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Παρασκευή, 1 Δεκεμβρίου 2017

The distribution of tritium in aquatic environments, Lithuania

Publication date: Available online 1 December 2017
Source:Journal of Environmental Radioactivity
Author(s): Olga Jefanova, Jonas Mažeika, Rimantas Petrošius, Žana Skuratovič
The aim of this study is to investigate mobile radionuclide tritium (3H or T) activity dynamics in aquatic environments related to Ignalina NPP (INPP) site and water bodies located in remote areas unaffected by the INPP. The 3H excess in the INPP environment was analyzed and compared to the variable 3H background level over the period of operation of the INPP (end of 1983 – end of 2009) and during the initial stage of decommissioning (2010–2017). 3H in the INPP vicinity has been studied in the water of artificial channels related to operation of the INPP and site drainage, in natural surface water bodies and, at a smaller scale, in unconfined groundwater. This study presents an extensive 3H data set extending back to 1980, i.e. before INPP operation started. To assess the contribution of global sources to 3H dynamics, monthly precipitation was also studied, along with water from the Baltic Sea, Curonian Lagoon and Nemunas River were studied as well, all three of these located in the Lithuanian maritime zone. The 3H activity concentration in water was measured using liquid scintillation counting (LSC) techniques (direct counting and counting after enrichment). During the period of INPP operation, 3H from liquid effluent could be clearly observed in discharge channels, occurring in rather low diluted conditions, as well as in Lake Druksiai, the cooling basin, at an even more diluted level. The highest 3H activity concentration in Lake Druksiai was observed in 2003 and reached 201.3 ± 1.3 TU at a time when 3H activity concentrations in background water bodies was 9.2 ± 3.5 TU. After the closure of the INPP, the 3H liquid effluent rate reduced by approximately two orders of magnitude (from 1012 Bq in 1991 to 1010 Bq in 2016) and when decommissioning activity commenced then the 3H activity concentration fell to that approaching the background level (19–27 TU) that can still be observed in industrial discharge and rainwater drainage channels. 3H as a result of leakage from the INPP can be observed in groundwater only in direct proximity to the INPP site near the radioactive waste storage zone.



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Time and dose-related changes in lung perfusion after definitive radiotherapy for NSCLC

To examine radiation-induced changes in regional lung perfusion per dose level in 58 non-small-cell lung cancer (NSCLC) patients treated with intensity-modulated radiotherapy (IMRT).

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Patterns of locoregional failure in locally advanced non-small cell lung cancer treated with definitive conformal radiotherapy: Results from the Gating 2006 trial

To determine the patterns of locoregional failure (LRF) in patients with locally advanced non-small cell lung cancer treated with definitive radiotherapy (RT).

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Independent component analysis for rectal bleeding prediction following prostate cancer radiotherapy

To evaluate the benefit of independent component analysis (ICA)-based models for predicting rectal bleeding (RB) following prostate cancer radiotherapy.

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Groundwater chemistry and radon-222 distribution in Jerba Island, Tunisia

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Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Faten Telahigue, Belgacem Agoubi, Fayza Souid, Adel Kharroubi
The present study integrates hydrogeological, hydrochemical and radiogenic data of groundwater samples taken from the Plio-Quaternary unconfined aquifer of Jerba Island, southeastern Tunisia, in order to interpret the spatial variations of the groundwater quality and identify the main hydrogeochemical factors responsible for the high ion concentrations and radon-222 content in the groundwater analysed. Thirty-nine groundwater samples were collected from open wells widespread on the island. Physical parameters (EC, pH, TDS and T °) were measured, major ions (Ca2+, Mg2+, Na+, K+, Cl, SO42−, NO3 and HCO3) were analysed and 222Rn concentrations were determined using a RAD7-H2O. Hydrogeochemical characterisation revealed that groundwater from the Jerba aquifer has several origins. Basically, two water types exist in the island. The first one, characterized by a low to moderate salinity with a chemical facies CaMgClSO4, characterizes the central part of Jerba (a recharge area) due to carbonate and gypsum dissolution. The second water type with high salinities, dominated by NaKCl type, was observed in coastal areas and some parts having low topographic and piezometric levels. These areas seem to be affected by the seawater intrusion process. The 222Rn concentrations in groundwater samples in Jerba varied from 0 Bq.L−1 to 2860 Bq.L−1 with an average of 867 Bq.L−1.The highest values were registered in the western coastal wells and near the fault of Guellala. However, the central and eastern wells showed low radon levels. Compared to 222Rn activity in some countries with the same lithology, radon concentrations in the Jerba unconfined aquifer have higher values influenced by the structure of the aquifer and by seawater inflow enriched with 222Rn resulting from the decay of uranium derived from phosphogypsum deposits in the gulf of Gabes. The EC and 222Rn spatial variability in the study area were mapped using ARC Map 10.3 software. Hydrochemical results in addition to geological data and radon activities confirm the existence of vertical communication between the Miocene aquifer and the unconfined Plio-Quaternary aquifer through fault system and a lateral communication with the sea via seawater intrusion.



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Fate of 137Cs, 90Sr and 239+240Pu in soil profiles at a water recharge site in Basel, Switzerland

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Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Johannes Abraham, Katrin Meusburger, Judith Kobler Waldis, Michael E. Ketterer, Markus Zehringer
An important process in the production of drinking water is the recharge of the withdrawn ground water with river water at protected recharge fields. While it is well known that undisturbed soils are efficiently filtering and adsorbing radionuclides, the goal of this study was to investigate their behaviour in an artificial recharge site that may receive rapid and additional input of radionuclides by river water (particularly when draining a catchment including nuclear power plants (NPP)). Soil profiles of recharge sites were drilled and analysed for radionuclides, specifically radiocesium (137Cs), radiostrontium (90Sr) and plutonium (239+240Pu). The distribution of the analysed radionuclides were compared with an uncultivated reference soil outside the recharge site. The main activity of 137Cs was located in the top soil (4.5–7.5 cm) and reached down to a depth of 84 cm and 48 cm for the recharge and the reference site, respectively. The found activities of 239+240Pu originate from the global fallout after 1950. 239+240Pu appeared to be strongly adsorbed onto soil particles. The shape of the depth profile was similar to 137Cs, but also similar between the recharge and the reference site. In contrast, 90Sr showed a uniform distribution over the entire depth of the recharge and reference profiles indicating that 90Sr already entered the gravel zone and the ground water. Elevated inventories of the radionuclides were observed for the recharge site. The soil of the recharge field exhibited a threefold higher activity of 137Cs compared to the reference soil. Also for 239+240Pu higher inventories where observed for the recharge sites (40%). 90Sr behaved differently, showing similar inventories between reference and recharge site. We estimate that 75–89% of the total inventory of 137Cs in the soil at the recharge site (7.000 Bq/m2) originated from the fallout of the Chernobyl accident and from emissions of Swiss NPPs. This estimate is based on the actual activity ratio of 137Cs/239+240Pu of 22 for global fallout. The investigations identified radiostrontium as potential threat to the ground water.



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Disappearing Leukoencephalopathy



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Single-access liver floss technique with antegrade hepatic vein access and recanalization in Budd-Chiari syndrome.

Single-access liver floss technique with antegrade hepatic vein access and recanalization in Budd-Chiari syndrome.

Diagn Interv Radiol. 2017 Nov 30;:

Authors: Weaver JJ, Dobrow EM, Hsu EK, Monroe EJ

Abstract
A 14-year-old boy presented with several months of increasing abdominal girth and fatigue. Imaging confirmed massive ascites and hepatic congestion secondary to central hepatic venous obstruction. Several large intrahepatic collateral veins were seen draining via caudate and emissary veins. After an unsuccessful attempt at retrograde recanalization utilizing intravascular ultrasound, the right hepatic vein was recanalized in an antegrade fashion by way of a prominent caudate collateral vein, and subsequently stented. We herein discuss the established treatment options for Budd-Chiari syndrome and describe our experience employing a single-access liver floss technique.

PMID: 29187341 [PubMed - as supplied by publisher]



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The Positive Lymph Node Number and Postoperative N-Staging Used to Estimate Survival in Patients with Differentiated Thyroid Cancer: Results from the Surveillance, Epidemiology, and End Results Dataset (1988-2008).

The Positive Lymph Node Number and Postoperative N-Staging Used to Estimate Survival in Patients with Differentiated Thyroid Cancer: Results from the Surveillance, Epidemiology, and End Results Dataset (1988-2008).

World J Surg. 2017 Nov 28;:

Authors: Wei WJ, Lu ZW, Wen D, Liao T, Li DS, Wang Y, Zhu YX, Wang ZY, Wu Y, Wang YL, Ji QH

Abstract
BACKGROUND: Lymph node metastasis is important when evaluating the prognosis of patients with differentiated thyroid cancer (DTC). However, the current N-staging system cannot fully reflect the clinical significance of cervical lymph node metastasis in DTC. In this study, we employed Surveillance, Epidemiology, and End Results (SEER)-registered DTC cases with lymph node metastasis to determine whether the positive lymph node number (PLNN) could be used to improve stratification of patients in terms of survival.
METHODS: We used the SEER dataset to identify all DTC patients with at least one positive cervical lymph node who were examined between 1988 and 2008. Multivariable modeling was used to compare cancer-specific survival (CSS) and overall survival (OS) and to calculate different PLNN cutoff points.
RESULTS: In total, 14,359 pN + DTC patients identified in the SEER were included. In multivariate Cox regression analysis, the PLNN was significantly associated with both CSS and OS, whereas neither the lymph node ratio (LNR) nor the (numbers of) lymph nodes examined (LNE) were so associated. The highest C-index value (0.933) and the lowest AIC value (9362.687) obtained indicated that the PLNN better predicted the CSS of DTC than did the LNR or LNE. As the p values for both CSS and OS were minimized, and as the PLNN performed best when cases were grouped, PLNN cutoff points of 10 and 3/10 efficiently stratified DTC patients into two and three levels, respectively. Based on the 3/10 trichotomy, the benefits of radioactive iodine (RAI) treatment were evaluated for each group. Such treatment afforded about a 10% survival benefit in patients with more than 10 lymph node metastases.
CONCLUSIONS: Compared with the LNR and LNE under different statistical models, PLNN was superior in terms of DTC staging. A cutoff point of 3/10 was optimal for stratifying patients according to prognosis and was of clinical significance in terms of RAI treatment selection.

PMID: 29185020 [PubMed - as supplied by publisher]



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Changes in Signal Intensity of the Dentate Nucleus and Globus Pallidus in Pediatric Patients: Impact of Brain Irradiation and Presence of Primary Brain Tumors Independent of Linear Gadolinium-based Contrast Agent Administration.

Changes in Signal Intensity of the Dentate Nucleus and Globus Pallidus in Pediatric Patients: Impact of Brain Irradiation and Presence of Primary Brain Tumors Independent of Linear Gadolinium-based Contrast Agent Administration.

Radiology. 2017 Nov 30;:171850

Authors: Tamrazi B, Nguyen B, Liu CJ, Azen CG, Nelson MB, Dhall G, Nelson MD

Abstract
Purpose To determine whether whole-brain irradiation, chemotherapy, and primary brain pathologic conditions affect magnetic resonance (MR) imaging signal changes in pediatric patients independent of the administration of gadolinium-based contrast agents (GBCAs). Materials and Methods This institutional review board-approved, HIPAA-compliant study included 144 pediatric patients who underwent intravenous GBCA-enhanced MR imaging examinations (55 patients with primary brain tumors and whole-brain irradiation, 19 with primary brain tumors and chemotherapy only, 52 with primary brain tumors without any treatment, and 18 with neuroblastoma without brain metastatic disease). The signal intensities (SIs) in the globus pallidus (GP), thalamus (T), dentate nucleus (DN), and pons (P) were measured on unenhanced T1-weighted images. GP:T and DN:P SI ratios were compared between groups by using the analysis of variance and were analyzed relative to group, total cumulative number of doses of GBCA, age, and sex by using multivariable linear models. Results DN:P ratio for the radiation therapy group was greater than that for the other groups except for the group of brain tumors treated with chemotherapy (P < .05). The number of GBCA doses was correlated with the DN:P ratio for the nontreated brain tumor group (P < .0001). The radiation therapy-treated brain tumor group demonstrated higher DN:P ratios than the nontreated brain tumor group for number of doses less than or equal to 10 (P < .0001), whereas ratios in the nontreated brain tumor group were higher than those in the radiation therapy-treated brain tumor group for doses greater than 20 (P = .05). The GP:T ratios for the brain tumor groups were greater than that for the neuroblastoma group (P = .01). Conclusion Changes in SI of the DN and GP that are independent of the administration of GBCA occur in patients with brain tumors undergoing brain irradiation, as well as in patients with untreated primary brain tumors. © RSNA, 2017.

PMID: 29189102 [PubMed - as supplied by publisher]



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Intermanufacturer Comparison of Dual-Energy CT Iodine Quantification and Monochromatic Attenuation: A Phantom Study.

Intermanufacturer Comparison of Dual-Energy CT Iodine Quantification and Monochromatic Attenuation: A Phantom Study.

Radiology. 2017 Nov 29;:170896

Authors: Jacobsen MC, Schellingerhout D, Wood CA, Tamm EP, Godoy MC, Sun J, Cody DD

Abstract
Purpose To determine the accuracy of dual-energy computed tomographic (CT) quantitation in a phantom system comparing fast kilovolt peak-switching, dual-source, split-filter, sequential-scanning, and dual-layer detector systems. Materials and Methods A large elliptical phantom containing iodine (2, 5, and 15 mg/mL), simulated contrast material-enhanced blood, and soft-tissue inserts with known elemental compositions was scanned three to five times with seven dual-energy CT systems and a total of 10 kilovolt peak settings. Monochromatic images (50, 70, and 140 keV) and iodine concentration images were created. Mean iodine concentration and monochromatic attenuation for each insert and reconstruction energy level were recorded. Measurement bias was assessed by using the sum of the mean signed errors measured across relevant inserts for each monochromatic energy level and iodine concentration. Iodine and monochromatic errors were assessed by using the root sum of the squared error of all measurements. Results At least one acquisition paradigm per scanner had iodine biases (range, -2.6 to 1.5 mg/mL) with significant differences from zero. There were no significant differences in iodine error (range, 0.44-1.70 mg/mL) among the top five acquisition paradigms (one fast kilovolt peak switching, three dual source, and one sequential scanning). Monochromatic bias was smallest for 70 keV (-12.7 to 15.8 HU) and largest for 50 keV (-80.6 to 35.2 HU). There were no significant differences in monochromatic error (range, 11.4-52.0 HU) among the top three acquisition paradigms (one dual source and two fast kilovolt peak switching). The lowest accuracy for both measures was with a split-filter system. Conclusion Iodine and monochromatic accuracy varies among systems, but dual-source and fast kilovolt-switching generally provided the most accurate results in a large phantom. © RSNA, 2017 Online supplemental material is available for this article.

PMID: 29185902 [PubMed - as supplied by publisher]



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Identification of Distant Metastatic Disease in Uterine Cervical and Endometrial Cancers with FDG PET/CT: Analysis from the ACRIN 6671/GOG 0233 Multicenter Trial.

Identification of Distant Metastatic Disease in Uterine Cervical and Endometrial Cancers with FDG PET/CT: Analysis from the ACRIN 6671/GOG 0233 Multicenter Trial.

Radiology. 2017 Nov 29;:170963

Authors: Gee MS, Atri M, Bandos AI, Mannel RS, Gold MA, Lee SI

Abstract
Purpose To assess the accuracy of staging positron emission tomography (PET)/computed tomography (CT) in detecting distant metastasis in patients with local-regionally advanced cervical and high-risk endometrial cancer in the clinical trial by the American College of Radiology Imaging Network (ACRIN) and the Gynecology Oncology Group (GOG) (ACRIN 6671/GOG 0233) and to compare central and institutional reader performance. Materials and Methods In this prospective multicenter trial, PET/CT and clinical data were reviewed for patients enrolled in ACRIN 6671/GOG 0233. Two central readers, blinded to site read and reference standard, reviewed PET/CT images for distant metastasis. Central review was then compared with institutional point-of-care interpretation. Reference standard was pathologic and imaging follow-up. Test performance for central and site reviews of PET/CT images was calculated and receiver operating characteristic analysis was performed. Generalized estimating equations and nonparametric bootstrap procedure for clustered data were used to assess statistical significance. Results There were 153 patients with cervical cancer and 203 patients with endometrial cancer enrolled at 28 sites. Overall prevalence of distant metastasis was 13.7% (21 of 153) for cervical cancer and 11.8% (24 of 203) for endometrial cancer. Central reader PET/CT interpretation demonstrated sensitivity, specificity, positive predictive value (PPV), and negative predictive value of 54.8%, 97.7%, 79.3%, and 93.1% for cervical cancer metastasis versus 64.6%, 98.6%, 86.1%, and 95.4% for endometrial cancer, respectively. By comparison, local institutional review demonstrated sensitivity, specificity, PPV, and negative predictive value of 47.6%, 93.9%, 55.6%, and 91.9% for cervical cancer metastasis and 66.7%, 93.9%, 59.3%, and 95.5% for endometrial cancer, respectively. For central readers, the specificity and PPV of PET/CT detection of cervical and endometrial cancer metastases were all significantly higher compared with that of local institutional review (P < .05). Central reader area under the receiver operating characteristic curve (AUC) values were 0.78 and 0.89 for cervical and endometrial cancer, respectively; these were not significantly different from local institutional AUC values (0.75 and 0.84, respectively; P > .05 for both). Conclusion FDG PET/CT demonstrates high specificity and PPV for detecting distant metastasis in cervical and endometrial cancer and should be included in the staging evaluation. Blinded central review of imaging provides improved specificity and PPV for the detection of metastases and should be considered for future oncologic imaging clinical trials. © RSNA, 2017.

PMID: 29185901 [PubMed - as supplied by publisher]



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Freiburg Neuropathology Case Conference



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Cortical Phase-Amplitude Coupling in a Progressive Model of Parkinsonism in Nonhuman Primates.

Cortical Phase-Amplitude Coupling in a Progressive Model of Parkinsonism in Nonhuman Primates.

Cereb Cortex. 2017 Nov 28;:1-11

Authors: Devergnas A, Caiola M, Pittard D, Wichmann T

Abstract
Parkinson's disease is associated with abnormal oscillatory electrical activities of neurons and neuronal ensembles throughout the basal ganglia-thalamocortical network. It has recently been documented in patients with advanced parkinsonism that the amplitude of gamma-band oscillations (50-200 Hz) in electrocorticogram recordings from the primary motor cortex is abnormally coupled to the phase of beta band oscillations within the same signals. It is not known when in the course of the disease the abnormal phase-amplitude coupling (PAC) arises, and whether it is influenced by arousal or prior exposure to dopaminergic medications. To address these issues, we analyzed the relationship between the severity of parkinsonian motor signs and the extent of PAC in a progressive model of parkinsonism, using primates that were not exposed to levodopa prior to testing. PAC was measured in electrocorticogram signals from the primary motor cortex and the supplementary motor area in 3 monkeys that underwent weekly injections of small doses of the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, rendering them progressively parkinsonian. We found that parkinsonism was associated with increased coupling between the phase of low-frequency (4-10 Hz) oscillations and the amplitude of oscillations in the high gamma band (50-150 Hz). These changes only reached significance when the animals became fully parkinsonian. The increased PAC was normalized after levodopa treatment. We also found a similar increase in PAC during sleep, even in normal animals. The identified PAC was independent of concomitant changes in spectral power in the 2.9-9.8Hz or 49.8-150.4 Hz ranges. We conclude that PAC is predominately a sign of advanced parkinsonism, and is, thus, not essential for the development of parkinsonism. However, increased PAC appears to correlate with the severity of fully developed parkinsonism.

PMID: 29190329 [PubMed - as supplied by publisher]



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EVALUATION OF OBSTRUCTIVE SLEEP APNEA SYNDROME AS A RISK FACTOR FOR DIABETIC MACULAR EDEMA IN PATIENTS WITH TYPE II DIABETES.

EVALUATION OF OBSTRUCTIVE SLEEP APNEA SYNDROME AS A RISK FACTOR FOR DIABETIC MACULAR EDEMA IN PATIENTS WITH TYPE II DIABETES.

Retina. 2017 Nov 22;:

Authors: Vié AL, Kodjikian L, Agard E, Voirin N, El Chehab H, Denis P, Coste O, Dot C

Abstract
PURPOSE: To evaluate the association between obstructive sleep apnea and diabetic macular edema (DME) in patients with Type II diabetes, using the apnea-hypopnea index and other nocturnal hypoxemia parameters.
METHODS: This cross-sectional, case-control study included 99 patients with Type II diabetes: the first group included patients with DME (DME+ group) and the second patients without DME (DME- group). Polysomnography was performed in all patients. The two groups were compared, and the risk factors were studied using logistic regression.
RESULTS: The DME+ group comprised 38 patients, and the DME- group comprised 61 patients, aged a mean 68.8 years and 66.3 years (P = 0.27), respectively; mean body mass index was 29.7 and 30.9 (P = 0.16), respectively. The mean apnea-hypopnea index was significantly higher in the DME+ group (43.95 [13.5-87.3]) than in the DME- group (35.18 [3.55-90.7]) (P = 0.034). Patients with DME had more severe obstructive sleep apnea (apnea-hypopnea index >30) than the others: 71% versus 50.8% (P = 0.049). Cumulative time of SPO2 below 90% (CT90%) was independently associated with DME after adjusting for confounding factors, whereas there was no difference between the oxygen desaturation index and minimum O2 saturation.
CONCLUSION: Severe obstructive sleep apnea (apnea-hypopnea index >30) and parameters of nocturnal hypoxemia (cumulative time of SPO2 below 90%) are associated with DME.

PMID: 29190244 [PubMed - as supplied by publisher]



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The effect of repeated light-dark shifts on uterine receptivity and early gestation in mice undergoing embryo transfer.

The effect of repeated light-dark shifts on uterine receptivity and early gestation in mice undergoing embryo transfer.

Syst Biol Reprod Med. 2017 Nov 30;:1-9

Authors: Goldstein CA, O'Brien LM, Bergin IL, Saunders TL

Abstract
Female shift workers are at increased risk for negative reproductive outcomes, and animal evidence suggests that manipulation of the light-dark cycle is detrimental to early gestation in female mice. Specifically, failure of implantation may be responsible for these findings. The objective of this study was to better delineate which reproductive processes are vulnerable to detrimental effects of maternal circadian disturbance. We exposed mice undergoing embryo transfer to repetitive phase advances of the photoperiod. Embryos were derived from donor sperm and eggs from mice living in normal light-dark conditions to isolate the effects of photoperiod disruption on uterine receptivity and early gestation. Twenty-eight mice receiving embryo transfer underwent an experimental light-dark condition (advance of lights on and lights off by 6 hours every 4 days). Twenty-eight mice remained in a normal light-dark condition. Animals lived in their assigned light-dark condition beginning 2 weeks prior to embryo transfer and ending the day of uterine necropsy (post-coitus day 14.5). Wilcoxon-Mann-Whitney test demonstrated no significant differences between control and experimental light-dark conditions in pups (Z=0.10, p=.92), resorptions (Z=0.20, p=.84), or implantations (Z=-0.34, p=.73). Pup and placental weights were similar between groups. In this investigation, uterine receptivity and maintenance of early gestation were preserved despite recurrent phase advances in photoperiod. This finding, in the context of the current literature, suggests that the negative effects of circadian disruption are mediated by reproductive processes upstream of implantation.

PMID: 29190151 [PubMed - as supplied by publisher]



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Reply: We Did This, and the Patient Improved: True, True, and Unrelated?

Reply: We Did This, and the Patient Improved: True, True, and Unrelated?

Ann Am Thorac Soc. 2017 Nov 30;:

Authors: Askari K, Sneij W, Krick S, Alvarez RA

PMID: 29190118 [PubMed - as supplied by publisher]



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[The association of schizophrenia with chronic non transmissible diseases].

[The association of schizophrenia with chronic non transmissible diseases].

Rev Med Chil. 2017 Aug;145(8):1047-1053

Authors: Orellana G, Rodríguez M, González N, Durán E

Abstract
The life expectancy of patients with schizophrenia (SCH) is 11 to 20 years less than the general population. There is an association between SCH and various diseases and chronic conditions, highlighting the cardio-metabolic diseases. This association has been attributed to the use of antipsychotics, however, evidence has also shown intrinsic susceptibility of schizophrenic patients the development of chronic conditions. This review aims to update knowledge about chronic conditions such as cardiometabolic risk and sleep, bone and kidney disorders related to SCH. These patients have a high prevalence of risk behaviors, including smoking and poor diet. They have a worse metabolic profile than the general population and a greater likelihood of developing metabolic syndrome, diabetes and cardiovascular disease. SCH has also been associated with other chronic diseases such as osteoporosis and chronic kidney disease. The high prevalence of these comorbidities in schizophrenic population is not explained solely by the antipsychotic treatment, therefore intrinsic mechanisms associated to SCH are postulated to be associated with these conditions. This new information requires a change in the multidisciplinary medical approach for the study and management of schizophrenic patients.

PMID: 29189863 [PubMed - in process]



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Neurological and Sleep Disturbances in Bronchiectasis.

Neurological and Sleep Disturbances in Bronchiectasis.

J Clin Med. 2017 Nov 30;6(12):

Authors: Phua CS, Wijeratne T, Wong C, Jayaram L

Abstract
Bronchiectasis unrelated to cystic fibrosis is a chronic lung disease that is increasingly recognised worldwide. While other common chronic lung conditions such as chronic obstructive lung disease have been associated with cardiovascular disease, there is a paucity of data on the relationship between bronchiectasis and cardiovascular risks such as stroke and sleep disturbance. Furthermore, it is unclear whether other neuropsychological aspects are affected, such as cognition, cerebral infection, anxiety and depression. In this review, we aim to highlight neurological and sleep issues in relation to bronchiectasis and their importance to patient care.

PMID: 29189747 [PubMed]



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Effectiveness of support groups to improve the quality of life of people with idiopathic pulmonary fibrosis a pre-post test pilot study.

Effectiveness of support groups to improve the quality of life of people with idiopathic pulmonary fibrosis a pre-post test pilot study.

Acta Biomed. 2017 Nov 30;88(5-S):5-12

Authors: Magnani D, Lenoci G, Balduzzi S, Artioli G, Ferri P

Abstract
BACKGROUND AND AIM OF THE WORK: Idiopathic Pulmonary Fibrosis (IPF) is an interstitial lung disease, which progressively leads to severe disability and death. The average survival expectancy, ranges from 3 to 5 years from diagnosis, and the available medicines do not lead to healing. The progression of IPF lead to a decline in forced vital capacity (FVC), dyspnea, cough, continuous sleep interruptions, resulting in increased fatigue and deteriorating quality of life (QOL), progressive limitation of daily life activities and social life, with repercussions on psychological and emotional well-being, aggravated by anxiety, loss of sense of self-confidence and depression. The aim of the study was to evaluate how the support groups influence the psychological well-being of people with IPF and their family members.
METHODS: A pre-post test pilot study with a single group was conducted in a university hospital in Northern Italy, a centre for diagnosis and treatment of IPF. A support group was conducted by a nurse and entirely dedicated to people with IPF and their family members. Eighteen participants were enrolled in the support group. To measure the changes in psychological well-being was chosen the Psychological General Well-Being Index (PGWBI), which was administered at the time of enrolment to the group and after six months of attendance.
RESULTS: Even if the effect is not statistically significant, the paired t-test showed that the participation in a support group conducted by a nurse, could increase psychological well-being in all of its dimensions: anxiety, depression, positivity, self-control, overall health, and vitality.
CONCLUSIONS: Despite the null association, the increase of psychological well-being, closely related to the quality of life, indicates the need to further studies. In the absence of effective pharmacological treatments for healing, the support groups represent an opportunity for the wellbeing of the IPF patients and their caregivers.

PMID: 29189700 [PubMed - in process]



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Comparison of psychiatric symptoms in patients with obstructive sleep apnea, simple snoring, and normal controls.

Comparison of psychiatric symptoms in patients with obstructive sleep apnea, simple snoring, and normal controls.

Psychosom Med. 2017 Nov 17;:

Authors: Kang JM, Cho SJ, Lee YJ, Kim JE, Shin SH, Park KH, Kim ST, Kang SG

Abstract
OBJECTIVE: Patients with sleep-related breathing disorders are known to have more severe psychiatric symptoms than good sleepers. The aim of this study was to compare the psychiatric symptoms of participants with obstructive sleep apnea (OSA), those with simple snoring (SS), and normal controls (NC).
METHODS: A total of 386 participants (260 with OSA, 75 with SS, and 51 NC) completed self-report questionnaires including the Symptoms Checklist 90-Revised (SCL-90-R) and underwent nocturnal polysomnography. The scores of nine primary symptom dimensions and three global distress indices of the SCL-90-R were compared among the three groups, adjusting for age, sex, and body mass index.
RESULTS: Participants with suspected OSA (OSA + SS) reported more severe psychiatric symptoms than the NC group. Compared with the participants with OSA, those with SS manifested more severe obsessive-compulsive (1.4±1.0 vs. 1.1±0.7; p = 0.008) and depressive (1.2±1.2 vs. 0.8±0.8; p = 0.031) symptoms and higher global severity index (GSI, 1.0±0.9 vs. 0.7±0.6; p = 0.039) and positive symptom distress index (PSDI, 2.0±0.8 vs. 1.7±0.6; p = 0.009). Only higher Pittsburgh Sleep Quality Index values predicted higher GSI (B = 0.11, p = 0.041) and PSDI (B = 0.46, p = 0.007) in suspected OSA participants.
CONCLUSION: This study found that individuals with suspected OSA suffered from more severe psychiatric symptoms than NCs and that psychiatric symptoms were more severe in the SS group than in the OSA group. The psychiatric symptoms of suspected OSA patients were associated with subjective sleep quality rather than with the apnea-hypopnea index.

PMID: 29189598 [PubMed - as supplied by publisher]



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Paraneoplastic Lambert-Eaton Myasthenic Syndrome With Limbic Encephalitis: Clinical Correlation With the Coexistence of Anti-VGCC and Anti-GABAB Receptor Antibodies.

Paraneoplastic Lambert-Eaton Myasthenic Syndrome With Limbic Encephalitis: Clinical Correlation With the Coexistence of Anti-VGCC and Anti-GABAB Receptor Antibodies.

J Clin Neuromuscul Dis. 2017 Dec;19(2):84-88

Authors: Cho JJ, Wymer JP

Abstract
OBJECTIVE: To characterize Lambert-Eaton myasthenic syndrome and limbic encephalitis with coexistent voltage-gated calcium channel (VGCC) antibody and γ-aminobutyric acid (GABA) B receptor antibody.
METHODS: Case study.
RESULTS: A 57-year-old man presented with 6 months of weakness, unsteadiness, and vision difficulties. Examination revealed proximal weakness and diminished reflexes. Electrodiagnostic study revealed low-amplitude motor potentials and facilitation on high-frequency stimulation. Laboratory evaluation identified P/Q-type VGCC antibody. Positron emission tomography identified a mediastinal lesion, confirmed as small-cell lung carcinoma. The patient developed confusion and seizures. Cerebrospinal fluid analysis identified antibodies to GABAB receptor.
CONCLUSIONS: This case describes a patient with Lambert-Eaton myasthenic syndrome, limbic encephalitis, and autoantibodies to VGCC and GABAB receptor. Atypical presentation of paraneoplastic neurological syndromes could indicate the presence of a second antibody that may have significant impact on therapy.

PMID: 29189554 [PubMed - in process]



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Is Obstructive Sleep Apnea Associated with Progressive Glaucomatous Optic Neuropathy?

Is Obstructive Sleep Apnea Associated with Progressive Glaucomatous Optic Neuropathy?

J Glaucoma. 2017 Nov 17;:

Authors: Swaminathan SS, Bhakta AS, Shi W, Feuer WJ, Abreu AR, Chediak AD, Greenfield DS

Abstract
PURPOSE: To evaluate the relationship between obstructive sleep apnea syndrome (OSAS) and glaucoma progression, and to examine the correlation between OSAS severity and rate of visual field (VF) loss.
METHODS: Patients with concurrent diagnoses of open-angle glaucoma and OSAS between 2010-2016 were identified. Enrollment criteria consisted of glaucomatous optic neuropathy and VF loss, ≥5 reliable VFs, ≥2 years of follow-up, and polysomnography (PSG) within 12 months of final VF. PSG parameters including apnea-hypopnea index (AHI) and oxygen saturation (SpO2) were collected. Eyes were classified as "progressors" or "non-progressors" based upon event analysis using Glaucoma Progression Analysis™ criteria. Two-tailed t-test comparisons were performed, and correlations between rates of VF loss and PSG parameters were assessed.
RESULTS: A total of 141 patients with OSAS and glaucoma were identified. Twenty-five patients (age 67.9±7.6 y) with OSAS (8 mild, 8 moderate, 9 severe) were enrolled. Eleven eyes (44%) were classified as progressors, and had more severe baseline VF loss (P=0.03). Progressors and non-progressors had non-significantly different (P>0.05) age (69.9±8.7 vs. 66.4±6.6 y), follow-up (4.4±0.7 vs. 4.3±1.0 y), intraocular pressure (13.1±2.8 vs. 14.9±2.5 mmHg), mean ocular perfusion pressure (49.7±5.5 vs. 48.8±9.0 mmHg), AHI (31.3±18.6 vs. 26.4±24.0), body-mass index (27.8±5.5 vs. 28.8±5.6), and SpO2 (94.1±1.6% vs. 94.0±1.6%). AHI was not correlated with slopes of VF mean deviation (r=-0.271, P=0.190) or pattern standard deviation (r=0.211, P=0.312), and no substantial increase in risk of progression was found with increase in AHI.
CONCLUSIONS: This study does not support a relationship between OSAS and glaucomatous progression. No correlation was observed between OSAS severity and rate of VF loss.

PMID: 29189544 [PubMed - as supplied by publisher]



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Wake-up Call to Clinicians: The Impact of Sleep Dysfunction on Gastrointestinal Health and Disease.

Wake-up Call to Clinicians: The Impact of Sleep Dysfunction on Gastrointestinal Health and Disease.

J Clin Gastroenterol. 2017 Nov 17;:

Authors: Parekh PJ, Oldfield EC, Johnson DA

Abstract
Sleep dysfunction is an epidemic affecting a large portion of the adult population. Recent studies have linked sleep dysfunction with an upregulation of proinflammatory cytokines (eg, tumor necrosis factor-α, interleukin-1 and interleukin-6), the implications of which can have a profound impact on a variety of gastrointestinal disease. In particular, sleep dysfunction seems to accelerate disease states characterized by inflammation (eg, gastroesophageal reflux disease, irritable bowel syndrome and functional dyspepsia, chronic liver disease, inflammatory bowel disease, and colorectal cancer). This article evaluates the complex interplay between sleep dysfunction and gastrointestinal health and disease.

PMID: 29189428 [PubMed - as supplied by publisher]



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Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes.

Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes.

Clin J Sport Med. 2017 Nov 16;:

Authors: Hoffman NL, Weber ML, Broglio SP, McCrea M, McAllister TW, Schmidt JD, CARE Consortium Investigators

Abstract
OBJECTIVE: To determine whether decreased sleep duration postconcussion influences days to asymptomatic and assessment of performance throughout recovery.
DESIGN: Prospective.
SETTING: Institutional Clinical Research Laboratory.
PATIENTS: Four hundred twenty-three collegiate athletes were diagnosed with concussion.
INTERVENTIONS: Multidimensional concussion assessment battery was conducted at baseline, within 24 to 48 hours, daily [2-4 days postinjury (PI); symptoms only], once asymptomatic, and after return-to-play. The battery included the following: 22-item symptom checklist, Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and computerized neurocognitive test [Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)].
MAIN OUTCOME MEASURES: We subtracted baseline sleep duration from 24 to 48 hours postconcussion sleep duration and categorized athletes into the following groups: shorter sleep (≤-1 hour), no change (>-1 hour, <+1 hour), and longer sleep (≥+1 hour). A 1-way analysis of variance (ANOVA) was conducted to compare days to asymptomatic and separate mixed-model ANOVAs to compare total symptom scores, SAC total scores, BESS total error scores, and ImPACT composite scores between sleep categories across time points (α = 0.05).
RESULTS: Sleep groups did not differ in days to asymptomatic. The shorter sleep group had greater symptom severity than no sleep change and longer sleep groups at 24 to 48 hours (shorter: 39.1 ± 20.7; no change: 25.1 ± 18.4, P = 0.007; longer: 25.7 ± 21.8, P = 0.004), and at 2 to 4 days PI (shorter: 21.8 ± 21.8; no change: 10.5 ± 10.8, P = 0.013; longer: 11.9 ± 14.2, P = 0.007), but did not differ at other time points (ie, asymptomatic and return-to-play). Participants with shorter sleep exhibited slower ImPACT reaction times at 24 to 48 hours (shorter: 0.68 ± 0.14; no change: 0.61 ± 0.09, P = 0.016; and longer: 0.62 ± 0.12, P = 0.028) and asymptomatic time points (shorter: 0.62 ± 0.11; no change: 0.56 ± 0.05; P = 0.015).
CONCLUSION: Postinjury sleep declines may be associated with symptom severity and worsened reaction time during initial stages of recovery or may be the result of the concussion itself. Clinicians should be aware of alterations in sleep duration and manage appropriately to mitigate initial symptom burden postconcussion.

PMID: 29189340 [PubMed - as supplied by publisher]



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Risk of Cognitive Impairment by Sleep-Disordered Breathing.

Risk of Cognitive Impairment by Sleep-Disordered Breathing.

Anesth Analg. 2017 Nov 14;:

Authors: Kawada T

PMID: 29189268 [PubMed - as supplied by publisher]



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Complementary, alternative and integrative medicine for childhood atopic dermatitis.

Complementary, alternative and integrative medicine for childhood atopic dermatitis.

Recent Pat Inflamm Allergy Drug Discov. 2017 Nov 28;:

Authors: Hon KL, Leung AKC, Leung TNH, Leeq V

Abstract
Backgroud: Atopic dermatitis (AD) is a chronic relapsing dermatosis associated with itch, sleep disturbance and poor quality of life. Treatment of AD includes the use of emollients, and topical and systemic immunomodulating agents. Many patients also use complementary and alternative medicine (CAM).
OBJECTIVE: This article reviews the pathophysiology of AD and clinical trials involving various modalities of CAM in the treatment of AD.
METHODS: A Medline/Pubmed search was conducted using Clinical Queries with the key terms "Chinese Medicine OR Complementary and Alternative medicine" AND "Eczema OR Atopic dermatitis". The search strategy included meta-analyses, randomized controlled trials (RCTs), clinical trials, reviews and pertinent references. Patents were searched using the key term &quot;atopic dermatitis&quot; from http://ift.tt/eVKF0q, www.uspto.gov, and http://ift.tt/N1R7MD.
RESULTS: Only a few RCTs evaluated the efficacy of Chinese medicinal herbs in treating AD. There was some evidence for other modalities of CAM. Integrative medicine (IM) usually refers to the various forms of CAM that combine conventional western medicine and Chinese medicine. Supporting evidence for the efficacy of IM in the treatment of AD is presently lacking. Integration is difficult. Western medicine practitioners are often ignorant about CAM and IM. Parents are concerned about the potential side effects of Western medicine and will tend to be non-compliant with the conventional Western component of IM. . Recent patents on CAM and IM are reviewed. Most CAM patents are herbal compositions, evidence on their efficacy is generally lacking.
CONCLUSIONS: AD is a complex disease. The psychodynamics of the child and his/her family is the reason for the often suboptimal outcomes. Both Western and CAM practitioners should collaborate to create a mutually encouraging environment for the advances of IM. CAM and IM publications and patents are reviewed. Evidence of their efficacy is generally lacking. Further research is needed.

PMID: 29189188 [PubMed - as supplied by publisher]



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Computer-aided drug design applied to Parkinson targets.

Computer-aided drug design applied to Parkinson targets.

Curr Neuropharmacol. 2017 Nov 28;:

Authors: Ishiki HM, Filho JMB, da Silva MS, Scotti MT, Scotti L

Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by debilitating motor deficits, as well as autonomic problems, cognitive declines, changes in affect and sleep disturbances. Although the scientific community has performed great efforts in the study of PD, and from the most diverse points of view, the disease remains incurable. The exact mechanism underlying its progression is unclear, but oxidative stress, mitochondrial dysfunction and inflammation are thought to play major roles in the etiology. Current pharmacological therapies for the treatment of Parkinson's disease are mostly inadequate, and new therapeutic agents are much needed. In this review, recent advances in computer-aided drug design for the rational design of new compounds against Parkinson disease; using methods such as Quantitative Structure-Activity Relationships (QSAR), molecular docking, molecular dynamics and pharmacophore modeling are discussed. In this review, four targets were selected: the enzyme monoamine oxidase, dopamine agonists, acetylcholine receptors, and adenosine receptors.

PMID: 29189169 [PubMed - as supplied by publisher]



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Brain Targeted Intranasal Zaleplon Nano-emulsion: In-Vitro Characterization and Assessment of Gamma Aminobutyric Acid Levels in rabbits' Brain and Plasma at low and high Doses.

Brain Targeted Intranasal Zaleplon Nano-emulsion: In-Vitro Characterization and Assessment of Gamma Aminobutyric Acid Levels in rabbits' Brain and Plasma at low and high Doses.

Curr Drug Deliv. 2017 Nov 30;:

Authors: Abd-Elrasheed E, El-Helaly SN, El-Ashmoony MM, Salah S

Abstract
BACKGROUND: Zaleplon is a pyrazolopyrimidin derivative hypnotic drug indicated for the short-term management of insomnia. Zaleplon belongs to Class II drugs, according to the biopharmaceutical classification system (BCS), showing poor solubility and high permeability. It undergoes extensive first-pass hepatic metabolism after oral absorption, with only 30% of Zaleplon being systemically available. It is available in tablet form which is unable to overcome the previous problems.
OBJECTIVE: The aim of this study is to enhance solubility and bioavailability via utilizing nanotechnology in the formulation of intranasal Zaleplon nano-emulsion (ZP-NE) to bypass the barriers and deliver an effective therapy to the brain.
METHODS: Screening studies were carried out wherein the solubility of zaleplon in various oils, surfactants(S) and co-surfactants(CoS) were estimated. Pseudo-ternary phase diagrams were constructed and various nano-emulsion formulations were prepared. These formulations were subjected to thermodynamic stability, in-vitro characterization, histopathological studies and assessment of the gamma aminobutyric acid (GABA) level in plasma and brain in rabbits compared to the market product (Sleep aid®).
CONCLUSIONS: Stable NEs were successfully developed with a particle size range of 44.57±3.351 to 136.90±1.62 nm. A NE composed of 10% Miglyol® 812, 40%Cremophor® RH40 40%Transcutol® HP and 10% water successfully enhanced the bioavailability and brain targeting in the rabbits, showing a three to four folds increase than the marketed product.

PMID: 29189154 [PubMed - as supplied by publisher]



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Applying network analysis to psychological comorbidity and health behavior: Depression, PTSD, and sexual risk in sexual minority men with trauma histories.

Applying network analysis to psychological comorbidity and health behavior: Depression, PTSD, and sexual risk in sexual minority men with trauma histories.

J Consult Clin Psychol. 2017 Dec;85(12):1158-1170

Authors: Choi KW, Batchelder AW, Ehlinger PP, Safren SA, O'Cleirigh C

Abstract
OBJECTIVE: High rates of depression and posttraumatic stress disorder (PTSD) contribute to sexual risk, particularly in men who have sex with men (MSM) who have experienced childhood sexual abuse. The comorbidity between depression and PTSD and mechanisms by which they contribute to sexual risk in MSM remain unclear. This study sought to demonstrate the feasibility and utility of a network approach to (a) characterize symptom interconnections between depression and PTSD in MSM, (b) identify specific symptoms related to sexual risk behavior, and (c) compare symptom networks across groups at different levels of risk.
METHOD: Cross-sectional baseline data were collected from 296 HIV-negative urban MSM as part of a multisite randomized intervention trial. Symptoms of depression and PTSD were self-reported along with sexual risk behavior. Analyses were performed in R using regularized partial correlation network modeling.
RESULTS: Network analyses revealed complex associations between depression and PTSD symptoms and in relation to sexual risk behavior. While symptoms clustered within their respective disorders, depression and PTSD were connected at key symptom nodes (e.g., sleep, concentration). Specific symptoms (e.g., avoiding thoughts and feelings) were linked to sexual risk behavior. Network comparisons across risk groups suggested avoidant processes could be more readily activated in higher-risk individuals, whereas hyperarousal symptoms may be more salient and protective for lower-risk individuals.
CONCLUSIONS: This study is one of the earliest network analyses of depression and PTSD, and first to extend this inquiry to health behavior. Symptom-level investigations may clarify mechanisms underlying psychological comorbidity and behavioral risk in MSM and refine targets for intervention/prevention. (PsycINFO Database Record

PMID: 29189032 [PubMed - in process]



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Association between Siesta (Daytime Sleep), Dietary Patterns and the Presence of Metabolic Syndrome in Elderly Living in Mediterranean Area (Medis Study): The Moderating Effect of Gender.

Association between Siesta (Daytime Sleep), Dietary Patterns and the Presence of Metabolic Syndrome in Elderly Living in Mediterranean Area (Medis Study): The Moderating Effect of Gender.

J Nutr Health Aging. 2017;21(10):1118-1124

Authors: Georgousopoulou EN, Naumovski N, Mellor DD, Tyrovolas S, Piscopo S, Valacchi G, Tsakountakis N, Zeimbekis A, Bountziouka V, Gotsis E, Metallinos G, Tyrovola D, Kellett J, Foscolou A, Tur JA, Matalas AL, Lionis C, Polychronopoulos E, Sidossis L, Panagiotakos D

Abstract
OBJECTIVES: Several lifestyle parameters including diet, physical activity and sleep were associated in isolation with the presence of Metabolic Syndrome (MetS) in adults, to date there is a paucity of studies which evaluated their combined role aging populations and especially with respect to gender. Therefore, the aim of the present study was to provide a global consideration of the lifestyle factors associated with MetS among elderly individuals.
DESIGN: Cross-sectional observational study.
SETTING: 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece.
PARTICIPANTS: during 2005-2015, 2749 older (aged 65-100 years) from were voluntarily enrolled in the study.
MEASUREMENTS: Dietary habits, energy intake, physical activity status, socio-demographic characteristics, lifestyle parameters (sleeping and smoking habits) and clinical profile aspects were derived through standard procedures. The presence of MetS was defined using the definition provided by NCEP ATP III (revised) and cluster analysis was used to identify overall dietary habit patterns.
RESULTS: The overall prevalence of MetS in the study sample was 36.2%, but occurred more frequently in females (40.0% vs. 31.8%, respectively, p=0.03). Individuals with MetS were more likely to sleep during the day (89.4% vs. 76.8% respectively, p=0.039) and frequent 'siesta' was positively linked to the odds of MetS presence in females (Odds Ratio (OR) =3.43, 95% Confidence Intervals (CI): 1.08-10.9), but not for men (p=0.999). The lower carbohydrate (i.e., 45.2% of total daily energy, 120±16gr/day) dietary cluster was inversely associated with the odds for MetS presence, but only for men (OR=0.094, 95%CI: 0.010-0.883).
CONCLUSIONS: Lifestyle parameters including sleep and diet quality are strongly associated with the presence of MetS in elderly cohort, but different their level of influence appears to be different, depending on gender. Further research is needed to better consider the role of lifestyle characteristics in the management of MetS in clinical practice.

PMID: 29188870 [PubMed - in process]



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2nd Symposium on Advances in Cancer Immunology and Immunotherapy, December 15–17, 2016, Athens, Greece

Abstract

This is the 2nd Symposium of a series organized annually. It aims to integrate tumor immunology basic research with results from most recent clinical trials based on the use of anti-cancer agents targeting immune system components.



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health technology; +403 new citations

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

health technology

These pubmed results were generated on 2017/12/01

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



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Reducing variations in care

Getting It Right First Time (GIRFT) is a new initiative in England aimed at reducing unwarranted variation in care. Interventions to understand how healthcare delivery and outcomes vary are not new....
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=-64JJekTjBg:FnOX45EtmwM:V_sGLiP recent?d=qj6IDK7rITs recent?i=-64JJekTjBg:FnOX45EtmwM:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=-64JJekTjBg:FnOX45EtmwM:F7zBnMy recent?i=-64JJekTjBg:FnOX45EtmwM:-BTjWOF


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Being “fat but fit” does not increase longevity

The widely publicised claim that life lasts longer for those who are modestly overweight is a myth, a new study has shown.The idea that being “fat but fit” confers advantages comes from many...
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=ykoPDGAFxUY:Cq1YP0Ga-Hw:V_sGLiP recent?d=qj6IDK7rITs recent?i=ykoPDGAFxUY:Cq1YP0Ga-Hw:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=ykoPDGAFxUY:Cq1YP0Ga-Hw:F7zBnMy recent?i=ykoPDGAFxUY:Cq1YP0Ga-Hw:-BTjWOF


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IJMS, Vol. 18, Pages 2584: In Vivo Imaging of Prostate Cancer Tumors and Metastasis Using Non-Specific Fluorescent Nanoparticles in Mice

IJMS, Vol. 18, Pages 2584: In Vivo Imaging of Prostate Cancer Tumors and Metastasis Using Non-Specific Fluorescent Nanoparticles in Mice

International Journal of Molecular Sciences doi: 10.3390/ijms18122584

Authors: Coralie Genevois Arnaud Hocquelet Claire Mazzocco Emilie Rustique Franck Couillaud Nicolas Grenier

With the growing interest in the use of nanoparticles (NPs) in nanomedicine, there is a crucial need for imaging and targeted therapies to determine NP distribution in the body after systemic administration, and to achieve strong accumulation in tumors with low background in other tissues. Accumulation of NPs in tumors results from different mechanisms, and appears extremely heterogeneous in mice models and rather limited in humans. Developing new tumor models in mice, with their low spontaneous NP accumulation, is thus necessary for screening imaging probes and for testing new targeting strategies. In the present work, accumulation of LipImageTM 815, a non-specific nanosized fluorescent imaging agent, was compared in subcutaneous, orthotopic and metastatic tumors of RM1 cells (murine prostate cancer cell line) by in vivo and ex vivo fluorescence imaging techniques. LipImageTM 815 mainly accumulated in liver at 24 h but also in orthotopic tumors. Limited accumulation occurred in subcutaneous tumors, and very low fluorescence was detected in metastasis. Altogether, these different tumor models in mice offered a wide range of NP accumulation levels, and a panel of in vivo models that may be useful to further challenge NP targeting properties.



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IJMS, Vol. 18, Pages 2580: Elevated Systemic IL-6 Levels in Patients with Aneurysmal Subarachnoid Hemorrhage Is an Unspecific Marker for Post-SAH Complications

IJMS, Vol. 18, Pages 2580: Elevated Systemic IL-6 Levels in Patients with Aneurysmal Subarachnoid Hemorrhage Is an Unspecific Marker for Post-SAH Complications

International Journal of Molecular Sciences doi: 10.3390/ijms18122580

Authors: Shafqat Chaudhry Birgit Stoffel-Wagner Thomas Kinfe Erdem Güresir Hartmut Vatter Dirk Dietrich Alf Lamprecht Sajjad Muhammad

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is still a fatal and morbid disease, although bleeding aneurysms can be secured in almost all cases. Occurrence of post-SAH complications including cerebral vasospasm, delayed cerebral ischemia, hydrocephalus, epilepsy, and infections are the main determinants of clinical outcome. Hence, it is important to search for early predictors for specific post-SAH complications to treat these complications properly. Both cellular and molecular (cytokines) inflammation play a key role after aSAH during the phase of occurrence of post-SAH complications. Interleukin-6 (IL-6) is a well-known cytokine that has been extensively analyzed in cerebrospinal fluid (CSF) of patients after aSAH, but detailed studies exploring the role of systemic IL-6 in aSAH associated complications and its impact on early clinical outcome prediction are lacking. The current study aims to analyze the systemic IL-6 levels over two weeks after bleeding and its role in post-SAH complications. Methods: We recruited 80 aSAH patients prospectively who underwent peripheral venous blood withdrawal in serum gel tubes. The blood was centrifuged to harvest the serum, which was immediately frozen at −80 °C until analysis. Serum IL-6 levels were quantified using Immulite immunoassay system. Patient records including age, gender, post-SAH complications, aneurysm treatment, and clinical outcome (modified Rankin scale and Glasgow outcome scale) were retrieved to allow different subgroup analysis. Results: Serum IL-6 levels were significantly raised after aSAH compared to healthy controls over the first two weeks after hemorrhage. Serum IL-6 levels were found to be significantly elevated in aSAH patients presenting with higher Hunt and Hess grades, increasing age, and both intraventricular and intracerebral hemorrhage. Interestingly, serum IL-6 was also significantly raised in aSAH patients who developed seizures, cerebral vasospasm (CVS), and chronic hydrocephalus. IL-6 levels were sensitive to the development of infections and showed an increase in patients who developed pneumoniae. Intriguingly, we found a delayed increase in serum IL-6 in patients developing cerebral infarction. Finally, IL-6 levels were significantly higher in patients presenting with poor clinical outcome in comparison to good clinical outcome at discharge from hospital. Conclusion: Serum IL-6 levels were elevated early after aSAH and remained high over the two weeks after initial bleeding. Serum IL-6 was elevated in different aSAH associated complications, acting as a non-specific marker for post-SAH complications and an important biomarker for clinical outcome at discharge.



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IJMS, Vol. 18, Pages 2589: The Role of Resveratrol in Cancer Therapy

IJMS, Vol. 18, Pages 2589: The Role of Resveratrol in Cancer Therapy

International Journal of Molecular Sciences doi: 10.3390/ijms18122589

Authors: Jeong-Hyeon Ko Gautam Sethi Jae-Young Um Muthu K Shanmugam Frank Arfuso Alan Prem Kumar Anupam Bishayee Kwang Seok Ahn

Abstract: Natural product compounds have recently attracted significant attention from the scientific community for their potent effects against inflammation-driven diseases, including cancer. A significant amount of research, including preclinical, clinical, and epidemiological studies, has indicated that dietary consumption of polyphenols, found at high levels in cereals, pulses, vegetables, and fruits, may prevent the evolution of an array of diseases, including cancer. Cancer development is a carefully orchestrated progression where normal cells acquires mutations in their genetic makeup, which cause the cells to continuously grow, colonize, and metastasize to other organs such as the liver, lungs, colon, and brain. Compounds that modulate these oncogenic processes can be considered as potential anti-cancer agents that may ultimately make it to clinical application. Resveratrol, a natural stilbene and a non-flavonoid polyphenol, is a phytoestrogen that possesses anti-oxidant, anti-inflammatory, cardioprotective, and anti-cancer properties. It has been reported that resveratrol can reverse multidrug resistance in cancer cells, and, when used in combination with clinically used drugs, it can sensitize cancer cells to standard chemotherapeutic agents. Several novel analogs of resveratrol have been developed with improved anti-cancer activity, bioavailability, and pharmacokinetic profile. The current focus of this review is resveratrol’s in vivo and in vitro effects in a variety of cancers, and intracellular molecular targets modulated by this polyphenol. This is also accompanied by a comprehensive update of the various clinical trials that have demonstrated it to be a promising therapeutic and chemopreventive agent.



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IJMS, Vol. 18, Pages 2581: The E3 Ubiquitin Ligase RNF7 Negatively Regulates CARD14/CARMA2sh Signaling

IJMS, Vol. 18, Pages 2581: The E3 Ubiquitin Ligase RNF7 Negatively Regulates CARD14/CARMA2sh Signaling

International Journal of Molecular Sciences doi: 10.3390/ijms18122581

Authors: Gianluca Telesio Ivan Scudiero Maddalena Pizzulo Pellegrino Mazzone Tiziana Zotti Serena Voccola Immacolata Polvere Pasquale Vito Romania Stilo

The three CARD-containing MAGUK (CARMA) proteins function as scaffolding molecules that regulate activation of the pro-inflammatory transcription factor NF-κB. Recently, mutations in CARMA2 have been linked to psoriasis susceptibility due to their acquired altered capacity to activate NF-κB. By means of two-hybrid screening with yeast, we identified RING finger protein 7 (RNF7) as an interactor of CARMA2. We present evidence that RNF7 functions as a negative regulator of the NF-κB-activating capacity of CARMA2. Mechanistically, RNF7 influences CARMA2 signaling by regulating the ubiquitination state of MALT1 and the NF-κB-regulatory molecule NEMO. Interestingly, CARMA2short (CARMA2sh) mutants associated with psoriasis susceptibility escape the negative control exerted by RNF7. In conclusion, our findings identify a new mechanism through which the ability of CARMA2 to activate NF-κB is regulated, which could have significant implications for our understanding of why mutations of this protein trigger human psoriasis.



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Feedback: How did cannibal rats sail a ship through the Arctic?

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Ghost ship documentary founders on the jagged reef of reality. Plus: driverless cars steer into the future, and Nigel Farage picks a fight with WHO?

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Identification of a Splicing Mutation in ITPR1 via WES in a Chinese Early-Onset Spinocerebellar Ataxia Family

Abstract

Mutations in the inositol 1,4,5-triphosphate receptor type 1 gene (ITPR1) lead to SCA15, SCA16, and SCA29. To date, only a few families with SCA29 have been reported. A three-generation Chinese family including four affected persons and two unaffected persons were enrolled in this study. We conducted whole-exome sequencing (WES) of the proband DNA initially to find the causal gene. We ascertained the family with autosomal dominant type of congenital nonprogressive cerebellar ataxia (CNPCA) associated with delayed motor and cognitive impairment. WES study was performed with two patients and identified c.1207-2A–T transition, in exon 14 of ITPR1, which was a splicing mutation. Sanger sequencing showed that four patients within this family carried the mutation and two unaffected members did not carry it. The results showed that the novel splicing mutation of ITPR1 was the causative gene for SCA29. In conclusion, we identified a novel SCA29 causative splicing mutation of ITPR1 in a Chinese family. We suggest ITPR1 gene analysis shall be a priority for diagnosis of patients with early-onset CNPCA. Our study demonstrated that whole-exome sequencing might rapidly improve the diagnosis of genetic ataxias.



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Paradoxical Activation in the Cerebellum During Language fMRI in Patients with Brain Tumors: Possible Explanations Based on Neurovascular Uncoupling and Functional Reorganization

Abstract

The cerebellum is known for its crossed activation pattern with the contralateral cerebral hemisphere during language functional magnetic resonance imaging (fMRI) tasks in healthy patients. Crossed cerebro-cerebellar activation has been previously shown to occur in patients with brain tumors not affecting the activation areas. However, the presence of a tumor in left Broca’s area in the inferior frontal gyrus is known to disrupt cerebral activation during language tasks. This study investigated if crossed cerebro-cerebellar activation patterns for language tasks would still occur in such patients. A total of 43 right-handed patients with a glioma affecting left Broca’s area were examined for their cerebral and cerebellar activation during an fMRI language task. Only 13 of the 43 patients exhibited crossed cerebro-cerebellar activation patterns. Statistically significant differences of atypical cerebro-cerebellar activation patterns were found between cerebral right-dominant (RD) and cerebral co-dominant (CD) (p < 0.001) as well as cerebral RD and cerebral left-dominant (LD) patients (p < 0.01), while no differences were found when patients were divided based on cerebellar dominance (p > 0.75) or tumor grade (p > 0.5). No relation was found between the cerebellar and cerebral laterality index (LI) values (ρ = − 0.20; p = 0.21). Atypical activation patterns are suspected to have been caused by the tumor, perhaps a result of contralateral reorganization in some cases and false negative activation in left Broca’s area from neurovascular uncoupling (NVU) in others. Cerebellar activation may also potentially indicate cerebral false negative behavior and future cerebral contralateral reorganization.



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The Effects of Gadolinium-Based Contrast Agents on the Cerebellum: from Basic Research to Neurological Practice and from Pregnancy to Adulthood

Abstract

Gadolinium (Gd)-based contrast agents (GBCAs) are used in magnetic resonance imaging (MRI) to increase the diagnostic yield. Current reports using animal models or human subjects have shown that GBCAs may be deposited in brain including the cerebellum. Although further studies may be required to clarify the toxicity of GBCAs, we should be more cautious to use these agents particularly in patients who more likely to have repeated enhanced MRI along their lifespan. In this editorial, current studies to clarify the toxicity of GBCAs in the cerebellum are introduced.



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A Novel Homozygous Mutation in SPTBN2 Leads to Spinocerebellar Ataxia in a Consanguineous Family: Report of a New Infantile-Onset Case and Brief Review of the Literature

Abstract

The objective of this study was the identification of likely genes and mutations associated with an autosomal recessive (AR) rare spinocerebellar ataxia (SCA) phenotype in two patients with infantile onset, from a consanguineous family. Using genome-wide SNP screening, autozygosity mapping, targeted Sanger sequencing and nextgen sequencing, family segregation analysis, and comprehensive neuropanel, we discovered a novel mutation in SPTBN2. Next, we utilized multiple sequence alignment of amino acids from various species as well as crystal structures provided by protein data bank (PDB# 1WYQ and 1WJM) to model the mutation site and its effect on β-III-spectrin. Finally, we used various bioinformatic classifiers to determine pathogenicity of the missense variant. A comprehensive clinical and diagnostic workup including radiological exams were performed on the patients as part of routine patient care. The homozygous missense variant (c.1572C>T; p.R414C) detected in exon 2 was fully segregated in the family and absent in a large ethnic cohort as well as publicly available data sets. Our comprehensive targeted sequencing approaches did not reveal any other likely candidate variants or mutations in both patients. The two male siblings presented with delayed motor milestones and cognitive and learning disability. Brain MRI revealed isolated cerebellar atrophy more marked in midline inferior vermis at ages of 3 and 6.5 years. Sequence alignments of the amino acids for β-III-spectrin indicated that the arginine at 414 is highly conserved among various species and located towards the end of first spectrin repeat domain. Inclusive bioinformatic analysis predicted that the variant is to be damaging and disease causing. In addition to the novel mutation, a brief literature review of the previously reported mutations as well as clinical comparison of the cases were also presented. Our study reviews the previously reported SPTBN2 mutations and cases. Moreover, the novel mutation, p.R414C, adds up to the literature for the infantile-onset form of autosomal recessive ataxia associated with SPTBN2. Previously, few SPTBN2 recessive mutations have been reported in humans. Animal models especially the β-III−/− mouse model provided insights into early coordination and gait deficit suggestive of loss-of-function. It is expected to see more recessive SPTBN2 mutations appearing in the literature during the upcoming years.



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JDB, Vol. 5, Pages 15: Drosophila as a Model to Study the Link between Metabolism and Cancer

JDB, Vol. 5, Pages 15: Drosophila as a Model to Study the Link between Metabolism and Cancer

Journal of Developmental Biology doi: 10.3390/jdb5040015

Authors: Héctor Herranz Stephen Cohen

Cellular metabolism has recently been recognized as a hallmark of cancer. Investigating the origin and effects of the reprogrammed metabolism of tumor cells, and identifying its genetic mediators, will improve our understanding of how these changes contribute to disease progression and may suggest new approaches to therapy. Drosophila melanogaster is emerging as a valuable model to study multiple aspects of tumor formation and malignant transformation. In this review, we discuss the use of Drosophila as model to study how changes in cellular metabolism, as well as metabolic disease, contribute to cancer.



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The Dual Carboxymethyl Cellulase and Gelatinase Activities of a Newly Isolated Protein from Brevibacillus agri ST15c10 Confer Reciprocal Regulations in Substrate Utilization

A protein showing endoglucanase-peptidase activity was prepared from a newly isolated bacterium (ST15c10). We identified ST15c10 as Brevibacillus agri based on electron-microscopic images and its 16S-rDNA sequence (GenBank accession No. HM446043), which exhibits 98.9% sequence identity to B. agri (KZ17)/B. formosus (DSM-9885T)/B. brevis. The enzyme was purified to homogeneity and gave a single peak during high-performance liquid chromatography on a Seralose 6B-150 gel-matrix/C-18 column. MALDI-TOF mass-spectrometry and bioinformatics studies revealed significant similarity to M42-aminopeptidases/endoglucanases of the CelM family. These enzymes are found in all Brevibacillus strains for which the genome sequence is known. ST15c10 grows optimally on carboxymethyl cellulose (CMC)-gelatin (40°C/pH 8-9), and also shows strong growth/carboxymethyl cellulase (CMCase) activity in submerged bagasse fermentation. The purified enzyme also functions as endoglucanase with solid bagasse/rice straw. Its CMCase activity (optimal at pH 5.6 and 60°C/Km = 35.5 µM/Vmax = 1,024U) was visualized by zymography on a CMC-polyacrylamide gel, which provided a strong band of approximately 70 kDa. The purified enzyme also showed strong peptidase (gelatinase) activity (pH 7.2/40°C during zymography on 6-12% gelatin/1% gelatin-PAGE (at approx. 70 kDa). The CMCase activity is inhibited by the metal ions Mn/Cu/Fe/Co (50%), Hg/KMnO4 (100%), and by glucose or lactose (50-75%; all at 1 mM). The observed dose/time-dependent inhibition by Hg ions could be prevented with 2-mercaptoethanol. A comparison of the B. agri endoglucanase-aminopeptidase (ELK43520; 350 aa) with other members of the M42-family revealed the conservation of active-site residues Cys256/Cys260, which were previously identified as metal-binding sites. Regulation of the endoglucanase activity probably occurs via metal binding-triggered changes in the redox state of the enzyme. Studies on this type of enzyme are of high importance for basic scientific and industrial research.
J Mol Microbiol Biotechnol 2017;27:319-331

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Ultrasound-ultrasound image overlay fusion improves real-time control of radiofrequency ablation margin in the treatment of hepatocellular carcinoma

Abstract

Objectives

To assess the clinical feasibility of US-US image overlay fusion with evaluation of the ablative margin in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).

Methods

Fifty-three patients with 68 HCCs measuring 0.9–4.0 cm who underwent RFA guided by US-US overlay image fusion were included in this retrospective study. By an overlay of pre-/postoperative US, the tumor image could be projected onto the ablative hyperechoic zone. Therefore, the ablative margin three-dimensionally could be shown during the RFA procedure. US-US image overlay was compared to dynamic CT a few days after RFA for assessment of early treatment response. Accuracy of graded response was calculated, and the performance of US-US image overlay fusion was compared with that of CT using a Kappa agreement test.

Results

Technically effective ablation was achieved in a single session, and 59 HCCs (86.8 %) succeeded in obtaining a 5-mm margin on CT. The response with US-US image overlay correctly predicted early CT evaluation with an accuracy of 92.6 % (63/68) (k = 0.67; 95 % CI: 0.39–0.95).

Conclusion

US-US image overlay fusion can be proposed as a feasible guidance in RFA with a safety margin and predicts early response of treatment assessment with high accuracy.

Key points

• US-US image overlay fusion visualizes the ablative margin during RFA procedure.

• Visualizing the margin during the procedure can prompt immediate complementary treatment.

• US image fusion correlates with the results of early evaluation CT.



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Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta

Abstract

Objectives

To compare a low-dose, tin-filtered, nonenhanced, high-pitch Sn100 kVp CT protocol (Sn100) with a standard protocol (STP) for the detection of calcifications in the ascending aorta in patients scheduled for cardiac surgery.

Methods

Institutional Review Board approval for this retrospective study was waived and the study was HIPAA-compliant. The study included 192 patients (128 men; age 68.8 ± 9.9 years), of whom 87 received the STP and 105 the Sn100 protocol. Size-specific dose estimates (SSDE) and radiation doses were obtained using dose monitoring software. Two blinded readers evaluated image quality on a scale from 1 (low) to 5 (high) and the extent of calcifications of the ascending aorta on a scale from 0 (none) to 10 (high), subdivided into 12 anatomic segments.

Results

The Sn100 protocol achieved a mean SSDE of only 0.5 ± 0.1 mGy and 0.20 ± 0.04 mSv compared with the mean SSDE of 5.4 ± 2.2 mGy achieved with the STP protocol (p < 0.0001). Calcification burden was associated with age (p < 0.0001), but was independent of protocol with mean calcification scores of 0.48 ± 1.23 (STP) and 0.55 ± 1.25 (Sn100, p = 0.18). Reader agreement was very good (STP κ = 0.87 ± 0.02, Sn100 κ = 0.88 ± 0.01). The STP protocol provided a higher subjective image quality than the Sn100 protocol: STP median 4, interquartile range 4–5, vs. SN100 3, 3–4; p < 0.0001) and a slightly better depiction of calcification (STP 5, 4–5, vs. Sn100 4, 4–5; p < 0.0001).

Conclusions

The optimized Sn100 protocol achieved a mean SSDE of only 0.5 ± 0.1 mGy while the depiction of calcifications remained good, and there was no systematic difference in calcification burden between the two protocols.

Key points

• Tin-filtered, low-dose CT can be used to assess aortic calcifications before cardiac surgery

• An optimized Sn100 protocol achieved a mean SSDE of only 0.5 ± 0.1 mGy

• The depiction of atherosclerosis of the thoracic aorta was similar with both protocols

• The depiction of relevant thoracic pathologies before cardiac surgery was similar with both protocols



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Construct validation and correlates of preoperative expectations of postsurgical recovery in persons undergoing knee replacement: baseline findings from a randomized clinical trial

A patient’s recovery expectations prior to knee arthroplasty influence postsurgical outcome and satisfaction but a unidimensional measure of expectation has not been reported in the literature. Our primary pur...

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Emotional distress and dysfunctional illness perception are associated with low mental and physical quality of life in Chinese breast cancer patients

To evaluate the relationship between quality of life (QOL) and physical as well as psychological variables in Chinese breast cancer patients.

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Rolling into the deep of the land planarian genus Choeradoplana (Tricladida, Continenticola, Geoplanidae) taxonomy

Abstract

The land planarian genus Choeradoplana (Plathelminthes, Tricladida) is currently integrated by 13 species. In previous works, morphological variation in its type species, Choeradoplana iheringi, was reported, but no attempt to test whether it is just a single species has been made yet. In order to disentangle the taxonomy of this species and further members of the genus, we sampled new specimens and combined morphological and molecular data and also have evaluated the performance of diverse methods of molecular species delimitation. Our data point to the presence of two cryptic species named C. iheringi, plus two new species, all hidden under the same general appearance. An in-depth morphological study of the specimens allowed detection of diagnostic morphological traits in each species, for which we also propose a molecular diagnosis. This integrative taxonomic study demonstrates once again the usefulness of molecular tools to weigh minor morphological characteristics and thus reveal the existence of species that would otherwise remain cryptic. However, under certain parameters, the molecular methods may over-split species with a high genetic structure, maybe pointing to incipient speciation. This makes critical the use of these methods combined with a comprehensive morphological approach. We also present a comprehensive phylogenetic tree including most Choeradoplana species. The tree, well supported, allows making some preliminary inferences on the evolution of the group and its historical biogeography.



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Mitteilungen der GÄCD



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Clinical outcomes associated with procalcitonin algorithms to guide antibiotic therapy in respiratory tract infections

CLINICAL QUESTION: In patients with respiratory tract infection, is measurement of procalcitonin to guide antibiotic prescriptions associated with reduced antibiotic exposure without increases in all-cause mortality or treatment failure? BOTTOM LINE: The measurement of procalcitonin to guide initiation and duration of antibiotic treatment in patients with respiratory tract infections of varying severity is associated with lower antibiotic exposure without increasing all-cause mortality or treatment failure.

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Using caesium-134 and cobalt-60 as tracers to assess the remobilization of recently-deposited overbank-derived sediment on river floodplains during subsequent inundation events



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Measuring Inflammasome Activation in Response to Bacterial Infection

Inflammasomes are multi-protein signaling platforms assembled in response to viral and bacterial pathogens as well as endogenous danger signals. Inflammasomes serve as activation platforms for the mammalian cysteine protease caspase-1, a central mediator of innate immunity. The hallmarks of inflammasome activation are the processing of caspase-1, the maturation and release of interleukin-1β (IL-1β) and the induction of pyroptosis, a lytic inflammatory cell death. This protocol describes methods for studying inflammasome activation in response to bacterial pathogens in bone-marrow derived murine macrophages (BMDMs). In particular, we outline the protocols to measure cytokine maturation by ELISA and pyroptosis by the release of Lactate Dehydrogenase (LDH). In addition, we describe methods to visualize endogenous ASC specks or foci in infected cells and to study the release of processed caspase-1, caspase-11 and mature cytokines into the cell supernatant by Western blotting. General considerations are discussed to design and optimize the infection protocol for the study of inflammasome activation by other bacterial pathogens.

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Influence of procalcitonin on decision to start antibiotic treatment in patients with a lower respiratory tract infection: insight from the observational multicentric ProREAL surveillance

Procalcitonin (PCT)-guided antibiotic stewardship is a successful strategy to decrease antibiotic use. We assessed if clinical judgement affected compliance with a PCT-algorithm for antibiotic prescribing in a multicenter surveillance of patients with lower respiratory tract infections (LRTI). Initiation and duration of antibiotic therapy, adherence to a PCT algorithm and outcome were monitored in consecutive adults with LRTI who were enrolled in a prospective observational quality control. We correlated initial clinical judgment of the treating physician with algorithm compliance and assessed the influence of PCT on the final decision to initiate antibiotic therapy. PCT levels correlated with physicians' estimates of the likelihood of bacterial infection (p for trend 0.25 mug/L), in European centers (e.g., in France -22 % if PCT 0.25 mug/L) and in centers, which had previous experience with the PCT-algorithm (-16 % if PCT 0.25 mug/L). Algorithm non-compliance, i.e. antibiotic prescribing despite low PCT-levels, was independently predicted by the likelihood of a bacterial infection as judged by the treating physician. Compliance was significantly associated with identification of a bacterial etiology (p = 0.01). Compliance with PCT-guided antibiotic stewardship was affected by geographically and culturally-influenced subjective clinical judgment. Initiation of antibiotic therapy was altered by PCT levels. Differential compliance with antibiotic stewardship efforts contributes to geographical differences in antibiotic prescribing habits and potentially influences antibiotic resistance rates.

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Swallowing difficulties with oral drugs among polypharmacy patients attending community pharmacies

Background Swallowing difficulties are common and can affect patients' ability to take solid oral dosage forms, thus compromising medication adherence. Strategies developed by patients to overcome such difficulties while taking medicines have seldom been described. Objective To determine prevalence and characteristics of swallowing difficulties among primary care patients attending their community pharmacies; to explore strategies developed by patients to overcome their difficulties, and health professionals' awareness of these problems. Setting Prospective study with a semi-structured questionnaire in random community pharmacies located in two Swiss regions. Method In each pharmacy, an interviewer asked 16 questions to each consecutive patient (18 years and older) with a prescription for at least 3 different solid oral forms. Main outcome measure Quantification of number of patients with swallowing difficulties and detailed description of difficulties. Results Among 122 pharmacies, 59 (48 %) accepted to join the study and 410 patients were enrolled. Thirty-seven patients (9.0 %) reported ongoing swallowing difficulties, while 55 patients (13.4 %) reported past difficulties. For the majority of patients, difficulties occurred at each single dose (83.7 %), with a single medication (59.8 %) and lasted for less than 12 months (53.8 %). Number of tablets was not the main trigger. Swallowing difficulties impaired extremely daily life in 12 % of the patients. Intentional non adherence (23 % of patients) and altering the oral dose formulation were the most common and potentially harmful strategies used by patients to overcome their swallowing difficulties. According to the patients, pharmacists and physicians rarely inquired about their swallowing difficulties. Conclusion We report a fairly high prevalence of swallowing difficulties in polypharmacy patients attending their community pharmacies. Pharmacists have to interview patients on their swallowing difficulties in a more systematic way, support patients in finding solutions and refer them to their physician if necessary to ensure continuity in care.

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Viruses, Vol. 9, Pages 368: Chikungunya Virus: Pathophysiology, Mechanism, and Modeling

Viruses, Vol. 9, Pages 368: Chikungunya Virus: Pathophysiology, Mechanism, and Modeling

Viruses doi: 10.3390/v9120368

Authors: Vaishnavi Ganesan Bin Duan St Reid

Chikungunya virus (CHIKV), a mosquito-transmitted alphavirus, is recurring in epidemic waves. In the past decade and a half, the disease has resurged in several countries around the globe, with outbreaks becoming increasingly severe. Though CHIKV was first isolated in 1952, there remain significant gaps in knowledge of CHIKV biology, pathogenesis, transmission, and mechanism. Diagnosis is largely simplified and based on symptoms, while treatment is supportive rather than curative. Here we present an overview of the disease, the challenges that lie ahead for future research, and what directions current studies are headed towards, with emphasis on improvement of current animal models and potential use of 3D models.



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IJERPH, Vol. 14, Pages 1488: Social Networks, Engagement and Resilience in University Students

IJERPH, Vol. 14, Pages 1488: Social Networks, Engagement and Resilience in University Students

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14121488

Authors: Elena Fernández-Martínez Elena Andina-Díaz Rosario Fernández-Peña Rosa García-López Iván Fulgueiras-Carril Cristina Liébana-Presa

Analysis of social networks may be a useful tool for understanding the relationship between resilience and engagement, and this could be applied to educational methodologies, not only to improve academic performance, but also to create emotionally sustainable networks. This descriptive study was carried out on 134 university students. We collected the network structural variables, degree of resilience (CD-RISC 10), and engagement (UWES-S). The computer programs used were excel, UCINET for network analysis, and SPSS for statistical analysis. The analysis revealed results of means of 28.61 for resilience, 2.98 for absorption, 4.82 for dedication, and 3.13 for vigour. The students had two preferred places for sharing information: the classroom and WhatsApp. The greater the value for engagement, the greater the degree of centrality in the friendship network among students who are beginning their university studies. This relationship becomes reversed as the students move to later academic years. In terms of resilience, the highest values correspond to greater centrality in the friendship networks. The variables of engagement and resilience influenced the university students’ support networks.



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IJERPH, Vol. 14, Pages 1487: Automated Ecological Assessment of Physical Activity: Advancing Direct Observation

IJERPH, Vol. 14, Pages 1487: Automated Ecological Assessment of Physical Activity: Advancing Direct Observation

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14121487

Authors: Jordan Carlson Bo Liu James Sallis Jacqueline Kerr J. Hipp Vincent Staggs Amy Papa Kelsey Dean Nuno Vasconcelos

Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three cameras in total) of video capturing up to nine participants engaged in sitting, standing, walking, and jogging in an open outdoor space while wearing accelerometers. Computer vision algorithms were developed to assess the number and proportion of people in sedentary, light, moderate, and vigorous activity, and group-based metabolic equivalents of tasks (MET)-minutes. Means and standard deviations (SD) of bias/difference values, and intraclass correlation coefficients (ICC) assessed the criterion validity compared to accelerometry separately for each camera. The number and proportion of participants sedentary and in moderate-to-vigorous physical activity (MVPA) had small biases (within 20% of the criterion mean) and the ICCs were excellent (0.82–0.98). Total MET-minutes were slightly underestimated by 9.3–17.1% and the ICCs were good (0.68–0.79). The standard deviations of the bias estimates were moderate-to-large relative to the means. The computer vision algorithms appeared to have acceptable sample-level validity (i.e., across a sample of time intervals) and are promising for automated ecological assessment of activity in open outdoor settings, but further development and testing is needed before such tools can be used in a diverse range of settings.



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Scenedesmus vacuolatus cultures for possible combined laccase-like phenoloxidase activity and biodiesel production

Abstract

A key aspect of the industrial development of microalgal production processes is the excessive cost of biomass production. A solution is a combination of biodiesel production and wastewater treatment. The microalga Scenedesmus has a high lipid content and a potential extracellular phenoloxidase activity, which could improve the phycoremediation of phenolic pollutants. In this work, the most suitable growth conditions to obtain this twofold aim were analyzed. First, different strains of Scenedesmus vacuolatus microalga were tested at different pH, salinity and CO2 concentration in the gas phase. The two most promising strains were then cultivated in autotrophic and heterotrophic conditions, and were investigated in terms of efficient nitrogen removal, fatty acid profile and maximized extracellular phenoloxidase activity in the medium. The results showed two extreme conditions: (1) biomass productivity doubled when photobioreactors were sparged with 5% CO2 supplemented air with respect to cultures sparged with air (the steady state values of strain 53 were 0.138 g L−1 day−1 in the presence of air, and 0.243 in the presence of CO2 addition), and N-starvation under 5% CO2enhanced the transesterified fraction of lipids (strain 53 FAME fraction in the presence of N-starvation was 33%, in the presence of nitrogen FAME fraction was 22%); (2) phenoloxidase activity was completely suppressed by presence of 5% CO2 in the gas phase (strain 53 0.21 U mL−1), indicating clear catabolite repression for the induction of this enzyme in the algal metabolism.



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The physics of small megavoltage photon beam dosimetry

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Publication date: Available online 30 November 2017
Source:Radiotherapy and Oncology
Author(s): Pedro Andreo
The increased interest during recent years in the use of small megavoltage photon beams in advanced radiotherapy techniques has led to the development of dosimetry recommendations by different national and international organizations. Their requirement of data suitable for the different clinical options available, regarding treatment units and dosimetry equipment, has generated a considerable amount of research by the scientific community during the last decade. The multiple publications in the field have led not only to the availability of new invaluable data, but have also contributed substantially to an improved understanding of the physics of their dosimetry. This work provides an overview of the most important aspects that govern the physics of small megavoltage photon beam dosimetry.



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