Rodríguez, I. Peña González
Purpose: Small intraoral defects are usually reconstructed using skin autografts. However, the goal of this research was to describe an alternative to the classical techniques using artificial dermis (Integra®) in the reconstruction of these types of injuries. Materials and Methods: Four patients with small intraoral lesions in different locations underwent resection. The created defects were covered with a bilayer of Integra®; then, a chlorhexidine stent cure (Laboratorios Salvat, Barcelona, Spain) was applied. The patients were followed-up daily during the first week to detect any signs of infection, dehiscence or loss of the lamina. Thereafter, they were followed-up once per week for one month. Results: None of the patients presented with infections or a loss of the dermis. When the silicon sheet was detached, granulation tissue was detected, with complete re-epithelialization of the lesion in the postsurgical third through fourth weeks. Conclusion: The use of the Integra® allowed for the rapid reconstruction of slight intraoral defects, while preventing the morbidity associated with classical techniques. In this research, no complications were observed.



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Early Occurrence of Sinking Skin Flap Syndrome in a State of Intracranial Hypertension



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Recommendations for Mechanical Thrombectomy in Patients with Acute Ischemic Stroke

Abstract

This document presents the consensus recommendations of the Hellenic Stroke Organization which can be of assistance to the treating stroke physicians.



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Clinically Directed Neuroimaging of Ophthalmoplegia

Abstract

Purpose

Ophthalmoplegia (OP) can have numerous etiologies and different clinical presentations. Most causes of OP can be narrowed down to specific anatomical locations based on clinical information. The aim of this study was to outline the different categories of diseases encountered in patients with OP, based on the location along the ocular motor pathways, and the most appropriate imaging modality for the given scenarios.

Methods

Representative neuroimaging examples of pathological processes causing OP are displayed, sequenced by anatomical location and disease category. Correlations between the clinical presentation and site of pathology with imaging protocol recommendations are also presented.

Results

Diseases affecting ocular movement can be divided into categories including: injuries or diseases of the cerebral hemispheres, midbrain, pons, and cerebellum, ocular motor nerve palsies, intrinsic extraocular muscle diseases and orbital diseases secondarily affecting the extraocular muscles. The cranial nerves responsible for ocular movements can be affected intrinsically or extrinsically along their nuclei, their course in the brainstem, in the cisterns, skull base, cavernous sinuses and orbits. The extraocular muscles can be affected primarily or secondarily by adjacent pathological processes in the orbit. Clinical information can help narrow down the differential diagnoses in terms of anatomical site of involvement and prompt the most appropriate neuroimaging techniques.

Conclusion

By understanding the pathophysiology of OP the neuroradiologist can discuss clinical cases with the referring clinician and determine a timely, accurate method of imaging to achieve the most precise differential diagnosis.



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Find Applications



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Impact of hybrid PET/MR technology on multiparametric imaging and treatment response assessment of cervix cancer

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Publication date: Available online 15 November 2017
Source:Radiotherapy and Oncology
Author(s): Michaela Daniel, Piotr Andrzejewski, Alina Sturdza, Katarina Majercakova, Pascal Baltzer, Katja Pinker, Wolfgang Wadsak, Markus Mitterhauser, Richard Pötter, Petra Georg, Thomas Helbich, Dietmar Georg
Background and purposeMultimodal tissue characterization by combined MRI and PET has high clinical potential in the context of sub-target definition for dose painting and response assessment but its clinical exploration is yet limited. The aim of this study was to prove the potential and feasibility of hybrid PET/MRI to non-invasively measure tumor hypoxia, perfusion and microstructure at one stop in tumors of the uterine cervix during chemoradiotherapy.Material and methodsTen cervix cancer patients were subjected to simultaneous multiparametric PET/MRI with [18F]fluoromisonidazole ([18F]FMISO). Imaging was scheduled before, twice during and after chemoradiotherapy. Intra- and inter-time point analyses of the extracted parameters (i.e. ADC, Ktrans, ABrix, [18F]FMISO-tumor to background ratio (TBR)) were performed. The [18F]FMISO uptake- and ADC-spatio-temporal changes were assessed.ResultsPatient averaged ADC values increased from baseline to follow up (1.03 ± 0.11/1.30 ± 0.13 × 10−3 mm2/s), while the TBR decreased (1.73 ± 0.24/1.36 ± 0.19), Ktrans dropped over time (0.17 ± 0.05/0.05 ± 0.05 min−1); for all above p < 0.05. None of these parameters correlated significantly on a voxel-by-voxel basis. Low-ADC regions spatially varied over time. There was pronounced reduction of the [18F]FMISO-avid volumes during treatment.ConclusionsThe suggested hybrid PET/MRI protocol to non-invasively investigate tumor hypoxia, perfusion and microstructure at one stop was feasible, revealing spatio-temporal response patterns that could be utilized for comprehensive sub-target definition for dose painting and response assessment.



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Late normal tissue effects in the arm and shoulder following lymphatic radiotherapy: Results from the UK START (Standardisation of Breast Radiotherapy) trials

Publication date: Available online 15 November 2017
Source:Radiotherapy and Oncology
Author(s): Joanne S Haviland, Mariella Mannino, Clare Griffin, Nuria Porta, Mark Sydenham, Judith M. Bliss, John R. Yarnold
Background and purposeAdjuvant lymphatic radiotherapy (LNRT) is recommended for selected axillary node positive women with early breast cancer. We investigated whether hypofractionated LNRT is safe combined with similarly-hypofractionated breast/chest wall radiotherapy (RT).Material and methodsThe Standardisation of Breast Radiotherapy (START) pilot, A and B trials randomised women with early breast cancer to schedules of 2.67–3.3 Gy versus 2.0 Gy fractions (control). RT adverse effects were assessed by patients using the EORTC QLQ-BR23 and protocol-specific questions, and by physicians. Rates of arm/shoulder effects were compared between schedules for patients given LNRT.Results864/5861 (14.7%) patients received LNRT (385 START-pilot, 318 START-A, 161 START-B). Prevalences of moderate/marked arm/shoulder effects were low up to 10 years. There were no significant differences between the hypofractionated and control groups for patient- and physician-assessed symptoms in START-A or START-B. In START-pilot, adverse effect rates were higher after 13 fractions of 3.3 Gy, consistent with effects reported in the breast/chest wall (significant for shoulder stiffness, HR 3.07, 95%CI 1.62–5.83, p = 0.001).ConclusionsThe START trial results suggest that appropriately-dosed hypofractionated LNRT is safe in the long-term, according to patient and physician-assessed arm and shoulder symptoms. These findings are consistent with those reported after the same schedules delivered to the breast/chest wall.



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International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma

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Publication date: Available online 15 November 2017
Source:Radiotherapy and Oncology
Author(s): Anne W. Lee, Wai Tong Ng, Jian Ji Pan, Sharon S. Poh, Yong Chan Ahn, Hussain AlHussain, June Corry, Cai Grau, Vincent Grégoire, Kevin J. Harrington, Chao Su Hu, Dora L. Kwong, Johannes A. Langendijk, Quynh Thu Le, Nancy Y. Lee, Jin Ching Lin, Tai Xiang Lu, William M. Mendenhall, Brian O'Sullivan, Enis Ozyar, Lester J. Peters, David I. Rosenthal, Yoke Lim Soong, Yungan Tao, Sue S. Yom, Joseph T. Wee
PurposeTarget delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome.MethodA review of the available literature addressing the natural behaviour of NPC and correlation between clinical and pathological aspects of the disease was conducted. Existing international guidelines as well as published protocols specified by clinical trials on contouring of clinical target volumes (CTV) were compared. This information was then summarized into a preliminary draft guideline which was then circulated to international experts in the field for exchange of opinions and subsequent voting on areas with the greatest controversies.ResultsCommon areas of uncertainty and variation in practices among experts experienced in radiation therapy for NPC were elucidated. Iterative revisions were made based on extensive discussion and final voting on controversial areas by the expert panel, to formulate the recommendations on contouring of CTV based on optimal geometric expansion and anatomical editing for those structures with substantial risk of microscopic infiltration.ConclusionThrough this comprehensive review of available evidence and best practices at major institutions, as well as interactive exchange of vast experience by international experts, this set of consensus guidelines has been developed to provide a practical reference for appropriate contouring to ensure optimal target coverage. However, the final decision on the treatment volumes should be based on full consideration of individual patients' factors and facilities of an individual centre (including the quality of imaging methods and the precision of treatment delivery).



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The NORM4Building database, a tool for radiological assessment when using by-products in building materials

Publication date: Available online 15 November 2017
Source:Construction and Building Materials
Author(s): Wouter Schroeyers, Zoltan Sas, Gergo Bator, Rosabianca Trevisi, Cristina Nuccetelli, Federica Leonardi, Sonja Schreurs, Tibor Kovacs
Scientific data on natural occurring radioactive materials (NORMs) is available in unknown quantities and the data is fragmented over several different sources. The new EU-BSS is regulating the use of NORM in building materials, however a large scale database with country specific information that can support legislators and industry in the assessment of the radiological impact of the use of by-products in construction is missing. Currently the COST Action 'NORM4BUILDING' (2014–2017) is creating such a database using a semi-automated datamining approach. In this paper radiological aspects on by-products that can find application in concrete are discussed based on the database.



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Celebrating 35 Years of the AJNR: November 1982 edition.

Celebrating 35 Years of the AJNR: November 1982 edition.

AJNR Am J Neuroradiol. 2017 Nov;38(11):2217

Authors:

PMID: 29141999 [PubMed - in process]



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2017 Scientific Referees



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Morphometric properties of the latissimus dorsi muscle in human fetuses for flap surgery.

Morphometric properties of the latissimus dorsi muscle in human fetuses for flap surgery.

Surg Radiol Anat. 2017 Nov 16;:

Authors: Beger O, Beger B, Uzmansel D, Erdoğan S, Kurtoğlu Z

Abstract
PURPOSE: Although latissimus dorsi (LD) flaps are extensively used in a wide range of interventions, fetus studies on this subject are quite limited. This study aims to obtain detailed information about the morphometric features of LD, thoracodorsal artery (TDA) and nerve (TDN).
METHODS: The study was carried out on both sides of 50 formalin-fixed human fetuses (22 male/28 female) with a mean gestational age of 24.5 ± 4.7 (range 18-36) weeks, which were in the inventory of Anatomy Department of Mersin University Faculty of Medicine. Dimensions of LD, lengths and width of TDA and TDN were measured. Surface area of LD was calculated using digital image analysis software.
RESULTS: All samples had LD muscle. Neither gender nor side-significant differences were observed in relation with the numerical data of LD, TDN and TDA. Linear function of surface area was calculated as "y = - 1767.532 + 114.582 × Age (weeks)". LD was attached directly to the posterior part of iliac crest in 59 of 100 sides meanwhile in the rest 41, it was attached by the thoracolumbar fascia. TDA gave a branch to serratus anterior in 96 cases and 2 branches in 4 cases. TDN passed superficial to TDA in 84 and deep to TDA in 16 samples. TDN had bifurcation in 93, trifurcation in 6 and tetrafurcation in 1 side.
CONCLUSION: Data obtained from this study can be useful for estimating the sizes of LD and related neurovascular structures, especially in neonate surgeries. Linear function of LD surface area can be helpful to design the flap dimensions in newborn surgeries. A throughout knowledge about the branching pattern of TDN and its location-wise relation with TDA should be kept in mind to prevent possible complications during harvesting LD flaps and TDN grafts.

PMID: 29143863 [PubMed - as supplied by publisher]



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Extraction, purification of Prostate Specific Antigen (PSA) and establishment of radioimmunoassay system as a diagnostic tool for prostate disorders.

Extraction, purification of Prostate Specific Antigen (PSA) and establishment of radioimmunoassay system as a diagnostic tool for prostate disorders.

J Immunoassay Immunochem. 2017 Nov 16;:

Authors: Abu-Bakr El-Bayoumy AS, Hessien Keshta AT, Sallam KM, Ebeid NH, Elsheikh HM, Bayoumy BE

Abstract
This study aimed to provide an easy and effective method for extraction and purification of prostate specific antigen (PSA) from human seminal fluid with high quantity (14 mg) and high purity (98%). The obtained PSA was injected into rabbits for production of anti-PSA polyclonal antibody (titer 1/1000), labeled with radioactive iodine-125 for preparation of radioactive PSA tracer (purity 98 ± 1.8% and specific activity 64 ± 1.9 µCi/µg), and used in preparation of PSA standards. All prepared components can be used in PSA immunoassays specially radioimmunoassay (RIA) kit preparation as a diagnostic tool for prostatic diseases.

PMID: 29144195 [PubMed - as supplied by publisher]



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Preoperative management in patients with Graves' disease.

Preoperative management in patients with Graves' disease.

Gland Surg. 2017 Oct;6(5):476-481

Authors: Piantanida E

Abstract
Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones). Graves' disease is treated with any of three effective and relatively safe initial treatment options: antithyroid drugs (ATDs), radioactive iodine ablation (RAIU), and surgery. Total thyroidectomy is favored in several clinical situations, such as intolerance, ineffectiveness or recurrence after ATD treatment, radioiodine therapy contraindicated, documented or suspected thyroid malignancy, one or more large thyroid nodules, coexisting moderate-to-severe active Graves' orbitopathy, women planning a pregnancy within 6 months. Whenever surgery is selected as treatment, selection of an expert high-volume thyroid surgeons is fundamental and careful preoperative management is essential to optimize surgical outcomes. Pretreatment with ATDs in order to promptly achieve the euthyroid state is recommended to avoid the risk of precipitating thyroid storm during surgery. For the majority of patients, euthyroidism is achieved after few weeks of ATD treatment. Beta-blockers, such as propranolol, are often added effectively to control hyperthyroid symptoms. Saturated solution of potassium iodide (SSKI) or potassium iodine (Lugol's solution), given for a short period prior to surgery, in order to reduce both thyroid hormone release and thyroid gland vascularity, is beneficial to decrease intra-operative blood loss.

PMID: 29142837 [PubMed]



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Probing nitrite ion dynamics in NaNO2 crystals by solid-state 17O NMR

Abstract

We report a solid-state 17O (I = 5/2) NMR study of the nitrite ion dynamics in crystalline NaNO2. Variable temperature (VT) 17O NMR spectra were recorded at 3 magnetic fields, 11.7, 14.1, and 21.1 T. The VT 17O NMR data suggest that the inline image ion in the ferroelectric phase of NaNO2 undergoes 2-fold flip motion about the crystallographic b axis and the corresponding rotational barrier is 68 ± 5 kJ mol−1. We also obtained a 2D 17O EXSY spectrum for a stationary sample of NaNO2 at 250 K, which, in combination with 1D 17O NMR spectral analyses, allowed precise determination of the relative orientation between the 17O quadrupolar coupling and chemical shift tensors in the molecular frame of reference. The experimentally determined 17O NMR tensors for NaNO2 were in agreement with quantum chemical calculations produced by a periodic DFT code BAND.



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La costituzione europea e il richiamo ai valori’



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Review of the book: Diversiones y juegos populares. Formas de sociabilidad y crítica social. Colchagua, 1850-1880



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Jean-Luc Nancy, L'esperienza della libertà



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I gemellini si abbracciano nel grembo della mamma affetta da tumore: sono tutti salvi

I gemellini si abbracciano nel grembo della mamma affetta da tumore: sono tutti salvi

Un delicato intervento ha salvato la vita a due gemelli nel grembo della madre nonostante un tumore alle ovaie. È successo nella clinica Sanatrix a Napoli dove è stato effettuato il primo intervento in Europa...



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Genes, Vol. 8, Pages 330: The HMGA1 Pseudogene 7 Induces miR-483 and miR-675 Upregulation by Activating Egr1 through a ceRNA Mechanism

Genes, Vol. 8, Pages 330: The HMGA1 Pseudogene 7 Induces miR-483 and miR-675 Upregulation by Activating Egr1 through a ceRNA Mechanism

Genes doi: 10.3390/genes8110330

Authors: Marco De Martino Giuseppe Palma Amalia Azzariti Claudio Arra Alfredo Fusco Francesco Esposito

Several studies have established that pseudogene mRNAs can work as competing endogenous RNAs and, when deregulated, play a key role in the onset of human neoplasias. Recently, we have isolated two HMGA1 pseudogenes, HMGA1P6 and HMGA1P7. These pseudogenes have a critical role in cancer progression, acting as micro RNA (miRNA) sponges for HMGA1 and other cancer-related genes. HMGA1 pseudogenes were found overexpressed in several human carcinomas, and their expression levels positively correlate with an advanced cancer stage and a poor prognosis. In order to investigate the molecular alterations following HMGA1 pseudogene 7 overexpression, we carried out miRNA sequencing analysis on HMGA1P7 overexpressing mouse embryonic fibroblasts. Intriguingly, the most upregulated miRNAs were miR-483 and miR-675 that have been described as key regulators in cancer progression. Here, we report that HMGA1P7 upregulates miR-483 and miR-675 through a competing endogenous RNA mechanism with Egr1, a transcriptional factor that positively regulates miR-483 and miR-675 expression.



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Hobbes und die Bilder

Book review of Thomas Hobbes. Visuelle Strategien. Der Leviathan: Urbild des modernen Staates by Horst Bredekamp, Berlin: Akademie Verlag, 1999.

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Chilean Feminists, the International Women's Movement, and Suffrage (1915 to 1950)



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Ancient enzyme could boost power of liquid biopsies to detect and profile cancers

Scientists are developing a set of medical tests called liquid biopsies that can rapidly detect the presence of cancers, infectious diseases and other conditions from only a small blood sample. Researchers at The University of Texas at Austin are...

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Computer program finds new uses for old drugs

Researchers at the Case Comprehensive Cancer Center at Case Western Reserve University School of Medicine have developed a computer program to find new indications for old drugs. The computer program, called DrugPredict, matches existing data about...

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Factors behind underrepresentation of minorities in American genetic cancer studies

Socio-cultural and clinical factors as well as healthcare processes were important drivers of a woman's willingness to provide saliva specimens for future cancer research. This is according to Vanessa B. Sheppard of Virginia Commonwealth University's...

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Scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

Paving the way for testing experimental drugs in more realistic environments, scientists at the National Institute of Standards and Technology (NIST) have discovered how to make tiny colonies of cells grow in useful new ways inside petri dishes. The...

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Tracheal agenesis: optimization of computed tomography diagnosis by airway ventilation

Abstract

Tracheal agenesis is a rare and often lethal congenital defect that leads to airway emergency at birth. Computed tomography (CT) is the modality of choice to evaluate anomalous tracheal anatomy. The absence of spontaneous aeration of the tracheobronchial tree in children with tracheal agenesis makes CT interpretation difficult. We describe a procedure of airway management applied in two newborns with suspected tracheal agenesis. Correct airway management was performed immediately prior to CT examination by airway ventilation, with bag-valve mask alone in one case, and attached to an endotracheal tube placed into the esophagus in the other case. The images allowed for classification of tracheal agenesis. Computed tomography with appropriate airway ventilation is fundamental for the diagnosis of tracheal agenesis.



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Comparative anatomy of zebrafish paired and median fin muscles: basis for functional, developmental, and macroevolutionary studies

Abstract

In the last decades, Danio rerio became one of the most used model organisms in various evo-devo studies devoted to the fin skeletal anatomy and fin-limb transition. Surprisingly, there is not even a single paper about the detailed anatomy of the adult muscles of the five fin types of this species. To facilitate more integrative developmental, functional, genetic, and evolutionary studies of the appendicular musculoskeletal system of the zebrafish and to provide a basis for further comparisons with other fishes and tetrapods, we describe here the identity, overall configuration, and attachments of appendicular muscles in a way that can be easily understood and implemented by non-anatomist researchers. We show that the muscle pattern of the caudal fin is very different from patterns seen in other fins but is very consistent within teleosts. Our observations support the idea of the developmental and evolutionary distinction of the caudal fin and point out that the musculature of the adult zebrafish pectoral and pelvic fins is in general very similar. Both paired fins have superficial and deep layers of abductors and adductors going to all/most rays plus the dorsal and ventral arrectors going only to the first ray. Nevertheless, we noted three major differences between the pelvic and pectoral fins of adult zebrafishes: (i) the pectoral girdle lacks a retractor muscle, which is present in the pelvic girdle – the retractor ischii; (ii) the protractor of the pelvic girdle is an appendicular/trunk muscle, while that of the pectoral girdle is a branchiomeric muscle; (iii) the first ray of the pectoral fin is moved by an additional arrector-3. The anal and dorsal fins consist of serially repeated units, each of which comprises one half-ray and three appendicular muscles (one erector, depressor, and inclinator) on each side of the body. The outermost rays are attachment points for the longitudinal protractor and retractor. Based on our results, we discuss whether the pectoral appendage might evolutionarily be closer to the head than to the pelvic appendage and whether the pelvic appendage might have been derived from the trunk/median fins. We discuss a hypothesis of paired fin origin that is a hybrid of the fin-fold and Gegenbaur's theories. Lastly, our data indicate that D. rerio is indeed an appropriate model organism for the appendicular musculature of teleosts in particular and, at least in the case of the paired fins, also of actinopterygians as a whole.



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3D analysis of sexual dimorphism in size, shape and breathing kinematics of human lungs

Abstract

Sexual dimorphism in the human respiratory system has been previously reported at the skeletal (cranial and thoracic) level, but also at the pulmonary level. Regarding lungs, foregoing studies have yielded sex-related differences in pulmonary size as well as lung shape details, but different methodological approaches have led to discrepant results on differences in respiratory patterns between males and females. The purpose of this study is to analyse sexual dimorphism in human lungs during forced respiration using 3D geometric morphometrics. Eighty computed tomographies (19 males and 21 females) were taken in maximal forced inspiration (FI) and expiration (FE), and 415 (semi)landmarks were digitized on 80 virtual lung models for the 3D quantification of pulmonary size, shape and kinematic differences. We found that males showed larger lungs than females (P < 0.05), and significantly greater size and shape differences between FI and FE. Morphologically, males have pyramidal lung geometry, with greater lower lung width when comparing with the apices, in contrast to the prismatic lung shape and similar widths at upper and lower lungs of females. Multivariate regression analyses confirmed the effect of sex on lung size (36.26%; P < 0.05) and on lung shape (7.23%; P < 0.05), and yielded two kinematic vectors with a small but statistically significant angle between them (13.22°; P < 0.05) that confirms sex-related differences in the respiratory patterns. Our 3D approach shows sexual dimorphism in human lungs likely due to a greater diaphragmatic action in males and a predominant intercostal muscle action in females during breathing. These size and shape differences would lead to different respiratory patterns between sexes, whose physiological implications need to be studied in future research.



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The incidence of bent dorsal fins in free-ranging cetaceans

Abstract

Laterally bent dorsal fins are rarely observed in free-ranging populations of cetaceans, contrary to captivity, where most killer whale Orcinus orca adult males have laterally collapsed fins. This topic has been poorly explored, and data/information on its occurrence and possible causes are limited. The present study: (i) undertakes a review of the available information on bent dorsal fins in free-ranging cetaceans, and updates it with new records, (ii) reports on the proportion of bent fins in different study populations, and (iii) discusses possible causes. An empirical approach based on bibliographic research and compilation of 52 new records collected worldwide resulted in a total of 17 species of cetaceans displaying bent dorsal fins. The species with the highest number of records (64%) and from most locations was O. orca. On average, individuals with bent dorsal fins represent < 1% of their populations, with the exception of false killer whales Pseudorca crassidens and O. orca. While line injuries associated with fisheries interactions may be the main cause for P. crassidens, and the vulnerability to health issues caused by the evolutionary enlargement of the fin may be the cause for O. orca adult males, factors contributing to this abnormality for other species are still unclear. The occurrence of bent dorsals could be influenced by a set of variables rather than by a single factor but, irrespective of the cause, it is suggested that it does not directly affect the animals' survivorship. While still rare in nature, this incident is more common (at least 101 known cases) and widespread (geographically and in species diversity) than hypothesized, and is not confined only to animals in captive environments. Investigation into the occurrence of bent fins may be an interesting avenue of research.



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We may know why Jupiter’s Great Red Spot is red instead of white

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The gases in Jupiter's atmosphere should form white clouds, so why do they look red? Two teams have found different recipes for the red in the Great Red Spot

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Congestive hepatopathy

Abstract

Passive hepatic congestion may result from a variety of distinct cardiovascular conditions. Injury to the liver caused by congestion is often asymptomatic and may not be recognized clinically. Diagnosis of congestive hepatopathy is important as it has the potential to cause complications including hepatic fibrosis and development of benign and malignant liver masses. This review will summarize the pathophysiologic mechanisms of congestive hepatopathy and provide both description and examples of its multimodality imaging findings. Examples of alternative disease which may have a similar imaging appearance will be provided. Knowledge regarding the characteristic imaging findings of congestive hepatopathy will allow for its accurate identification. Reviewing both the benefits and limitations of imaging performed to evaluate congestive hepatopathy and its complications will help to avoid pitfalls and enable recommendation of appropriate next steps in diagnostic evaluation.



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Pictorial essay: imaging findings following Y90 radiation segmentectomy for hepatocellular carcinoma

Abstract

Transarterial radioembolization is a novel therapy that has gained rapid clinical acceptance for the treatment of hepatocellular carcinoma (HCC). Segmental radioembolization [also termed radiation segmentectomy (RS)] is a technique that can deliver high doses (> 190 Gy) of radiation selectively to the hepatic segment(s) containing the tumor. The aim of this comprehensive review is to provide an illustrative summary of the most relevant imaging findings encountered after radiation segmentectomy. A 62-patient cohort of Child–Pugh A patients with solitary HCC < 5 cm in size was identified. A comprehensive retrospective imaging review was done by interventional radiology staff at our institution. Important imaging findings were reported and illustrated in a descriptive account. For the purposes of completeness, specific patients outside our initial cohort with unique educational imaging features that also underwent segmentectomy were included in this pictorial essay. This review shows that response assessment after RS requires a learning curve with common drawbacks that can lead to false-positive interpretations and secondary unnecessary treatments. It is important to recognize that treatment responses and pathological changes both are time dependent. Findings such as benign geographical enhancement and initial benign pathological enhancement can easily be misinterpreted. Capsular retraction and segmental atrophy are some other examples of unique post-RS response that are not seen in any other treatment.



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Prognostic value of tumour-infiltrating lymphocytes in small HER2-positive breast cancer

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Publication date: December 2017
Source:European Journal of Cancer, Volume 87
Author(s): Carmen Criscitiello, Vincenzo Bagnardi, Giancarlo Pruneri, Andrea Vingiani, Angela Esposito, Nicole Rotmensz, Giuseppe Curigliano
BackgroundThe standard treatment for patients with small, node-negative, human epidermal growth factor receptor type 2 (HER2)–positive breast cancer (BC) is still controversial. Our aim was to assess the prognostic role of tumour-infiltrating lymphocytes (TILs) in patients with stage pT1a–b HER2-positive BC.Patients and methodsHaematoxylin and eosin slides from node-negative, pT1a–b HER2-positive BC surgical specimens were retrieved from pathology archives to assess TILs and their association with outcome.ResultsTILs were evaluated in 205 patients with HER2-positive, pT1a–b tumours, who underwent breast surgery between 1997 and 2009 at the European Institute of Oncology. At a median follow-up of 11 years, we did not observe any association between the presence of TILs, either assessed as a continuous or dichotomous variable (<50 versus ≥ 50%), and outcome. Within the subgroup of patients with pT1a tumours who did not receive any adjuvant therapy (36/97 patients), the rate of disease-free survival events was lower in lymphocyte-predominant BC (LPBC) as compared with non-LPBC patients (p = 0.066).ConclusionsTILs cannot be used as a prognostic biomarker in pT1a–b HER2-positive BC. Additional biomarkers are needed for selecting patients with stage I HER2-positive BC who candidate to adjuvant therapy de-escalation.



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We may know why Jupiter’s Great Red Spot is red instead of white

The gases in Jupiter's atmosphere should form white clouds, so why do they look red? Two teams have found different recipes for the red in the Great Red Spot

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Dark matter may be the source of antimatter streaming past Earth

Two nearby powerful pulsars aren’t responsible for the stream of antimatter positrons snaking past Earth, so dark matter might be behind it after all

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Weak links in US power grid vulnerable in event of catastrophe

Largest study of 'cascading failures' finds that only a small subset of North America's power grid is at risk from domino-like electrical failure

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Gene drives can beat pests, but we can’t afford any mistakes

Invasive pests could be eliminated by so-called gene drives, but we must make sure they can’t spread beyond our control

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Trump to let Americans import ivory and hunting trophies again

Donald Trump's administration is reversing a ban on the imports of elephant trophies—including ivory—from Zimbabwe and Zambia

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Why we should celebrate Scotland’s minimum alcohol price plan

Death and ill health will be averted now Scotland's pioneering minimum alcohol policy has finally cleared legal hurdles, say John Holmes and Petra Meier

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What’s the best way to scare an elephant? Use an AI scarecrow

Elephants cause a lot of damage, but like other smart animals, they're too smart to scare away. An AI scarecrow that adapts its tactics for continuous scaring could be the answer

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Why a female fly will ruin your drink, but a male is fine

We’re able to sense even tiny quantities of a female fruit fly pheromone, meaning one can ruin your wine no matter how quickly you remove it from your glass

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Enhancing patients' autonomy by involving them in research ethics committees

Objective : Although clinical trial participants are the most affected by research ethics committee’s decisions, they are not formally represented on Swiss committees. We aimed to find out what patients think about the idea of being members of such committees. Design : Latent thematic analysis was used to analyse the interviews. Setting: Patients were recruited in a Swiss university hospital. Participants: The study involved 26 patients suffering from diabetes or gout. Interventions: We conducted semi-structured interviews. Main Outcome Measures: We explored what patients think of being established members of research ethics committees. Results : We identified three different attitudes among our participants regarding participation in research ethics committees: 1) positive attitude regarding the idea of being members of such committees 2) ambivalent attitude and 3) negative attitude. Patients belonging to the first group 1) often mentioned that they wanted their health condition to be more visible. Patients from the second group 2) mentioned positive as well as negative aspects. Patients from the third group 3) said that patients in general did not have enough background knowledge to be able to gain an overview of a whole clinical trial. Conclusions: Our study adds important knowledge about the idea of patients becoming research ethics committee members by exploring their perceptions of being members. Stable patients tended to be interested in the idea of participation and some specific recommendations could be derived (patients could have an advisory instead of a decision-making role on committees). However, further studies with more patients and further quantitative research are needed.

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Identity as an older prisoner: findings from a qualitative study

The increasing numbers of aging prisoners raise the issue of how they maintain their personal identity and self-esteem in light of long-standing detention. This study sought to answer this question since identity and self-esteem could influence mental and physical health. We conducted a secondary analysis of 35 qualiutative interviews that were carried out with older inmates aged 51-75 years (mean age: 61 years) living in 12 Swiss prisons. We identified three main themes that characterized their identity: personal characterization of identity, occupational identity, and social identity. These main themes were divided into sub-themes such as familial network, retirement rights or subjective social position. Personal characterization of identity mostly happened through being part of a network of family and/or friends that supported them during imprisonment and where the prisoner could return to after release. Individual activities and behaviour also played an important role for prisoners in defining themselves. Occupational identity was drawn from work that had been carried out either before or during imprisonment although in some cases the obligation to work in prison even after reaching retirement age was seen as a constraint. Social identity came from a role of mentor or counselor for younger inmates, and in a few cases older prisoners compared themselves to other inmates and perceived themselves as being in a higher social position. Identity was often expressed as a mix between positive and negative traits. Building on those elements during incarceration can contribute to better mental health of the individual prisoner which in turn influences the chances for successful rehabilitation.

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Impact of the EU Structural Funds on Financial Capacities of Non-profit Organizations

To fulfil their role, non-profit organizations (NPOs) need sufficient capacities. These include, first and foremost, financial capacity. EU Cohesion Policy commands financial resources of 351.8 bn. EUR. The EU is also willing to support NPOs from this source. With such considerable funding, the research questions arise: How much money have NPOs received? What are the effects of such assistance on the financial capacities of NPOs? On a sample of 2715 non-profit organizations in the Czech Republic, we have found that EU subsidies have a positive impact on financial capacities, measured as real assets. It is caused by using EU funds for investment. We have not proved an effect on short-term financial capacities measured on revenues. Moreover, the distribution of financial support among PBOs is unequal as 4% of NPOs collected 80% of subsidies due to differences in skills among NPOs’ managers.

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Kämpfen gegen Windmühlen und reale Mächte: William Lottigs Tagebuch (1919-1921) als Ausdruck der politischen, pädagogischen und schulinternen Machverhältnisse in einer Hamburger Gemeinschaftsschule zu Beginn der 1920er Jahre

Normal 0 21 false false false DE-CH X-NONE X-NONE In his daily journal on the founding of the public experimental school, a “community school” at the Berliner Tor in Hamburg between Spring 1919 and September 1921, Lottig describes the everyday issues confronting the principal of the ‘new school’ at that time. These concern classroom instruction, teachers, parents, external pressures on the Berliner Tor-School, the relationship with the school administration, political issues prevalent in Hamburg at that time, ideological and philosophical debates as well as personal and family relationship problems, all of which Lottig describes in his journal. Lottig also noted the reasoning underpinning the development of the school experiments: the ‘old’ schools in Hamburg had been closed, and the state had in their place established experimental schools. The journal clearly records the difficulties, issues and successes of a principal of one of the newly established community schools ( Lebensgemeinschaftsschulen ) , which had been established as experimental schools . A perusal of the diary indicates that Jakob Robert Schmid’s sole and up to now only one known analysis of the journal comes off as biased and misleading. Schmid, professor of education at the University of Berne, had, at the beginning of the thirties, only perused and analyzed those portions of Lottig’s journal in which Lottig describes the rather turbulent if inspiring – and yet chaotic – operation of the community school in its first two years. While Schmid analyzed these portions, he did not consider Lottig’s other, more favourable and constructive comments. Schmid also did not explain his one-sided selection of journal passages. Schmid brands Lottig and his team of teachers as educational novices and classifies the Berliner Tor-School as an ‘anti-authoritarian’ institution, an experimental school like any other school experiment which overshoots the mark, not being educationally and institutionally meaningful. A more objective and principled approach in examining Lottig’s journal would have revealed that Lottig and his teachers were well aware of the main issue confronting the school, an issue that Schmid would also have found relevant: the relation of freedom and compulsion, within a setting that Lottig wanted to revitalize, to productively equilibrate without employing the customary disciplinary instruments. Lottig furthermore again and again points emphatically to the ‘growing pains’ of all alternative schools (even when regulated by the state as an experimental school), whose goal it had been, to establish, even under difficult circumstances, a ‘new school-type’ not utilizing the traditional instruments of discipline, instruction, and school management. This proves that Lottig was neither an educational ignoramus nor unaware of the basic issue of classroom instruction: how one can instruct with or without compulsion. Lottig’s goal had always been – and this Schmid also disregarded – to replace traditional, imposed, mandated or even self-imposed rules and regulations by new, commonly worked out rules. Lottig’s journal is a good example for the steadfast, unrelenting and energy-sapping aspiration of a school principal to balance the relation of school management versus a school’s self-development under the given circumstances. In addition, Schmid’s misinterpretation is a good example of how an observer, who hardly knew the Berliner Tor-School , would misuse this historical source by means of a biased interpretation to further his own views on scholastic education, views that Lottig himself would have preferred to provocatively examine – Schmid’s ‘authoritative pedagogy’, that goes beyond all authoritarian and non-authoritarian educational policies. What then would Lottig have recorded in his journal about a meeting with Schmid?

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'Who Are We?' – An Essay on Richard Rorty, Rhetoric and Politics

It is not unusual to think of Rorty’s work as a success in rhetoric and a failure in political philosophy. In this article we re-evaluate this assessment by analyzing a typical feature of Rorty’s writing: his frequent use of “we so-and-so.” Taking stock of the existing literature on the subject we discuss how Rorty’s use of the “we” was received by peers and how he himself made sense of it. We then analyze Rorty’s oeuvre in order to show that a better understanding of his rhetorical “we” could make his politico-philosophical “we” more appealing. We suggest that Rorty’s pragmatist take on “ethnos” is preferable to other notions that are currently championed in political theory and philosophy.

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Racial and Geographic Disparities in Interhospital ICU Transfers

OBJECTIVES: Interhospital transfer, a common intervention, may be subject to healthcare disparities. In mechanically ventilated patients with sepsis, we hypothesize that disparities not disease related would be found between patients who were and were not transferred. DESIGN: Retrospective cohort study. SETTING: Nationwide Inpatient Sample, 2006-2012. PATIENTS: Patients over 18 years old with a primary diagnosis of sepsis who underwent mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We obtained age, gender, length of stay, race, insurance coverage, do not resuscitate status, and Elixhauser comorbidities. The outcome used was interhospital transfer from a small- or medium-sized hospital to a larger acute care hospital. Of 55,208,382 hospitalizations, 46,406 patients met inclusion criteria. In the multivariate model, patients were less likely to be transferred if the following were present: older age (odds ratio, 0.98; 95% CI, 0.978-0.982), black race (odds ratio, 0.79; 95% CI, 0.70-0.89), Hispanic race (odds ratio, 0.79; 95% CI, 0.69-0.90), South region hospital (odds ratio, 0.79; 95% CI, 0.72-0.88), teaching hospital (odds ratio, 0.31; 95% CI, 0.28-0.33), and do not resuscitate status (odds ratio, 0.19; 95% CI, 0.15-0.25). CONCLUSIONS: In mechanically ventilated patients with sepsis, we found significant disparities in race and geographic location not explained by medical diagnoses or illness severity.

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Mit Kiffen aufhören. Die Bereitschaft zur Verhaltensänderung bei Cannabisgebrauchenden in der Schweiz

The study aims to identify factors that are associated with the willingness of adolescents and young adults to modify their cannabis use. It is hypothesized that frequency of use, cannabis-related problems and age of onset are associated with their willingness to change.; In 2004, a survey on cannabis use was conducted among 13 to 29 year-olds living in Switzerland. Of the 5025 participants 593 had taken cannabis during the past six months. They were then asked about their willingness to change. Three groups of users were compared: those not willing to change, those considering change, and those determined to change. Pearson Chi-square-tests and logistic regressions were performed to test the hypotheses.; Experience of problems motivates users to start thinking about changing their behavior. Frequent use and early onset are associated with young people not making the transition from considering changing behavior to resolving to do so.; The need to perceive problematic use as a first step towards change and the inhibiting effect of dependence-related factors on the transition from consideration to determination calls for tailored intervention approaches that are matched to the willingness to change.

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Mentoring in gerontology doctoral education: the role of elders in mentoring gerontologists

This study examined elder mentors' and students' roles, functions, and satisfaction with the Elder Mentorship program at the Graduate Center for Gerontology, University of Kentucky. The Elder Mentorship program matches gerontology doctoral students with older adults in the community. Parallel surveys were constructed to evaluate the program from the perspectives of elder mentors and student mentees. Data were analyzed using descriptive frequency analyses, with open-ended questions analyzed thematically. Results show that students and elder mentors were mostly satisfied with their experiences. Elder mentors perceived their participation more positively than did student mentees. Future programs utilizing the elder mentorship model may benefit from matching students and elder mentors in terms of shared interests.

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Sudden death: ethical and legal problems of post-mortem forensic genetic testing for hereditary cardiac diseases

Hereditary non-structural diseases such as catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT, and the Brugada syndrome as well as structural disease such as hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC) cause a significant percentage of sudden cardiac deaths in the young. In these cases, genetic testing can be useful and does not require proxy consent if it is carried out at the request of judicial authorities as part of a forensic death investigation. Mutations in several genes are implicated in arrhythmic syndromes, including SCN5A, KCNQ1, KCNH2, RyR2, and genes causing HCM. If the victim's test is positive, this information is important for relatives who might be themselves at risk of carrying the disease-causing mutation. There is no consensus about how professionals should proceed in this context. This article discusses the ethical and legal arguments in favour of and against three options: genetic testing of the deceased victim only; counselling of relatives before testing the victim; counselling restricted to relatives of victims who tested positive for mutations of serious and preventable diseases. Legal cases are mentioned that pertain to the duty of geneticists and other physicians to warn relatives. Although the claim for a legal duty is tenuous, recent publications and guidelines suggest that geneticists and others involved in the multidisciplinary approach of sudden death (SD) cases may, nevertheless, have an ethical duty to inform relatives of SD victims. Several practical problems remain pertaining to the costs of testing, the counselling and to the need to obtain permission of judicial authorities.

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Pathogens, Vol. 6, Pages 58: The Role of the Mammalian Prion Protein in the Control of Sleep

Pathogens, Vol. 6, Pages 58: The Role of the Mammalian Prion Protein in the Control of Sleep

Pathogens doi: 10.3390/pathogens6040058

Authors: Amber Roguski Andrew Gill

Sleep disruption is a prevalent clinical feature in many neurodegenerative disorders, including human prion diseases where it can be the defining dysfunction, as in the case of the “eponymous” fatal familial insomnia, or an early-stage symptom as in certain types of Creutzfeldt-Jakob disease. It is important to establish the role of the cellular prion protein (PrPC), the key molecule involved in prion pathogenesis, within the sleep-wake system in order to understand fully the mechanisms underlying its contribution to both healthy circadian rhythmicity and sleep dysfunction during disease. Although severe disruption to the circadian rhythm and melatonin release is evident during the pathogenic phases of some prion diseases, untangling whether PrPC plays a role in circadian rhythmicity, as suggested in mice deficient for PrPC expression, is challenging given the lack of basic experimental research. We provide a short review of the small amount of direct literature focused on the role of PrPC in melatonin and circadian rhythm regulation, as well as suggesting mechanisms by which PrPC might exert influence upon noradrenergic and dopaminergic signaling and melatonin synthesis. Future research in this area should focus upon isolating the points of dysfunction within the retino-pineal pathway and further investigate PrPC mediation of pinealocyte GPCR activity.



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Retrospective analysis of Austrian health recording data of antibiotic or nonantibiotic dry-off treatment on milk yield, somatic cell count, and frequency of mastitis in subsequent lactation

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): T. Wittek, A. Tichy, B. Grassauer, C. Egger-Danner
Typically, dairy cows are dried off at the end of lactation. During the dry period, intramammary infections may be cured or persist, and new infections may occur. Traditionally, antibiotics (AB) have been used at dry-off. However, blanket antibiotic dry-off treatment may no longer be justifiable and, recently, selective use of antibiotics at dry off has been proposed and different decision criteria suggested. The objective of the study was to evaluate cows receiving antibiotic treatment at dry off (AB group) compared with cows dried off without antibiotics (non-AB group) using a large data set. Primary outcome parameters were milk yield, somatic cell count (SCC), and frequency of mastitis in the subsequent lactation. Additionally, we aimed to calculate cut-off values to determine, at the cow level, whether antibiotic dry-off treatment is indicated. A data set of 88,534 lactations was used; 27,723 cows were dried off using antibiotics (AB group; 31.3%) and 60,811cows were dried off without antibiotics (non-AB group; 68.7%). Milk yield in previous and subsequent lactations was higher in the AB group. Cows in the AB group produced, on average, 91 kg more milk in the subsequent lactation. The average SCC during the final 90 d of the previous lactation and at dry-off did not differ between the 2 groups. The probability of drying off using antibiotics increased almost linearly with higher milk yield and with higher SCC. The use of antibiotics resulted in an average decrease in SCC of 1,500 cells/mL in the subsequent lactation. The frequency of clinical mastitis during the previous lactation was higher in the AB group than in the non-AB group. Independently of the dry-off treatment, this difference remained in the subsequent lactation within 90 d in milk. The use of antibiotics at dry-off had no significant effect on the frequency of mastitis within 90 d in milk of the subsequent lactation. The study indicates that Austrian farmers and veterinarians are applying selective dry-cow treatment using milk yield and, to a lesser extent, SCC and mastitis frequency, for decision-making. However, even though a large data set was used, cut-off values with sufficient diagnostic value for selective dry-cow treatment could not be identified. It is likely that cut-off values must be identified at the herd level or in combination with additional parameters (e.g., results of bacterial culture).



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Invited review: Practical feeding management recommendations to mitigate the risk of subacute ruminal acidosis in dairy cattle

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): E. Humer, R.M. Petri, J.R. Aschenbach, B.J. Bradford, G.B. Penner, M. Tafaj, K.-H. Südekum, Q. Zebeli
Rumen health is of vital importance in ensuring healthy and efficient dairy cattle production. Current feeding programs for cattle recommend concentrate-rich diets to meet the high nutritional needs of cows during lactation and enhance cost-efficiency. These diets, however, can impair rumen health. The term “subacute ruminal acidosis” (SARA) is often used as a synonym for poor rumen health. In this review, we first describe the physiological demands of cattle for dietary physically effective fiber. We also provide background information on the importance of enhancing salivary secretions and short-chain fatty acid absorption across the stratified squamous epithelium of the rumen; thus, preventing the disruption of the ruminal acid–base balance, a process that paves the way for acidification of the rumen. On-farm evaluation of dietary fiber adequacy is challenging for both nutritionists and veterinarians; therefore, this review provides practical recommendations on how to evaluate the physical effectiveness of the diet based on differences in particle size distribution, fiber content, and the type of concentrate fed, both when the latter is part of total mixed ration and when it is supplemented in partial mixed rations. Besides considering the absolute amount of physically effective fiber and starch types in the diet, we highlight the role of several feeding management factors that affect rumen health and should be considered to control and mitigate SARA. Most importantly, transitional feeding to ensure gradual adaptation of the ruminal epithelium and microbiota; monitoring and careful management of particle size distribution; controlling feed sorting, meal size, and meal frequency; and paying special attention to primiparous cows are some of the feeding management tools that can help in sustaining rumen health in high-producing dairy herds. Supplementation of feed additives including yeast products, phytogenic compounds, and buffers may help attenuate SARA, especially during stress periods when the risk of a deficiency of physically effective fiber in the diet is high, such as during early lactation. However, the usage of feed additives cannot fully compensate for suboptimal feeding management.



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Minimum inhibitory concentrations of frequently used antibiotics against Escherichia coli and Trueperella pyogenes isolated from uteri of postpartum dairy cows

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): A. Pohl, A. Lübke-Becker, W. Heuwieser
The objective of this study was to determine minimum inhibitory concentrations (MIC) of frequently used antimicrobials for Escherichia coli and Trueperella pyogenes isolated from postpartum bovine uteri of cows with acute puerperal metritis (APM, n = 67), cows suspected to have APM (n = 37), and healthy cows (n = 37) and to evaluate possible differences in MIC according to clinical signs. Cows with APM had reddish-brown, fetid vaginal discharge and rectal temperature (RT) ≥39.5°C within 21 d in milk; cows suspected to have APM had either reddish-brown, fetid vaginal discharge or RT ≥39.5°C within 21 d in milk; and healthy cows had neither fetid discharge nor RT ≥39.5°C. Samples were collected from cows on commercial dairy herds (n = 7) using the cytobrush technique. A total of 37 T. pyogenes isolates and 85 E. coli isolates were tested. Ceftiofur, a third-generation cephalosporin that is often used to treat APM, was the focus of analysis. Trueperella pyogenes and E. coli were isolated more often from samples of cows with APM (46 and 90%, respectively) compared with samples from healthy cows (19 and 54%, respectively). Regarding cows suspected to have APM, T. pyogenes and E. coli were numerically more often isolated (30 and 70%, respectively) than in healthy cows (19 and 54%, respectively). Minimum inhibitory concentrations of ceftiofur were low. For T. pyogenes and E. coli, MIC50 (concentration that inhibited growth of 50% of isolates) were 0.25 and 0.5 µg/mL and MIC90 (concentration that inhibited growth of 90% of isolates) were 0.5 and 1 µg/mL, respectively. Although ceftiofur inhibited all T. pyogenes at the highest concentration tested (64 µg/mL), the growth of 5.9% of E. coli was not impaired. Recently, ampicillin has been suggested as an alternative treatment for APM. Although the T. pyogenes isolates exhibited low MIC in general (MIC50 ≤0.015 µg/mL and MIC90 = 0.06 µg/mL) and 81.1% of all T. pyogenes could be inhibited at the lowest ampicillin concentration tested, 11.8% of the E. coli isolates were not impaired at the highest concentration (64 µg/mL) tested in this study. The MIC50 and MIC90 of E. coli were 4 and ≥128 µg/mL, respectively. We detected no difference in the MIC distributions of ceftiofur or ampicillin among isolates from the 3 APM groups. In summary, E. coli with high MIC against ceftiofur as well as against ampicillin were found in this study.



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Biofilm formation of Staphylococcus aureus dairy isolates representing different genotypes

Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): E. Thiran, P.A. Di Ciccio, H.U. Graber, E. Zanardi, A. Ianieri, J. Hummerjohann
The objective of this study was to compare the biofilm-forming capabilities of different genotypes of Staphylococcus aureus dairy isolates from Switzerland and northern Italy, including Staph. aureus genotype B (GTB) and methicillin-resistant Staph. aureus (MRSA). We hypothesized that biofilm formation might be more pronounced in the contagious GTB isolates compared with other genotypes affecting individual animals. Twenty-four dairy isolates, including 9 MRSA, were further characterized by genotyping by using ribosomal spacer PCR, spa typing, biofilm formation under static and dynamic conditions, and scanning electron microscopy. The GTB isolates (n = 6) were more able to form biofilms than other genotypes at 37°C and at 20°C after 48 and 72 h of incubation in the static assay using polystyrene microtiter plates. This result was supported by scanning electron micrographs showing a GTB isolate producing strong biofilm with extracellular matrix in contrast to a genotype C isolate. Furthermore, none of the MRSA isolates formed strong biofilms in the static assay. However, some MRSA produced low or moderate amounts of biofilm depending on the applied conditions. Under dynamic conditions, a much more diverse situation was observed. The ability of GTB isolates to be strong biofilm formers was not observed in all cases, emphasizing the importance of growth conditions for the expression of biofilm-related genes. No specific genotype, spa type, or MRSA isolate could be categorized significantly into one level of biofilm formation. Nineteen percent of isolates behaved similarly under static and dynamic conditions. The results of this study expand our knowledge of different dairy-related Staph. aureus subtypes and indicate the benefit of genotyping when biofilms are studied.



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Uncertainty assessment of the breath methane concentration method to determine methane production of dairy cows

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): Liansun Wu, Peter W.G. Groot Koerkamp, Nico Ogink
The breath methane concentration method uses the methane concentrations in the cow's breath during feed bin visits as a proxy for the methane production rate. The objective of this study was to assess the uncertainty of a breath methane concentration method in a feeder and its capability to measure and rank cows' methane production. A range of controlled methane fluxes from a so-called artificial reference cow were dosed in a feed bin, and its exhaled air was sampled by a tube inside the feeder and analyzed. The artificial reference cow simulates the lungs, respiratory tract, and rumen of a cow and releases a variable methane flux to generate a concentration pattern in the exhaled breath that closely resembles a real cow's pattern. The strength of the relation between the controlled methane release rates of the artificial reference cow and the measured methane concentrations was analyzed by linear regression, using the coefficient of determination (R2) and the residual standard error as performance indicators. The effect of error sources (source-sampling distance, air turbulence, and cow's head movement) on this relation was experimentally investigated, both under laboratory and barn conditions. From the laboratory to the dairy barn at the 30-cm sampling distance, the R2-value decreased from 0.97 to 0.37 and the residual standard error increased from 75 to 86 ppm as a result of barn air turbulence, the latter increasing to a theoretical 94 ppm if modeled variability due to cow's head movement was accounted for as well. In practice, the effect of these random errors can be compensated by sampling strategies including repeated measurements on each cow over time, thus increasing the distinctive power between cows. However, systematic errors that may disturb the relation between concentration and production rate, such as cow variation in air exhalation rate and air flow patterns around sampling locations that differ between barns, cannot be compensated by repeated measurements. As a result, the methane concentrations of breath air will vary between cows with the same methane production. We conclude that the capability of the breath concentration measurement method to adequately measure and rank methane production rates among cows is highly uncertain and requires further investigation into variation sources with a systematic nature.



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Determination of fat, protein, moisture, and salt content of Cheddar cheese using mid-infrared transmittance spectroscopy

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): Brenda J. Margolies, David M. Barbano
The objective of our work was to develop and evaluate the performance of a rapid method for measuring fat, protein, moisture, and salt content of Cheddar cheese using a combination mid-infrared (MIR) transmittance analysis and an in-line conductivity sensor in an MIR milk analyzer. Cheddar cheese was blended with a dissolving solution containing pentasodium triphosphate and disodium metasilicate to achieve a uniform, particle-free dispersion of cheese, which had a fat and protein content similar to milk and could be analyzed using a MIR transmittance milk analyzer. Annatto-colored Cheddar cheese samples (34) from one cheese factory were analyzed using reference chemistry methods for fat (Mojonnier ether extraction), crude protein (Kjeldahl), moisture (oven-drying total solids), and salt (Volhard silver nitrate titration). The same 34 cheese samples were also dissolved using the cheese dissolver solution, and then run through the MIR and used for calibration. The reference testing for fat and crude protein was done on the cheese after dispersion in the dissolver solution. Validation was done using a total of 36 annatto-colored Cheddar cheese samples from 4 cheese factories. The 36 validation cheese samples were also analyzed using near-infrared spectroscopy for fat, moisture, and the coulometric method for salt in each factory where they were produced. The validation cheeses were also tested using the same chemical reference methods that were used for analysis of the calibration samples. Standard error of prediction (SEP) values for moisture and fat on the near-infrared spectroscopy were 0.30 and 0.45, respectively, whereas the MIR produced SEP values of 0.28 and 0.23 for moisture (mean 36.82%) and fat (mean 34.0%), respectively. The MIR also out-performed the coulometric method for salt determination with SEP values of 0.036 and 0.139 at a mean level of salt of 1.8%, respectively. The MIR had an SEP value of 0.19 for estimation at a mean level of 24.0% crude protein, which suggests that MIR could be an easy and effective way for cheese producers to measure protein to determine protein recovery in cheese making.



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Physicochemical and sensory properties of yogurts containing sacha inchi (Plukenetia volubilis L.) seeds and β-glucans from Ganoderma lucidum

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): Ana-Milena Vanegas-Azuero, Luis-Felipe Gutiérrez
Dairy products have been widely used for adding various biomolecules with the aim of improving their functional properties and health benefits. In this study, the physicochemical properties and sensory acceptance of yogurts enriched with sacha inchi (Plukenetia volubilis) seeds (SIS) and β-glucans from Ganoderma lucidum (BGGL) were investigated. The angiotensin-converting enzyme–inhibitory activity of some yogurt samples was also evaluated. Yogurts were produced from reconstituted skim milk powder, and SIS (4% wt/wt) and BGGL were added at different concentrations (0–1.5% wt/wt). The fermentation kinetics were not affected by the enrichment process. The addition of SIS and BGGL significantly increased (P < 0.05) the contents of protein, fat, carbohydrates, ash, total solids, aspartic acid, serine, arginine, glycine, threonine, tyrosine, and alanine. α-Linolenic (49.3%) and linoleic (32.2%) acids were the main fatty acids found in the enriched samples, whose values were about 50- and 25-fold higher than those of the control yogurt. The textural parameters (firmness, consistency, cohesiveness, and index of viscosity) of the enriched yogurts were significantly lower (P < 0.05) than those of the control samples during the whole storage period. All enriched yogurts showed a sensorial acceptance higher than 70% by untrained panelists. The angiotensin-converting enzyme–inhibitory activity of some selected yogurt samples ranged between 36 and 59%. These results indicate that SIS and BGGL could be used as natural ingredients for improving the nutritional value of yogurt and fermented milks.



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Short communication: Growth of dairy isolates of Geobacillus thermoglucosidans in skim milk depends on lactose degradation products supplied by Anoxybacillus flavithermus as secondary species

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): Y. Zhao, M. Kumar, M.P.M. Caspers, M.N. Nierop Groot, J.M.B.M. van der Vossen, T. Abee
Thermophilic bacilli such as Anoxybacillus and Geobacillus are important contaminants in dairy powder products. Remarkably, one of the common contaminants, Geobacillus thermoglucosidans, showed poor growth in skim milk, whereas significant growth of G. thermoglucosidans was observed in the presence of an Anoxybacillus flavithermus dairy isolate. In the present study, we investigated the underlying reason for this growth dependence of G. thermoglucosidans. Whole-genome sequences of 4 A. flavithermus strains and 4 G. thermoglucosidans strains were acquired, with special attention given to carbohydrate utilization clusters and proteolytic enzymes. Focusing on traits relevant for dairy environments, comparative genomic analysis revealed that all G. thermoglucosidans strains lacked the genes necessary for lactose transport and metabolism, showed poor growth in skim milk, and produced white colonies on X-gal plates, indicating the lack of β-galactosidase activity. The A. flavithermus isolates scored positive in these tests, consistent with the presence of a putative lactose utilization gene cluster. All tested isolates from both species showed proteolytic activity on milk plate count agar plates. Adding glucose or galactose to liquid skim milk supported growth of G. thermoglucosidans isolates, in line with the presence of the respective monosaccharide utilization gene clusters in the genomes. Analysis by HPLC of A. flavithermus TNO-09.006 culture filtrate indicated that the previously described growth dependence of G. thermoglucosidans in skim milk was based on the supply of glucose and galactose by A. flavithermus TNO-09.006.



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Rapid species- and subspecies-specific level classification and identification of Lactobacillus casei group members using MALDI Biotyper combined with ClinProTools

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): Chien-Hsun Huang, Lina Huang
Using common taxonomic methods such as 16S rDNA sequencing and physiological and biochemical analysis to identify members of the Lactobacillus casei group (LCG) is time-consuming, expensive and inaccurate. In this study, we applied matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to rapid discriminate LCG strains by creating an analytical in-house database (IHDB) and to develop a classification model for subspecies-level differentiation based on MS biomarkers using ClinProTools bioinformatics software (Bruker Daltonics, Billerica, MA). Genotypic methods (housekeeping gene sequencing and species-specific PCR) were also established to validate the MALDI-TOF MS platform. A total of 48 LCG reference strains were correctly identified at the species level (mean score: 2.45 ± 0.1) by using MALDI-TOF MS with an IHDB and had high score values, which was in accordance with results from mutL gene sequencing and specific PCR-based methods. However, one strain that was identified as L. casei had a relatively low score value (2.02 ± 0.02), lower sequence similarities (mutL: 90.4%), and failed to amplify a species-specific amplicon; it may therefore represent an undescribed novel species. In addition, after implementation of the classification model (based on 2 biomarker peaks: m/z 4,930 and 5,303), L. paracasei strains could be clearly and easily differentiated to the subspecies level. Afterward, 7 LCG-related isolates from different probiotic samples were analyzed and accurately identified. Our data demonstrate the high-resolution performance of MALDI-TOF MS for fast and accurate demarcation of LCG strains when used with an IHDB coupled to ClinProTools; this methodology can serve as an alternative for quality control of probiotic products.



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Modeling greenhouse gas emissions from dairy farms

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Publication date: Available online 15 November 2017
Source:Journal of Dairy Science
Author(s): C. Alan Rotz
Dairy farms have been identified as an important source of greenhouse gas emissions. Within the farm, important emissions include enteric CH4 from the animals, CH4 and N2O from manure in housing facilities during long-term storage and during field application, and N2O from nitrification and denitrification processes in the soil used to produce feed crops and pasture. Models using a wide range in level of detail have been developed to represent or predict these emissions. They include constant emission factors, variable process-related emission factors, empirical or statistical models, mechanistic process simulations, and life cycle assessment. To fully represent farm emissions, models representing the various emission sources must be integrated to capture the combined effects and interactions of all important components. Farm models have been developed using relationships across the full scale of detail, from constant emission factors to detailed mechanistic simulations. Simpler models, based upon emission factors and empirical relationships, tend to provide better tools for decision support, whereas more complex farm simulations provide better tools for research and education. To look beyond the farm boundaries, life cycle assessment provides an environmental accounting tool for quantifying and evaluating emissions over the full cycle, from producing the resources used on the farm through processing, distribution, consumption, and waste handling of the milk and dairy products produced. Models are useful for improving our understanding of farm processes and their interacting effects on greenhouse gas emissions. Through better understanding, they assist in the development and evaluation of mitigation strategies for reducing emissions and improving overall sustainability of dairy farms.



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RT @oncology_bg : 1st keynote at #ESMOAsia17 and Dr. Chia makes important comments close to my heart. 1) cut red tape 2) Asian countries str…

RT @oncology_bg : 1st keynote at #ESMOAsia17 and Dr. Chia makes important comments close to my heart. 1) cut red tape 2) Asian countries str…

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A global call to arms for clinical laboratories – Harmonised quantification and reporting of monoclonal proteins

Publication date: Available online 15 November 2017
Source:Clinical Biochemistry
Author(s): Jillian R. Tate, David F. Keren, Peter Mollee




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Is a positive intracutaneous test induced by penicillin mediated by histamine? A cutaneous microdialysis study in penicillin-allergic patients

Diagnostic workup of penicillin allergy comprises skin testing with penicillins, and patients are deemed allergic if skin test is positive. However, the literature suggests that skin test-positive patients may...

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Generating evidence on a risk-based monitoring approach in the academic setting - lessons learned

In spite of efforts to employ risk-based strategies to increase monitoring efficiency in the academic setting, empirical evidence on their effectiveness remains sparse. This mixed-methods study aimed to evaluate the risk-based on-site monitoring approach currently followed at our academic institution.; We selected all studies monitored by the Clinical Trial Unit (CTU) according to Risk ADApted MONitoring (ADAMON) at the University Hospital Basel, Switzerland, between 01.01.2012 and 31.12.2014. We extracted study characteristics and monitoring information from the CTU Enterprise Resource Management system and from monitoring reports of all selected studies. We summarized the data descriptively. Additionally, we conducted semi-structured interviews with the three current CTU monitors.; During the observation period, a total of 214 monitoring visits were conducted in 43 studies resulting in 2961 documented monitoring findings. Our risk-based approach predominantly identified administrative (46.2%) and patient right findings (49.1%). We identified observational study design, high ADAMON risk category, industry sponsorship, the presence of an electronic database, experienced site staff, and inclusion of vulnerable study population to be factors associated with lower numbers of findings. The monitors understand the positive aspects of a risk-based approach but fear missing systematic errors due to the low frequency of visits.; We show that the factors mostly increasing the risk for on-site monitoring findings are underrepresented in the current risk analysis scheme. Our risk-based on-site approach should further be complemented by centralized data checks, allowing monitors to transform their role towards partners for overall trial quality, and success.

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A glass half full: the dubious history of elder abuse policy

This article highlights the brief 30-year history of major U.S. policies that address elder abuse. The history of elder abuse policy is checkered and incomplete, reflecting a lack of comprehensive federal legislation. We begin our review by discussing the scope of elder abuse policy and, in particular, the Social Security Block Grant, which has become the sole source of federal aid for Adult Protective Services programs. The other source of federal aid, typically for helping efforts by Area Agencies on Aging, is the Older Americans Act. We document the incremental but increasing attention paid to elder abuse by chronicling key initiatives, including early congressional reports and hearings; White House Conferences on Aging; and efforts by pioneers such as Mario Biaggi, Claude Pepper, John Breaux, and Orin Hatch-efforts that we believe have led to the various introductions of the Elder Justice Act.

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WorldView Environmental Scan on Elder Abuse

In response to a growing and worldwide recognition of elder abuse, the WorldView Environmental Scan on Elder Abuse was undertaken. It represented an attempt to collect both information on the nature of the problem of elder abuse and responses to it from a global perspective. The first of its kind, the Scan gathered information about elder abuse as well as on related legislation and policy, services and programs, educational resources and needs, training, and past and ongoing research. A total of 53 countries responded to the survey questionnaire, with 362 respondents representing the six world regions designated by the World Health Organization. Findings revealed that factors contributing to elder abuse include changing social and economic structures, isolation of victims, inadequate knowledge of laws and services, intergenerational conflict, and poverty. Barriers to seeking resources to intervene and protect older adults include the culture of the country, language issues, literacy, stigma, lack of mobility, lack of funding, and insufficient familiarity with and access to the internet. The data serve as a catalyst to take action, both globally and nationally, while emphasizing the changes necessary to protect the rights and dignity of older adults.

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Kentucky's Local Elder Abuse Coordinating Councils: a model for other states

In 1998 Kentucky's Local Coordinating Councils on Elder Abuse (LCCEAs) were established to intervene in cases of elder abuse in local communities. As of 2008 there were 39 LCCEAs in the state, covering 112 of Kentucky's 120 counties. This study was an attempt to understand a concerted statewide multidisciplinary team (MDT) effort related to elder abuse. Survey questions examined the roles, processes, varieties, and accomplishments of these councils. Nearly half of the councils have been in existence for less than 3 years. Councils provided a range of services from expert consultation to service provided for keeping members up to date about services, programs, and legislation. Roles for the councils included identifying service gaps and systemic problems and advocating for change. Half the councils conducted case reviews, and of those, most examined all types of cases. Lack of funding was a major problem for all councils. Funding came from a patchwork of sources, which suggested that it was inadequate and unreliable. The LCCEAs appear to function largely as community educators. To ensure the long-term viability of the LCCEAs and to better integrate and unify their efforts, LCCEAs need committed staffs, constant funding, clear vision and goals, and uniform and consistent outcome measures.

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Locomotor speed control circuits in the caudal brainstem

Locomotion is a universal behaviour that provides animals with the ability to move between places. Classical experiments have used electrical microstimulation to identify brain regions that promote locomotion, but the identity of neurons that act as key intermediaries between higher motor planning centres and executive circuits in the spinal cord has remained controversial. Here we show that the mouse caudal brainstem encompasses functionally heterogeneous neuronal subpopulations that have differential effects on locomotion. These subpopulations are distinguishable by location, neurotransmitter identity and connectivity. Notably, glutamatergic neurons within the lateral paragigantocellular nucleus (LPGi), a small subregion in the caudal brainstem, are essential to support high-speed locomotion, and can positively tune locomotor speed through inputs from glutamatergic neurons of the upstream midbrain locomotor region. By contrast, glycinergic inhibitory neurons can induce different forms of behavioural arrest mapping onto distinct caudal brainstem regions. Anatomically, descending pathways of glutamatergic and glycinergic LPGi subpopulations communicate with distinct effector circuits in the spinal cord. Our results reveal that behaviourally opposing locomotor functions in the caudal brainstem were historically masked by the unexposed diversity of intermingled neuronal subpopulations. We demonstrate how specific brainstem neuron populations represent essential substrates to implement key parameters in the execution of motor programs.

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Organization and function of neuronal circuits controlling movement



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Columnar-Intrinsic Cues Shape Premotor Input Specificity in Locomotor Circuits

Control of movement relies on the ability of circuits within the spinal cord to establish connections with specific subtypes of motor neuron (MN). Although the pattern of output from locomotor networks can be influenced by MN position and identity, whether MNs exert an instructive role in shaping synaptic specificity within the spinal cord is unclear. We show that Hox transcription-factor-dependent programs in MNs are essential in establishing the central pattern of connectivity within the ventral spinal cord. Transformation of axially projecting MNs to a limb-level lateral motor column (LMC) fate, through mutation of the Hoxc9 gene, causes the central afferents of limb proprioceptive sensory neurons to target MNs connected to functionally inappropriate muscles. MN columnar identity also determines the pattern and distribution of inputs from multiple classes of premotor interneurons, indicating that MNs broadly influence circuit connectivity. These findings indicate that MN-intrinsic programs contribute to the initial architecture of locomotor circuits.

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