Role of 18 F-FDG PET/CT in Renal Cyst Infection

Abstract

Purpose of Review

Cyst infection (CI) is a severe complication of cystic renal disorders, notably in autosomal-dominant polycystic kidney disease (ADPKD), and constitutes a diagnostic challenge because of the lack of specific clinical manifestations and limitations of conventional imaging methods. The role of ¹⁸fluorodeoxyglucose positron-emission computed tomography combined with computed tomography (¹⁸F-FDG PET/CT) in renal CI is reviewed.

Recent Findings

Recent reports suggest that ¹⁸F-FDG PET/CT is the best tool for CI detection. This technique has been demonstrated to play a role not only in the identification of CI, but also in the guidance of invasive procedures, in the detection of other infectious or even incidental neoplastic foci, and in monitoring therapy response.

Summary

This article aims to review the role of ¹⁸F-FDG PET/CT in renal CI, particularly in the context of ADPKD, compare this technique with conventional radiological and nuclear medicine methods, and discuss future perspectives in the approach to such a diagnostic challenge.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2DNUtte

Dosimetric parameters predicting contralateral liver hypertrophy after unilobar radioembolization of hepatocellular carcinoma

Abstract

Purpose

This study aimed at identifying prior therapy dosimetric parameters using ^99mTc-labeled macro-aggregates of albumin (MAA) that are associated with contralateral hepatic hypertrophy occurring after unilobar radioembolization of hepatocellular carcinoma (HCC) performed with ⁹⁰Y–loaded glass microspheres.

Methods

The dosimetry data of 73 HCC patients were collected prior to the treatment with ⁹⁰Y–loaded microspheres for unilateral disease. The injected liver dose (ILD), the tumor dose (TD) and healthy injected liver dose (HILD) were calculated based on MAA quantification. Following treatment, the maximal hypertrophy (MHT) of an untreated lobe was calculated.

Results

Mean MHT was 35.4 ± 40.4%. When using continuous variables, the MHT was not correlated with any tested variable, i.e., injected activity, ILD, HILD or TD except with a percentage of future remnant liver (FRL) following the ⁹⁰Y–microspheres injection  (r = −0.56). MHT ≥ 10% was significantly more frequent for patients with HILD ≥ 88 Gy, (52% of the cases), i.e., in 92.2% versus 65.7% for HILD < 88 Gy (p = 0.032). MHT ≥ 10% was also significantly more frequent for patients with a TD ≥ 205 Gy and a tumor volume (VT) ≥ 100 cm³ in patients with initial FRL < 50%. MHT ≥10% was seen in 83.9% for patients with either an HILD ≥ 88 Gy or a TD ≥ 205 Gy for tumors larger than 100cm³ (85% of the cases), versus only 54.5% (p = 0.0265) for patients with none of those parameters. MHT ≥10% was also associated with FRL and the Child-Pugh score. Using multivariate analysis, the Child-Pugh score (p < 0.0001), FRL (p = 0.0023) and HILD (p = 0.0029) were still significantly associated with MHT ≥10%.

Conclusion

This study demonstrates for the first time that HILD is significantly associated with liver hypertrophy. There is also an impact of high tumor doses in large lesions in one subgroup of patients. Larger prospective studies evaluating the MAA dosimetric parameters have to be conducted to confirm these promising results.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rIGkrz

Reply to ‘Single high dose versus repeated bone-targeted radionuclide therapy’

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2GkYPWd

Incidental identification of osteoid osteoma by 68 Ga-PSMA PET/CT

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rQM2Ib

18 F–fluorodeoxyglucose uptake of hepatocellular carcinoma as a prognostic predictor in patients with sorafenib treatment

Abstract

Purpose

Sorafenib, an oral multikinase inhibitor, is a recommended treatment option available for patients with Barcelona Clinic Liver Cancer (BCLC)-C stage hepatocellular carcinoma (HCC). This study aimed to evaluate the performance of ¹⁸F–fluorodeoxyglucose positron emission tomography (¹⁸F–FDG PET) for predicting tumour progression during sorafenib treatment.

Methods

We formed a retrospective cohort comprising patients treated with sorafenib for at least 30 days and undergoing ¹⁸F–FDG PET/CT within 1 month before treatment. For statistical analyses, the tumour-to-liver standardised uptake value (SUV) ratio (TLR) of the most hypermetabolic lesion was measured.

Results

Among a total of 35 patients, two obtained partial remission, and 11 showed stable disease after the first response evaluation. Patients with a TLR ≥ 2.9 (n = 17) had a median overall survival (OS) of 3.7 months after sorafenib treatment, whereas patients with a TLR < 2.9 (n = 18) had median OS of 12.2 months (P < 0.001), although the disease control rate was not significantly different between the two groups. Pretreatment TLR ≥ 2.9 (hazard ratio [HR] = 6.318, P = 0.002) and Child-Pugh class B (HR = 4.316, P = 0.044) were poor prognostic factors for OS, and a TLR ≥ 2.9 (HR = 2.911, P = 0.024) was the only poor prognostic factor for progression-free survival in a multivariate analysis.

Conclusion

Pretreatment tumour metabolic activity assessed by ¹⁸F–FDG PET is an independent prognostic factor for survival in patients with BCLC-C stage HCC receiving sorafenib monotherapy, although it may not predict tumour response to the treatment.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rKuBJc

Is the whole larger than the sum of the parts? Integrated PET/MRI as a tool for response prediction

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2GpNfJI

177 Lu-PSMA-617 radioligand therapy in mCRPC: ready for phase III trial?

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rKeuLB

FDG PET/CT radiomics for predicting the outcome of locally advanced rectal cancer

Abstract

Purpose

The aim of this study was to investigate the prognostic value of baseline ¹⁸F-FDG PET/CT textural analysis in locally-advanced rectal cancer (LARC).

Methods

Eighty-six patients with LARC underwent ¹⁸F-FDG PET/CT before treatment. Maximum and mean standard uptake values (SUVmax and SUVmean), metabolic tumoral volume (MTV), total lesion glycolysis (TLG), histogram-intensity features, as well as 11 local and regional textural features, were evaluated. The relationships of clinical, pathological and PET-derived metabolic parameters with disease-specific survival (DSS), disease-free survival (DFS) and overall survival (OS) were assessed by Cox regression analysis. Logistic regression was used to predict the pathological response by the Dworak tumor regression grade (TRG) in the 66 patients treated with neoadjuvant chemoradiotherapy (nCRT).

Results

The median follow-up of patients was 41 months. Seventeen patients (19.7%) had recurrent disease and 18 (20.9 %) died, either due to cancer progression (n = 10) or from another cause while in complete remission (n = 8). DSS was 95% at 1 year, 93% at 2 years and 87% at 4 years. Weight loss, surgery and the texture parameter coarseness were significantly associated with DSS in multivariate analyses. DFS was 94 % at 1 year, 86 % at 2 years and 79 % at 4 years. From a multivariate standpoint, tumoral differentiation and the texture parameters homogeneity and coarseness were significantly associated with DFS. OS was 93% at 1 year, 87% at 2 years and 79% after 4 years. cT, surgery, SUVmean, dissimilarity and contrast from the neighborhood intensity-difference matrix (contrast_NGTDM) were significantly and independently associated with OS. Finally, RAS-mutational status (KRAS and NRAS mutations) and TLG were significant predictors of pathological response to nCRT (TRG 3-4).

Conclusion

Textural analysis of baseline ¹⁸F-FDG PET/CT provides strong independent predictors of survival in patients with LARC, with better predictive power than intensity- and volume-based parameters. The utility of such features, especially coarseness, should be confirmed by larger clinical studies before considering their potential integration into decisional algorithms aimed at personalized medicine.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2GpBQt2

Head to head comparison of [ 18 F] AV-1451 and [ 18 F] THK5351 for tau imaging in Alzheimer’s disease and frontotemporal dementia

Abstract

Purpose

Tau accumulation is a core pathologic change in various neurodegenerative diseases including Alzheimer's disease and frontotemporal lobar degeneration-tau. Recently, tau positron emission tomography tracers such as [¹⁸F] AV-1451 and [¹⁸F] THK5351 have been developed to detect tau deposition in vivo. In the present study, we performed a head to head comparison of these two tracers in Alzheimer's disease and frontotemporal dementia cases and aimed to investigate which tracers are better suited to image tau in these disorders.

Methods

A cross-sectional study was conducted using a hospital-based sample at a tertiary referral center. We recruited eight participants (two Alzheimer's disease, four frontotemporal dementia and two normal controls) who underwent magnetic resonance image, amyloid positron emission tomography with [¹⁸F]-Florbetaben and tau positron emission tomography with both THK5351 and AV-1451. To measure regional AV1451 and THK5351 uptakes, we used the standardized uptake value ratios by dividing mean activity in target volume of interest by mean activity in the cerebellar hemispheric gray matter.

Results

Although THK5351 and AV-1451 uptakes were highly correlated, cortical uptake of AV-1451 was more striking in Alzheimer's disease, while cortical uptake of THK5351 was more prominent in frontotemporal dementia. THK5351 showed higher off-target binding than AV-1451 in the white matter, midbrain, thalamus, and basal ganglia.

Conclusions

AV-1451 is more sensitive and specific to Alzheimer's disease type tau and shows lower off-target binding, while THK5351 may mirror non-specific neurodegeneration.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rGoIwq

Striking lack of visualization of striatum on 18 F-FDG brain PET in chorea-acanthocytosis

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2GnpNwq

Absolute number of new lesions on 18 F-FDG PET/CT is more predictive of clinical response than SUV changes in metastatic melanoma patients receiving ipilimumab

Abstract

Purpose

Evaluation of response to immunotherapy is a matter of debate. The aim of the present study was to evaluate the response of metastatic melanoma to treatment with ipilimumab by means of ¹⁸F-FDG PET/CT, using the patients' clinical response as reference.

Methods

The final cohort included in the analyses consisted of 41 patients with metastatic melanoma who underwent ¹⁸F-FDG PET/CT before and after administration of ipilimumab. After determination of the best clinical response, the PET/CT scans were reviewed and a separate independent analysis was performed, based on the number and functional size of newly emerged ¹⁸F-FDG-avid lesions, as well as on the SUV changes after therapy.

Results

The median observation time of the patients after therapy was 21.4 months (range 6.3–41.9 months). Based on their clinical response, patients were dichotomized into those with clinical benefit (CB) and those without CB (No-CB). The CB group (31 patients) included those with stable disease, partial remission and complete remission, and the No-CB group (10 patients) included those with progressive disease. The application of a threshold of four newly emerged ¹⁸F-FDG-avid lesions on the posttherapy PET/CT scan led to a sensitivity (correctly predicting CB) of 84% and a specificity (correctly predicting No-CB) of 100%. This cut-off was lower for lesions with larger functional diameters (three new lesions larger than 1.0 cm and two new lesions larger than 1.5 cm). SUV changes after therapy did not correlate with clinical response. Based on these findings, we developed criteria for predicting clinical response to immunotherapy by means of ¹⁸F-FDG PET/CT (PET Response Evaluation Criteria for Immunotherapy, PERCIMT).

Conclusion

Our results show that a cut-off of four newly emerged ¹⁸F-FDG-avid lesions on posttherapy PET/CT gives a reliable indication of treatment failure in patients under ipilimumab treatment. Moreover, the functional size of the new lesions plays an important role in predicting the clinical response. Validation of these results in larger cohorts of patients is warranted.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2Gr0qKm

Visualization of multiple organ amyloid involvement in systemic amyloidosis using 11 C-PiB PET imaging

Abstract

Purpose

To investigate the utility of Pittsburgh compound B (PiB) positron emission tomography (PET) imaging for evaluating whole-body amyloid involvement in patients with systemic amyloidosis.

Methods

Whole-body ¹¹C-PiB PET was performed in seven patients with systemic immunoglobulin light-chain (AL) amyloidosis, seven patients with hereditary transthyretin (ATTRm) amyloidosis, one asymptomatic TTR mutation carrier and three healthy controls. The correlations between clinical organ involvement, radiological ¹¹C-PiB uptake and histopathological findings were analysed for each organ.

Results

Organ involvement on ¹¹C-PiB PET imaging showed good correlations with the clinical findings for the heart and stomach. Abnormal tracer uptake was also observed in the spleen, lachrymal gland, submandibular gland, sublingual gland, lymph node, brain, scalp, extraocular muscles, nasal mucosa, pharynx, tongue and nuchal muscles, most of which were asymptomatic. Physiological tracer uptake was universally observed in the urinary tract (kidney, renal pelvis, ureter and bladder) and enterohepatic circulatory system (liver, gallbladder, bile duct and small intestine) in all participants. Most of the patients and one healthy control subject showed asymptomatic tracer uptake in the lung and parotid gland. The peripheral nervous system did not show any tracer uptake even in patients with apparent peripheral neuropathy. Histological amyloid deposition was confirmed in biopsied myocardium and gastric mucosa where abnormal ¹¹C-PiB retention was observed.

Conclusions

¹¹C-PiB PET imaging can be used clinically in the systemic evaluation of amyloid distribution in patients with AL and ATTRm amyloidosis. Quantitative analysis of ¹¹C-PiB PET images may be useful in therapy evaluation and will reveal whether amyloid clearance is correlated with clinical response.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rLgPWH

Third-line treatment and 177 Lu-PSMA radioligand therapy of metastatic castration-resistant prostate cancer: a systematic review

Abstract

Aims

There is a controversy as to the relative efficacy of ¹⁷⁷Lu prostate specific membrane antigen (PSMA) radioligand therapy (RLT) and third-line treatment for patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of our systematic review was to elucidate whether ¹⁷⁷Lu-PSMA RLT and third-line treatment have similar effects and adverse effects (PROSPERO ID CRD42017067743).

Methods

The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Searches in Pubmed and Embase selected articles up to September 2017. A search in ClinicalTrials.gov indicated ongoing studies. The meta-analysis used the random-effects model.

Results

Twelve studies including 669 patients reported ¹⁷⁷Lu-PSMA RLT. Overall, 43% of the patients had a maximum decline of PSA of ≥50% following treatment with ¹⁷⁷Lu-PSMA RLT. The treatment with ¹⁷⁷Lu-PSMA-617 and ¹⁷⁷Lu-PSMA for imaging and therapy (I&T) had mainly transient adverse effects. Sixteen studies including 1338 patients reported third-line treatment. Overall, 21% of the patients had a best decline of PSA of ≥50% following third-line treatment. After third-line treatment with enzalutamide and cabazitaxel, adverse effects caused discontinuation of treatment for 10% to 23% of the patients. ¹⁷⁷Lu-PSMA RLT gave a best PSA decline ≥50% more often than third-line treatment (mean 44% versus 22%, p = 0.0002, t test). ¹⁷⁷Lu-PSMA RLT gave objective remission more often than third-line treatment (overall 31 of 109 patients versus 43 of 275 patients, p = 0.004, χ² test). Median survival was longer after ¹⁷⁷Lu-PSMA RLT than after third-line treatment, but the difference was not statistically significant (mean 14 months versus 12 months, p = 0.32, t test). Adverse effects caused discontinuation of treatment more often for third-line treatment than for ¹⁷⁷Lu-PSMA RLT (22 of 66 patients versus 0 of 469 patients, p < 0.001, χ² test).

Conclusions

As for patients with mCRPC, treatment with ¹⁷⁷Lu-PSMA-617 RTL and ¹⁷⁷Lu-PSMA I&T gave better effects and caused fewer adverse effects than third-line treatment.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2DLvk2b

Founder of EJNM passed away

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2GoYLVq

EANM/EARL FDG-PET/CT accreditation - summary results from the first 200 accredited imaging systems

Abstract

Purpose

From 2010 until July 2016, the EANM Research Ltd. (EARL) FDG-PET/CT accreditation program has collected over 2500 phantom datasets from approximately 200 systems and 150 imaging sites worldwide. The objective of this study is to report the findings and impact of the accreditation program on the participating PET/CT systems.

Methods

To obtain and maintain EARL accredited status, sites were required to complete and submit two phantom scans - calibration quality control (CalQC), using a uniform cylindrical phantom and image quality control (IQQC), using a NEMA NU2–2007 body phantom. Average volumetric SUV bias and SUV recovery coefficients (RC) were calculated and the data evaluated on the basis of quality control (QC) type, approval status, PET/CT system manufacturer and submission order.

Results

SUV bias in 5% (n = 96) of all CalQC submissions (n = 1816) exceeded 10%. After corrective actions following EARL feedback, sites achieved 100% compliance within EARL specifications. 30% (n = 1381) of SUVmean and 23% (n = 1095) of SUVmax sphere recoveries from IQQC submissions failed to meet EARL accreditation criteria while after accreditation, failure rate decreased to 12% (n = 360) and 9% (n = 254), respectively. Most systems demonstrated longitudinal SUV bias reproducibility within ±5%, while RC values remained stable and generally within ±10% for the four largest and ±20% for the two smallest spheres.

Conclusions

Regardless of manufacturer or model, all investigated systems are able to comply with the EARL specifications. Within the EARL accreditation program, gross PET/CT calibration errors are successfully identified and longitudinal variability in PET/CT performances reduced. The program demonstrates that a harmonising accreditation procedure is feasible and achievable.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2rFVjCs

Prospective evaluation of 18 F-FACBC PET/CT and PET/MRI versus multiparametric MRI in intermediate- to high-risk prostate cancer patients (FLUCIPRO trial)

Abstract

Purpose

The purpose of this study was to evaluate ¹⁸F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa).

Methods

Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq ¹⁸F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUV_max) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (V_T). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455.

Results

In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p < 0.01) outperformed that of PET/CT while no differences were detected between PET/MRI and mpMRI. SUV_max and V_T of Gleason score (GS) >3 + 4 tumors were significantly (p < 0.05) higher than those for GS 3 + 3 and benign hyperplasia. A total of 442 lymph nodes were evaluable for staging, and PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes.

Conclusions

Quantitative ¹⁸F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. ¹⁸F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI.

from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2GoyUNF

Cycle for your supper on a gyro-spiraliser

Struggling to stay on top of your New Year's resolutions? Shred veg with this pedal-powered contraption

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2njaBsp
via IFTTT

Dry Eye Post-Laser-Assisted In Situ Keratomileusis: Major Review and Latest Updates

Dry eye is one of the most common complications occurring after laser-assisted in situ keratomileusis (LASIK), with virtually all patients experiencing some degree of postoperative dry eye symptoms. Enhanced understanding of the pathophysiology and mechanism of dry eye development in addition to preoperative screening of patients who are prone to dry eye is essential for better patient satisfaction and for improving short-term visual outcome postoperatively. This article reviews the latest studies published on LASIK-associated dry eye, including epidemiology, pathophysiology, risk factors, preoperative assessment, and management.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2GplQYd
via IFTTT

Accuracy of Patient Opioid Use Reporting at the Time of Medical Cannabis License Renewal

The decision to authorize a patient for continued enrollment in a state-sanctioned medical cannabis program is difficult in part due to the uncertainty in the accuracy of patient symptom reporting and health functioning including any possible effects on other medication use. We conducted a pragmatic convenience study comparing patient reporting of previous and current prescription opioid usage to the opioid prescription records in the Prescription Monitoring Program (PMP) among 131 chronic pain patients (mean age = 54; 54% male) seeking the first annual renewal of their New Mexico Medical Cannabis Program (NMMCP) license. Seventy-six percent of the patients reported using prescription opioids prior to enrollment in the NMMCP, however, the PMP records showed that only 49% of the patients were actually prescribed opioids in the six months prior to enrollment. Of the 64 patients with verifiable opioid prescriptions prior to NMMCP enrollment, 35 (55%) patients reported having eliminated the use of prescription opioids by the time of license renewal. PMP records showed that 26 patients (63% of patients claiming to have eliminated the use of opioid prescriptions and 41% of all patients with verifiable preenrollment opioid use) showed no prescription opioid activity at their first annual NMMCP renewal visit.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rJtGbZ
via IFTTT

Air-Cured Fiber-Cement Composite Mixtures with Different Types of Cellulose Fibers

This present study was carried out to check the feasibility of different cellulose fibers obtained from cropped virgin cellulose, blenched eucalyptus, and araucaria pulps through different new environmentally friendly curing processes for fiber-cement production. The aim is to introduce the different sources of cellulose fibers with lower cost to produce the “fiber-cement without autoclave” (FCWA). The slurries used in the experiments contain approximately 8% wt. of cellulose. The influence of the waste marble powder addition to the cement mixture was also studied. The physical and mechanical properties of the products which were prepared with this method under different curing conditions were investigated. The mechanical properties of eucalyptus cellulose appear to offer the best combination, especially after longer air-cure cycles. The results showed that the production of FCWA is very economical by using waste marble powders. And moreover, two new types of cellulose fibers (eucalyptus and araucaria celluloses; EuC and ArC, resp.), which provide a better density and packing in the fiber-cement leading to better modulus of rupture (MOR) and modulus of elasticity (MOE) values as virgin cellulose (ViC), are very usable for production of the fiber-cement in industrial scale.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DIiUZ8
via IFTTT

PM2.5 Induced the Expression of Fibrogenic Mediators via HMGB1-RAGE Signaling in Human Airway Epithelial Cells

Background. The aim of the present study was to test whether fine particulate matter (PM2.5) induces the expression of platelet-derived growth factor-AB (PDGF-AB), PDGF-BB, and transforming growth factor-β1 (TGF-β1) in human bronchial epithelial cells (HBECs) in vitro via high-mobility group box 1 (HMGB1) receptor for advanced glycation end products (RAGE) signaling. Methods. Sprague-Dawley rats were exposed to motor vehicle exhaust (MVE) or clean air. HBECs were either transfected with a small interfering RNA (siRNA) targeting HMGB1 or incubated with anti-RAGE antibodies and subsequently stimulated with PM2.5. Results. The expression of HMGB1 and RAGE was elevated in MVE-treated rats compared with untreated rats, and PM2.5 increased the secretion of HMGB1 and upregulated RAGE expression and the translocation of nuclear factor κB (NF-κB) into the nucleus of HBECs. This activation was accompanied by an increase in the expression of PDGF-AB, PDGF-BB, and TGF-β1. The HMGB1 siRNA prevented these effects. Anti-RAGE antibodies attenuated the activation of NF-κB and decreased the secretion of TGF-β1, PDGF-AB, and PDGF-BB from HBECs. Conclusion. PM2.5 induces the expression of TGF-β1, PDGF-AB, and PDGF-BB in vitro via HMGB1-RAGE signaling, suggesting that this pathway may contribute to the airway remodeling observed in patients with COPD.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2niIB7m
via IFTTT

Powerful or powerless: The backdoor to our cyberfuture

In a highly networked, increasingly insecure cyberworld, our smartphones make us both powerful and powerless as never before, argue two new books

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2BxMryK
via IFTTT

Cycle for your supper on a gyro-spiraliser

Struggling to stay on top of your New Year's resolutions? Shred veg with this pedal-powered contraption

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2njaBsp
via IFTTT

"Otolaryngol Head Neck Surg"[jour]; +24 new citations

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

"Otolaryngol Head Neck Surg"[jour]

These pubmed results were generated on 2018/01/28

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

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2Fp6bGR
via IFTTT

Comparison of Mask Oxygen Therapy and High-Flow Oxygen Therapy after Cardiopulmonary Bypass in Obese Patients

Background. To clarify the efficiency of mask O2 and high-flow O2 (HFO) treatments following cardiopulmonary bypass (CPB) in obese patients. Methods. During follow-up, oxygenization parameters including arterial pressure of oxygen (PaO2), peripheral oxygen saturation (SpO2), and arterial partial pressure of carbon dioxide (PaCO2) and physical examination parameters including respiratory rate, heart rate, and arterial pressure were recorded respectively. Presence of atelectasia and dyspnea was noted. Also, comfort scores of patients were evaluated. Results. Mean duration of hospital stay was 6.9 ± 1.1 days in the mask O2 group, whereas the duration was significantly shorter (6.5 ± 0.7 days) in the HFO group (). The PaO2 values and SpO2 values were significantly higher, and PaCO2 values were significantly lower in patients who received HFO after 4th, 12th, 24th, 36th, and 48th hours. In postoperative course, HFO leads patients to achieve better postoperative FVC (). Also, dyspnea scores and comfort scores were significantly better in patients who received HFO in both postoperative day 1 and day 2 (, resp.). Conclusion. Our study demonstrated that HFO following CPB in obese patients improved postoperative PaO2, SpO2, and PaCO2 values and decreased the atelectasis score, reintubation, and mortality rates when compared with mask O2.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2GoVZiX
via IFTTT

Recurrent Syncope, a Clue in Amyloid Cardiomyopathy

Infiltrative cardiomyopathies include a variety of disorders that lead to myocardial thickening resulting in a constellation of clinical manifestations and eventually heart failure that could be the first clue to reach the diagnosis. Among the more described infiltrative diseases of the heart is amyloid cardiomyopathy. The disease usually presents with subtle, nonspecific symptoms. Herein, we illustrate a case of recurrent syncope as the initial presenting symptom for systemic amyloid with polyneuropathy and cardiomyopathy as a cause of syncope. The article illustrates the role of advanced cardiac imaging in the diagnosis of the disease with a focused literature review. We also highlight the role of early, shared decision-making between patient, family, and medical team in the management of cardiac amyloidosis.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rJUsRz
via IFTTT

A Type-Based Blocking Technique for Efficient Entity Resolution over Large-Scale Data

In data integration, entity resolution is an important technique to improve data quality. Existing researches typically assume that the target dataset only contain string-type data and use single similarity metric. For larger high-dimensional dataset, redundant information needs to be verified using traditional blocking or windowing techniques. In this work, we propose a novel ER-resolving method using a hybrid approach, including type-based multiblocks, varying window size, and more flexible similarity metrics. In our new ER workflow, we reduce the searching space for entity pairs by the constraint of redundant attributes and matching likelihood. We develop a reference implementation of our proposed approach and validate its performance using real-life dataset from one Internet of Things project. We evaluate the data processing system using five standard metrics including effectiveness, efficiency, accuracy, recall, and precision. Experimental results indicate that the proposed approach could be a promising alternative for entity resolution and could be feasibly applied in real-world data cleaning for large datasets.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2Gq3pCS
via IFTTT

Efficacy of Dexmedetomidine versus Ketofol for Sedation of Postoperative Mechanically Ventilated Patients with Obstructive Sleep Apnea

Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex: received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2–0.7 mcg/kg/hr; Group KFL: received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5–10 mcg/kg/min. Sedation level (Ramsay sedation score), bispectral index (BIS), duration of mechanical ventilation, surgical intensive care unit (SICU) stay, and mean time to extubation were evaluated. Complications (hypotension, hypertension, bradycardia, postextubation apnea, respiratory depression, and desaturation) and number of patients requiring reintubation were recorded. There was a statistically significant difference between the two groups in BIS at the third hour only (Group DEX 63.00 ± 3.542 and Group KFL 66.42 ± 4.010, value = 0.036). Duration of mechanical ventilation, SICU stay, and extubation time showed no statistically significant differences. No complications were recorded in both groups. Thus, dexmedetomidine was associated with lesser duration of mechanical ventilation and time to extubation than ketofol, but these differences were not statistically significant.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rJ7jU3
via IFTTT

Existence of Global Solutions for Nonlinear Magnetohydrodynamics with Finite Larmor Radius Corrections

We discuss the existence of global solutions to the magnetohydrodynamics (MHD) equations, where the effects of finite Larmor radius corrections are taken into account. Unlike the usual MHD, the pressure is a tensor and it depends on not only the density but also the magnetic field. We show the existence of global solutions by the energy methods. Our techniques of proof are based on the existence of local solution by semigroups theory and a priori estimate.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2GqNtAf
via IFTTT

IJERPH, Vol. 15, Pages 220: Aedes Mosquitoes and Aedes-Borne Arboviruses in Africa: Current and Future Threats

IJERPH, Vol. 15, Pages 220: Aedes Mosquitoes and Aedes-Borne Arboviruses in Africa: Current and Future Threats

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15020220

Authors: David Weetman Basile Kamgang Athanase Badolo Catherine Moyes Freya Shearer Mamadou Coulibaly João Pinto Louis Lambrechts Philip McCall

The Zika crisis drew attention to the long-overlooked problem of arboviruses transmitted by Aedes mosquitoes in Africa. Yellow fever, dengue, chikungunya and Zika are poorly controlled in Africa and often go unrecognized. However, to combat these diseases, both in Africa and worldwide, it is crucial that this situation changes. Here, we review available data on the distribution of each disease in Africa, their Aedes vectors, transmission potential, and challenges and opportunities for Aedes control. Data on disease and vector ranges are sparse, and consequently maps of risk are uncertain. Issues such as genetic and ecological diversity, and opportunities for integration with malaria control, are primarily African; others such as ever-increasing urbanization, insecticide resistance and lack of evidence for most control-interventions reflect problems throughout the tropics. We identify key knowledge gaps and future research areas, and in particular, highlight the need to improve knowledge of the distributions of disease and major vectors, insecticide resistance, and to develop specific plans and capacity for arboviral disease surveillance, prevention and outbreak responses.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DEWZxS
via IFTTT

Printable Materials for the Realization of High Performance RF Components: Challenges and Opportunities

Printing methods such as additive manufacturing (AM) and direct writing (DW) for radio frequency (RF) components including antennas, filters, transmission lines, and interconnects have recently garnered much attention due to the ease of use, efficiency, and low-cost benefits of the AM/DW tools readily available. The quality and performance of these printed components often do not align with their simulated counterparts due to losses associated with the base materials, surface roughness, and print resolution. These drawbacks preclude the community from realizing printed low loss RF components comparable to those fabricated with traditional subtractive manufacturing techniques. This review discusses the challenges facing low loss RF components, which has mostly been material limited by the robustness of the metal and the availability of AM-compatible dielectrics. We summarize the effective printing methods, review ink formulation, and the postprint processing steps necessary for targeted RF properties. We then detail the structure-property relationships critical to obtaining enhanced conductivities necessary for printed RF passive components. Finally, we give examples of demonstrations for various types of printed RF components and provide an outlook on future areas of research that will require multidisciplinary teams from chemists to RF system designers to fully realize the potential for printed RF components.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2nkqLSj
via IFTTT

Inflammatory Stimuli Significantly Change the miRNA Profile of Human Adipose-Derived Stem Cells

Background. Human adipose-derived stem cells (hASCs) have been shown to have immunoregulatory properties in many studies. However, the mechanisms remain unknown. miRNAs are associated with many cellular processes, including immune responses. Thus, we hypothesized that miRNAs act as immunoregulators when hASCs are stimulated by inflammatory environments. Methods. A set of cytokines was used to stimulate the hASCs in the cytokine group, while no cytokines were used to stimulate the cells in the normal group. A microarray was used to obtain the miRNA expression profile of hASCs, and RT-PCR was used to validate the miRNAs that were differentially expressed between the two groups. Target genes were predicted using online databases, and KEGG analysis was performed to identify the pathways enriched by the target genes of all the differentially expressed miRNAs. Results. Five miRNAs were significantly upregulated, and 2 miRNAs were downregulated in the cytokine group compared with the normal group. We identified several immune-related pathways that are targeted individually or collectively by those miRNAs. Conclusion. Inflammatory stimuli changed the miRNA expression profile of hASCs. miRNAs may play a pivotal role in the immune response in hASCs and may be targets through which the immunoregulatory functions of hASCs can be enhanced.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2BzdZDJ
via IFTTT

A Clustering -Anonymity Privacy-Preserving Method for Wearable IoT Devices

Wearable technology is one of the greatest applications of the Internet of Things. The popularity of wearable devices has led to a massive scale of personal (user-specific) data. Generally, data holders (manufacturers) of wearable devices are willing to share these data with others to get benefits. However, significant privacy concerns would arise when sharing the data with the third party in an improper manner. In this paper, we first propose a specific threat model about the data sharing process of wearable devices’ data. Then we propose a -anonymity method based on clustering to preserve privacy of wearable IoT devices’ data and guarantee the usability of the collected data. Experiment results demonstrate the effectiveness of the proposed method.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2neuiBF
via IFTTT

Modeling and Kinematics Simulation of a Mecanum Wheel Platform in RecurDyn

The innovative method of modeling and kinematics simulation in RecurDyn are proposed, taking a Mecanum wheel platform(MWP) for omnidirectional wheelchair as research object. In order to study the motion characteristics and mobile performance of the MWP, the virtual prototype simulation model is established in SolidWorks, and virtual prototype simulation is carried out in RecurDyn. The experience of simulation for the MWP in RecurDyn is introduced, and the simulation steps and points for attention are described detailedly. The working states of the mobile system in real environment have been simulated through virtual simulation experiments. Four typical motion models including moving forward, moving laterally, moving laterally in the direction of 45°, and rotation have been simulated in RecurDyn. The simulation results exactly reflect the motion of the MWP. By comparing the simulation results with the theoretical results, there are acceptable errors that are relatively less overall in the simulation results. The simulation results can be used to predict the performance of the platform and evaluate the design rationality, and design quality can be improved according to the exposed problem. This paper can provide reference for the simulation of mobile platform by using RecurDyn.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2BzUiLT
via IFTTT

3D Simulation of Self-Compacting Concrete Flow Based on MRT-LBM

A three-dimensional multiple-relaxation-time lattice Boltzmann method (MRT-LBM) with a D3Q27 discrete velocity model is applied for simulation of self-compacting concrete (SCC) flows. In the present study, the SCC is assumed as a non-Newtonian fluid, and a modified Herschel–Bulkley model is used as constitutive mode. The mass tracking algorithm was used for modeling the liquid-gas interface. Two numerical examples of the slump test and enhanced L-box test were performed, and the calculated results are compared with available experiments in literatures. The numerical results demonstrate the capability of the proposed MRT-LBM in modeling of self-compacting concrete flows.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2nhtJXD
via IFTTT

Feedforward Harmonic Mitigation Strategy for Single-Phase Voltage Source Converter

With the development of distributed generations (DGs), single-phase voltage source converter (SPVSC) has been widely used, but it brings about the problem of harmonic pollution to power grid. Hence, it is significant to explore the mechanism of harmonic injection from SPVSC and propose effective control strategies to mitigate the harmonic pollution. In this paper, a harmonic analysis model of SPVSC based on dynamic phasor (DP) has been established. With the model, the harmonics interaction between the ac side and the dc side can be analyzed with the consideration of the control strategies, which reveals the generation mechanism of the harmonics in SPVSC. Based on the mechanism, a feedforward harmonic mitigation strategy has been presented. The principle of the strategy is to add low-order harmonic signal to the PWM modulation signals to reduce the harmonic current on the ac side. The harmonic mitigation strategy not only has clear physical meaning and fast calculation, but also is robust for the uncertainty of parameters. Finally, the simulation and experiment results demonstrate the correctness of the model and the effectiveness of the harmonic mitigation strategy.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2ByiPBh
via IFTTT

Primary Effusion Lymphoma without an Effusion: A Rare Case of Solid Extracavitary Variant of Primary Effusion Lymphoma in an HIV-Positive Patient

Primary effusion lymphoma (PEL) is a unique form of non-Hodgkin lymphoma, usually seen in severely immunocompromised, HIV-positive patients. PEL is related to human herpesvirus-8 (HHV-8) infection, and it usually presents as a lymphomatous body cavity effusion in the absence of a solid tumor mass. There have been very few case reports of HIV-positive patients with HHV-8-positive solid tissue lymphomas not associated with an effusion (a solid variant of PEL). In the absence of effusion, establishing an accurate diagnosis can be challenging, and a careful review of morphology, immunophenotype, and presence of HHV-8 is necessary to differentiate from other subtypes of non-Hodgkin lymphoma. Treatment involves intensive chemotherapy, and prognosis is usually poor. We present a rare case of a PEL variant in an HIV-positive patient who presented with extensive lymphadenopathy without any associated effusions.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2neAUA4
via IFTTT

"Otolaryngol Head Neck Surg"[jour]; +24 new citations

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

"Otolaryngol Head Neck Surg"[jour]

These pubmed results were generated on 2018/01/28

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

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DIhiOW
via IFTTT

Inconsistencies in the drawing and interpretation of smiley faces: an observational study

Pre-prepared smiley face symbols are used widely to gather information on, for example, satisfaction with services or health and well-being. We investigated how women and men of different ages respond when ask...

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2GmprGi
via IFTTT

Prediction of opioid dose in cancer pain patients using genetic profiling: not yet an option with support vector machine learning

Use of opioids for pain management has increased over the past decade; however, inadequate analgesic response is common. Genetic variability may be related to opioid efficacy, but due to the many possible comb...

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rO9sxL
via IFTTT

Implementing measurement based care in community mental health: a description of tailored and standardized methods

Although tailored implementation methods are touted as superior to standardized, few researchers have directly compared the two and little guidance regarding the specific details of each method exist. Our stud...

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2GlPTA5
via IFTTT

Sonographic evaluation of kidney echogenicity and morphology among HIV sero-positive adults at Lagos University Teaching Hospital.

Related Articles

Sonographic evaluation of kidney echogenicity and morphology among HIV sero-positive adults at Lagos University Teaching Hospital.

J Ultrasound. 2018 Jan 05;:

Authors: Eze CU, Eze CU, Adeyomoye A

Abstract
AIM: To evaluate the role of kidney echogenicity and morphology in the diagnosis of human immunodeficiency virus-associated nephropathy (HIVAN).
SUBJECTS AND METHODS: In the cross-sectional study, a sample of 340 anti-retroviral therapy (ART)-naïve AIDS patients underwent laboratory CD4+ count, serum creatinine determination and sonographic renal echogenicity grading and size measurement. Rounded kidneys were described as bulbous while bean-shaped kidneys were described as reniform; echogenicity was categorized into grades 0, 1, 2 and 3. Kidney length, width, thickness and volume were measured in HIVAN and control groups.
RESULTS: Mean age of the population was 42.7 ± 9.4 years; 87.4% had HIVAN. Mean CD4+ count, serum creatinine and GFR for HIVAN patients were 153.1 ± 103.2 cells/mm3, 218.4 ± 147.4 mmol/L and 50.1 ± 23.6 mL/min/1.73 m2 for males and 121.9 ± 91.0 cells/mm3, and 222.0 ± 150.4 mmol/L and 39.3 ± 20.6 mL/min/1.73 m2 for females, respectively; control subjects and non-HIVAN patients had grade 0 renal echogenicity; 56.9% of HIVAN patients had echogenicity grade 3; 5.3% had kidney length < 10 cm; 73.9% had bulbous kidneys; the kidney was significantly wider and thicker in HIVAN (p < 0.05).
CONCLUSION: Sonographic evaluation of renal echogenicity and morphology can reliably predict HIVAN diagnosis. Apathy to screening and late presentation were high while HIV/AIDS remains an important public health problem in the city of Lagos. Unilateral reduction in kidney size could be a major sequela of AIDS while sonographic measurement of absolute kidney length appears inadequate in the evaluation of AIDS patients with nephropathy.

PMID: 29374399 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2Fmvr0u
via IFTTT

Cyclospora cayetanensis infections among diarrheal outpatients in Shanghai: a retrospective case study.

Related Articles

Cyclospora cayetanensis infections among diarrheal outpatients in Shanghai: a retrospective case study.

Front Med. 2018 Jan 26;:

Authors: Jiang Y, Yuan Z, Zang G, Li D, Wang Y, Zhang Y, Liu H, Cao J, Shen Y

Abstract
Cyclospora cayetanensis is a foodborne and waterborne pathogen that causes endemic and epidemic human diarrhea worldwide. A few epidemiological studies regarding C. cayetanensis infections in China have been conducted. During 2013, a total of 291 stool specimens were collected from patients with diarrhea at a hospital in urban Shanghai. C. cayetanensis was not detected in any of the stool specimens by traditional microscopy, whereas five stool specimens (1.72%, 5/291) were positive by PCR. These positive cases confirmed by molecular technology were all in the adult group (mean age 27.8 years; 2.94%, 5/170) with watery diarrhea. Marked infection occurred in the rainy season of May and July. Sequence and phylogenetic analyses of the partial 18S rRNA genes of C. cayetanensis isolated showed intra-species diversity of this parasite. This study showed, for the first time, that C. cayetanensis is a pathogen in outpatients with diarrhea in Shanghai, albeit at a low level. However, the transmission dynamics of this parasite in these patients remain uncertain.

PMID: 29374385 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DUqPSa
via IFTTT

The regulatory network analysis of long noncoding RNAs in human colorectal cancer.

Related Articles

The regulatory network analysis of long noncoding RNAs in human colorectal cancer.

Funct Integr Genomics. 2018 Jan 26;:

Authors: Zhang Y, Tao Y, Li Y, Zhao J, Zhang L, Zhang X, Dong C, Xie Y, Dai X, Zhang X, Liao Q

Abstract
Colorectal cancer (CRC) is among one of the most prevalent and lethiferous diseases worldwide. Long noncoding RNAs (lncRNAs) are commonly accepted to function as a key regulatory factor in human cancer, but the potential regulatory mechanisms of CRC-associated lncRNA are largely obscure. Here, we integrated several expression profiles to obtain 55 differentially expressed (DE) lncRNAs. We first detected lncRNA interactions with transcription factors, microRNAs, mRNAs, and RNA-binding proteins to construct a regulatory network and then create functional enrichment analyses for them using bioinformatics approaches. We found the upregulated genes in the regulatory network are enriched in cell cycle and DNA damage response, while the downregulated genes are enriched in cell differentiation, cellular response, and cell signaling. We then employed module-based methods to mine several intriguing modules from the overall network, which helps to classify the functions of genes more specifically. Next, we confirmed the validity of our network by comparisons with a randomized network using computational method. Finally, we attempted to annotate lncRNA functions based on the regulatory network, which indicated its potential application. Our study of the lncRNA regulatory network provided significant clues to unveil lncRNAs potential regulatory mechanisms in CRC and laid a foundation for further experimental investigation.

PMID: 29374362 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DIadh7
via IFTTT

Identifying Older Adults at Risk of Delirium Following Elective Surgery: A Systematic Review and Meta-Analysis.

Related Articles

Identifying Older Adults at Risk of Delirium Following Elective Surgery: A Systematic Review and Meta-Analysis.

J Gen Intern Med. 2018 Jan 26;:

Authors: Watt J, Tricco AC, Talbot-Hamon C, Pham B, Rios P, Grudniewicz A, Wong C, Sinclair D, Straus SE

Abstract
BACKGROUND: Postoperative delirium is a common preventable complication experienced by older adults undergoing elective surgery. In this systematic review and meta-analysis, we identified prognostic factors associated with the risk of postoperative delirium among older adults undergoing elective surgery.
METHODS: Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and AgeLine were searched for articles published between inception and April 21, 2016. A total of 5692 titles and abstracts were screened in duplicate for possible inclusion. Studies using any method for diagnosing delirium were eligible. Two reviewers independently completed all data extraction and quality assessments using the Cochrane Risk-of-Bias Tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random effects meta-analysis models were used to derive pooled effect estimates.
RESULTS: Forty-one studies (9384 patients) reported delirium-related prognostic factors. Among our included studies, the pooled incidence of postoperative delirium was 18.4% (95% confidence interval [CI] 14.3-23.3%, number needed to follow [NNF] = 6). Geriatric syndromes were important predictors of delirium, namely history of delirium (odds ratio [OR] 6.4, 95% CI 2.2-17.9), frailty (OR 4.1, 95% CI 1.4-11.7), cognitive impairment (OR 2.7, 95% CI 1.9-3.8), impairment in activities of daily living (ADLs; OR 2.1, 95% CI 1.6-2.6), and impairment in instrumental activities of daily living (IADLs; OR 1.9, 95% CI 1.3-2.8). Potentially modifiable prognostic factors such as psychotropic medication use (OR 2.3, 95% CI 1.4-3.6) and smoking status (OR 1.8 95% CI 1.3-2.4) were also identified. Caregiver support was associated with lower odds of postoperative delirium (OR 0.69, 95% CI 0.52-0.91).
DISCUSSION: Though caution must be used in interpreting meta-analyses of non-randomized studies due to the potential influence of unmeasured confounding, we identified potentially modifiable prognostic factors including frailty and psychotropic medication use that should be targeted to optimize care.

PMID: 29374358 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2FnTuMI
via IFTTT

Influence of green grass-based diets on growth and reproductive performance in dairy heifers.

Related Articles

Influence of green grass-based diets on growth and reproductive performance in dairy heifers.

Trop Anim Health Prod. 2018 Jan 26;:

Authors: Habib MR, Rashid MH, Islam MA, Majumder S, Islam KMS, Ahmed S, Alam MS, Vargas-Bello-Pérez E

Abstract
The objective of this study was to monitor the changes in growth, dry matter intake, and blood profiles (nutrition and reproductive hormones) of dairy heifers in response to green grass-based diets. Twelve crossbred heifers were equally divided into group 1: rice straw and concentrate; group 2: rice straw, green grass, and concentrate; group 3: green grass and concentrate; group 4: green grass, soybean hay, and concentrate. Dry matter intake in group 4 was found 6% higher (P < 0.05) than group 1. Negative body weight gain was found in group 1 and group 2 showed 14% higher body weight gain per 30 days compared to groups 3 and 4 (P < 0.05). Heifers in group 4 had significantly (P < 0.05) higher heart girth gain, serum albumin, urea, and blood urea nitrogen than the heifers in other groups. Endocrine parameters were found similar among groups. Overall, supply of green grass especially a mix of leguminous and non-leguminous was found advantageous in heifer feeding.

PMID: 29374345 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DUyjEU
via IFTTT

Assessment of antimicrobial drug administration and antimicrobial residues in food animals in Enugu State, Nigeria.

Related Articles

Assessment of antimicrobial drug administration and antimicrobial residues in food animals in Enugu State, Nigeria.

Trop Anim Health Prod. 2018 Jan 26;:

Authors: Njoga EO, Onunkwo JI, Okoli CE, Ugwuoke WI, Nwanta JA, Chah KF

Abstract
Imprudent administration of antimicrobial drugs in food-producing animals can facilitate the development and spread of antimicrobial-resistant organisms and also enhance the occurrence of antimicrobial residue in animal products. This study was undertaken to assess antimicrobial drug administration to food animals in livestock farms in Enugu State and determine livestock farmers' awareness on the consequences of imprudent antimicrobial administration to food animals and finally the prevalence of antimicrobial drug residues in edible tissues of cattle and pigs in the state. Structured questionnaire was used to extract information on antimicrobial drug administration and consequences of irresponsible use of antimicrobials in food animals from 109 livestock farms/farmers randomly selected using multi-stage sampling technique. Premi® test technology (R-Biopharm, Germany) was used to screen for antimicrobial residues in edible tissues from 300 carcasses consisting of 165 cattle and 135 pigs slaughtered for human consumption in two major slaughterhouses in Enugu State. Tetracyclines (90.8%), penicillins and beta-lactams (89.9%), and aminoglycoside (57.8%) were the classes of antimicrobials most frequently administered to food animals in the farms surveyed. Withdrawal period was not observed in 65% of the farms. About 30% of cattle and 23% of pig carcasses screened contained detectable amounts of antimicrobial residues. There is widespread indiscriminate administration of antimicrobial drugs in food animals in Enugu State. This underscores the need for public enlightenment on prudent use of antimicrobial drugs in food-producing animals in order to preserve the therapeutic efficacy for sustainable livestock production and to safeguard human health.

PMID: 29374344 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2FmvnOi
via IFTTT

Frequency and Impact of Adverse Events in Inpatients: A Nationwide Analysis of Episodes between 2000 and 2015.

Related Articles

Frequency and Impact of Adverse Events in Inpatients: A Nationwide Analysis of Episodes between 2000 and 2015.

J Med Syst. 2018 Jan 26;42(3):48

Authors: Sousa-Pinto B, Marques B, Lopes F, Freitas A

Abstract
Despite being a potential cause of morbidity and economic costs, adverse events remain insufficiently studied. Therefore, we aimed to assess the frequency and impact of adverse events among inpatients. We analysed an administrative database containing a registration of all hospitalisations occurring in Portuguese public hospitals between 2000 and 2015. We identified all episodes with a registration of adverse events, and classified them into three categories, namely (1) misadventures of surgical and medical care, (2) complications of surgical or medical procedures, and (3) adverse drug events (including adverse drug reactions, poisoning events, and late effects). These episodes were compared over their length of stay, in-hospital mortality, and hospital costs with an equal number of hospitalisations matched for patients' and episodes' characteristics. Between 2000 and 2015, 5.8% (n = 861,372) of all Portuguese hospitalisations had a registration of at least one adverse event. Hospitalisations with registration of adverse events had a median length of stay of 8 days, median hospitalisation costs of 3060.7 Euro, and an in-hospital mortality of 6.7%. Hospitalisations with registration of misadventures of care, complications of procedures and adverse drug reactions had significantly higher lengths of stay and hospitalisation costs than their matched controls. In-hospital mortality was significantly higher for episodes of misadventures of care and complications of procedures, but lower for adverse drug events hospitalisations. Therefore, adverse events are common among inpatients, and have an important clinical and economic impact. Administrative databases may be useful in their epidemiological assessment.

PMID: 29374332 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DQXiJ3
via IFTTT

Ribosome Incorporation into Somatic Cells Promotes Lineage Transdifferentiation towards Multipotency.

Related Articles

Ribosome Incorporation into Somatic Cells Promotes Lineage Transdifferentiation towards Multipotency.

Sci Rep. 2018 Jan 26;8(1):1634

Authors: Ito N, Katoh K, Kushige H, Saito Y, Umemoto T, Matsuzaki Y, Kiyonari H, Kobayashi D, Soga M, Era T, Araki N, Furuta Y, Suda T, Kida Y, Ohta K

Abstract
Recently, we reported that bacterial incorporation induces cellular transdifferentiation of human fibroblasts. However, the bacterium-intrinsic cellular- transdifferentiation factor remained unknown. Here, we found that cellular transdifferentiation is caused by ribosomes. Ribosomes, isolated from both prokaryotic and eukaryotic cells, induce the formation of embryoid body-like cell clusters. Numerous ribosomes are incorporated into both the cytoplasm and nucleus through trypsin-activated endocytosis, which leads to cell-cluster formation. Although ribosome-induced cell clusters (RICs) express several stemness markers and differentiate into derivatives of all three germ layers in heterogeneous cell populations, RICs fail to proliferate, alter the methylation states of pluripotent genes, or contribute to teratoma or chimera formation. However, RICs express markers of epithelial-mesenchymal transition without altering the cell cycle, despite their proliferation obstruction. These findings demonstrate that incorporation of ribosomes into host cells induces cell transdifferentiation and alters cellular plasticity.

PMID: 29374279 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DJqa6U
via IFTTT

Endoscopic non-ablative fractional laser therapy in an orthotopic colon tumour model.

Related Articles

Endoscopic non-ablative fractional laser therapy in an orthotopic colon tumour model.

Sci Rep. 2018 Jan 26;8(1):1673

Authors: Yoo SW, Oh G, Safi AM, Hwang S, Seo YS, Lee KH, Kim YL, Chung E

Abstract
Colorectal cancer is one of the leading causes of cancer-related deaths. Although several therapeutic management strategies are available at the early colon cancer stages, such as endoscopic mucosal or submucosal dissection, associated complications often include bleeding or bowel perforations. As an alternative approach, we investigated endoscopic non-ablative fractional laser (eNAFL) irradiation as a minimally invasive therapeutic modality for the treatment of early-stage colorectal cancer. By implanting SL4-DsRed colon cancer cells into the colons of the C57BL/6 mice, we developed an orthotopic colon tumour mouse model and demonstrated the early-stage tumour growth delay following the eNAFL irradiation. Additionally, we evaluated the temperature changes in the eNAFL-irradiated area using numerical simulations, and induced inflammation using histological analysis. Our results indicate a minimal thermal damage confined to the irradiated spot, sparing the adjacent tissue and alteration in the tumour microenvironment. eNAFL irradiation may be clinically useful as a minimally invasive therapeutic intervention at the early stage of tumourigenesis. In future, an optimal eNAFL therapeutic dose should be determined, in order to increase the efficacy of this approach.

PMID: 29374265 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DKgCsr
via IFTTT

HIV-1 with HBV-associated Q151M substitution in RT becomes highly susceptible to entecavir: structural insights into HBV-RT inhibition by entecavir.

Related Articles

HIV-1 with HBV-associated Q151M substitution in RT becomes highly susceptible to entecavir: structural insights into HBV-RT inhibition by entecavir.

Sci Rep. 2018 Jan 26;8(1):1624

Authors: Yasutake Y, Hattori SI, Hayashi H, Matsuda K, Tamura N, Kohgo S, Maeda K, Mitsuya H

Abstract
Hepatitis B virus (HBV) reverse transcriptase (RT) is essential for viral replication and is an important drug target. Nonetheless, the notorious insolubility of HBV RT has hindered experimental structural studies and structure-based drug design. Here, we demonstrate that a Q151M substitution alone at the nucleotide-binding site (N-site) of human immunodeficiency virus type-1 (HIV-1) RT renders HIV-1 highly sensitive to entecavir (ETV), a potent nucleoside analogue RT inhibitor (NRTI) against HBV. The results suggest that Met151 forms a transient hydrophobic interaction with the cyclopentyl methylene of ETV, a characteristic hydrophobic moiety of ETV. We thus solved the crystal structures of HIV-1 RTQ151M:DNA complex with bound dGTP or ETV-triphosphate (ETV-TP). The structures revealed that ETV-TP is accommodated at the N-site slightly apart from the ribose ring of the 3'-end nucleotide, compared to the position of bound dGTP and previously reported NRTI/dNTP. In addition, the protruding methylene group of bound ETV-TP directly pushes the side-chain of Met184 backward. Met184 is a key residue that confers ETV resistance upon substitution with smaller Ile/Val. These results provide novel insights into NRTI binding to the N-site and further provide important clues for the development of novel anti-HBV/HIV-1 RT inhibitors to overcome critical drug resistance.

PMID: 29374261 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2nj56Jn
via IFTTT

Role of Quzhou Fructus Aurantii Extract in Preventing and Treating Acute Lung Injury and Inflammation.

Related Articles

Role of Quzhou Fructus Aurantii Extract in Preventing and Treating Acute Lung Injury and Inflammation.

Sci Rep. 2018 Jan 26;8(1):1698

Authors: Li L, Zhang S, Xin Y, Sun J, Xie F, Yang L, Chen Z, Chen H, Liu F, Xuan Y, You Z

Abstract
Quzhou Fructus Aurantii (QFA) is an authentic herb of local varieties in Zhejiang, China, which is usually used to treat gastrointestinal illnesses, but its effects on respiratory inflammation have not been reported yet. In our study, the anti-inflammatory activity of QFA extract (QFAE) was evaluated on copper sulfate pentahydrate (CuSO4·5H2O)-induced transgenic neutrophil fluorescent zebrafish model. QFAE showed a significant effect of anti-inflammation in CuSO4·5H2O-induced zebrafish by reducing the neutrophil number in the inflammatory site. We investigated the anti-inflammatory activity of QFAE on lipopolysaccharide (LPS)-induced acute lung injury (ALI) mice models and RAW 264.7 cells. QFAE had an anti-inflammatory effect on reducing total cells, neutrophils, and macrophages in BALF and attenuated alveolus collapse, neutrophils infiltration, lung W/D ratio, myeloperoxidase (MPO) protein expression and other pulmonary histological changes in lung tissues, as well as hematological changes. Levels of pro-inflammatory cytokines, including TNF, IL-6, IFN-γ, MCP-1, and IL-12p70, were decreased, whereas anti-inflammatory cytokine IL-10 was increased after treatment with QFAE both in vivo and in vitro. In summary, our results suggested that QFAE had apparent anti-inflammatory effects on CuSO4·5H2O-induced zebrafish, LPS-induced ALI mice, and RAW 264.7 cells. Furthermore, QFAE may be a therapeutic drug to treat ALI/ARDS and other respiratory inflammations.

PMID: 29374248 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2nj52cB
via IFTTT

Fingerprint analysis of Huolingshengji Formula and its neuroprotective effects in SOD1G93A mouse model of amyotrophic lateral sclerosis.

Related Articles

Fingerprint analysis of Huolingshengji Formula and its neuroprotective effects in SOD1G93A mouse model of amyotrophic lateral sclerosis.

Sci Rep. 2018 Jan 26;8(1):1668

Authors: Zhou Q, Wang Y, Zhang J, Shao Y, Li S, Wang Y, Cai H, Feng Y, Le W

Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurological disease characterized by progressive loss of motor neurons. There are no definitive pathogenic mechanisms and effective treatments for ALS now. Traditional Chinese medicine (TCM) plays an important role in Chinese health care system. Huolingshengji Formula (HLSJ) is a TCM formula which is applied for treating flaccid syndrome. Our previous clinical study has indicated that HLSJ may have therapeutic effects in ALS patients. In the present study, we analyzed the chemical profile of HLSJ by the high-performance liquid chromatographic (HPLC) fingerprint analysis. And we investigated the therapeutic effects and neuroprotective mechanisms of HLSJ against ALS in SOD1G93A mouse model. Eleven typical peaks were identified by the fingerprint analysis of HLSJ, and the HPLC method had good precision, repeatability and stability. Consistent with our clinical studies, HLSJ significantly prolonged the lifespan, extended the disease duration, and prevented the motor neuron loss in the anterior horn of the lumbar spinal cords in SOD1G93A ALS model mice. Additionally, HLSJ alleviated the atrophy of the gastrocnemius muscles and ameliorated the apoptotic and inflammatory levels in the spinal cords of SOD1G93A mice. Collectively, our study indicated that HLSJ might be a novel candidate for the treatment of ALS.

PMID: 29374221 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2FpVa8t
via IFTTT

Downregulation of annexin A3 inhibits tumor metastasis and decreases drug resistance in breast cancer.

Related Articles

Downregulation of annexin A3 inhibits tumor metastasis and decreases drug resistance in breast cancer.

Cell Death Dis. 2018 Jan 26;9(2):126

Authors: Du R, Liu B, Zhou L, Wang D, He X, Xu X, Zhang L, Niu C, Liu S

Abstract
Annexin A3 (ANXA3) is dysregulated and plays an important role in various cancers. However, the role of ANXA3 in breast cancer is still unclear. Here, we observed that the expression level of ANXA3 was significantly upregulated in breast cancer tissues. ANXA3 knockdown inhibited cell invasion but promoted cell proliferation in both in vitro and in vivo assays. Furthermore, we found that ANXA3 knockdown inhibited the NFκB pathway via upregulating IκBα, resulting in mesenchymal-epithelial transition (MET) and a heterogeneity change of breast cancer stem cells (BCSCs). In addition, we demonstrated that ANXA3 knockdown increased the sensitivity of breast cancer cells to doxorubicin by increasing the drug uptake. The combination of ANXA3 knockdown and doxorubicin treatment simultaneously inhibited tumor growth and metastasis in vivo. This study described the role and mechanisms of ANXA3 in regulating BCSCs and breast cancer growth and metastasis, indicating that downregulating ANXA3 together with chemotherapy might be a novel therapeutic strategy for treating breast cancer.

PMID: 29374148 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2nh9Yj7
via IFTTT

Healthcare utilisation and costs of home mechanical ventilation.

Related Articles

Healthcare utilisation and costs of home mechanical ventilation.

Thorax. 2018 Jan 26;:

Authors: Nonoyama ML, McKim DA, Road J, Guerriere D, Coyte PC, Wasilewski M, Avendano M, Katz SL, Amin R, Goldstein R, Zagorski B, Rose L

Abstract
BACKGROUND: Individuals using home mechanical ventilation (HMV) frequently choose to live at home for quality of life, despite financial burden. Previous studies of healthcare utilisation and costs do not consider public and private expenditures, including caregiver time.
OBJECTIVES: To determine public and private healthcare utilisation and costs for HMV users living at home in two Canadian provinces, and examine factors associated with higher costs.
METHODS: Longitudinal, prospective observational cost analysis study (April 2012 to August 2015) collecting data on public and private (out-of-pocket, third-party insurance, caregiving) costs every 2 weeks for 6 months using the Ambulatory and Home Care Record. Functional Independence Measure (FIM) was used at baseline and study completion. Regression models examined variables associated with total monthly costs selected a priori using Andersen and Newman's framework for healthcare utilisation, relevant literature, and clinical expertise. Data are reported in 2015 Canadian dollars ($C1=US$0.78=₤0.51=€0.71).
RESULTS: We enrolled 134 HMV users; 95 with family caregivers. Overall median (IQR) monthly healthcare cost was $5275 ($2291-$10 181) with $2410 (58%) publicly funded; $1609 (39%) family caregiving; and $141 (3%) out-of-pocket (<1% third-party insurance). Median healthcare costs were $8733 ($5868-$15 274) for those invasively ventilated and $3925 ($1212-$7390) for non-invasive ventilation. Variables associated with highest monthly costs were amyotrophic lateral sclerosis (1.88, 95% CI 1.09 to 3.26, P<0.03) and lower FIM quintiles (higher dependency) (up to 6.98, 95% CI 3.88 to 12.55, P<0.0001) adjusting for age, sex, tracheostomy and ventilation duration.
CONCLUSIONS: For HMV users, most healthcare costs were publicly supported or associated with family caregiving. Highest costs were incurred by the most dependent users. Understanding healthcare costs for HMV users will inform policy decisions to optimise resource allocation, helping individuals live at home while minimising caregiver burden.

PMID: 29374088 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DT9usU
via IFTTT

Bacterial catabolism of β-hydroxypropiovanillone and β-hydroxypropiosyringone produced in the reductive cleavage of arylglycerol-β-aryl ether in lignin.

Related Articles

Bacterial catabolism of β-hydroxypropiovanillone and β-hydroxypropiosyringone produced in the reductive cleavage of arylglycerol-β-aryl ether in lignin.

Appl Environ Microbiol. 2018 Jan 26;:

Authors: Higuchi Y, Aoki S, Takenami H, Kamimura N, Takahashi K, Hishiyama S, Lancefield CS, Ojo OS, Katayama Y, Westwood NJ, Masai E

Abstract
Sphingobium sp. strain SYK-6 converts four stereoisomers of arylglycerol-β-guaiacyl ether into achiral β-hydroxypropiovanillone (HPV) via three stereospecific reaction steps. Here we determined the HPV catabolic pathway and characterized the HPV catabolic genes involved in the first two steps of the pathway. In SYK-6 cells, HPV was oxidized to vanilloyl acetic acid (VAA) via vanilloyl acetaldehyde (VAL). The resulting VAA was further converted into vanillate through the activation of VAA by coenzyme A. A syringyl-type HPV analog, β-hydroxypropiosyringone (HPS), was also catabolized via the same pathway. SLG_12830 (hpvZ), which belongs to the glucose-methanol-choline oxidoreductase family, was isolated as the HPV-converting enzyme gene. An hpvZ mutant completely lost the ability to convert HPV and HPS, indicating that hpvZ is essential for the conversion of both the substrates. HpvZ produced in Escherichia coli oxidized both HPV and HPS, and other 3-phenyl-1-propanol derivatives. HpvZ localized to both the cytoplasm and membrane of SYK-6 and used ubiquinone derivatives as electron acceptors. Thirteen gene products of the 23 aldehyde dehydrogenase (ALDH) genes in SYK-6 were able to oxidize VAL into VAA. Mutant analyses suggested that multiple ALDH genes, including SLG_20400, contribute to the conversion of VAL. We examined whether the genes encoding feruloyl-CoA synthetase (ferA) and feruloyl-CoA hydratase/lyase (ferB and ferB2) are involved in the conversion of VAA. Only FerA exhibited activity toward VAA; however, disruption of ferA did not affect VAA conversion. These results indicate that another enzyme system is involved in VAA conversion.IMPORTANCE Cleavage of the β-aryl ether linkage is the most essential process in lignin biodegradation. Although the bacterial β-aryl ether cleavage pathway and catabolic genes have been well documented, there have been no reports regarding the catabolism of HPV or HPS, the products of cleavage of β-aryl ether compounds. HPV and HPS have also been found to be obtained from lignin by chemoselective catalytic oxidation by 2,3-dichloro-5,6-dicyano-1,4-benzoquinone/tert-butyl nitrite/O2, followed by cleavage of the β-aryl ether with zinc. Therefore, value-added chemicals are expected to be produced from these compounds. In this study, we determined the SYK-6 catabolic pathways for HPV and HPS, and identified the catabolic genes involved in the first two steps of the pathways. Since SYK-6 catabolizes HPV through 2-pyrone-4,6-dicarboxylate, which is a building block for functional polymers, characterization of HPV catabolism is important not only for understanding the bacterial lignin catabolic system but also for lignin utilization.

PMID: 29374031 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2FoVDaJ
via IFTTT

A Web-Based Course on Public Health Principles in Disaster and Medical Humanitarian Response: Survey Among Students and Faculty.

Related Articles

A Web-Based Course on Public Health Principles in Disaster and Medical Humanitarian Response: Survey Among Students and Faculty.

JMIR Med Educ. 2018 Jan 26;4(1):e2

Authors: Tam G, Chan EYY, Liu S

Abstract
BACKGROUND: Web-based public health courses are becoming increasingly popular. "Public Health Principles in Disaster and Medical Humanitarian Response" is a unique Web-based course in Hong Kong. This course aimed to fill a public health training gap by reaching out to postgraduates who are unable to access face-to-face learning.
OBJECTIVE: The aim of this paper was to use a structured framework to objectively evaluate the effectiveness of a Web-based course according to Greenhalgh et al's quality framework and the Donabedian model to make recommendations for program improvement.
METHODS: An interim evaluation of the first cohort of students in 2014 was conducted according to the Donabedian model and a quality framework by Greenhalgh et al using objective and self-reported data.
RESULTS: Students who registered for the first cohort (n=1152) from June 16, 2014 to December 15, 2014 (6 months) were surveyed. Two tutors and the course director were interviewed. The Web-based course was effective in using technology to deliver suitable course materials and assessment and to enhance student communication, support, and learning. Of the total number of students registered, 59.00% (680/1152) were nonlocal, originating from 6 continents, and 72.50% (835/1152) possessed a bachelor's or postgraduate degree. The completion rate was 20.00% (230/1152). The chi-square test comparing students who completed the course with dropouts showed no significant difference in gender (P=.40), age (P=.98), occupation (P=.43), or qualification (P=.17). The cost (HK $272 per student) was lower than that of conducting a face-to-face course (HK $4000 per student).
CONCLUSIONS: The Web-based course was effective in using technology to deliver a suitable course and reaching an intended audience. It had a higher completion rate than other Web-based courses. However, sustainable sources of funding may be needed to maintain the free Web-based course.

PMID: 29374007 [PubMed]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2DVbqkD
via IFTTT

eHealth Technologies, Multimorbidity, and the Office Visit: Qualitative Interview Study on the Perspectives of Physicians and Nurses.

Related Articles

eHealth Technologies, Multimorbidity, and the Office Visit: Qualitative Interview Study on the Perspectives of Physicians and Nurses.

J Med Internet Res. 2018 Jan 26;20(1):e31

Authors: Macdonald GG, Townsend AF, Adam P, Li LC, Kerr S, McDonald M, Backman CL

Abstract
BACKGROUND: eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to telemedicine and multiple forms of health education and digital tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has created a group of informed, engaged, and empowered patients as partners, equipped to take part in shared decision making and effectively self-manage chronic illness. Less attention has been given to health care professionals' (HCPs) experiences of the role of eHealth in patient encounters.
OBJECTIVE: The objective of this study was to examine HCPs' perspectives on how eHealth affects their relationships with patients living with multiple chronic conditions, as well as its ethical and practical ramifications.
METHODS: We interviewed HCPs about their experiences with eHealth and its impact on the office visit. Eligible participants needed to report a caseload of ≥25% of patients with multimorbidity to address issues of managing complex chronic conditions and coordination of care. We used a semistructured discussion guide for in-depth interviews, and follow-up interviews served to clarify and expand upon initial discussions. Constant comparisons and a narrative approach guided the analyses, and a relational ethics conceptual lens was applied to the data to identify emergent themes.
RESULTS: A total of 12 physicians and nurses (6 male, 6 female; median years of practice=13) participated. eHealth tools most frequently described were Web-based educational resources for patients and Web-based resources for HCPs such as curated scientific summaries on diagnostic criteria, clinical therapies, and dosage calculators. Analysis centered on a grand theme of the two-way conversation between HCPs and patients, which addresses a general recentering of the ethical relationship between HCPs and patients around engagement. Subthemes explain the evolution of the two-way conversation, and having, using, and supporting the two-way conversation with patients, primarily as this relates to achieving adherence and health outcomes.
CONCLUSIONS: Emerging ethical concerns were related to the ambiguity of the ideal of empowered patients and the ways in which health professionals described enacting those ideals in practice, showing how the cultural shift toward truly mutually respectful and collaborative practice is in transition. HCPs aim to act in the best interests of their patients; the challenge is to benefit from emergent technologies that may enhance patient-HCP interactions and effective care, while abiding by regulations, dealing with the strictures of the technology itself, and managing changing demands on their time.

PMID: 29374004 [PubMed - in process]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2FpIePZ
via IFTTT

Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis.

Related Articles

Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis.

JMIR Res Protoc. 2018 Jan 26;7(1):e28

Authors: Melia R, Francis K, Duggan J, Bogue J, O'Sullivan M, Chambers D, Young K

Abstract
BACKGROUND: Previous research has reported that two of the major barriers to help-seeking for individuals at risk of suicide are stigma and geographical isolation. Mobile technology offers a potential means of delivering evidence-based interventions with greater specificity to the individual, and at the time that it is needed. Despite documented motivation by at-risk individuals to use mobile technology to track mental health and to support psychological interventions, there is a shortfall of outcomes data on the efficacy of mobile health (mHealth) technology on suicide-specific outcomes.
OBJECTIVE: The objective of this study is to develop a protocol for a systematic review and meta-analysis that aims to evaluate the effectiveness of mobile technology-based interventions for suicide prevention.
METHODS: The search includes the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase, PsycINFO, CRESP and relevant sources of gray literature. Studies that have evaluated psychological or nonpsychological interventions delivered via mobile computing and communication technology, and have suicidality as an outcome measure will be included. Two authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, suicidal behavior). Secondary outcomes will be measures of symptoms of depression. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. A narrative synthesis will be conducted if the data is unsuitable for a meta-analysis.
RESULTS: The review is in progress, with findings expected by summer 2018.
CONCLUSIONS: To date, evaluations of mobile technology-based interventions in suicide prevention have focused on evaluating content as opposed to efficacy. Indeed, previous research has identified mobile applications that appear to present harmful content. The current review will address a gap in the literature by evaluating the efficacy of stand-alone mobile technology tools in suicide prevention. It is imperative that research identifies the evidence base for such tools in suicide prevention in order to inform policy, guide clinical practice, inform users and focus future research.
TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42017072899; https:// http://ift.tt/2Gl6KTr  (Archived by WebCite at http://ift.tt/1aom0IK 6tZAj0yqJ).

PMID: 29374003 [PubMed]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2Gl6Lqt
via IFTTT

Examining the Frequency and Contribution of Foods Eaten Away From Home in the Diets of 18- to 30-Year-Old Australians Using Smartphone Dietary Assessment (MYMeals): Protocol for a Cross-Sectional Study.

Related Articles

Examining the Frequency and Contribution of Foods Eaten Away From Home in the Diets of 18- to 30-Year-Old Australians Using Smartphone Dietary Assessment (MYMeals): Protocol for a Cross-Sectional Study.

JMIR Res Protoc. 2018 Jan 26;7(1):e24

Authors: Wellard-Cole L, Jung J, Kay J, Rangan A, Chapman K, Watson WL, Hughes C, Ni Mhurchu C, Bauman A, Gemming L, Yacef K, Koprinska I, Allman-Farinelli M

Abstract
BACKGROUND: Young Australians aged between 18 and 30 years have experienced the largest increase in the body mass index and spend the largest proportion of their food budget on fast food and eating out. Frequent consumption of foods purchased and eaten away from home has been linked to poorer diet quality and weight gain. There has been no Australian research regarding quantities, type, or the frequency of consumption of food prepared outside the home by young adults and its impact on their energy and nutrient intakes.
OBJECTIVES: The objective of this study was to determine the relative contributions of different food outlets (eg, fast food chain, independent takeaway food store, coffee shop, etc) to the overall food and beverage intake of young adults; to assess the extent to which food and beverages consumed away from home contribute to young adults' total energy and deleterious nutrient intakes; and to study social and physical environmental interactions with consumption patterns of young adults.
METHODS: A cross-sectional study of 1008 young adults will be conducted. Individuals are eligible to participate if they: (1) are aged between 18 and 30 years; (2) reside in New South Wales, Australia; (3) own or have access to a smartphone; (4) are English-literate; and (5) consume at least one meal, snack, or drink purchased outside the home per week. An even spread of gender, age groups (18 to 24 years and 25 to 30 years), metropolitan or regional geographical areas, and high and low socioeconomic status areas will be included. Participants will record all food and drink consumed over 3 consecutive days, together with location purchased and consumed in our customized smartphone app named Eat and Track (EaT). Participants will then complete an extensive demographics questionnaire. Mean intakes of energy, nutrients, and food groups will be calculated along with the relative contribution of foods purchased and eaten away from home. A subsample of 19.84% (200/1008) of the participants will complete three 24-hour recall interviews to compare with the data collected using EaT. Data mining techniques such as clustering, decision trees, neural networks, and support vector machines will be used to build predictive models and identify important patterns.
RESULTS: Recruitment is underway, and results will be available in 2018.
CONCLUSIONS: The contribution of foods prepared away from home, in terms of energy, nutrients, deleterious nutrients, and food groups to young people's diets will be determined, as will the impact on meeting national recommendations. Foods and consumption behaviors that should be targeted in future health promotion efforts for young adults will be identified.

PMID: 29374002 [PubMed]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rID7Z7
via IFTTT

A Breastfeed-Promoting Mobile App Intervention: Usability and Usefulness Study.

Related Articles

A Breastfeed-Promoting Mobile App Intervention: Usability and Usefulness Study.

JMIR Mhealth Uhealth. 2018 Jan 26;6(1):e27

Authors: Wang CJ, Chaovalit P, Pongnumkul S

Abstract
BACKGROUND: Breastfeeding is proven to have lasting health benefits for both mothers and infants; however, 6-month exclusive breastfeeding rate remains below 20% in Thailand. Although the number of research literature and commercial apps for breastfeeding women is significantly growing, they are country-specific and restricted to English-speaking users. There exists a major knowledge gap on how mobile health apps could support breastfeeding in Thailand. To address these gaps, MoomMae has been developed with the intention to support Thai women in breastfeeding outside of their homes and in keeping their feeding records.
OBJECTIVE: The aim of this study was to evaluate the usability and usefulness of MoomMae, a mobile phone app designed to support breastfeeding women.
METHODS: Our study was reviewed and approved by Thailand's National Science and Technology Development Agency (NSTDA) ethics committee. A total of 21 breastfeeding women with at least one Android phone or tablet were recruited via convenience and snowball sampling. The study process for each participant was as follows: the participant was requested to attend a preuse interview and given the app to use for 4 weeks. Following this period, a postuse interview was conducted to examine the usability and usefulness of the app. Both sessions were held individually and audiorecorded for qualitative analysis.
RESULTS: The mean scores of usability and usefulness from the postuse survey were 4.33 (SD 0.87; range 1-5) and 4.60 (SD 0.74; range 2-5). Our qualitative analysis revealed a total of 137 feedbacks: 71 related to usability and 66 associated with usefulness. A further sentimental analysis showed that comments on usability were generally negative (59 negative, 11 positive, and 1 neutral), and comments on usefulness were relatively positive (56 positive, 9 negative, and 1 neutral). We discovered 26 unique design issues and proposed recommendations for future improvement.
CONCLUSIONS: Our usability and usefulness assessment of MoomMae demonstrated that MoomMae has a great potential to be a useful self-management tool for breastfeeding mothers in Thailand. The qualitative analysis suggested that the app is supportive of breastfeeding on demand, but the flow and inputs of the app should be redesigned to be more intuitive. For future implementations, the most desirable feature is a pump-reminding notification system.

PMID: 29374000 [PubMed]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rJGvmm
via IFTTT

Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: 'you know you have to eat to survive'.

Related Articles

Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: 'you know you have to eat to survive'.

Support Care Cancer. 2018 Jan 27;:

Authors: McCarter K, Baker AL, Britton B, Halpin SA, Beck A, Carter G, Wratten C, Bauer J, Wolfenden L, Burchell K, Forbes E

Abstract
PURPOSE: The aim of this study was to explore head and neck cancer (HNC) patient experiences of a novel dietitian delivered health behaviour intervention.
METHODS: This study is a qualitative study which employed semi-structured individual interviews using open and axial coding and then final selective coding to organise the data. Patients with HNC who had participated in a dietitian delivered health behaviour intervention to reduce malnutrition were invited to discuss their experience of this intervention. Individual interviews were conducted, transcribed and analysed using grounded theory.
RESULTS: Nine patients participated in the interviews. Four dimensions were identified in the initial coding process: 'information', which described patients' desire for tailored advice during their treatment; 'challenges of treatment experience', which described the difficulties related to treatment side effects; 'key messages: importance of eating and maintaining weight', which covered perceived integral messages delivered to patients by dietitians; and 'dietitian's approach' describing patient experiences of empathic and compassionate dietitians. Two overarching themes resulted from examining the connections and relationships between these dimensions: 'survival', a connection between eating and living; and 'support', describing the valued working partnership between dietitian and patient.
CONCLUSIONS: Dimensions and themes overlapped with the qualitative literature on HNC patient experience of treatment. However, some themes, such as the empowerment of a message linking eating to survival, appeared unique to this study. Patients found this message to be delivered in a supportive manner that motivated change.

PMID: 29374300 [PubMed - as supplied by publisher]

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2rLyy01
via IFTTT