Δευτέρα, 25 Δεκεμβρίου 2017

Chordomas and Chondrosarcomas of the Skull Base and Spine. 2nd Edition



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Cosmetics, Vol. 5, Pages 2: Macroalgae-Derived Ingredients for Cosmetic Industry—An Update

Cosmetics, Vol. 5, Pages 2: Macroalgae-Derived Ingredients for Cosmetic Industry—An Update

Cosmetics doi: 10.3390/cosmetics5010002

Authors: Filipa Pimentel Rita Alves Francisca Rodrigues M. P. P. Oliveira

Aging is a natural and progressive declining physiological process that is influenced by multifactorial aspects and affects individuals’ health in very different ways. The skin is one of the major organs in which aging is more evident, as it progressively loses some of its natural functions. With the new societal paradigms regarding youth and beauty have emerged new concerns about appearance, encouraging millions of consumers to use cosmetic/personal care products as part of their daily routine. Hence, cosmetics have become a global and highly competitive market in a constant state of evolution. This industry is highly committed to finding natural sources of functional/bioactive-rich compounds, preferably from sustainable and cheap raw materials, to deliver innovative products and solutions that meet consumers’ expectations. Macroalgae are an excellent example of a natural resource that can fit these requirements. The incorporation of macroalgae-derived ingredients in cosmetics has been growing, as more and more scientific evidence reports their skin health-promoting effects. This review provides an overview on the possible applications of macroalgae as active ingredients for the cosmetic field, highlighting the main compounds responsible for their bioactivity on skin.



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Cosmetics, Vol. 5, Pages 1: Cutaneous Permeation and Penetration of Sunscreens: Formulation Strategies and In Vitro Methods

Cosmetics, Vol. 5, Pages 1: Cutaneous Permeation and Penetration of Sunscreens: Formulation Strategies and In Vitro Methods

Cosmetics doi: 10.3390/cosmetics5010001

Authors: Silvia Tampucci Susi Burgalassi Patrizia Chetoni Daniela Monti

Sunscreens are the most common products used for skin protection against the harmful effects of ultraviolet radiation. However, as frequent application is recommended, the use of large amount of sunscreens could reflect in possible systemic absorption and since these preparations are often applied on large skin areas, even low penetration rates can cause a significant amount of sunscreen to enter the body. An ideal sunscreen should have a high substantivity and should neither penetrate the viable epidermis, the dermis and the systemic circulation, nor in hair follicle. The research of methods to assess the degree of penetration of solar filters into the skin is nowadays even more important than in the past, due to the widespread use of nanomaterials and the new discoveries in cosmetic formulation technology. In the present paper, different in vitro studies, published in the last five years, have been reviewed, in order to focus the attention on the different methodological approaches employed to effectively assess the skin permeation and retention of sunscreens.



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IJERPH, Vol. 15, Pages 29: Stimulating Parenting Practices in Indigenous and Non-Indigenous Mexican Communities

IJERPH, Vol. 15, Pages 29: Stimulating Parenting Practices in Indigenous and Non-Indigenous Mexican Communities

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010029

Authors: Heather Knauer Emily Ozer William Dow Lia Fernald

Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range of child-level (age; sex; and cognitive and socio-emotional development); household-level (indigenous ethnicity; poverty; and parental education); and community-level (economic marginalization and majority indigenous population) variables among 1893 children ages 4–18 months in poor; rural communities in Mexico. We also explored modifiers of associations between living in an indigenous community and parenting. Key findings were that stimulating parenting was negatively associated with living in an indigenous community or family self-identification as indigenous (β = −4.25; SE (Standard Error) = 0.98; β = −1.58; SE = 0.83 respectively). However; living in an indigenous community was associated with significantly more stimulating parenting among indigenous families than living in a non-indigenous community (β = 2.96; SE = 1.25). Maternal education was positively associated with stimulating parenting only in indigenous communities; and household crowding was negatively associated with stimulating parenting only in non-indigenous communities. Mothers’ parenting practices were not associated with child sex; father’s residential status; education; or community marginalization. Our findings demonstrate that despite greater community marginalization; living in an indigenous community is protective for stimulating parenting practices of indigenous mothers.



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IJERPH, Vol. 15, Pages 30: Emotional Regulation in Young Adults with Internet Gaming Disorder

IJERPH, Vol. 15, Pages 30: Emotional Regulation in Young Adults with Internet Gaming Disorder

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010030

Authors: Ju-Yu Yen Yi-Chun Yeh Peng-Wei Wang Tai-Ling Liu Yun-Yu Chen Chih-Hung Ko

People diagnosed with Internet gaming disorder (IGD) have been frequently reported to experience depression, anxiety, and hostility. Emotional regulation contributes to these mood symptoms. This study evaluated emotional regulation in subjects with IGD and examined relationships between emotional regulation, depression, anxiety, and hostility in young adults with IGD. We recruited 87 people with IGD and a control group of 87 people without a history of IGD. All participants underwent a diagnostic interview based on the IGD criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and they completed a questionnaire on emotional regulation, depression, anxiety, and hostility. We found that subjects with IGD were less likely to practice cognitive reappraisal and were more likely to suppress their emotions. Linear regression revealed the higher cognitive reappraisal and lower expressive suppression associated with depression, anxiety, and hostility among subjects with IGD. The emotional regulation strategies that characterize those with IGD could be contributing factors to the depression and hostility tendencies of these people. When treating patients with IGD, in addition to providing appropriate interventions to relieve depression and hostility, practitioners should effectively assess emotional regulation strategies and provide emotional regulation therapy to prevent a vicious cycle of negative emotions.



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IJERPH, Vol. 15, Pages 31: Contact to Nature Benefits Health: Mixed Effectiveness of Different Mechanisms

IJERPH, Vol. 15, Pages 31: Contact to Nature Benefits Health: Mixed Effectiveness of Different Mechanisms

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010031

Authors: Mathias Hofmann Christopher Young Tina Binz Markus Baumgartner Nicole Bauer

How can urban nature contribute to the reduction of chronic stress? We twice measured the concentration of the “stress hormone” cortisol in the hair of 85 volunteer gardeners (six months apart), relating cortisol level change to (self-reported) characteristics of their recreational activities. Both time spent in nature and physical activity led to decreases in cortisol, while time spent being idle led to an increase. At high levels of present stressors, however, the relationship for time spent in nature and for idleness was reversed. Time spent with social interaction had no effect on cortisol levels. Our results indicate that physical activity is an effective means of mitigating the negative effects of chronic stress. The results regarding the time spent in nature and time spent being idle are less conclusive, suggesting the need for more research. We conclude that if chronic stress cannot be abolished by eradicating its sources, public health may take to measures to reduce it—providing urban nature being one effective possibility.



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Inhaled Treprostinil in Pulmonary Hypertension Associated with Lung Disease.

Inhaled Treprostinil in Pulmonary Hypertension Associated with Lung Disease.

Lung. 2017 Dec 23;:

Authors: Faria-Urbina M, Oliveira RKF, Agarwal M, Waxman AB

Abstract
PURPOSE: Pulmonary hypertension (PH) in the setting of parenchymal lung disease adversely affects quality of life and survival. However, PH-specific drugs may result in ventilation/perfusion imbalance and currently, there are no approved PH treatments for this patient population. In the present retrospective study, data from 22 patients with PH associated with lung disease treated with inhaled treprostinil (iTre) and followed up clinically for at least 3 months are presented.
METHODS: PH was defined by resting right heart catheterization as a mean pulmonary artery pressure (mPAP) ≥ 35 mmHg, or mPAP ≥ 25 mmHg associated with pulmonary vascular resistance ≥ 4 Woods Units. Follow-up evaluation was performed at the discretion of the attending physician.
RESULTS: From baseline to follow-up, we observed significant improvement in functional class (n = 22, functional class III-IV 82 vs. 59%, p = 0.041) and 6-min walk distance (n = 11, 243 ± 106 vs. 308 ± 109; p = 0.022), without a deleterious effect on resting peripheral oxygen saturation (n = 22, 92 ± 6 vs. 94 ± 4; p = 0.014). Most of the patients (86%, n = 19/22) were using long-term nasal supplemental oxygen at baseline. During follow-up, only one patient had increased supplemental oxygen requirement. The most common adverse events were cough, headache, and diarrhea. No severe adverse event was reported.
CONCLUSIONS: The results suggest that iTre is safe in patients with Group 3 PH and evidence of pulmonary vascular remodeling in terms of functional class, gas exchange, and exercise capacity. Additionally, iTre was well tolerated. The potential role of PH-specific drugs in Group 3 PH should be further assessed in larger prospective studies.

PMID: 29275453 [PubMed - as supplied by publisher]



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Workflow interruptions and stress atwork: a mixed-methods study among physicians and nurses of a multidisciplinary emergency department.

Workflow interruptions and stress atwork: a mixed-methods study among physicians and nurses of a multidisciplinary emergency department.

BMJ Open. 2017 Dec 22;7(12):e019074

Authors: Weigl M, Beck J, Wehler M, Schneider A

Abstract
OBJECTIVES: Dealing with multiple workflow interruptions is a major challenge in emergency department (ED) work. This study aimed to establish a taxonomy of workflow interruptions that takes into account the content and purpose of interruptive communication. It further aimed to identify associations of workflow interruptions with ED professionals' work stress.
DESIGN: Combined data from expert observation sessions and concomitant self-evaluations of ED providers.
SETTING: ED of an academic community hospital in Germany.
PARTICIPANTS: Multidisciplinary sample of ED physicians and nurses. 77 matched observation sessions of interruptions and self-evaluations of work stress were obtained on 20 randomly selected days.
OUTCOME MEASURES: ED professionals' stress evaluations were based on standardised measures. ED workload data on patient load, patient acuity and staffing were included as control variables in regression analyses.
RESULTS: Overall mean rate was 7.51 interruptions/hour. Interruptions were most frequently caused by ED colleagues of another profession (27.1%; mean interruptions/hour rate: 2.04), by ED colleagues of the same profession (24.1%; 1.81) and by telephone/beeper (21%; 1.57). Concerning the contents of interruption events, interruptions most frequently occurred referring to a parallel case under care (30.3%, 2.07), concerning the current case (19.1%; 1.28), or related to coordination activities (18.2%, 1.24). Regression analyses revealed that interruptive communication related to parallel cases significantly increased ED providers' stress levels (β=0.24, P=0.03). This association remained significant after controlling for ED workload.
DISCUSSION: Interruptions that refer to parallel cases under care were associated with increased stress among ED physicians and nurses. Our approach to distinguish between sources and contents of interruptions contributes to an improved understanding of potential benefits and risks of workflow interruptions in ED work environments. Despite some limitations, our findings add to future research on the implications of interruptions for effective and safe patient care and work in complex and dynamic care environments.

PMID: 29275350 [PubMed - in process]



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Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays.

Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays.

BMJ Open. 2017 Dec 22;7(12):e018747

Authors: Bion J, Aldridge CP, Girling A, Rudge G, Beet C, Evans T, Temple RM, Roseveare C, Clancy M, Boyal A, Tarrant C, Sutton E, Sun J, Rees P, Mannion R, Chen YF, Watson SI, Lilford R, HiSLAC collaboration

Abstract
INTRODUCTION: The mortality associated with weekend admission to hospital (the 'weekend effect') has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services.
METHODS AND ANALYSIS: Cross-sectional two-epoch case record review of 20 acute hospital Trusts in England. Anonymised case records of 4000 EAs to hospital, 2000 at weekends and 2000 on weekdays, covering two epochs (financial years 2012-2013 and 2016-2017). Admissions will be randomly selected across the whole of each epoch from Trust electronic patient records. Following training, structured implicit case reviews will be conducted by consultants or senior registrars (senior residents) in acute medical specialities (60 case records per reviewer), and limited to the first 7 days following hospital admission. The co-primary outcomes are the weekend:weekday admission ratio of errors per case record, and a global assessment of care quality on a Likert scale. Error rates will be analysed using mixed effects logistic regression models, and care quality using ordinal regression methods. Secondary outcomes include error typology, error-related adverse events and any correlation between error rates and staffing. The data will also be used to inform a parallel health economics analysis.
ETHICS AND DISSEMINATION: The project has received ethics approval from the South West Wales Research Ethics Committee (REC): reference 13/WA/0372. Informed consent is not required for accessing anonymised patient case records from which patient identifiers had been removed. The findings will be disseminated through peer-reviewed publications in high-quality journals and through local High-intensity Specialist-Led Acute Care (HiSLAC) leads at the 121 hospitals that make up the HiSLAC Collaborative.

PMID: 29275347 [PubMed - in process]



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Improving ICU services in resource-limited settings: Perceptions of ICU workers from low-middle-, and high-income countries.

Improving ICU services in resource-limited settings: Perceptions of ICU workers from low-middle-, and high-income countries.

J Crit Care. 2017 Dec 14;44:352-356

Authors: Haniffa R, Pubudu De Silva A, de Azevedo L, Baranage D, Rashan A, Baelani I, Schultz MJ, Dondorp AM, Dünser MW

Abstract
PURPOSE: To evaluate perceptions of intensive care unit (ICU) workers from low-and-middle income countries (LMICs) and high income countries (HICs).
MATERIALS AND METHODS: A cross sectional design. Data collected from doctors using an anonymous online, questionnaire.
RESULTS: Hundred seventy-five from LMICs and 43 from HICs participated. Barriers in LMICs were lack of formal training (Likert score median 3 [inter quartile range 3]), lack of nurses (3[3]) and low wages (3[4]). Strategies for LMICs improvement were formal training of ICU staff (4[3]), an increase in number of ICU nurses (4[2]), collection of outcome data (3[4]), as well as maintenance of available equipment [3(3)]. The most useful role of HIC ICU staff was training of LMIC staff (4[2]). Donation of equipment [2(4)], drugs [2(4)], and supplies (2[4]) perceived to be of limited usefulness. The most striking difference between HIC and LMIC staff was the perception on the lack of physician leadership as an obstacle to ICU functioning (4[3] vs. 0[2], p<0.005).
CONCLUSION: LMICs ICU workers perceived lack of training, lack of nurses, and low wages as major barriers to functioning. Training, increase of nurse workforce, and collection of outcome data were proposed as useful strategies to improve LMIC ICU services.

PMID: 29275269 [PubMed - as supplied by publisher]



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Effect of a multifaceted social franchising model on quality and coverage of maternal, newborn, and reproductive health-care services in Uttar Pradesh, India: a quasi-experimental study.

Effect of a multifaceted social franchising model on quality and coverage of maternal, newborn, and reproductive health-care services in Uttar Pradesh, India: a quasi-experimental study.

Lancet Glob Health. 2017 Dec 20;:

Authors: Tougher S, Dutt V, Pereira S, Haldar K, Shukla V, Singh K, Kumar P, Goodman C, Powell-Jackson T

Abstract
BACKGROUND: How to harness the private sector to improve population health in low-income and middle-income countries is heavily debated and one prominent strategy is social franchising. We aimed to evaluate whether the Matrika social franchising model-a multifaceted intervention that established a network of private providers and strengthened the skills of both public and private sector clinicians-could improve the quality and coverage of health services along the continuum of care for maternal, newborn, and reproductive health.
METHODS: We did a quasi-experimental study, which combined matching with difference-in-differences methods. We matched 60 intervention clusters (wards or villages) with a social franchisee to 120 comparison clusters in six districts of Uttar Pradesh, India. The intervention was implemented by two not-for-profit organisations from September, 2013, to May, 2016. We did two rounds (January, 2015, and May, 2016) of a household survey for women who had given birth up to 2 years previously. The primary outcome was the proportion of women who gave birth in a health-care facility. An additional 56 prespecified outcomes measured maternal health-care use, content of care, patient experience, and other dimensions of care. We organised conceptually similar outcomes into 14 families to create summary indices. We used multivariate difference-in-differences methods for the analyses and accounted for multiple inference.
FINDINGS: The introduction of Matrika was not significantly associated with the change in facility births (4 percentage points, 95% CI -1 to 9; p=0·100). Effects for any of the other individual outcomes or for any of the 14 summary indices were not significant. Evidence was weak for an increase of 0·13 SD (95% CI 0·00 to 0·27; p=0·053) in recommended delivery care practices.
INTERPRETATION: The Matrika social franchise model was not effective in improving the quality and coverage of maternal health services at the population level. Several key reasons identified for the absence of an effect potentially provide generalisable lessons for social franchising programmes elsewhere.
FUNDING: Merck Sharp and Dohme Limited.

PMID: 29275135 [PubMed - as supplied by publisher]



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Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

J Arthroplasty. 2017 Dec 06;:

Authors: McLawhorn AS, Schairer WW, Schwarzkopf R, Halsey DA, Iorio R, Padgett DE

Abstract
BACKGROUND: For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures.
METHODS: All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes.
RESULTS: A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P < .001), more transfusions (37% vs 17%, P < .001), and longer length of stay (4.4 vs 3.1 days, P < .001). Conversion THA had increased odds of complications (odds ratio [OR] 1.75; 95% confidence interval [CI] 1.37-2.24), deep infection (OR 4.21; 95% CI 1.72-10.28), discharge to inpatient care (OR 1.52; 95% CI 1.34-1.72), and death (OR 2.39; 95% CI 1.04-5.47). Readmission odds were similar.
CONCLUSION: Compared with primary THA, conversion THA is associated with more complications, longer length of stay, and increased discharge to continued inpatient care, implying greater resource utilization for conversion patients. As reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate.

PMID: 29275113 [PubMed - as supplied by publisher]



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Treatment satisfaction and bothersome bladder, bowel, sexual symptoms in multiple sclerosis.

Treatment satisfaction and bothersome bladder, bowel, sexual symptoms in multiple sclerosis.

Mult Scler Relat Disord. 2017 Dec 14;20:16-21

Authors: Wang G, Marrie RA, Fox RJ, Tyry T, Cofield SS, Cutter GR, Salter A

Abstract
BACKGROUND: Bladder, bowel, and sexual symptoms are common among persons with multiple sclerosis (MS). We aimed to investigate the frequency and severity of bladder, bowel, and sexual symptoms, the relationships between these symptoms, satisfaction with treatment of these symptoms, and factors associated with symptom severity and treatment satisfaction.
METHODS: In the fall 2010, we surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry regarding the severity of being bothered by bladder, bowel, and sexual symptoms, their satisfaction of health providers' inquiry and treatment with these symptoms, and whether their quality of life (QOL) had changed with the treatment. Logistic regression was used to evaluate demographic and clinical factors associated with each outcome.
RESULTS: Of 9341 respondents included in the study, 7720 (77.4%) were female and their mean (SD) age was 50.3 (10.5) years. Ninety-one percent of participants were mildly, moderately or severely bothered by bladder, bowel or sexual symptoms. Severity of disability (measured using the Patient Determined Disease Steps), having a relapse in the last 6 months, and catheter use were consistently associated with being bothered (versus not bothered) by each of the three symptoms. Among respondents, 5764 (62.1%) reported that their MS health providers asked about bladder problems, 4523 (51.1%) about bowel problems, and 1890 (20.6%) about sexual problems. At most one-third of participants were completely satisfied with treatment for any of the symptoms. For those who reported how their QOL changed with treatment, 23.0% reported their QOL being better.
CONCLUSION: Bladder, bowel, and sexual problems remain common among persons with MS, and treatment satisfaction is low. Health care providers should consider systematically asking about these symptoms in clinical practice. Greater efforts could be devoted to developing novel, effective therapies to manage these symptoms and thereby improve QOL.

PMID: 29275057 [PubMed - as supplied by publisher]



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Open Surgical Implantation of a Viable Intact Cryopreserved Human Placental Membrane for the Treatment of Recalcitrant Plantar Fasciitis: Case Report With Greater than 2-Year Follow-Up Duration.

Open Surgical Implantation of a Viable Intact Cryopreserved Human Placental Membrane for the Treatment of Recalcitrant Plantar Fasciitis: Case Report With Greater than 2-Year Follow-Up Duration.

J Foot Ankle Surg. 2017 Dec 20;:

Authors: Sun XP, Wilson AG, Michael GM

Abstract
Plantar fasciitis is one of the most common conditions encountered by a podiatric physician. Although most individuals respond well to traditional conservative and surgical remedies, a portion of patients will exhaust all available treatment options and will experience ongoing pain that can ultimately affect their quality of life. There has been an increase in scientific and clinical research surrounding the medical use of human placental membranes (HPMs) and many of these point-of-care allografts are now commercially available. We present the case of a 53-year-old female with chronic plantar fasciitis for whom both conservative therapies and surgical treatments of 1 year's duration had previously failed. After open revision with implantation of viable intact cryopreserved human placental membrane (vCPM; Grafix®, Osiris Therapeutics, Inc., Columbia, MD), the patient was able to resume her full-work duty with minimal symptoms at the 12- and 24-month follow-up examinations. This case report highlights the use of HPMs as an adjunct approach in the treatment of recalcitrant plantar fasciitis and the need for continued research.

PMID: 29275037 [PubMed - as supplied by publisher]



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Lesbian, Gay, Bisexual, and Transgender (LGBT) Survivorship.

Lesbian, Gay, Bisexual, and Transgender (LGBT) Survivorship.

Semin Oncol Nurs. 2017 Dec 20;:

Authors: Kamen C

Abstract
OBJECTIVE: To discuss lesbian, gay, bisexual, and transgender (LGBT)-specific survivorship issues including: integrating sexual and gender minority identities with cancer survivor identities; coordinating medical care and disclosing identities to health care providers; dealing with late effects of treatment; and addressing LGBT family and relationship issues.
DATA SOURCES: Published articles, quotes from an online survey of 311 LGBT survivors.
CONCLUSION: The transition from active cancer treatment to survivorship presents challenges, and LGBT cancer survivors may face additional challenges as they enter the survivorship phase.
IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses can improve the quality of survivorship care delivered to LGBT survivors and their caregivers by addressing the disparities and gaps in health care.

PMID: 29275016 [PubMed - as supplied by publisher]



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The past, present, and future of selective progesterone receptor modulators in the management of uterine fibroids.

The past, present, and future of selective progesterone receptor modulators in the management of uterine fibroids.

Am J Obstet Gynecol. 2017 Dec 21;:

Authors: Singh SS, Belland L, Leyland N, von Riedemann S, Murji A

Abstract
Uterine fibroids (UF) are common in women of reproductive age and can have a significant impact on quality of life and fertility. Although a number of international OB/GYN societies have issued evidence-based clinical practice guidelines for the management of symptomatic UF, many of these guidelines do not yet reflect the most recent clinical evidence and approved indication for one of the key medical management options: the selective progesterone receptor modulator (SPRM) class. This paper aims to share the clinical experience gained with SPRMs in Europe and Canada by reviewing the historical development of SPRMs, current best practices for SPRM use based on available data, and potential future uses for SPRMs in UF and other gynecologic conditions.

PMID: 29274830 [PubMed - as supplied by publisher]



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Geographic Region and Profit Status Drive Variation in Hospital Readmission Outcomes among Inpatient Rehabilitation Facilities in the United States.

Geographic Region and Profit Status Drive Variation in Hospital Readmission Outcomes among Inpatient Rehabilitation Facilities in the United States.

Arch Phys Med Rehabil. 2017 Dec 21;:

Authors: Daras LC, Ingber MJ, Deutsch A, Hefele JG, Perloff J

Abstract
OBJECTIVE: To examine whether there are differences in inpatient rehabilitation facilities (IRFs') all-cause, 30-day post-discharge hospital readmission rates by organizational characteristics and geographic regions.
DESIGN: Observational study.
SETTING AND PARTICIPANTS: We analyzed Medicare claims and administrative data sources for Medicare fee-for-service beneficiaries discharged from all IRFs nationally (N=1,166) in 2013 and 2014.
MAIN OUTCOME MEASURE: We applied specifications for an existing quality measure adopted by CMS for public reporting that assesses all-cause unplanned hospital readmissions for 30 days post-discharge from inpatient rehabilitation. We estimated facility-level observed and risk-standardized readmission rates and then examined variation by several organizational characteristics (facility type, profit status, teaching status, proportion of low-income patients, size) and geographic factors (rural/urban, census division, and state).
RESULTS: The mean IRF risk-standardized hospital readmission rate was 13.00 percent (SD 0.77). After controlling for organizational characteristics and practice patterns, we found substantial variation in IRFs' readmission rates: for-profit IRFs had significantly higher readmission rates compared to not-for-profit IRFs (p<0.001). We also found geographic variation: IRFs in the South Atlantic and South Central census regions had the highest hospital readmission rates compared to IRFs in New England that had the lowest rates.
CONCLUSIONS: Our findings point to variation in the quality of care, as measured by risk-standardized hospital readmission rates following IRF discharge. Thus, monitoring of readmission outcomes is important to encourage quality improvement in discharge care planning, care transitions and follow-up.

PMID: 29274725 [PubMed - as supplied by publisher]



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No. 283-Treatments for Overactive Bladder: Focus on Pharmacotherapy.

No. 283-Treatments for Overactive Bladder: Focus on Pharmacotherapy.

J Obstet Gynaecol Can. 2018 Jan;40(1):e22-e32

Authors: Geoffrion R

Abstract
OBJECTIVE: To provide guidelines for pharmacotherapy to treat overactive bladder syndrome (OAB).
OPTIONS: Pharmacotherapy for OAB includes anticholinergic (antimuscarinic) drugs and vaginal estrogen. Both oral and transdermal anticholinergic preparations are available.
OUTCOMES: To provide understanding of current available evidence concerning safety and clinical efficacy of pharmacotherapy for OAB; to guide selection of anticholinergic therapy based on individual patient characteristics.
EVIDENCE: The Cochrane Library and Medline were searched for articles published from 1950 to the present related to individual anticholinergic drugs. Review articles on management of refractory OAB were also examined. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to 2010.
VALUES: The quality of evidence is rated and recommendations are made using the criteria described by the Canadian Task Force on Preventive Health Care (Table 1).
BENEFITS, HARMS, AND COSTS: Anticholinergics are the mainstay of pharmacotherapy for OAB. Evidence for their efficacy is mostly derived from short-term phase III randomized drug trials. Placebo response is strong, and long-term follow-up and patient subjective outcome data are lacking. Care providers need to be well acquainted with the side effects of anticholinergics and select therapy based on individual patient parameters.
RECOMMENDATIONS:

PMID: 29274717 [PubMed - in process]



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Effectiveness of the Malnutrition Quality Improvement Initiative on Practitioner Malnutrition Knowledge and Screening, Diagnosis, and Timeliness of Malnutrition-Related Care Provided to Older Adults Admitted to a Tertiary Care Facility: A Pilot Study.

Effectiveness of the Malnutrition Quality Improvement Initiative on Practitioner Malnutrition Knowledge and Screening, Diagnosis, and Timeliness of Malnutrition-Related Care Provided to Older Adults Admitted to a Tertiary Care Facility: A Pilot Study.

J Acad Nutr Diet. 2018 Jan;118(1):101-109

Authors: Silver HJ, Pratt KJ, Bruno M, Lynch J, Mitchell K, McCauley SM

Abstract
BACKGROUND: Malnutrition is present in 30% to 50% of hospitalized patients aged 60 years or older. As few as 3.2% of patients identified as high risk have a malnutrition diagnosis documented by medical providers. The Malnutrition Quality Improvement Initiative (MQii) aims to reduce the burden of hospital malnutrition by improving the process and delivery of care.
OBJECTIVE: To evaluate implementing the MQii toolkit of best practice resources for screening, diagnosis, documentation, and timeliness of malnutrition care.
DESIGN: This 6-month prospective pilot included a 3-month intervention with training and education modules tailored to type of practitioner and integrated into existing teaching and clinical workflow.
PARTICIPANTS/SETTING: Forty-five health care professionals from geriatric, general medicine, and general surgery units at Vanderbilt University Hospital during January to June 2016.
MAIN OUTCOME MEASURES: Malnutrition knowledge by 30-item questionnaire; electronic medical record (EMR) documentation; and timeliness of malnutrition screening, diagnosis, intervention, and discharge planning.
STATISTICAL ANALYSES: Analysis of variance was used to test change over time.
RESULTS: Malnutrition knowledge score increased 14%, from 39% to 53% (P=0.009). All patients whose nutrition screen indicated they were malnourished/high risk had registered dietitian nutritionist diagnosis of malnutrition documented in the EMR. The proportion who had medical provider (physician, nurse practitioner, or physician assistant) malnutrition diagnosis documented in the EMR increased 11.6%, from 26.7% to 38.3% (P=0.08). About 95% of malnourished/high risk patients had a documented intervention addressing malnutrition. Inclusion of malnutrition care in the discharge plan increased 4.8%, from 70.0% to 74.8% (P=0.13).
CONCLUSIONS: This pilot study demonstrated feasibility of implementing the MQii resources to improve malnutrition knowledge and professionals' skills relevant to screening, diagnosis, intervention, and timeliness of malnutrition care. By optimizing the process and delivery of malnutrition care, it is expected that the quality of clinical care provided to older adults with malnutrition or at high malnutrition risk will improve.

PMID: 29274640 [PubMed - in process]



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The changing roles of community nurses: the case of health plan nurses in Israel.

The changing roles of community nurses: the case of health plan nurses in Israel.

Isr J Health Policy Res. 2017 Dec 23;6(1):69

Authors: Nissanholtz-Gannot R, Rosen B, Hirschfeld M, Community Nursing Study Group

Abstract
BACKGROUND: In Israel, approximately one-third of the country's nurses work in community settings - primarily as salaried employees in Israel's four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care).
OBJECTIVES: The main objectives of the study were to identify recent changes in the roles of health plan nurses and their current areas of activity. It also explored the experience of front-line nurses with regard to autonomy, work satisfaction, and barriers to further role development.
METHODS: The study integrated interviews and surveys of nurses and other professionals conducted across 4 years. Data generated from earlier study components were used to guide questions and focus for later components. In 2013, in-depth interviews were held with 55 senior nursing and medical professionals supplemented by interviews in mid-2017 with the head nurses in the four health plans. In addition, a national survey was conducted in 2014-5 among a representative sample of 1019 community nurses who work for the health plans and who are engaged in direct patient care. Six hundred ninety-two nurses responded to the survey, yielding a response rate of 69%. The survey sample consisted of an equal number of nurses from each health plan, and the observations were weighted accordingly.
FINDINGS: Senior professionals identified general themes associated with a shift in nursing roles, including a transition from reactive to initiated work, increased specialization, and a shifting of tasks from hospitals to community settings. They identified the current main areas of activity in the health plans as being: routine care, chronic care, health promotion, quality monitoring and improvement, specialized care (such as wound care), and home care. In the survey of front-line nurses, 38% of the nurses identified "caring for chronically ill patients" as their main area of activity aside from routine care; 30% did so regarding "health promotion", and 26% did so regarding "a specific area of specialization" e.g., diabetes, wound care or women's health). In response to a separate question, 77% reported "great" or "very great" involvement in quality measurement programs. Four out of five front-line nurses were satisfied with their work to a great or very great extent, and approximately three out of four of them (73%) felt that they had autonomy at work to a great or very great extent. About half of the nurses take into account, to a great or very great extent, the financial concerns of the health plans that employ them. A large majority of the nurses (85%) indicated that the nature of their work had changed substantially in recent years, with an increase in autonomy noted as one of the key changes. Perceived barriers to further role development include attitudes on the part of some physicians and nurses, an insufficient number of dedicated nursing positions, and insufficiently attractive wage levels.
CONCLUSIONS: The findings, gathered over 4 years, indicate alignment between universal and Israel-specific trends in health care and the evolving roles of nurses in Israel's health plans. The findings provide support for ongoing efforts in the health plans to give nurses more authority and responsibility in the management of chronically ill patients, a more central role in health promotion efforts, more advanced training - both inter-professional and nurse-specific, and more opportunity to focus on the roles and tasks that require nursing professionals.

PMID: 29274639 [PubMed - in process]



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Medicare Program; Medicare Shared Savings Program: Extreme and Uncontrollable Circumstances Policies for Performance Year 2017. Interim final rule with comment period.

Medicare Program; Medicare Shared Savings Program: Extreme and Uncontrollable Circumstances Policies for Performance Year 2017. Interim final rule with comment period.

Fed Regist. 2017 Dec 26;82(246):60912-9

Authors: Centers for Medicare & Medicaid Services (CMS), HHS.

Abstract
This interim final rule with comment period establishes policies for assessing the financial and quality performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) affected by extreme and uncontrollable circumstances during performance year 2017, including the applicable quality reporting period for the performance year. Under the Shared Savings Program, providers of services and suppliers that participate in ACOs continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. ACOs in performance-based risk agreements may also share in losses. This interim final rule with comment period establishes extreme and uncontrollable circumstances policies for the Shared Savings Program that will apply to ACOs subject to extreme and uncontrollable events, such as Hurricanes Harvey, Irma, and Maria, and the California wildfires, effective for performance year 2017, including the applicable quality data reporting period for the performance year.

PMID: 29274632 [PubMed - as supplied by publisher]



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Homotopy Series Solutions to Time-Space Fractional Coupled Systems

We apply the homotopy perturbation Sumudu transform method (HPSTM) to the time-space fractional coupled systems in the sense of Riemann-Liouville fractional integral and Caputo derivative. The HPSTM is a combination of Sumudu transform and homotopy perturbation method, which can be easily handled with nonlinear coupled system. We apply the method to the coupled Burgers system, the coupled KdV system, the generalized Hirota-Satsuma coupled KdV system, the coupled WBK system, and the coupled shallow water system. The simplicity and validity of the method can be shown by the applications and the numerical results.

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Evolution of the Mesoscopic Parameters and Mechanical Properties of Granular Materials upon Loading

Biaxial tests of granular materials under different lateral pressures were numerically simulated to study both the macromechanical behavior and evolution of mesoscopic parameters, including the coordination number, degree, clustering coefficient, and average shortest path length, which can provide information bridging mesoscale to macroscale of the mechanical properties of granular materials in a different and new way. The analysis results demonstrate that, with the increasing lateral pressure, there is a higher coordination number for denser granular material, and the coordination number of the samples eventually tends to the similar value at critical state with the same lateral pressure for different initial porosities; the distribution of the degree is very similar for samples with different initial porosities at critical state; the evolution of the clustering coefficients with axial strain is almost the same as that of the coordination number. At critical state, the clustering coefficients of all samples are almost identical, which means that the internal structures of samples with various initial porosities are similar; the average shortest path decreases with increasing lateral pressure and tends to be stable in the critical state. Additionally, the diameter of the contact network of granular material hardly changes at different lateral pressures at critical state.

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Fatty Acid Profile of Fat of Grass Carp, Bighead Carp, Siberian Sturgeon, and Wels Catfish

The objective of this study was to determine fish species differences in fatty acid profile of the fat of farmed grass carp, bighead carp, Siberian sturgeon, and wels catfish so as to compare the consumer health benefits they provide. Fatty acid composition range was as follows: saturated fatty acids (SFA), 16.32%–32.96%; monounsaturated fatty acids (MUFA), 41.84%–55.31%; and polyunsaturated fatty acids (PUFA), 13.4%–26.31%. The total content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in 100 g of muscle tissue of the fish examined in the current study was 62.61 mg for grass carp, 150.51 mg for wels catfish, 488.67 mg for bighead carp, and 619.06 mg for Siberian sturgeon. The ratios of n-6/n-3 (0.44–1.72) and PUFA/SFA (0.45–1.61) in the fat of the fish analyzed were beneficial.

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Standardized Digital Colposcopy with Dynamic Spectral Imaging for Conservative Patient Management

Background. Colposcopy is subjective and management of young patients with high-grade disease is challenging, as treatments may impair subsequent pregnancies and adversely affect obstetric outcomes. Conservative management of selected patients is becoming more popular amongst clinicians; however it requires accurate assessment and documentation. Novel adjunctive technologies for colposcopy could improve patient care and help individualize management decisions by introducing standardization, increasing sensitivity, and improving documentation. Case. A nulliparous 27-year-old woman planning pregnancy underwent colposcopy following high-grade cytology. The colposcopic impression was of low-grade changes, whilst the Dynamic Spectral Imaging (DSI) map of the cervix suggested potential high-grade. A DSI-directed biopsy confirmed CIN2. At follow-up, both colposcopy and DSI were suggestive of low-grade disease only, and image comparison confirmed the absence of previously present acetowhite epithelium areas. Histology of the transformation zone following excisional treatment, as per patient’s choice, showed no high-grade changes. Conclusion. Digital colposcopy with DSI mapping helps standardize colposcopic examinations, increase diagnostic accuracy, and monitor cervical changes over time, improving patient care. When used for longitudinal tracking of disease and when it confirms a negative colposcopy, it can help towards avoiding overtreatment and hence decrease morbidity related to cervical excision.

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Biophotonics: the big picture.

Biophotonics: the big picture.

J Biomed Opt. 2017 Dec;23(2):1-7

Authors: Marcu L, Boppart SA, Hutchinson MR, Popp J, Wilson BC

Abstract
The 5th International Conference on Biophotonics (ICOB) held April 30 to May 1, 2017, in Fremantle, Western Australia, brought together opinion leaders to discuss future directions for the field and opportunities to consider. The first session of the conference, "How to Set a Big Picture Biophotonics Agenda," was focused on setting the stage for developing a vision and strategies for translation and impact on society of biophotonic technologies. The invited speakers, panelists, and attendees engaged in discussions that focused on opportunities and promising applications for biophotonic techniques, challenges when working at the confluence of the physical and biological sciences, driving factors for advances of biophotonic technologies, and educational opportunities. We share a summary of the presentations and discussions. Three main themes from the conference are presented in this position paper that capture the current status, opportunities, challenges, and future directions of biophotonics research and key areas of applications: (1) biophotonics at the nano- to microscale level; (2) biophotonics at meso- to macroscale level; and (3) biophotonics and the clinical translation conundrum.

PMID: 29275543 [PubMed - in process]



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Integrative Application of Life Cycle Assessment and Risk Assessment to Environmental Impacts of Anthropogenic Pollutants at a Watershed Scale.

Integrative Application of Life Cycle Assessment and Risk Assessment to Environmental Impacts of Anthropogenic Pollutants at a Watershed Scale.

Bull Environ Contam Toxicol. 2017 Dec 23;:

Authors: Lin X, Yu S, Ma H

Abstract
Intense human activities have led to increasing deterioration of the watershed environment via pollutant discharge, which threatens human health and ecosystem function. To meet a need of comprehensive environmental impact/risk assessment for sustainable watershed development, a biogeochemical process-based life cycle assessment and risk assessment (RA) integration for pollutants aided by geographic information system is proposed in this study. The integration is to frame a conceptual protocol of "watershed life cycle assessment (WLCA) for pollutants". The proposed WLCA protocol consists of (1) geographic and environmental characterization mapping; (2) life cycle inventory analysis; (3) integration of life-cycle impact assessment (LCIA) with RA via characterization factor of pollutant of interest; and (4) result analysis and interpretation. The WLCA protocol can visualize results of LCIA and RA spatially for the pollutants of interest, which might be useful for decision or policy makers for mitigating impacts of watershed development.

PMID: 29275526 [PubMed - as supplied by publisher]



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Voice alterations in patients with Morquio A syndrome.

Voice alterations in patients with Morquio A syndrome.

J Appl Genet. 2017 Dec 23;:

Authors: Szklanny K, Gubrynowicz R, Tylki-Szymańska A

Abstract
Morquio A syndrome, or mucopolysaccharidosis (MPS IV A), is an inherited lysosomal storage disorder which belongs to the group of mucopolysaccharidoses (MPSs). It is caused by N-acetylgalactosamine-6-sulfatase (GALNS) activity deficiency, which results in impaired degradation of glycosaminoglycans (GAGs), including keratan sulfate (KS) and chondroitin-6-sulfate (CS). These compounds infiltrate and disrupt the architecture of the extracellular matrix, compromising the integrity of the connective tissue. Patients with Morquio A have also been noted for exhibiting abnormalities of the larynx and vocal tract. The aim of the study was to assess voice alterations using noninvasive acoustic and electroglottographic voice analysis. Electroglottographic signal and acoustic analyses revealed considerable changes in the voices of patients with Morquio A syndrome when compared to the voices of healthy controls. Affected patients tended toward tense voice, incomplete glottal closure, increased incidence of vocal fold nodules, dysphonia, and hoarse voice. Morquio A syndrome is characterized by connective tissue disease, which adversely affects voice quality. The use of objective voice analysis makes it possible to quantitatively monitor changes in the vocal apparatus over the course of disease progression, and also allows for assessment of the effects of the enzyme replacement therapy.

PMID: 29275451 [PubMed - as supplied by publisher]



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A framework for designing hand hygiene educational interventions in schools.

A framework for designing hand hygiene educational interventions in schools.

Int J Public Health. 2017 Dec 23;:

Authors: Appiah-Brempong E, Harris MJ, Newton S, Gulis G

Abstract
OBJECTIVES: Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational intervention in schools. We sought to suggest a framework underpinned by psychosocial theories towards bridging this knowledge gap. Furthermore, we sought to propound a more comprehensive definition of hand hygiene which could guide the conceptualisation of hand hygiene interventions in varied settings.
METHODS: Literature search was guided by a standardized tool and literature was retrieved on the basis of a predetermined inclusion criteria. Databases consulted include PubMed, ERIC, and EBSCO host (Medline, CINAHL, PsycINFO, etc.). Evidence bordering on a theoretical framework to aid the design of school-based hand hygiene educational interventions is summarized narratively.
RESULTS: School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms (normative beliefs and motivation to comply).
CONCLUSIONS: A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools.

PMID: 29275443 [PubMed - as supplied by publisher]



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In Vivo Validation of Patient-Specific Pressure Gradient Calculations for Iliac Artery Stenosis Severity Assessment.

In Vivo Validation of Patient-Specific Pressure Gradient Calculations for Iliac Artery Stenosis Severity Assessment.

J Am Heart Assoc. 2017 Dec 23;6(12):

Authors: Heinen SGH, van den Heuvel DAF, Huberts W, de Boer SW, van de Vosse FN, Delhaas T, de Vries JPM

Abstract
BACKGROUND: Currently, the decision to treat iliac artery stenoses is mainly based on visual inspection of digital subtraction angiographies. Intra-arterial pressure measurements can provide clinicians with accurate hemodynamic information. However, pressure measurements are rarely performed because of their invasiveness and the time required. Therefore, the aim of the study was to test the feasibility of a computational model that can predict translesional pressure gradients across iliac artery stenoses on the basis of imaging data only.
METHODS AND RESULTS: Patients (N=21) with symptomatic peripheral arterial disease and a peak systolic velocity ratio between 2.5 and 5.0 were included in the study. Patients underwent per-procedural 3-dimensional rotational angiography and hyperemic intra-arterial translesional pressure measurements. Vascular anatomical features were reconstructed from the 3-dimensional rotational angiography data into an axisymmetrical 2-dimensional computational mesh, and flow was estimated on the basis of the stenosis geometry. Computational fluid dynamics were performed to predict the pressure gradient and were compared with the measured pressure gradients. A good agreement by overlapping error bars of the predicted and measured pressure gradients was found in 21 of 25 lesions. Stratification of the stenosis on the basis of the predicted pressure gradient into hemodynamic not significant (<10 mm Hg) and hemodynamic significant (≥10 mm Hg) resulted in sensitivity, specificity, and overall predictive values of 95%, 60%, and 88%, respectively.
CONCLUSIONS: The feasibility of the patient-specific computational model to predict the hyperemic translesional pressure gradient over iliac artery stenosis was successfully tested. Presented results suggest that, with further optimization and corroboration, the model can become a valuable aid to the diagnosis of equivocal iliac artery stenosis.
CLINICAL TRIAL REGISTRATION: URL: http://ift.tt/13oTAKm. Unique identifier: NTR5085.

PMID: 29275367 [PubMed - in process]



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Evaluation of the relative effectiveness of the 2017 updated Manchester scoring system for predicting BRCA1/2 mutations in a Southeast Asian country.

Evaluation of the relative effectiveness of the 2017 updated Manchester scoring system for predicting BRCA1/2 mutations in a Southeast Asian country.

J Med Genet. 2017 Dec 23;:

Authors: Chew W, Moorakonda RB, Courtney E, Soh H, Li ST, Chen Y, Shaw T, Allen JC, Evans DGR, Ngeow J

Abstract
BACKGROUND: Germline mutations in the BRCA1 and BRCA2 genes have significant clinical implications for both risk-reducing and early surveillance management. The third and most recent revision of the Manchester scoring system (MSS3) used to distinguish patients indicated for germline BRCA1/2 testing included further adjustments for triple negative breast cancer, high-grade serous ovarian cancer and human epidermal growth factor 2 (HER2) receptor status. This study aims to evaluate the relative effectiveness of MSS3 in a Southeast Asian population.
METHODS: All patients in our centre were tested using next-generation sequencing (NGS) panels that included full gene sequencing as well as coverage for large deletions/duplications in BRCA1/2. We calculated MSS1-3 scores for index patients between 2014 and 2017 who had undergone BRCA1/2 genetic testing and recorded their genetic test results. MSS1-3 outcomes were compared using receiver operating characteristic analysis, while associations with predictors were investigated using Fisher's exact test and logistics regression. Calculations were performed using Medcalc17.
RESULTS: Of the 330 included patients, 47 (14.2%) were found to have a germline mutation in BRCA1 or BRCA2. A positive HER2 receptor was associated with a lower likelihood of a BRCA1/2mutation (OR=0.125, 95% CI 0.016 to 0.955; P=0.007), while high-grade serous ovarian cancer was conversely associated with an increased likelihood of a BRCA1/2 mutation (OR=5.128, 95% CI 1.431 to 18.370; P=0.012). At the 10% threshold, 43.0% (142/330) of patients were indicated for testing under MSS3, compared with 35.8% (118/330) for MSS1% and 36.4% (120/330) for MSS2. At the 10% threshold, MSS3 sensitivity was 91.5% and specificity 65.0%, significantly better than the previous MSS1 (P=0.037) and MSS2 (P=0.032) models.
CONCLUSION: Our results indicate that the updated MSS3 outperforms previous iterations and relative to the Manchester population, is just as effective in identifying patients with BRCA1/2 mutations in a Southeast Asian population.

PMID: 29275357 [PubMed - as supplied by publisher]



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Association between serum uric acid and atrial fibrillation: a cross-sectional community-based study in China.

Association between serum uric acid and atrial fibrillation: a cross-sectional community-based study in China.

BMJ Open. 2017 Dec 22;7(12):e019037

Authors: Chen Y, Xia Y, Han X, Yang Y, Yin X, Qiu J, Liu H, Zhou Y, Liu Y

Abstract
OBJECTIVES: To investigate the effects of gender on the association of serum uric acid (SUA) levels and atrial fibrillation (AF) prevalence in a community-based Chinese population.
SETTING: Data were obtained from annual Jidong Oilfield employee and family member health checkups. The Jidong community is geographically located in Tangshan City in northern China.
PARTICIPANTS: A total of 9078 residents were invited to take part in the survey and provided informed consents. Individuals without data of ECG or SUA were excluded, leaving 8937 residents in our study.
PRIMARY AND SECONDARY OUTCOME MEASURES: SUA was measured at baseline using the uricase-peroxidase method. Hyperuricaemia was defined as a SUA level >7.0 mg/dL in men and >5.7 mg/dL in women. AF was diagnosed based on ECG findings and/or any medical history of AF from referring physicians. The crude and independent association between SUA levels and AF prevalence was evaluated with logistic regression analysis.
RESULTS: AF prevalence was 0.6% (53/8937). Participants with hyperuricaemia had a higher AF prevalence compared with those with normal SUA levels (1.1% vs 0.5%; P=0.02). Hyperuricaemia was correlated with AF after adjustment for various cardiovascular risk factors in all participants (P=0.03, OR 2.051, 95% CI 1.063 to 3.856). This correlation was particularly stronger in women compared with men (P<0.001, OR 6.366, 95% CI 2.553 to 15.871 in women and P=0.96, OR 1.025, 95% CI 0.400 to 2.626 in men).
CONCLUSIONS: We demonstrated a significant association between increased SUA levels and AF prevalence in a Chinese population. Our data indicate that there is a gender-specific mechanism underlying the relationship between SUA and AF.

PMID: 29275349 [PubMed - in process]



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Innovating at the food, water, and energy interface.

Innovating at the food, water, and energy interface.

J Environ Manage. 2017 Dec 21;209:17-22

Authors: Helmstedt KJ, Stokes-Draut JR, Larsen AE, Potts MD

Abstract
Food, energy, and water (FEW) systems are inexorably linked. Earth's changing climate and increasing competition for finite land resources are creating and amplifying challenges at the FEW nexus. Managing FEW systems to mitigate these negative impacts and stresses is a pressing policy issue. The FEW interface is often managed as three independent systems, missing disruptive opportunities for streamlined integrated management. We contend that existing technologies can be reframed and emerging technologies can be harnessed for integrated FEW management, changing the way that each resource system operates within the broader system. We discuss solutions to three main challenges to integrating FEW system management: resolving spatiotemporal disconnections over multiple scales; closing resource loops; and creating actionable information. Sustainable resource management is critical for humanity, as well as for functioning trade systems and ecological health. Embracing integrated management in FEW systems would enable policy makers and managers to more efficiently and effectively secure critical resource systems in the face of global change.

PMID: 29275281 [PubMed - as supplied by publisher]



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SnS2/SnO2 heterostructured nanosheet arrays grown on carbon cloth for efficient photocatalytic reduction of Cr(VI).

SnS2/SnO2 heterostructured nanosheet arrays grown on carbon cloth for efficient photocatalytic reduction of Cr(VI).

J Colloid Interface Sci. 2017 Dec 18;514:306-315

Authors: Zhang G, Chen D, Li N, Xu Q, Li H, He J, Lu J

Abstract
Nowadays, among the many heavy metal pollutants, hexavalent chromium (Cr(VI)) seriously threatens ecological systems and human health due to its high solubility, acute toxicity and potential carcinogenicity in wastewater. Meanwhile, semiconductor photocatalytic reduction is continuously gaining increasing significant research attention in the treatment of Cr(VI). Hence, we report an efficient preparation method for SnS2/SnO2 composites on carbon cloth (CC), for efficient photocatalytic reduction of aqueous Cr(VI). The morphology, composition, surface elements and optical properties of CC@SnS2/SnO2 composites were characterized using scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and UV-vis diffuse reflectance spectroscopy. It was found that carbon cloth (CC) could be effectively used as a catalyst support in the obtained SnS2/SnO2 composites. In addition, the CC@SnS2 calcined 30 min exhibited the best efficiency for photocatalytic reduction of aqueous Cr(VI), which can be attributed to the formation of a heterostructure and the effective separation of photogenerated electrons (e-) and holes (h+). It was also found that acidic conditions are more favorable for the photocatalytic reduction of aqueous Cr(VI) due to the presence of abundant H+. The photocatalytic mechanism of as-prepared composites is also discussed in detail.

PMID: 29275249 [PubMed - as supplied by publisher]



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Association of co-exposure to heavy metals with renal function in a hypertensive population.

Association of co-exposure to heavy metals with renal function in a hypertensive population.

Environ Int. 2017 Dec 21;112:198-206

Authors: Wu W, Zhang K, Jiang S, Liu D, Zhou H, Zhong R, Zeng Q, Cheng L, Miao X, Tong Y, Lu Q

Abstract
BACKGROUND: Chronic kidney disease (CKD) is an increasing health problem worldwide. Recent studies have suggested the potential associations between exposure to metals and CKD events, particularly in participants with hypertension. However, relevant studies are limited.
OBJECTIVES: We aimed to explore the associations of metal exposure with renal function in participants with essential hypertension.
METHODS: Nine hundred and thirty-four participants with essential hypertension were recruited at the Department of Cardiology, Union Hospital, Wuhan, China. We measured the levels of chromium, cadmium, thallium and uranium in urine and calculated the estimated glomerular filtration rate (eGFR) for renal function. Multivariable linear regression models adjusted for potential confounders were applied.
RESULTS: After adjusting for potential confounders and other metals, doubling of urinary chromium or uranium levels decreased eGFR by 2.90 (95% confidence interval, 2.04 to 3.76) and 1.87 (0.58 to 3.15) mL/min per 1.73m2, respectively. Co-exposure to chromium and uranium was found to greatly decrease eGFR, particularly in women. Compared with those in the low exposure group, women with high exposure to chromium and uranium had a 11.36 (3.66 to 19.07) mL/min per 1.73m2 adjusted decline in eGFR. Higher urinary thallium levels were positively related to elevated eGFR in men. The adjusted increase in eGFR with doubling of thallium levels was 3.12 (1.14 to 5.10) mL/min per 1.73m2. Sex-difference in the associations of exposure to heavy metals with eGFR was also suggested.
CONCLUSIONS: Our findings suggest that environmental exposure to chromium and uranium might contribute to a decline in eGFR in individuals with hypertension. The associations of exposure to heavy metals with eGFR might be sex-different. Further studies are warranted to confirm our findings and clarify the underlying mechanisms.

PMID: 29275245 [PubMed - as supplied by publisher]



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In vitro characterization of alkylaminophenols-induced cell death.

In vitro characterization of alkylaminophenols-induced cell death.

Eur J Pharmacol. 2017 Dec 21;:

Authors: Doan P, Anufrieva O, Yli-Harja O, Kandhavelu M

Abstract
Alkylaminophenols are synthetic derivatives well known for their anticancer activity. In the previous studies, we described the activity of the series of Alkylaminophenols derivatives and their ability to induce cell death for many cancer cell lines. However, temporal heterogeneity in cell death induced by lead compounds, N-(2-hydroxy-5-nitrophenyl (4'-methylphenyl) methyl) indoline (Compound I) and 2-((3,4-dihydroquinolin-1(2H)-yl) (4-methoxyphenyl) methyl) phenol (Compound II), has never been tested on osteosarcoma cells (U2OS). Here, we address the level of cell-to-cell heterogeneity by examine whether differences in the type of compounds could influence its effects on cell death of U2OS. Here, we applied imaging, computational methods and biochemical methods to study heterogeneity, apoptosis, reactive oxygen species and caspase. Our results demonstrate that the Hill coefficient of dose-response curve of Compound II is greater than compound I in treated U2OS cells. Both Compounds trigger not only apoptotic cell death but also necro-apoptotic and necrotic cell death. The percentage of these sub-populations varies depending on compounds in which greater variance is induced by compound II than Compound I. We also identified the accumulation of compounds-induced reactive oxygen species during the treatment. This resulted in caspase 3/7 activation in turn induced apoptosis. In summary, the screening of Compound I and II molecules for heterogeneity, apoptosis, reactive oxygen species and caspase has identified compound II as promising anti-osteosarcoma cancer agent. Compound II could be a promising lead compound for future antitumor agent development.

PMID: 29275157 [PubMed - as supplied by publisher]



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Preparation, characterization and evaluation of the immune effect of alginate/chitosan composite microspheres encapsulating recombinant protein of Streptococcus iniae designed for fish oral vaccination.

Preparation, characterization and evaluation of the immune effect of alginate/chitosan composite microspheres encapsulating recombinant protein of Streptococcus iniae designed for fish oral vaccination.

Fish Shellfish Immunol. 2017 Dec 21;:

Authors: Wang E, Wang X, Wang K, He J, Zhu L, He Y, Chen D, Ouyang P, Geng Y, Huang X, Lai W

Abstract
Streptococcus iniae has caused serious harm to the fish farming industry in recent years. Vaccination is a potential approach for preventing and controlling disease, being oral vaccination the most suitable vaccination route in fish. Alginate and chitosan microspheres have been widely used as controlled release systems for oral vaccination in fish. In this study, we prepared and characterized alginate/chitosan composite microspheres encapsulating the recombinant protein serine-rich repeat (rSrr) of S. iniae. We evaluated effect of these microspheres on the immune system of channel catfish. The microsphere preparation conditions were optimized by Response Surface Method and target microspheres were obtained under 1.68% alginate (w/v), the W/O ratio 3.6:7.4 (liquid paraffin with 4% Span 80, v/v) with stirring at 1000 rpm, 9.64% CaCl2 (w/v) and 0.95% chitosan (w/v) with an encapsulation efficiency of 92.38%. The stability and safety of rSrr-microspheres were evaluated in vitro and in vivo, respectively. Furthermore, compared with control group, oral vaccination with rSrr-microspheres induced higher serum antibody titers, higher lysozyme activity, higher total protein and higher expression of immune-related genes, and resulted in higher relative percent survival (RPS) with the value of 60% for channel catfish against S.iniae infection. Our results thus indicate that alginate/chitosan microspheres encapsulating rSrr can be used as oral vaccine for channel catfish, providing efficient immunoprotection against S. iniae infection.

PMID: 29275131 [PubMed - as supplied by publisher]



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Factors influencing progress through the liminal phase: A model to assist transition into nurse academic life.

Factors influencing progress through the liminal phase: A model to assist transition into nurse academic life.

Nurse Educ Today. 2017 Dec 08;61:269-272

Authors: McDermid F, Mannix J, Jackson D, Daly J, Peters K

PMID: 29275127 [PubMed - as supplied by publisher]



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Precision design of nanomedicines to restore gemcitabine chemosensitivity for personalized pancreatic ductal adenocarcinoma treatment.

Precision design of nanomedicines to restore gemcitabine chemosensitivity for personalized pancreatic ductal adenocarcinoma treatment.

Biomaterials. 2017 Dec 20;158:44-55

Authors: Zhao X, Wang X, Sun W, Cheng K, Qin H, Han X, Lin Y, Wang Y, Lang J, Zhao R, Zheng X, Zhao Y, Shi J, Hao J, Miao QR, Nie G, Ren H

Abstract
Low chemosensitivity considerably restricts the therapeutic efficacy of gemcitabine (GEM) in pancreatic cancer treatment. Using immunohistochemical evaluation, we investigated that decreased expression of human equilibrative nucleoside transporter-1 (hENT1, which is the major GEM transporter across cell membranes) and increased expression of ribonucleotide reductase subunit 2 (RRM2, which decreases the cytotoxicity of GEM) was associated with low GEM chemosensitivity. To solve these problems, we employed a nanomedicine-based formulation of cationic liposomes for co-delivery of GEM along with siRNA targeting RRM2. Due to the specific endocytic uptake mechanism of nanocarriers and gene-silencing effect of RRM2 siRNA, this nanomedicine formulation significantly increased GEM chemosensitivity in tumor models of genetically engineered Panc1 cells with low hENT1 or high RRM2 expression. Moreover, in a series of patient-derived cancer cells, we demonstrated that the therapeutic benefits of the nanomedicine formulations were associated with the expression levels of hENT1 and RRM2. In summary, we found that the essential factors of GEM chemosensitivity were the expression levels of hENT1 and RRM2, and synthesized nanoformulations can overcome these problems. This unique design of nanomedicine not only provides a universal platform to enhance chemosensitivity but also contributes to the precision design and personalized treatment in nanomedicine.

PMID: 29275122 [PubMed - as supplied by publisher]



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Breast lesion classification based on supersonic shear-wave elastography and automated lesion segmentation from B-mode ultrasound images.

Breast lesion classification based on supersonic shear-wave elastography and automated lesion segmentation from B-mode ultrasound images.

Comput Biol Med. 2017 Dec 15;93:31-46

Authors: Yu Y, Xiao Y, Cheng J, Chiu B

Abstract
Supersonic shear-wave elastography (SWE) has emerged as a useful imaging modality for breast lesion assessment. Regions of interest (ROIs) were required to be specified for extracting features that characterize malignancy of lesions. Although analyses have been performed in small rectangular ROIs identified manually by expert observers, the results were subject to observer variability and the analysis of small ROIs would potentially miss out important features available in other parts of the lesion. Recent investigations extracted features from the entire lesion segmented by B-mode ultrasound images either manually or semi-automatically, but lesion delineation using existing techniques is time-consuming and prone to variability as intensive user interactions are required. In addition, rich diagnostic features were available along the rim surrounding the lesion. The width of the rim analyzed was subjectively and empirically determined by expert observers in previous studies after intensive visual study on the images, which is time-consuming and susceptible to observer variability. This paper describes an analysis pipeline to segment and classify lesions efficiently. The lesion boundary was first initialized and then deformed based on energy fields generated by the dyadic wavelet transform. Features of the SWE images were extracted from inside and outside of a lesion for different widths of the surrounding rim. Then, feature selection was performed followed by the Support Vector Machine (SVM) classification. This strategy obviates the empirical and time-consuming selection of the surrounding rim width before the analysis. The pipeline was evaluated on 137 lesions. Feature selection was performed 20 times using different sets of 14 lesions (7 malignant, 7 benign). Leave-one-out SVM classification was performed in each of the 20 experiments with a mean sensitivity, specificity and accuracy of 95.1%, 94.6% and 94.8% respectively. The pipeline took an average of 20 s to process a lesion. The fact that this efficient pipeline generated classification accuracy superior to that of existing algorithms suggests that improved efficiency did not compromise classification accuracy. The ability to streamline the quantitative assessment of SWE images will potentially accelerate the adoption of the combined use of ultrasound and elastography in clinical practice.

PMID: 29275098 [PubMed - as supplied by publisher]



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Genetic analysis of Southern Brazil subjects using the PowerSeq™ AUTO/Y system for short tandem repeat sequencing.

Genetic analysis of Southern Brazil subjects using the PowerSeq™ AUTO/Y system for short tandem repeat sequencing.

Forensic Sci Int Genet. 2017 Dec 16;33:129-135

Authors: Silva DSBS, Sawitzki FR, Scheible MKR, Bailey SF, Alho CS, Faith SA

Abstract
With the advent of Next-Generation Sequencing technology, sequencing of short tandem repeats (STRs) allows for a more detailed analysis when compared to size-based fragment methods (capillary electrophoresis-CE). The implementation of high-throughput sequencing can help uncover deeper genetic diversities of different populations. Subjects from the South region of Brazil present a particular and more homogeneous ancestry background when compared to other regions of the country. Both autosomal and Y- STRs have been analyzed in these individuals; however, all analyses published to date encompass data from CE-based fragment analysis. In this study, a genetic analysis of 59 individuals from Southern Brazil was performed on STR sequences. Forensically relevant STRs were PCR-enriched using a prototype of the PowerSeq™ AUTO/Y system (Promega Corp.). Next-generation sequencing was performed on an Illumina MiSeq instrument. The raw data (FASTQ files) were processed using a custom designed sequence processing tool, Altius. Isoalleles, which are sequence-based allelic variants that do not differ in length, were observed in nine autosomal and in six Y- STRs from the core global forensic marker set. The number of distinctive alleles based on sequence was higher when compared to those based on length, 37.3% higher in autosomal STRs and 13.8% higher in Y-STRs. The most polymorphic autosomal locus was D12S391, which presented 38 different sequence-based alleles. Among the loci in the Y chromosome, DYS389II presented the highest number of isoalleles. In comparison to CE analysis, Observed and Expected Heterozygosity, Polymorphic Information Content (PIC) and Genetic Diversity also presented higher values when the alleles were analyzed based on their sequence. For autosomal loci, Polymorphic Information Content (PIC) was 2.6% higher for sequence-based data. Diversity was 9.3% and 6.5% higher for autosomal and Y markers, respectively. In the analysis of the repeat structures for the STR loci, a new allele variant was found for allele 18 in the vWA locus. The STR flanking regions were also further investigated and sixteen variations were observed at nine autosomal STR loci and one Y-STR locus. The results obtained in this study demonstrate the importance of genetic analysis based on sequencing and highlight the diversity of the South Brazilian population when characterized by STR sequencing.

PMID: 29275088 [PubMed - as supplied by publisher]



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Optimal adjuvant endocrine treatment of ER+/HER2+ breast cancer patients by age at diagnosis: A population-based cohort study.

Optimal adjuvant endocrine treatment of ER+/HER2+ breast cancer patients by age at diagnosis: A population-based cohort study.

Eur J Cancer. 2017 Dec 21;90:92-101

Authors: Dackus GMHE, Jóźwiak K, Sonke GS, van der Wall E, van Diest PJ, Hauptmann M, Siesling S, Linn SC

Abstract
BACKGROUND: Prior randomised controlled trials on adjuvant hormonal therapy included HER2any patients; however, a differential effect of aromatase inhibitors (AIs) versus tamoxifen (TAM) may have been missed in ER+/HER2+ patients that comprise 7-15% of all breast cancer patients. In addition, a woman's hormonal microenvironment may influence sensitivity to TAM and AIs in the adjuvant setting, which changes during menopausal transition, a process that takes years. We studied the efficacy of AIs versus TAM in ER+/HER2+ breast cancer patients grouped by age at diagnosis as a proxy for menopausal status using treatment and outcome data from the nationwide population-based Netherlands Cancer Registry (NCR).
PATIENTS AND METHODS: All women diagnosed between 2005 and 2007 with endocrine-treated, TanyNanyM0, ER+/HER2+ breast cancer were identified through the NCR (n = 1155). Patients were divided by age at diagnosis: premenopausal (≤45 years; n = 326), perimenopausal (45<years≤55; n = 304) and postmenopausal (>55 years; n = 525). A time-dependent variable, indicating whether AI or TAM was received for >50% of endocrine treatment duration, was applied to subdivide groups by predominant treatment received. Recurrence-free survival (RFS) and overall survival (OS) were assessed using Kaplan-Meier survival estimation and Cox regression. Hazard ratios (HRs) were adjusted for chemotherapy, trastuzumab, age at diagnosis, N-status, grade, pT-stage and ovarian ablation.
RESULTS: During follow-up, 237 recurrences and 182 deaths occurred. Perimenopausal women derived significant RFS and OS benefit from AI compared with TAM, HR 0.47 (95% CI 0.25-0.91; P = 0.03) and HR 0.37 (95% CI 0.18-0.79; P = 0.01), respectively, whereas premenopausal women derived no benefit from AI compared with TAM. Treatment effects differed significantly between these age groups (interaction P = 0.03 and P = 0.02, respectively). Among postmenopausal women a small but non-significant AI benefit was observed.
CONCLUSION: AI treatment, preferably without any TAM treatment, was associated with the best RFS and OS outcome in ER+/HER2+ perimenopausal breast cancer patients.

PMID: 29274928 [PubMed - as supplied by publisher]



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RNA-Seq transcriptomic analysis of the Morus alba L. leaves exposed to high-level UVB with or without dark treatment.

RNA-Seq transcriptomic analysis of the Morus alba L. leaves exposed to high-level UVB with or without dark treatment.

Gene. 2017 Dec 21;:

Authors: Guan Q, Yu J, Zhu W, Yang B, Li Y, Zhang L, Tian J

Abstract
Ultraviolet-B (UVB) irradiation induces oxidative stress in plant cells due to the generation of excessive reactive oxygen species. Morus alba L. (M. abla) is an important medicinal plant used for the treatment of human diseases. Also, its leaves are widely used as food for silkworms. In our previous research, we found that a high level of UVB irradiation with dark incubation led to the accumulation of secondary metabolites in M. abla leaf. The aim of the present study was to describe and compare M. alba leaf transcriptomics with different treatments (control, UVB, UVB+dark). Leaf transcripts from M. alba were sequenced using an Illumina Hiseq 2000 system, which produced 14.27Gb of data including 153,204,462 paired-end reads among the three libraries. We de novo assembled 133,002 transcripts with an average length of 1270bp and filtered 69,728 non-redundant unigenes. A similarity search was performed against the non-redundant National Center of Biotechnology Information (NCBI) protein database, which returned 41.08% hits. Among the 20,040 unigenes annotated in UniProtKB/SwissProt database, 16,683 unigenes were assigned 102,232 gene ontology terms and 6667 unigenes were identified in 287 known metabolic pathways. Results of differential gene expression analysis together with real-time quantitative PCR tests indicated that UVB irradiation with dark incubation enhanced the flavonoid biosynthesis in M. alba leaf. Our findings provided a valuable proof for a better understanding of the metabolic mechanism under abiotic stresses in M. alba leaf.

PMID: 29274907 [PubMed - as supplied by publisher]



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Repolarization in perfused myocardium predicts reperfusion ventricular tachyarrhythmias.

Repolarization in perfused myocardium predicts reperfusion ventricular tachyarrhythmias.

J Electrocardiol. 2017 Dec 06;:

Authors: Bernikova OG, Sedova KA, Arteyeva NV, Ovechkin AO, Kharin SN, Shmakov DN, Azarov JE

Abstract
BACKGROUND: Aim of the study was to find out which myocardial repolarization parameters predict reperfusion ventricular tachycardia and fibrillation (VT/VF) and determine how these parameters express in ECG.
METHODS: Coronary occlusion and reperfusion (30/30min) was induced in 24 cats. Local activation and end of repolarization times (RT) were measured in 88 intramyocardial leads. Computer simulations of precordial electrograms were performed.
RESULTS: Reperfusion VT/VF developed in 10 animals. Arrhythmia-susceptible animals had longer RTs in perfused areas [183(177;202) vs 154(140;170) ms in susceptible and resistant animals, respectively, P<0.05]. In logistic regression analysis, VT/VFs were associated with prolonged RTs in the perfused area (OR 1.068; 95% CI 1.012-1.128; P=0.017). Simulations demonstrated that prolonged repolarization in the perfused/border zone caused precordial terminal T-wave inversion.
CONCLUSIONS: The reperfusion VT/VFs were independently predicted by the longer RT in the perfused zone, which was reflected in the terminal negative phase of the electrocardiographic T-wave.

PMID: 29274899 [PubMed - as supplied by publisher]



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Platelet-to-lymphocyte ratio predicts long-term survival in laryngeal cancer.

Platelet-to-lymphocyte ratio predicts long-term survival in laryngeal cancer.

Eur Arch Otorhinolaryngol. 2017 Dec 23;:

Authors: Mao Y, Fu Y, Gao Y, Yang A, Zhang Q

Abstract
OBJECTIVES: Although the survival rate of laryngeal cancer is relatively high, some patients with laryngeal squamous cell carcinoma (LSCC) show the least benefit from laryngectomy, owing to few determining diagnostic tools. We aimed to identify high-risk patients according to a preoperatively determined signature of the platelet-to-lymphocyte ratio (PLR) of > 193.55, as an indicator of poor treatment outcome in LSCC patients.
METHODS: We retrospectively evaluated 899 patients who underwent laryngectomy for LSCC. The patients were stratified by PLR into three subgroups: low (≤ 119.55), moderate (> 119.55 and ≤ 193.55), and high (> 193.55). Kaplan-Meier curves were plotted to compare the intergroup cancer-specific survival (CSS).
RESULTS: Patients with high PLR had significantly worse survival outcomes (5-year CSS, low vs. moderate vs. high: 75.3 vs. 68.4 vs. 53.9%; 10-year CSS, low vs. moderate vs. high: 65.0 vs. 56.0 vs. 38.6%, P < 0.001). Patients with PLR > 193.55 represented malnutrition and more advanced cancer stage..
CONCLUSION: Patients with PLR > 193.55 experience poor outcomes and represent malnutrition, more advanced cancer stage.

PMID: 29275426 [PubMed - as supplied by publisher]



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Oropharyngeal and tongue exercises (myofunctional therapy) for snoring: a systematic review and meta-analysis.

Oropharyngeal and tongue exercises (myofunctional therapy) for snoring: a systematic review and meta-analysis.

Eur Arch Otorhinolaryngol. 2017 Dec 23;:

Authors: Camacho M, Guilleminault C, Wei JM, Song SA, Noller MW, Reckley LK, Fernandez-Salvador C, Zaghi S

Abstract
PURPOSE: Oropharyngeal and tongue exercises (myofunctional therapy) have been shown to improve obstructive sleep apnea. However, to our knowledge, a systematic review has not been performed for snoring. The study objective is to perform a systematic review, with a meta-analysis, dedicated to snoring outcomes after myofunctional therapy.
METHODS: PubMed/MEDLINE and three other databases were searched through November 25, 2017. Two authors independently searched the literature. Eligibility (1) patients: children or adults with snoring, (2) intervention: oropharyngeal and/or tongue exercises, (3) comparison: pre and post-treatment data for snoring, (4) outcomes: snoring frequency and snoring intensity, (5) study design: publications of all study designs.
RESULTS: A total of 483 articles were screened, 56 were downloaded in their full text form, and nine studies reported outcomes related to snoring. There were a total of 211 patients (all adults) in these studies. The snoring intensity was reduced by 51% in 80 patients from pre-therapy to post-therapy visual analog scale values of 8.2 ± 2.1 (95% CI 7.7, 8.7) to 4.0 ± 3.7 (95% CI 3.2, 4.8). Berlin questionnaire snoring intensity reduced by 36% in 34 patients from 2.5 ± 1.0 (95% CI 2.2, 2.8) to 1.6 ± 0.8 (95% CI 1.3, 1.9). Finally, time spent snoring during sleep was reduced by 31% in 60 patients from 26.3 ± 18.7% (95% CI 21.6, 31.0) to 18.1 ± 20.5% (95% CI 12.9, 23.3) of total sleep time.
CONCLUSIONS: This systematic review demonstrated that myofunctional therapy has reduced snoring in adults based on both subjective questionnaires and objective sleep studies.

PMID: 29275425 [PubMed - as supplied by publisher]



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Mechanism of Action of the Anti-Influenza Virus Active Kampo (Traditional Japanese Herbal) Medicine, Hochuekkito.

Mechanism of Action of the Anti-Influenza Virus Active Kampo (Traditional Japanese Herbal) Medicine, Hochuekkito.

Pharmacology. 2017 Dec 22;101(3-4):148-155

Authors: Dan K, Takanashi K, Akiyoshi H, Munakata K, Hasegawa H, Ogawa K, Watanabe K

Abstract
When the Kampo medicine, Hochuekkito (Hochu), was administered to normal mice for 2 weeks, influenza virus titer was reduced. The mechanism of action of Hochu was examined using the plaque assay method. It was suggested that Hochu may either obstruct the first stage of the infection process (adsorption and entry) or may directly target viral particles. Using the plaque assay method, these 2 modes of action could not be differentiated. Virus RNA in the infected cell was verified by quantitative real-time polymerase chain reaction. An equal inhibition effect was obtained when Hochu was preprocessed for normal cells and when they were made to act simultaneously with virus adsorption. The viral load at the cell surface following UV irradiation was higher in the Hochu-administered group as compared with that of the control. Moreover, the affinity of Hochu for the influenza virus was hundred times higher than its affinity for the host cell. The effect of entry obstruction by Hochu was observed via image analysis, where the amount of virus nucleocapsid protein (NP) invading the cell was visualized with FITC-labeled NP antibody. Hochu does not seem to have an effect on nucleic acid synthesis, viral release from infected cells, and on the subsequent second round of infection. In conclusion, Hochu binds to viral particles and forms complexes that can obstruct the entry of influenza virus into cells.

PMID: 29275416 [PubMed - as supplied by publisher]



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Maxillary chondrosarcoma mimicking torus palatinus.

Maxillary chondrosarcoma mimicking torus palatinus.

BMJ Case Rep. 2017 Dec 22;2017:

Authors: Brimioulle M, Bowles PF, Pelser A

PMID: 29275381 [PubMed - in process]



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Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck: A French multicenter study.

Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck: A French multicenter study.

J Craniomaxillofac Surg. 2017 Dec 12;:

Authors: Moreau A, Galmiche L, Minard-Colin V, Rachwalski M, Belhous K, Orbach D, Joly A, Picard A, Kadlub N

Abstract
OBJECTIVES: Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck is a rare entity with uncertain clinical behavior. Radical surgical resection is the current recommended treatment, however this can cause severe aesthetic and functional sequelae. The aim of this study was to clinically characterize MNTIs and to stratify risk factors that may influence locoregional recurrence.
METHODS: A retrospective multicenter study, including 11 patients from eight centers with a confirmed diagnosis of MNTI, was conducted. Epidemiological, clinical, radiological, pathological, and immunohistochemical examinations were reviewed. A statistical analysis using a t-test was conducted to calculate parameters correlating with tumor recurrence.
RESULTS: MNTIs mainly occurred in the maxilla, with a mean age at diagnosis of 3.18 months (range: 0-6 months). Primary surgery was performed on 10 patients, with a clear margin resection on two patients. Overall recurrence rate was 27% with a survival of 100% at time of follow-up. No statistical correlation between recurrence rate, age at diagnosis, localization, resection margins, and pathological and immunohistochemical characteristics could be established.
CONCLUSION: In our study, locoregional tumor recurrence did not seem to correlate with resection margins, so a conservative surgical approach may need to be considered to avoid functional and aesthetic sequelae.

PMID: 29275074 [PubMed - as supplied by publisher]



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Comparison of Video Head Impulse Test and Caloric Reflex Test in advanced unilateral definite Menière's disease.

Comparison of Video Head Impulse Test and Caloric Reflex Test in advanced unilateral definite Menière's disease.

Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Dec 20;:

Authors: Rubin F, Simon F, Verillaud B, Herman P, Kania R, Hautefort C

Abstract
AIMS: There have been very few studies of the Video Head Impulse Test (VHIT) in patients with Menière's Disease (MD). Some reported 100% normal VHIT results, others not. These discrepancies may be due to differences in severity. The present study compared VHIT and caloric reflex test results in advanced unilateral definite MD.
MATERIAL AND METHOD: A prospective study included 37 consecutive patients, with a mean age of 56±12 years. Mean hearing loss was 59±18dB HL; 12 patients were subject to Tumarkin's otolithic crises. Abnormal caloric reflex was defined as ≥20% deficit, and abnormal VHIT as presence of saccades or <0.64 gain in vertical semicircular canals and <0.78 in horizontal canals.
RESULTS: All patients had normal VHIT results, and 3 had normal caloric reflex; mean caloric reflex deficit was 45%.
CONCLUSION: The present study is the only one to use the August 2015 updated definition of MD. The results showed that, outside of episodes of crisis, VHIT was normal during advanced unilateral definite MD, in contrast to abnormal caloric reflex. This feature could help distinguish MD from other inner ear diseases, and it would be interesting to try to confirm this hypothesis by studying MD patients.

PMID: 29274769 [PubMed - as supplied by publisher]



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[Forensic Analysis of 63 Cases of Non-violent Death Occurred in Custody].

[Forensic Analysis of 63 Cases of Non-violent Death Occurred in Custody].

Fa Yi Xue Za Zhi. 2017 Oct;33(5):509-513

Authors: Yang SM, Cheng YB

Abstract
OBJECTIVES: To collect cases of non-violent death occurred in custody for analyzing the forensic characteristics and related influencing factors.
METHODS: Sixty-three cases of non-violent death among detainees in custody that handled by a forensic science center from 2000 to 2015 were collected. The type, onset season, medical history, clinical manifestation, treatment and duration of related fatal diseases were analyzed retrospectively.
RESULTS: The deaths due to diseases in custody were common in male, and with a high incidence in middle aged adults. The most common cause of death was cardiac death (50.8%). Chronic inflammatory diseases such as gastrointestinal perforation, pulmonary tuberculosis, pneumonia, hepatitis and pancreatitis, were common. There was a peak incidence in summer. The acute symptoms included sudden onset during sleep and sudden apsychia, and emesis, abdominal pain, fatigue, chest tightness, shortness of breath, fever and anorexia were the most common chronic symptoms.
CONCLUSIONS: The management system, custody condition, medical level and rescue rudiment of custody still need improvements. It should be pay more attention to collecting the information of medical history, autopsy, histological examination and toxicological analysis, etc.

PMID: 29275557 [PubMed - in process]



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