Outcomes of Patients Who Have Do Not Resuscitate Status prior to Being Admitted to an Intensive Care Unit

Admission of patients who have do not resuscitate (DNR) status to an intensive care unit (ICU) is potentially a misallocation of limited resources to patients who may neither need nor want intensive care. Yet, patients who have DNR status are often admitted to the ICU. This is a retrospective review of patients who had a valid DNR status at the time that they were admitted to an ICU in a single hospital over an eighteen-month period. Thirty-five patients met the criteria for inclusion in the study. The primary reasons for admission to the ICU were respiratory distress (54.2%) and sepsis (45.7%). Sixteen (45.7%) of the patients died, compared to a 5.4% mortality rate for all patients admitted to our ICU during this period (). APACHE II score was a significant predictor of mortality (18.5 ± 1.3 alive and 23.4 ± 1.4 dead; ). Of the 19 patients discharged alive, 9 were discharged home, 5 to hospice, and 4 to a post-acute care facility. Conclusions. Patients who have DNR status and are admitted to the ICU have a higher mortality than other ICU patients. Those who survive have a high likelihood of being discharged to hospice or a post-acute care facility. The value of intensive intervention for these patients is not supported by these results. Only a minority of patients were seen by palliative care and chaplain teams, services which the literature supports as valuable for DNR patients. Our study supports the need for less expensive and less intensive but more appropriate resources for patients and families who have chosen DNR status.

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Establishing the Psychometric Properties of the ICOAP Questionnaire through Intra-Articular Treatment of Osteoarthritic Pain: Implementation for the Greek Version

Objectives. In this prospective study, we intend to establish the psychometric properties of ICOAP for its use in studies involving the Hellenic population. Methods. SF-36 Health Survey was used as a standard against ICOAP scores from a sample of 89 patients (mean age: 71.07, 69 females) with hip and knee OA pain who underwent 2 treatment cycles of 4 intra-articular injections of sodium hyaluronate, separated by a 12-week medication-free time interval. Both questionnaires were filled twice with no missing data during follow-up. Results. ROC analysis accomplished ICOAP’s criterion-related validation. Wilcoxon Signed-Rank Test and paired samples -test endorsed ICOAP’s responsiveness along with Effect Size values, standard response mean, and Relative Efficiency. Comparisons between the areas under curves (AUC) on ROC plots established external responsiveness. Cronbach’s-alpha value favored ICOAP’s internal consistency. This, along with intraclass correlation, results in both advocated reliability and content validity. Interitem discrimination was demonstrated by the ease of completion of ICOAP as well as the degree of familiarity with it. These findings inaugurated construct validity in collaboration with Spearman’s and One-Way ANOVA results. Conclusions. ICOAP is a valid, reliable, and responsive QoL instrument and suitable for studies of osteoarthritic joint pain in the Greek setting.

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Gelam Honey Attenuates the Oxidative Stress-Induced Inflammatory Pathways in Pancreatic Hamster Cells

Purpose. Type 2 diabetes consists of progressive hyperglycemia and insulin resistance, which could result from glucose toxicity, inflammatory cytokines, and oxidative stress. In the present study we investigated the effect of Gelam honey and quercetin on the oxidative stress-induced inflammatory pathways and the proinflammatory cytokines. Methods. HIT-T15 cells were cultured and preincubated with the extract of Gelam honey (20, 40, 60, and 80 μg/mL), as well as quercetin (20, 40, 60, and 80 μM), prior to stimulation by 20 and 50 mM glucose. Results. HIT-T15 cells cultured under hyperglycemic condition showed a significant increase in the inflammatory pathways by phosphorylating JNK, IKK-β, and IRS-1 at Ser307 (). There was a significant decrease in the phosphorylation of Akt at Ser473 (). Pretreatment with Gelam honey and quercetin reduced the expression of phosphorylated JNK, IKK-β, and IRS-1, thereby significantly reducing the expression of proinflammatory cytokines like TNF-α, IL-6, and IL-1β (). At the same time there was a significant increase in the phosphorylated Akt showing the protective effects against inflammation and insulin resistance (). In conclusion, our data suggest the potential use of the extract from Gelam honey and quercetin in modulating the inflammation induced insulin signaling pathways.

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Hydrogen Peroxide Treatment and the Phenylpropanoid Pathway Precursors Feeding Improve Phenolics and Antioxidant Capacity of Quinoa Sprouts via an Induction of L-Tyrosine and L-Phenylalanine Ammonia-Lyases Activities

Hydrogen peroxide treatment and the phenylpropanoid pathway precursors feeding affected the antioxidant capacity of quinoa sprouts. Compared to the control, total phenolics content was significantly increased by treatment of control sprouts with 50 mM and 200 mM H2O2—an elevation of about 24% and 28%, respectively. The highest increase of flavonoids content was found for the sprouts treated with 200 mM H2O2 obtained from seeds fed with shikimic acid. All the studied modifications increased the antioxidant potential of sprouts (at least by 50% compared to control). The highest reducing power was found for the sprouts treated with 200 mM H2O2 obtained by phenylalanine feeding (5.03 mg TE/g DW) and those obtained from the seeds fed with tyrosine (5.26 mg TE/g DW). The activities of L-tyrosine (TAL) and L-phenylalanine (PAL) ammonia-lyases were strongly affected by germination time as well as the applied modification of sprouting. On the 3rd day the highest PAL activity was determined for both untreated and induced with 50 mM H2O2 sprouts obtained by phenylalanine feeding. H2O2 induced TAL activity; the highest TAL activity was determined for 3-day-old sprouts induced with 200 mM H2O2 obtained from seeds fed with phenylalanine.

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Trail without Catheter after Transurethral Resection of Prostate: Clamp It or Not?

Background. There has been argument between clinical practitioners about clamping catheter or not prior to its removal after transurethral resection of prostate (TURP). We conducted a clinical trial to assess whether clamping has any role in early bladder tone recovery particularly in patients who undergo TURP. Methods. Randomized clinical trial was conducted at a tertiary care hospital, Karachi from January 2014 to July 2015. Eighty-six study participants who underwent TURP were randomly allocated into two groups of 43 participants each. In Group I, patient’s Foley catheter was not clamped prior to its removal and in Group II Foley catheter was clamped. Data of all subjects were analyzed using SPSS version 20. Results. There was no significant difference in age and weight of resected tissues between two groups. Among 4 patients in Group I who required recatheterization, 1 patient was discharged with catheter as compared to Group II in which 2 patients were discharged with catheter (). Only 1 patient (2.3%) in Group II had bleeding which required recatheterization. Length of stay was significantly affected by early and free removal of Foley catheter (). Conclusion. The results of current study identified that clamping whether done or not had no significant impact on urinary retention.

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The Ritz Method for Boundary Problems with Essential Conditions as Constraints

We give an elementary derivation of an extension of the Ritz method to trial functions that do not satisfy essential boundary conditions. As in the Babuška-Brezzi approach boundary conditions are treated as variational constraints and Lagrange multipliers are used to remove them. However, we avoid the saddle point reformulation of the problem and therefore do not have to deal with the Babuška-Brezzi inf-sup condition. In higher dimensions boundary weights are used to approximate the boundary conditions, and the assumptions in our convergence proof are stated in terms of completeness of the trial functions and of the boundary weights. These assumptions are much more straightforward to verify than the Babuška-Brezzi condition. We also discuss limitations of the method and implementation issues that follow from our analysis and examine a number of examples, both analytic and numerical.

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Neoatherosclerosis in Very Late Stenosis of Bare Metal Stent by Optical Coherence Tomography

Bare metal stents (BMS) continue to be widely used in patients with coronary artery disease undergoing percutaneous revascularization. Progressive luminal renarrowing has been reported late after BMS implantation resulting in a significant rate of stent failure events. We present a case of very late BMS failure due to in-stent restenosis where optical coherence tomography (OCT) was used to demonstrate neoatherosclerosis as the underlying mechanism. We provide a brief review of neoatherosclerosis and showcase salient features on OCT evaluation.

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Comment on “Early Results of Slanted Recession of the Lateral Rectus Muscle for Intermittent Exotropia with Convergence Insufficiency”

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A Structured Assessment to Decrease the Amount of Inconclusive Endometrial Biopsies in Women with Postmenopausal Bleeding

Objective. To determine whether structured assessment of outpatient endometrial biopsies decreases the number of inconclusive samples. Design. Retrospective cohort study. Setting. Single hospital pathology laboratory. Population. Endometrial biopsy samples of 66 women with postmenopausal bleeding, collected during the usual diagnostic work-up and assessed as insufficient for a reliable histological diagnosis. Methods. Endometrial biopsy samples were requested from the pathology laboratories. The retrieved samples were systematically reassessed by a single pathologist specialized in gynecology. Main Outcome Measure. Disagreement between initial assessment and conclusion after structured reassessment. Results. We retrieved 36 of 66 endometrial biopsy samples from six different pathology laboratories. Structured reassessment of the retrieved samples by a single pathologist specialized in gynecology did not change the conclusion in 35 of the 36 samples. The remaining sample contained a large amount of endometrial tissue and the diagnosis at reassessment was endometrial hyperplasia without atypia. All other samples contained insufficient material for a reliable diagnosis. Conclusion. A structured reassessment of endometrial biopsies samples, which were classified as inconclusive due to insufficient material, did not change the conclusion. Although it might be helpful for pathologists to have diagnostic criteria for adequacy and/or inadequacy of an endometrial biopsy sample, the gain in efficiency is likely to be small.

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The Synthesis and Characterization of Poly(methyl methacrylate-tourmaline acrylate)

In order to synthesize the tourmaline-containing functional copolymer, the polymerizable organic tourmaline acrylate was prepared by the surface modification on tourmaline powder and then copolymerization with methyl methacrylate to get poly(methyl methacrylate-tourmaline acrylate). The synthetic processes were optimized, and the structures of the as-prepared samples were characterized by IR, SEM, and X-ray fluorescence analysis. The characterization results indicated that the tourmaline has been introduced into the copolymer by means of surface modification with acryloyl chloride and following copolymerization with methyl methacrylate. The results from the negative ions measurement revealed that the amounts of released negative ions from both the modified tourmaline and its copolymer are much larger than that of tourmaline.

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Antioxidant Activity and Cytotoxicity Effect of Cocoa Beans Subjected to Different Processing Conditions in Human Lung Carcinoma Cells

Lung cancer is a common malignancy in men and the second leading cause of cancer-related mortality in men in the western world. Phenolic cocoa ingredients have a strong antioxidative activity and the potential to have a protective effect against cancer. In the present study, we have evaluated the influence of cocoa beans subjected to different processing conditions on cell viability and apoptosis of human lung cancer cells (A549). We measured the viability of lung cells treated with cocoa beans, unroasted slates (US), roasted slates (RS), unroasted well fermented (UWF) cocoa, and roasted well fermented (RWF) cocoa for 24 h. Using an MTT assay, we observed a decrease in the viability of A549 cells after treatment with cocoa bean extracts. Flow cytometer analysis revealed that cocoa beans increased the percentage of cells in sub- phase and promoted up to twofold increase of apoptotic cells when compared to the control group. Taken together, the present study suggests that cocoa beans may have a protective effect against lung cancer.

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Habitat Preferences of the Grey Parrot in Heterogeneous Vegetation Landscapes and Their Conservation Implications

The wild Grey Parrot Psittacus erithacus Linnaeus suffers from many habitat use challenges in the wake of extensive deforestation in its endemic range of West and Central African rainforests. To determine effects of these challenges on the bird species, seasonal densities of the Grey Parrot were determined using line transects in major heterogeneous vegetation types in the Korup Rainforest, south-western Cameroon. Results of the study highlight habitat preferences of this species on a seasonal base and under different situations of human activity intensity in the landscape. This information can be used to understand the causes of changes in the distribution and abundance of endangered species and also to determine sustainable conservation strategies. It is concluded that the parrot needs diverse vegetation types for survival in the wild state, as it depends on specific tree species for specific habitat resources such as food, roosts, security, and nests at specific periods of the year. Hence, the continuous survival of the Grey Parrot in the range states is not certain, if sustainable measures are not taken to conserve the parrot and its habitat resources both in and outside protected areas.

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Functional Visual Acuity of Early Presbyopia

Purpose

To evaluate visual function in patients with early presbyopia using the functional visual acuity (FVA) test.

Methods

This study included 27 eyes of 27 healthy older volunteers (mean age, 44.1 ± 2.6 years) and 14 eyes of 14 healthy young volunteers (mean age, 28.4±4.8 years). The distance-corrected visual acuity (DCVA), distance-corrected near VA (DCNVA), subjective amplitude of accommodation (AA), and distance and near pupillary diameters were measured. The distance FVA and distance-corrected near FVA (DCNFVA) were measured using the FVA Measurement System. The standard Schirmer test and standard tear break-up time measurement also were performed.

Results

The logarithm of the minimum angle of resolution (logMAR) DCVA was better than 0 in all subjects. The percentages of subjects with logMAR DCNVA below 0 was significantly lower in the presbyopia group than in the young group. The DCNFVA in the presbyopia group was significantly (P P P Conclusions

Measurement of the DCNFVA can detect decreased AA in early presbyopia better than measurement of the conventional near VA. The DCNFVA is a good index for early presbyopia.

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Plasmablastic Lymphoma Mimicking Acute Pancreatitis

Background. Plasmablastic lymphoma (PBL) is a rare B-cell neoplasm. It predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients and exhibits a highly aggressive clinical behavior. Case Presentation. We describe an unusual case of a 37-year-old HIV-positive male who presented with acute pancreatitis secondary to multiple peripancreatic masses compressing the pancreas. Histopathological examination of the lesions showed diffuse and cohesive pattern of large B-cells resembling immunoblasts or plasmablasts. The neoplastic cells were positive for BOB1 and MUM1, partially positive for CD79a, and negative for CD20, CD56, CD138, CD3, CD5, AE1/AE3, and HHV8. Epstein-Barr virus-encoded RNA in situ hybridization was positive. These features were consistent with PBL. The patient was initiated on cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy, demonstrating a striking response. Conclusion. To our research, this is the first report of PBL with the initial presentation of acute pancreatitis. The findings in this case suggest that PBL should be included in the differential diagnosis of pancreatic and peripancreatic tumors.

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ASEP of MIMO System with MMSE-OSIC Detection over Weibull-Gamma Fading Channel Subject to AWGGN

Ordered successive interference cancellation (OSIC) is adopted with minimum mean square error (MMSE) detection to enhance the multiple-input multiple-output (MIMO) system performance. The optimum detection technique improves the error rate performance but increases system complexity. Therefore, MMSE-OSIC detection is used which reduces error rate compared to traditional MMSE with low complexity. The system performance is analyzed in composite fading environment that includes multipath and shadowing effects known as Weibull-Gamma (WG) fading. Along with the composite fading, a generalized noise that is additive white generalized Gaussian noise (AWGGN) is considered to show the impact of wireless scenario. This noise model includes various forms of noise as special cases such as impulsive, Gamma, Laplacian, Gaussian, and uniform. Consequently, generalized -function is used to model noise. The average symbol error probability (ASEP) of MIMO system is computed for 16-quadrature amplitude modulation (16-QAM) using MMSE-OSIC detection in WG fading perturbed by AWGGN. Analytical expressions are given in terms of Fox-H function (FHF). These expressions demonstrate the best fit to simulation results.

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Reiteration Theorems for Two-Parameter Limiting Real Interpolation Methods

We introduce a limiting real interpolation method involving two scalar parameters. We derive Holmstedt-type estimates for this method that are applied to establish the reiteration theorems.

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Real and Complex Dynamics of Iterative Methods

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Quantitative ELISA-Like Immunohistochemistry of Fibroblast Growth Factor 23 in Diagnosis of Tumor-Induced Osteomalacia and Clinical Characteristics of the Disease

Tumor-induced osteomalacia (TIO) is a rare acquired paraneoplastic disorder and fibroblast growth factor 23 (FGF23) plays a key role in its pathogenesis. This study was conducted to describe a novel FGF23 detecting procedure and describe clinical features of the disease. Fourteen TIO cases were retrieved and FGF23 expression was measured by quantitative ELISA-like immunohistochemistry using formalin-fixed and paraffin-embedded tissues. As summarized from 14 TIO cases, clinical features of TIO were long-standing history of osteomalacia, hypophosphatemia, and urinary phosphate wasting. The associated tumors were mostly benign phosphaturic mesenchymal tumors mixed connective tissue variant (PMTMCT) which could be located anywhere on the body, and most of them could be localized by conventional examinations and octreotide scanning. By quantitative ELISA-like immunohistochemistry, all the 14 TIO cases had high FGF23 expression (median 0.69, 25%–75% interquartile 0.57–1.10, compared with 26 non-TIO tumors of median 0.07, 25%–75% interquartile 0.05–0.11, ). The quantitative ELISA-like immunohistochemistry was a feasible and reproducible procedure to detect the high FGF23 expression in formalin-fixed and paraffin-embedded biopsies or specimens. Since TIO was often delay-diagnosed or misdiagnosed, clinicians and pathologists should be aware of TIO and PMTMCT, respectively.

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Kaposi Sarcoma among HIV Infected Patients in Lagos University Teaching Hospital, Nigeria: A 14-Year Retrospective Clinicopathological Study

Background. Despite the increased incidence of Kaposi sarcoma (KS) resulting from the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic, there is still significant underreporting of KS in this environment. Objectives. This study was aimed at determining the incidence and clinicopathologic patterns of KS among HIV infected patients in Lagos University Teaching Hospital (LUTH), Nigeria, over a 14-year period: January 2000 to December 2013. Methodology. The materials for this study included patients’ hospital clinical files, duplicate copies of histopathologic reports, and tissue blocks and corresponding archival slides in the Anatomic and Molecular Pathology Department and the HIV/AIDS unit of the Department of Haematology. Results. Within the study period, 182 cases of KS were diagnosed, accounting for 1.2% of all patients managed for HIV/AIDS and 2.99% of solid malignant tumours. The male-to-female ratio and modal age group were 1 : 1.3 and 5th decade, respectively. Most cases (90%) had purely mucocutaneous involvement with the lower limb being the commonest site (65.8%). The majority of lesions were plaques (65.8%). Vascular formation was the predominant histologic type seen (43.5%). Conclusion. KS in Lagos followed the same epidemiologic trend as other centers in Nigeria, with an increasing incidence in this era of HIV/AIDS.

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Increased Circulating Th17 Cells, Serum IL-17A, and IL-23 in Takayasu Arteritis

Introduction. Th17, γδT, NK, and NKT cells in peripheral blood and serum IL-17 and IL-23 in Takayasu arteritis (TA) were measured and correlated with disease activity. Methods. Th17 (anti-CD3APC, CD4PECy7, and IL-17PE), NKT, NK (anti-CD3APC, CD56FITC), and γδT (anti-CD3FITC and γδTCRAPC) cells were enumerated by flow cytometry in peripheral blood of 30 patients with TA (ACR1990 criteria) and 20 healthy controls, serum IL-17 and IL-23 measured by ELISA. Relation with disease activity (NIH criteria, ITAS2010) was analyzed (using nonparametric tests, median with interquartile range). Results. Mean age of patients was years (25 females); mean symptom duration was years. 13 were not on immunosuppressants; 12 were active (ITAS2010 ≥ 4). The percentage of Th17 cells was significantly expanded in TA (patients 2.1 (1.5–3.2) versus controls 0.75 (0.32–1.2); ) with no differences in other cell populations. Serum IL-17 and IL-23 (pg/mL) in patients (6.2 (4.6–8.5) and 15 (14.9–26.5), resp.) were significantly higher () than controls (3.9 (3.9–7.3) and undetectable median value, resp.). Subgroup analysis revealed no correlation of Th17 cells, serum IL-17, and IL-23 with disease activity or medications, nor any significant difference before and after medication. Conclusions. There is significant expansion of Th17 cells and elevated serum IL-17 and IL-23 levels in TA patients compared to healthy controls.

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Transient Creatine Kinase Elevation Followed by Hypocomplementemia in a Case of Rotavirus Myositis

We report an infant case of rotavirus myositis, a rare complication of rotavirus infection. Complement levels of the patient were normal when serum creatine kinase (CK) level was at its peak and then decreased when the CK level became normalized. In a previous case report of rotavirus myositis, transient decrease of serum albumin, immunoglobulin, and complement levels was reported. The authors speculated that intravascular complement activation was caused by rotavirus and resulted in the pathogenesis of myositis, although complement levels at onset were not measured by the authors. In this report, however, we demonstrate that the complement activation of our patient is a result of, rather than the cause of, skeletal muscle damage.

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Effect of Inhalation of Aromatherapy Oil on Patients with Perennial Allergic Rhinitis: A Randomized Controlled Trial

This study aimed to investigate the effects of aromatherapy oil inhalation on symptoms, quality of life, sleep quality, and fatigue level among adults with perennial allergic rhinitis (PAR). Fifty-four men and women aged between 20 and 60 were randomized to inhale aromatherapy oil containing essential oil from sandalwood, geranium, and Ravensara or almond oil (the placebo) for 5 minutes twice daily for 7 days. PAR symptoms determined by Total Nasal Symptom Score (TNSS), the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), sleep quality by Verran Synder-Halpern (VSH) scale, and fatigue level by Chalder Fatigue Scale (CFS) were assessed before and after intervention period. Compared with the placebo, the experimental group showed significant improvement in TNSS, especially in nasal obstruction. The aromatherapy group also showed significantly higher improvements in total score of RQLQ and CFS. These findings indicate that inhalation of certain aromatherapy oil helps relieve PAR symptoms, improve rhinitis-specific quality of life, and reduce fatigue in patients with PAR. In conclusion, inhalation of aromatherapy essential oil may have potential as an effective intervention to alleviate PAR.

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Cervical Spondylotic Myelopathy Secondary to Dropped Head Syndrome: Report of a Case and Review of the Literature

The dropped head syndrome (DHS) is a disabling condition caused by severe weakness of the neck extensor muscles causing progressive reducible kyphosis of the cervical spine and the inability to hold the head up. Weakness can occur in isolation or in association with a generalized neuromuscular disorder. Isolated cases are owed to the late onset of noninflammatory myopathy designated as INEM, where persistent chin to chest deformity may gradually cause or aggravate preexisting degenerative changes of the cervical spine and ultimately result in myelopathy. In review of the literature, we could find only 5 cases, with no unique guidelines to address the management of these two concomitant pathologies. Herein, a 69-year-old man who had developed cervical myelopathy 2 years after being affected by isolated dropped head syndrome is presented. Chin to chest deformity and cervical myelopathy were managed through three-level anterior cervical discectomy and fusion (ACDF) combined with decompressive cervical laminectomy and stabilization with C2 to C7 pedicle screw-rod construct. At 4-month follow-up, despite recovery in patient’s neurological status, flexion deformity reappeared with recurrence of dropped head due to C7 pedicle screws pull-out. However, this was successfully managed with extension of the construct to the upper thoracic levels.

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Periostin Facilitates the Epithelial-Mesenchymal Transition of Endometrial Epithelial Cells through ILK-Akt Signaling Pathway

Although periostin was confirmed to facilitate the pathogenesis of endometriosis by enhancing the migration, invasion, and adhesion of human endometrial stromal cells (ESCs), its effect on the endometrial epithelial cells (EECs) is still unknown. The current study aimed to determine whether periostin enhanced the epithelial-mesenchymal transition (EMT) of EECs. EECs were isolated from 12 women with endometriosis. The migration and invasion abilities of EECs were evaluated by transwell assays. Expressions of proteins were detected by western blot. After treatment with periostin, the migration and invasion abilities of EECs were enhanced. Additionally, E-cadherin and keratin were downregulated while N-cadherin and vimentin were upregulated in EECs. Simultaneously, levels of ILK, p-Akt, slug, and Zeb1 were all upregulated in EECs. After silencing the expression of ILK in EECs, levels of p-Akt, slug, Zeb1, N-cadherin, and vimentin were downregulated while E-cadherin and keratin were upregulated. Although periostin weakened the above effects in EECs after silencing the expression of ILK, it failed to induce the EMT of EECs. Thus, periostin enhanced invasion and migration abilities of EECs and facilitated the EMT of EECs through ILK-Akt signaling pathway. Playing a pivotal role in the pathogenesis of endometriosis, periostin may be a new clinical therapy target for endometriosis.

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Thyroid Hormones as Renal Cell Cancer Regulators

It is known that thyroid hormone is an important regulator of cancer development and metastasis. What is more, changes across the genome, as well as alternative splicing, may affect the activity of the thyroid hormone receptors. Mechanism of action of the thyroid hormone is different in every cancer; therefore in this review thyroid hormone and its receptor are presented as a regulator of renal cell carcinoma.

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Sinus surgery: optimal surgery, optimal outcome?

Sinus surgery: optimal surgery, optimal outcome?

Rhinology. 2016 Mar 12;

Authors: Fokkens WJ

Abstract
Sinus surgery remains an issue of discussion. We lack data on a number of important issues. In this issue of the journal Jiang et al. show that 67 % of their patients who underwent FESS for CRS had OSAS (of which more than half moderate to severe) but only 38% complained of daytime sleepiness irrespective of BMI. The OSAS was also not correlated with the severity of rhinosinusitis, SNOT-20 score, nasal obstruction score, en- doscopic score, CT score, and smell function. It could be an argument for FESS although unfortunately the authors did not report whether the OSAS decreased after FESS.

PMID: 26970345 [PubMed - as supplied by publisher]

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Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis.

Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis.

Rhinology. 2016 Mar 12;

Authors: Pundir V, Pundir J, Lancaster G, Baer S, Kirkland P, Cornet M, Lourijsen ES, Georgalas C, Fokkens WJ

Abstract
BACKGROUND: The aim of our study is to systematically review the existing evidence on the role of corticosteroids in patients undergoing functional endoscopic sinus surgery (FESS).
METHODOLOGY: Systematic search of MEDLINE (1950- 2014), EMBASE (1980-2014), metaRegister, Cochrane Library and ISI conference proceedings was carried out.
RESULTS: Eighteen randomised controlled trials with 1309 patients were included. Use of local and/or systemic corticosteroids with FESS was reported in four categories; operative, anaesthesia related, post-operative outcomes and risk of recurrence. Meta-analysis for operative outcomes demonstrated that, mean operative time (MD -10.70 minutes; 95% CI -15.86, -5.55; P <0.0001) and mean estimated blood loss (MD -28.32 mls; 95% CI -40.93, -15.72; P <0.0001) was significantly lower; and surgical field quality (MD -0.81; 95% CI -1.32, -0.30; P = 0.002) was significantly better in corticosteroid group. Meta-analysis showed that post-operative endoscopic scores (SMD -0.39; 95% CI -0.60, -0.17; P = 0.0004) were significantly better in corticosteroid group compared to no corticosteroid group. There was no increase in risk of sinusitis (RR 0.64; 95% CI 0.32, 1.30; P = 0.22) between use of corticosteroids and no corticosteroids; There was no significant difference in recurrence risk of chronic rhinosinusitis (CRS) in mixed population studies (RR 0.77; 95% CI 0.35, 1.70; P = 0.52) between the two groups but analysis of studies reporting on chronic rhinosinusitis with nasal polyps (CRSwNP) (RR 0.64;95% CI 0.45,0.91;P=0.01) showed significant difference in favour of the corticosteroid group.
CONCLUSION: Pre-operative use of local and/or systemic corticosteroids in FESS, results in significantly reduced blood loss, shorter operative time and improved surgical field quality. Studies are limited on the intra-operative use of corticosteroids to reduce postoperative pain. Postoperative corticosteroids improve postoperative endoscopic scores in CRS and recurrence rates in cases of CRSwNP.

PMID: 26970247 [PubMed - as supplied by publisher]

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Automated assessment of intranasal trigeminal function.

Automated assessment of intranasal trigeminal function.

Rhinology. 2016 Mar 12;

Authors: Hummel T, Kaehling C, Grosse F

Abstract
BACKGROUND: The intranasal trigeminal system is a key player in the perception of intranasal airflow. Why it has not been studied very well may be due to the lack of techniques that allow for fast, reliable and inexpensive routine investigation of the system. The basis of the current study is the notion that - within limits - the intranasal trigeminal system detects the overall mass of a stimulus and not just its concentration. Thus, changing the duration of the stimulus at a given concentration has a similar effect as changing its concentration.
METHODOLOGY: Ninety-nine normosmic subjects participated [48 women and 51 men; mean (range) age = 45 years (20-88 years)]. In addition, 50 patients with olfactory loss were investigated once (28 women, 22 men; mean age 58 years, SD = 14 years; age range 24-88 years; causes of olfactory loss: viral infections n = 22, head trauma n = 8, chronic sinunasal disease n = 3, idiopathic n = 17). CO2-stimuli with various durations (multiples of 50 ms) were presented through a standard bilateral nasal cannula at an interval of 10 s; stimulus duration was increased by 50 ms from one stimulus presentation to the next, until the subject pushed a button indicating a painful sensation. This was the basis for automated assessment of CO2-pain responsiveness.
RESULTS: This current study had four main findings: (1) Using the new, automated device CO2 pain responsiveness can be measured reliably, (2) CO2 pain responsiveness correlates with olfactory function, (3) as with olfaction, women are more sensitive to CO2 , and CO2 - pain responsiveness also correlates with aging, (4) CO2 - pain responsiveness is lower in patients with olfactory loss compared to normosmic, healthy controls, even when controlling for age.
CONCLUSION: We have demonstrated that the current approach is a reliable and valid measure of intranasal trigeminal function.

PMID: 26970101 [PubMed - as supplied by publisher]

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Human Hemochromatosis Protein (HFE) Immunoperoxidase Stain Highlights Choriocarcinoma within Mixed Germ Cell Tumors

Identification of choriocarcinoma within a germ cell tumor can have major implications for the subsequent staging and treatment of testicular neoplasms. Immunoperoxidase staining greatly enhances the speed and sensitivity of identifying occult, though clinically significant, tumor components. In mixed germ cell tumors, staining for beta-human chorionic gonadotropin (β-hCG) has been historically used to assess for the presence and burden of choriocarcinoma. However, current β-hCG stains produce variable, intense staining of trophoblastic elements and surrounding tissues, clouding the assessment of true-positive staining. Human hemochromatosis protein (HFE) is a membrane bound mediator of iron transport expressed at high levels within placenta. Additionally, previous reports have demonstrated that choriocarcinoma cell lines express HFE, although in vivo expression had not been examined. To address whether HFE can stain trophoblastic elements, HFE immunohistochemistry was conducted in choriocarcinoma (), mixed germ cell tumors (), seminoma (), and placenta (). HFE consistently demonstrated cytoplasmic and membranous staining, highlighting both syncytiotrophoblasts and cytotrophoblasts within choriocarcinoma and placenta. Staining of intratumoral white blood cells was observed within seminomas and mixed germ cell tumors, corroborating prior reports stating that HFE highlights monocytes and macrophages. Taken together, HFE may serve as an alternative target from β-hCG for immunoperoxidase studies when highlighting choriocarcinoma.

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China's soil and groundwater management challenges: Lessons from the UK's experience and opportunities for China.

China's soil and groundwater management challenges: Lessons from the UK's experience and opportunities for China.

Environ Int. 2016 Mar 9;91:196-200

Authors: Coulon F, Jones K, Li H, Hu Q, Gao J, Li F, Chen M, Zhu YG, Liu R, Liu M, Canning K, Harries N, Bardos P, Nathanail P, Sweeney R, Middleton D, Charnley M, Randall J, Richell M, Howard T, Martin I, Spooner S, Weeks J, Cave M, Yu F, Zhang F, Jiang Y, Longhurst P, Prpich G, Bewley R, Abra J, Pollard S

Abstract
There are a number of specific opportunities for UK and China to work together on contaminated land management issues as China lacks comprehensive and systematic planning for sustainable risk based land management, encompassing both contaminated soil and groundwater and recycling and reuse of soil. It also lacks comprehensive risk assessment systems, structures to support risk management decision making, processes for verification of remediation outcome, systems for record keeping and preservation and integration of contamination issues into land use planning, along with procedures for ensuring effective health and safety considerations during remediation projects, and effective evaluation of costs versus benefits and overall sustainability. A consequence of the absence of these overarching frameworks has been that remediation takes place on an ad hoc basis. At a specific site management level, China lacks capabilities in site investigation and consequent risk assessment systems, in particular related to conceptual modelling and risk evaluation. There is also a lack of shared experience of practical deployment of remediation technologies in China, analogous to the situation before the establishment of the independent, non-profit organisation CL:AIRE (Contaminated Land: Applications In Real Environments) in 1999 in the UK. Many local technology developments are at lab-scale or pilot-scale stage without being widely put into use. Therefore, a shared endeavour is needed to promote the development of technically and scientifically sound land management as well as soil and human health protection to improve the sustainability of the rapid urbanisation in China.

PMID: 26970591 [PubMed - as supplied by publisher]

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Cancer Cell Membrane-Coated Upconversion Nanoprobes for Highly Specific Tumor Imaging.

Cancer Cell Membrane-Coated Upconversion Nanoprobes for Highly Specific Tumor Imaging.

Adv Mater. 2016 Mar 10;

Authors: Rao L, Bu LL, Cai B, Xu JH, Li A, Zhang WF, Sun ZJ, Guo SS, Liu W, Wang TH, Zhao XZ

Abstract
Cancer cell membrane-coated upconversion nanoprobes (CC-UCNPs) with immune escape and homologous targeting capabilities are used for highly specific tumor imaging. The combination of UCNPs with biomimetic cancer cell membranes embodies a novel materials design strategy and presents a compelling class of advanced materials.

PMID: 26970518 [PubMed - as supplied by publisher]

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Improvement of islet engrafts by enhanced angiogenesis and microparticle-mediated oxygenation.

Improvement of islet engrafts by enhanced angiogenesis and microparticle-mediated oxygenation.

Biomaterials. 2016 Feb 27;89:157-165

Authors: Montazeri L, Hojjati-Emami S, Bonakdar S, Tahamtani Y, Hajizadeh-Saffar E, Noori-Keshtkar M, Najar-Asl M, Ashtiani MK, Baharvand H

Abstract
A major hindrance in islet transplantation as a feasible therapeutic approach for patients with type 1 diabetes is the insufficient oxygenation of the grafts, which results in cell death in portions of the implant. Here we address this limitation through the application of oxygen-generating microparticles (MP) and a fibrin-conjugated heparin/VEGF collagen scaffold to support cell survival by using a β cell line and pancreatic rat islets. MP are composed of a polyvinylpyrrolidone/hydrogen peroxide (PVP/H2O2) core and poly(d,l-lactide-co-glycolide) (PLGA) shell, along with immobilized catalase on the shell. The presence of MP is sufficient to reduce hypoxia-induced cell dysfunction and death for both cell types, resulting in localization of hypoxia-inducible factor (HIF-1α) into the cytoplasm and enhanced metabolic function. After co-transplantation of MP and a reduced islet mass (250 islet equivalents) within an angiogenic scaffold in the omental pouch of streptozotocin-induced diabetic nude mice, we have observed significantly promoted graft function as evidenced by improved blood glucose levels, body weight, glucose tolerance, serum C-peptide, and graft revascularization. These results suggest that the developed platform has great potential to enhance the efficacy for implants in cases where the cell dosage is critical for efficacy, such as islet transplantation and ischemic tissues.

PMID: 26970510 [PubMed - as supplied by publisher]

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The 2015 International Society for Heart and Lung Transplantation Guidelines for the management of fungal infections in mechanical circulatory support and cardiothoracic organ transplant recipients: Executive summary.

The 2015 International Society for Heart and Lung Transplantation Guidelines for the management of fungal infections in mechanical circulatory support and cardiothoracic organ transplant recipients: Executive summary.

J Heart Lung Transplant. 2016 Mar;35(3):261-282

Authors: Husain S, Sole A, Alexander BD, Aslam S, Avery R, Benden C, Billaud EM, Chambers D, Danziger-Isakov L, Fedson S, Gould K, Gregson A, Grossi P, Hadjiliadis D, Hopkins P, Luong ML, Marriott DJ, Monforte V, Muñoz P, Pasqualotto AC, Roman A, Silveira FP, Teuteberg J, Weigt S, Zaas AK, Zuckerman A, Morrissey O

PMID: 26970469 [PubMed - as supplied by publisher]

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Comparison of the psychometric properties of four dementia knowledge measures: Which test should be used with dementia care staff?

Comparison of the psychometric properties of four dementia knowledge measures: Which test should be used with dementia care staff?

Australas J Ageing. 2016 Mar 11;

Authors: Sullivan KA, Mullan MA

Abstract
AIM: To compare the psychometric properties of four measures of dementia institutional knowledge.
METHODS: Fifty-eight dementia care staff completed the Dementia Knowledge Assessment Tool Version Two (DKAT2), Alzheimer's Disease Knowledge Test (ADKT), Alzheimer's Disease Knowledge Scale (ADKS) and Dementia Knowledge Twenty (DK-20). The convergent validity and reliability of each measure were examined.
RESULTS: The level of dementia knowledge in this sample was similar to that reported in comparable surveys. The ADKT, DKAT-2 and DK-20 had marginal to acceptable internal consistency (α ≥ 0.67), and the ADKT, DK-20 and ADKS were positively correlated with each other (r's = 0.45-0.60), demonstrating convergent validity. The DKAT2 had lower intercorrelations with the other measures (r's = 0.32-0.45). The ADKS had poor internal consistency (α = 0.29).
CONCLUSION: As the first head-to-head comparison of these tests in a single sample, this study should assist clinicians and researchers to select a dementia knowledge test.

PMID: 26970426 [PubMed - as supplied by publisher]

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A web-based survey of horse owners' perceptions and network analysis of horse movements relating to African horse sickness distribution in Namibia and South Africa.

A web-based survey of horse owners' perceptions and network analysis of horse movements relating to African horse sickness distribution in Namibia and South Africa.

Acta Trop. 2016 Mar 9;

Authors: Liebenberg D, Piketh S, Hamburg HV

Abstract
Africa horse sickness (AHS) is the most lethal infectious non-contagious horse disease and has accordingly been declared notifiable by the World Organisation for Animal Health. AHS is endemic to sub-Saharan Africa and causes considerable losses to the equestrian industry. The effect of diseases in livestock on socio-economic factors is well researched, but the effect of anthropogenic factors on the distribution of a disease is poorly understood. The purpose of the study was to assess Namibian and South African horse owners' perceptions and the effect of horse movement on AHS distribution. A cross-sectional study was conducted to collect information from horse owners in Namibia and South Africa. To that end 'Fluid survey(©)' was used for survey development. The survey was launched on Facebook(©) and the link shared to horse related focus groups in Namibia and South Africa. A total of 508 responses were collected during the survey period. Of the 417 completed questionnaires received, 22% were from Namibia and 78% from South Africa. The participants comprised of 71% social and 29% professional riders. The most popular precautionary measures used, in addition to vaccination, were chemical repellents (64%) and stabling of horses during dusk and dawn (59%). A network analysis was performed in Gephi 0.8.2.B to illustrate the movement of horses between countries and districts/provinces. Network analysis results indicate that areas with the highest movement of horses corresponded to the areas with a high occurrence of AHS. Although 93% of the participants were aware that AHS is a notifiable and controlled disease, the process and efficiency of reporting is mostly unknown. With this snapshot of horse owners' perceptions and the effect of horse movement on the distribution of AHS, it is clear that a more holistic approach is needed. To that end, all environmental and social factors must be taken into account in effective management strategies.

PMID: 26970371 [PubMed - as supplied by publisher]

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Paving the way of systems biology and precision medicine in allergic diseases: The MeDALL success story.

Paving the way of systems biology and precision medicine in allergic diseases: The MeDALL success story.

Allergy. 2016 Mar 10;

Authors: Bousquet J, Anto JM, Akdis M, Auffray C, Keil T, Momas I, Postma D, Valenta R, Wickman M, Cambon-Thomsen A, Haahtela T, Lambrecht BN, Lodrup-Carlsen K, Koppelman GH, Sunyer J, Zuberbier T, Annesi-Maesano I, Arno A, Bindslev-Jensen C, De Carlo G, Forastiere F, Heinrich J, Kowalski ML, Maier D, Melén E, Palkonen S, Smit HA, Standl M, Wright J, Arsanoj A, Benet M, Balardini N, Garcia-Aymerich J, Gehring U, Guerra S, Hohman C, Kull I, Lupinek C, Pinart M, Skrindo I, Westman M, Smagghe D, Akdis C, Albang R, Anastasova V, Anderson N, Bachert C, Ballereau S, Ballester F, Basagana X, Bedbrook A, Bergstrom A, von Berg A, Brunekreef B, Burte E, Carlsen KH, Chatzi L, Coquet JM, Curin M, Demoly P, Eller E, Fantini MP, Gerhard B, Hammad H, von Hertzen L, Hovland V, Jacquemin B, Just J, Keller T, Kerkhof M, Kiss R, Kogevinas M, Koletzko S, Lau S, Lehmann I, Lemonnier N, McEachan R, Mäkelä M, Mestres J, Minina E, Mowinckel P, Nadif R, Nawijn M, Oddie S, Pellet J, Pin I, Porta D, Rancière F, Rial-Sebbag A, Saes Y, Schuijs MJ, Siroux V, Tischer CG, Torrent M, Varraso R, De Vocht J, Wenger K, Wieser S, Xu C

Abstract
MeDALL Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 20 (10) -2015 proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy(.) MeDALL linked epidemiological, clinical and basic research using a stepwise, large-scale and integrative approach: precisely phenotyped children followed in 14 birth cohorts spread across Europe were combined with systems biology omics, IgE measurement using micro-arrays and environmental data(.) Multimorbidity in the same child is more common than expected by chance alone, suggesting that these diseases share causal mechanisms irrespective of IgE sensitisation(.) IgE sensitisation should be considered differently in mono and polysensitized individuals(.) Allergic multimorbidities and IgE polysensitization are often associated with the persistence or severity of allergic diseases(.) Environmental exposures are relevant for the development of allergy-related diseases(.) To complement the population-based studies in children, MeDALL included mechanistic experimental animal studies and in vitro studies in humans(.) The integration of multimorbidities and polysensitization has resulted in a new classification framework of allergic diseases that could help to improve the understanding of genetic and epigenetic mechanisms of allergy as well as to better manage allergic diseases(.) Ethics and gender were considered(.) MeDALL had translational activities deployed within the EU agenda(.) This article is protected by copyright. All rights reserved.

PMID: 26970340 [PubMed - as supplied by publisher]

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Mechanisms of nonsteroidal anti-inflammatory drugs in cancer prevention.

Mechanisms of nonsteroidal anti-inflammatory drugs in cancer prevention.

Semin Oncol. 2016 Feb;43(1):65-77

Authors: Umar A, Steele VE, Menter DG, Hawk ET

Abstract
Various clinical and epidemiologic studies show that nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and cyclooxygenase inhibitors (COXIBs) help prevent cancer. Since eicosanoid metabolism is the main inhibitory targets of these drugs the resulting molecular and biological impact is generally accepted. As our knowledge base and technology progress we are learning that additional targets may be involved. This review attempts to summarize these new developments in the field.

PMID: 26970125 [PubMed - as supplied by publisher]

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The promise of omics-based approaches to cancer prevention.

The promise of omics-based approaches to cancer prevention.

Semin Oncol. 2016 Feb;43(1):36-48

Authors: Meerzaman D, Dunn BK, Lee M, Chen Q, Yan C, Ross S

Abstract
Cancer is a complex category of diseases caused in large part by genetic or genomic, transcriptomic, and epigenetic or epigenomic alterations in affected cells and the surrounding microenvironment. Carcinogenesis reflects the clonal expansion of cells that progressively acquire these genetic and epigenetic alterations-changes that, in turn, lead to modifications at the RNA level. Gradually advancing technology and most recently, the advent of next-generation sequencing (NGS), combined with bioinformatics analytic tools, have revolutionized our ability to interrogate cancer cells. The ultimate goal is to apply these high-throughput technologies to the various aspects of clinical cancer care: cancer-risk assessment, diagnosis, as well as target identification for treatment and prevention. In this article, we emphasize how the knowledge gained through large-scale omics-oriented approaches, with a focus on variations at the level of nucleic acids, can inform the field of chemoprevention.

PMID: 26970123 [PubMed - as supplied by publisher]

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Depletion of mitochondrial enzyme system in liver, lung, brain, stomach and kidney induced by benzo(a)pyrene.

Depletion of mitochondrial enzyme system in liver, lung, brain, stomach and kidney induced by benzo(a)pyrene.

Environ Toxicol Pharmacol. 2016 Mar 4;43:83-93

Authors: Ji X, Li Y, He J, Shah W, Xue X, Feng G, Zhang H, Gao M

Abstract
Mitochondrial dysfunction has recently received considerable attention as it plays an important role in adult human pathology caused by various drugs, endogenous agents and environmental agents. Benzo(a)pyrene (BaP), is a ubiquitous environmental contaminant mainly derived from anthropogenic activity during incomplete combustion of organic materials from various sources. The present study aimed to evaluate the effects of benzo(a)pyrene (BaP) on mitochondrial enzymes in the multiple organs including liver, lung, brain, stomach and kidney. ICR mice were exposed to different doses of BaP (2.5, 5 and 10mg/kg body weight) through oral gavage and intraperitoneal injection treatment for 13 weeks consecutively. The induced mitochondrial damage in the examined organs was assayed in terms of significant increase in lipid peroxidation (LPO) and prominent decrease in antioxidant enzymes. Non enzymatic antioxidants and Krebs cycle's enzymes were also significantly decreased in mitochondria. Additionally, BaP induced the body growth retardation and decrease in relative liver weight, increase in relative lung, stomach, kidney and brain weights, and this was further certified through histopathological lesions. Liver and lungs were more prominently damaged by BaP. The mitochondrial depletion increased in BaP dose-dependent manner.

PMID: 26970059 [PubMed - as supplied by publisher]

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Serum TCTP is involved in rat liver regeneration after hepatectomy.

Serum TCTP is involved in rat liver regeneration after hepatectomy.

Hepatol Res. 2016 Mar 11;

Authors: Hao S, Qin Y, Yin S, He J, He D, Wang C

Abstract
AIMS: The translationally controlled tumor protein (TCTP) has been reported to promote progression of many physiological processes. However, whether TCTP is involved in liver regeneration has been rarely studied. This study aimed to investigate the potential role of serum TCTP in liver regeneration after 2/3 partial hepatectomy.
METHODS: The synthesis rate and accumulated expression of TCTP was assessed by phosphor imaging and Western blotting, respectively. The mRNA expression of tctp was analyzed by quantitative real-time PCR. The effect of serum TCTP on hepatocyte proliferation was investigated by bromodeoxyuridine (BrdU) incorporation, liver/body weight ratio, albumin concentration and histological examination of liver following treatment of rat with anti-TCTP antibody or prokaryotic TCTP protein before hepatectomy. The MTT assay was used to examine effect of TCTP on hepatocyte proliferation in vitro.
RESULTS: The results showed that the expression of intracellular and serum TCTP protein was significantly increased in rats after 2/3 partial hepatectomy (PHx). In vivo BrdU labeling assay suggested that administration of anti-TCTP antibody before hepatectomy significantly decreased hepatocyte proliferation and liver/body weight ratio. The prokaryotic TCTP had potential promoting effect on hepatocyte proliferation both in vivo and in vitro although administration of prokaryotic TCTP into rats prior to hepatectomy did not increase the proliferation ratio and liver/body weight ratio. Furthermore, anti-TCTP antibody pretreatment decreased the expression of cyclinE, cdk2 and interleukin-6 in rat liver.
CONCLUSIONS: These findings suggest serum TCTP is involved in rat liver regeneration through promoting hepatocyte proliferation. This article is protected by copyright. All rights reserved.

PMID: 26969900 [PubMed - as supplied by publisher]

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Counties eliminating racial disparities in colorectal cancer mortality.

Counties eliminating racial disparities in colorectal cancer mortality.

Cancer. 2016 Mar 11;

Authors: Rust G, Zhang S, Yu Z, Caplan L, Jain S, Ayer T, McRoy L, Levine RS

Abstract
BACKGROUND: Although colorectal cancer (CRC) mortality rates are declining, racial-ethnic disparities in CRC mortality nationally are widening. Herein, the authors attempted to identify county-level variations in this pattern, and to characterize counties with improving disparity trends.
METHODS: The authors examined 20-year trends in US county-level black-white disparities in CRC age-adjusted mortality rates during the study period between 1989 and 2010. Using a mixed linear model, counties were grouped into mutually exclusive patterns of black-white racial disparity trends in age-adjusted CRC mortality across 20 three-year rolling average data points. County-level characteristics from census data and from the Area Health Resources File were normalized and entered into a principal component analysis. Multinomial logistic regression models were used to test the relation between these factors (clusters of related contextual variables) and the disparity trend pattern group for each county.
RESULTS: Counties were grouped into 4 disparity trend pattern groups: 1) persistent disparity (parallel black and white trend lines); 2) diverging (widening disparity); 3) sustained equality; and 4) converging (moving from disparate outcomes toward equality). The initial principal component analysis clustered the 82 independent variables into a smaller number of components, 6 of which explained 47% of the county-level variation in disparity trend patterns.
CONCLUSIONS: County-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. Counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all. Cancer 2016. © 2016 American Cancer Society.

PMID: 26969874 [PubMed - as supplied by publisher]

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Resolution of Rac-Bambuterol via Diastereoisomeric Salt Formation with o-Chloromandelic Acid and Differences in the Enantiomers' Pharmacodynamical Effects in Guinea Pigs and Beagles.

Resolution of Rac-Bambuterol via Diastereoisomeric Salt Formation with o-Chloromandelic Acid and Differences in the Enantiomers' Pharmacodynamical Effects in Guinea Pigs and Beagles.

Chirality. 2016 Apr;28(4):306-312

Authors: Wu J, Liu F, Wang S, Wang H, Liu Q, Song X, Li J, Xu L, Tan W

Abstract
In this study an enantioseparation method for rac-bambuterol (5-(2-(tert-butylamino)-1-hydroxyethyl)-1,3-phenylene bis(dimethylcarbamate)) via diastereoisomeric salt formation with o-chloromandelic acid was developed. The enantiomeric excess (ee) values and chemical purities of the desired products were confirmed by high-performance liquid chromatography (HPLC) using chiral stationary phase and reverse-phase HPLC analyses, respectively. The ee values and the chemical purities both exceeded 99%. Animal experiments showed that (R)-bambuterol was a potent inhibitor for histamine-induced asthma reactions. (S)-bambuterol was ineffective in relaxing the airways. Both enantiomers increased heart rates in beagles. Therefore, replacing rac-bambuterol with (R)-bambuterol could be beneficial for asthma patients. Chirality 28:306-312, 2016. © 2016 Wiley Periodicals, Inc.

PMID: 26969816 [PubMed - as supplied by publisher]

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International GWAS Consortium Identifies Novel Loci Associated with Blood Pressure in Children and Adolescents.

International GWAS Consortium Identifies Novel Loci Associated with Blood Pressure in Children and Adolescents.

Circ Cardiovasc Genet. 2016 Mar 11;

Authors: Parmar PG, Taal HR, Timpson NJ, Thiering E, Lehtimäki T, Marinelli M, Lind PA, Howe LD, Verwoert G, Aalto V, Uitterlinden AG, Briollais L, Evans DM, Wright MJ, Newnham JP, Whitfield JB, Lyytikäinen LP, Rivadeneira F, Boomsma DI, Viikari J, Gillman MW, St Pourcain B, Hottenga JJ, Montgomery GW, Hofman A, Kähönen M, Martin NG, Tobin MD, Raitakari O, Vioque J, Jaddoe VW, Jarvelin MR, Beilin LJ, Heinrich J, van Duijn CM, Pennell CE, EArly Genetics and Lifecourse Epidemiology Consortium, Lawlor DA, Palmer LJ

Abstract
BACKGROUND: -Our aim was to identify genetic variants associated with blood pressure (BP) in childhood and adolescence.
METHODS AND RESULTS: -Genome-wide association study data from participating European ancestry cohorts of the EAGLE ( EA: rly G: enetics and L: ifecourse E: pidemiology) Consortium was meta-analysed across three 'epochs'; pre-puberty [4-7 years], puberty [8-12 years] and post-puberty [13-20 years]. Two novel loci were identified as having genome-wide associations with systolic blood pressure across specific age epochs; rs1563894 (ITGA11, located in active H3K27Ac mark and transcription factor CHiP and CpG methylation site) during pre-puberty (p = 2.86 × 10(-8)) and rs872256 during puberty (p = 8.67 × 10(-9)). Several SNP 'clusters' were also associated with childhood BP at p < 5 × 10(-3). Using a p-value threshold of < 5 × 10(-3) we found some overlap in variants across the different age epochs within our study, and between several SNPs in any of the three epochs and adult BP related SNPs.
CONCLUSIONS: -Our results suggest that genetic determinants of blood pressure act from childhood, develop over the lifecourse, and show some evidence of age-specific effects.

PMID: 26969751 [PubMed - as supplied by publisher]

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Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery: a nationwide cohort study.

Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery: a nationwide cohort study.

Interact Cardiovasc Thorac Surg. 2016 Mar 10;

Authors: Thorsteinsson K, Andreasen JJ, Mortensen RN, Kragholm K, Torp-Pedersen C, Gislason G, Køber L, Fonager K

Abstract
OBJECTIVES: Data on nursing home admission in patient's ≥80 years after isolated coronary artery bypass grafting (CABG) are scarce. The purpose of this study was to evaluate longevity and subsequent admission to a nursing home stratified by age in a nationwide CABG cohort.
METHODS: All patients who underwent isolated CABG from 1996 to 2012 in Denmark were identified through nationwide registers. The cumulative incidence of admission to a nursing home after CABG was estimated. A Cox regression model was constructed to identify predictors for living in a nursing home 1 year after CABG. Kaplan-Meier estimates were used for survival analysis. Subanalysis on home care usage was performed in the period 2008-2012.
RESULTS: A total of 38 487 patients were included. The median age was 65.4 ± 9.5 years (1455 > 80 years) and 80% were males. The 30-day mortality rate was 2.8%, increasing with age (1.2% in patients <60 years and 7.8% in patients ≥80 years). The mortality rate at 1 year was 2.2% among patients aged <60 and 14.1% among patients ≥80 years. At the 1-year follow-up, 4.2% of patients <60 years, 7.9% of patients 60-70 years, 14.4% of patients 70-74 years, 18.5% of patients 75-79 years and 29.1% of patients ≥80 years had received home care. The proportion of patients admitted to a nursing home at 1, 5 and 10 years after CABG was 0.1, 0.4 and 1.0% (<60 years), and 1.4, 7.5 and 16.8% (≥80 years), respectively. Main predictors for living in a nursing home 1 year postoperatively were: age ≥80 years [hazard ratio (HR) 17.8, 95% confidence interval (CI) 7.4-42.8], female sex (HR 1.7, 95% CI 1.1-2.6), previous heart failure (HR 1.6, 95% CI 1.0-2.4), previous myocardial infarction (HR 2.0, 95% CI 1.3-3.2) and previous stroke (HR 3.3, 95% CI 2.1-4.9). Neither urgent nor emergency surgeries were significant predictors for living in a nursing home 1 year postoperatively.
CONCLUSIONS: The majority of all patients selected for CABG surgery in Denmark between 1996-2012, including the elderly, were able to live independently at home without the need of home care for many years after CABG. The risk of nursing home admission was small and dependent on the patient's age, sex and preoperative comorbidities.

PMID: 26969738 [PubMed - as supplied by publisher]

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The Association Between Built Environment Attributes and Physical Activity in East Asian Adolescents: A Systematic Review.

The Association Between Built Environment Attributes and Physical Activity in East Asian Adolescents: A Systematic Review.

Asia Pac J Public Health. 2016 Mar 10;

Authors: Lee LL, Kuo YL, Chan ES

Abstract
Asian adolescents living in Australia and England were found to be less active than their Western peers. We aimed to systematically examine evidence of the associations between attributes of the built environment and physical activity in adolescents dwelling in East Asian countries. A total of 10 electronic databases for relevant observational studies without time limit were searched. Five studies met the eligibility criteria, which involved a total of 43 817 schoolchildren aged 11 to 17 years. The majority of the built environment attributes measured was significantly associated with reported physical activity. Difficult access to public facilities was associated with physical inactivity. Inconsistent finding of the association between residential density and physical activity was found. Further studies comparing participants from different Asian countries using a longitudinal design with an appropriate period of follow-up and both objective and reported measures of built environment attributes and physical activity are needed.

PMID: 26969634 [PubMed - as supplied by publisher]

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A systematic review of the characteristics and validity of monitoring technologies to assess Parkinson's disease.

A systematic review of the characteristics and validity of monitoring technologies to assess Parkinson's disease.

J Neuroeng Rehabil. 2016;13(1):24

Authors: Godinho C, Domingos J, Cunha G, Santos AT, Fernandes RM, Abreu D, Gonçalves N, Matthews H, Isaacs T, Duffen J, Al-Jawad A, Larsen F, Serrano A, Weber P, Thoms A, Sollinger S, Graessner H, Maetzler W, Ferreira JJ

Abstract
BACKGROUND: There is growing interest in having objective assessment of health-related outcomes using technology-based devices that provide unbiased measurements which can be used in clinical practice and scientific research. Many studies have investigated the clinical manifestations of Parkinson's disease using such devices. However, clinimetric properties and clinical validation vary among the different devices.
METHODS: Given such heterogeneity, we sought to perform a systematic review in order to (i) list, (ii) compare and (iii) classify technological-based devices used to measure motor function in individuals with Parkinson's disease into three groups, namely wearable, non-wearable and hybrid devices. A systematic literature search of the PubMed database resulted in the inclusion of 168 studies. These studies were grouped based on the type of device used. For each device we reviewed availability, use, reliability, validity, and sensitivity to change. The devices were then classified as (i) 'recommended', (ii) 'suggested' or (iii) 'listed' based on the following criteria: (1) used in the assessment of Parkinson's disease (yes/no), (2) used in published studies by people other than the developers (yes/no), and (3) successful clinimetric testing (yes/no).
RESULTS: Seventy-three devices were identified, 22 were wearable, 38 were non-wearable, and 13 were hybrid devices. In accordance with our classification method, 9 devices were 'recommended', 34 devices were 'suggested', and 30 devices were classified as 'listed'. Within the wearable devices group, the Mobility Lab sensors from Ambulatory Parkinson's Disease Monitoring (APDM), Physilog®, StepWatch 3, TriTrac RT3 Triaxial accelerometer, McRoberts DynaPort, and Axivity (AX3) were classified as 'recommended'. Within the non-wearable devices group, the Nintendo Wii Balance Board and GAITRite® gait analysis system were classified as 'recommended'. Within the hybrid devices group only the Kinesia® system was classified as 'recommended'.

PMID: 26969628 [PubMed - as supplied by publisher]

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Characteristics of atmospheric single particles during haze periods in a typical urban area of Beijing: A case study in October, 2014.

Characteristics of atmospheric single particles during haze periods in a typical urban area of Beijing: A case study in October, 2014.

J Environ Sci (China). 2016 Feb;40:145-53

Authors: Liu L, Wang Y, Du S, Zhang W, Hou L, Vedal S, Han B, Yang W, Chen M, Bai Z

Abstract
To investigate the composition and possible sources of particles, especially during heavy haze pollution, a single particle aerosol mass spectrometer (SPAMS) was deployed to measure the changes of single particle species and sizes during October of 2014, in Beijing. A total of 2,871,431 particles with both positive and negative spectra were collected and characterized in combination with the adaptive resonance theory neural network algorithm (ART-2a). Eight types of particles were classified: dust particles (dust, 8.1%), elemental carbon (EC, 29.0%), organic carbon (OC, 18.0%), EC and OC combined particles (ECOC, 9.5%), Na-K containing particles (NaK, 7.9%), K-containing particles (K, 21.8%), organic nitrogen and potassium containing particles (KCN, 2.3%), and metal-containing particles (metal, 3.6%). Three haze pollution events (P1, P2, P3) and one clean period (clean) were analyzed, based on the mass and number concentration of PM2.5 and the back trajectory results from the hybrid single particle Lagrangian integrated trajectory model (Hysplit-4 model). Results showed that EC, OC and K were the major components of single particles during the three haze pollution periods, which showed clearly increased ratios compared with those in the clean period. Results from the mixing state of secondary species of different types of particles showed that sulfate and nitrate were more readily mixed with carbon-containing particles during haze pollution episodes than in clean periods.

PMID: 26969554 [PubMed - in process]

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Ethanol infiltration into demineralized dentin collagen fibrils via molecular dynamics simulations.

Ethanol infiltration into demineralized dentin collagen fibrils via molecular dynamics simulations.

Acta Biomater. 2016 Mar 8;

Authors: Jee SE, Zhou J, Tan J, Breschi L, Tay FR, Grégoire G, Pashley DH, Jang SS

Abstract
The purpose of this study is to investigate the interaction of neat ethanol with bound and non-bound water in completely demineralized dentin that is fully hydrated, using molecular dynamics (MD) simulation method. The key to creating resin-dentin bonds is the removal of residual free water layers and its replacement by ethanol solvent in which resin monomers are soluble, using the ethanol wet-bonding technique. The test null hypotheses were that ethanol cannot remove any collagen-bound water, and that ethanol cannot infiltrate into the spacing between collagen triple helix due to narrow interlayer spacing. Collagen fibrillar structures of overlap and gap regions were constructed by aligning the collagen triple helix of infinite length in hexagonal packing. Three layers of the water molecules were specified as the layers of 0.15-0.22 nm, 0.22-0.43 nm and 0.43-0.63 nm from collagen atoms by investigating the water distribution surrounding collagen molecules. Our simulation results show that ethanol molecules infiltrated into the intermolecular spacing in the gap region, which increased due to the lateral shrinkage of the collagen structures in contact with ethanol solution, while there was no ethanol infiltration observed in the overlap region. Infiltrated ethanol molecules in the gap region removed residual water molecules via modifying mostly the third water layer (50% decrease), which would be considered as a loosely-bound water layer. The first and second hydration layers, which would be considered as bound water layers, were not removed by the ethanol molecules, thus maintaining the helical structures of the collagen molecules.
STATEMENT OF SIGNIFICANCE: Highlight of the Research Using molecular simulation, ethanol infiltration into the demineralized dentin collagen structures is investigated. It is discovered that alignment of the collagen triple helices in the gap regions is altered by the contact with the ethanol, resulting into the infiltration of the ethanol molecules into the interlayer spacing of the collagen fibrillar structures. It is also found that non-bound water layers in the gap region are considerably mixed with the ethanol molecules, while the tightly bound water layers are not influenced by the ethanol infiltration.

PMID: 26969524 [PubMed - as supplied by publisher]

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Influencing chondrogenic differentiation of human mesenchymal stromal cells in scaffolds displaying a structural gradient in pore size.

Influencing chondrogenic differentiation of human mesenchymal stromal cells in scaffolds displaying a structural gradient in pore size.

Acta Biomater. 2016 Mar 8;

Authors: Di Luca A, Szlazak K, Lorenzo-Moldero I, Ghebes CA, Lepedda A, Swieszkowski W, Van Blitterswijk C, Moroni L

Abstract
Articular cartilage lesions have a limited ability to heal by themselves. Yet, golden standard treatments for cartilage repair such as drilling, microfracture and mosaicplasty provide further damage and an unstable solution that degenerates into fibrocartilage in time. Articular cartilage presents a number of gradients in cell number and size along with structural gradients in extra cellular matrix (ECM) composition. Therefore, creating scaffolds that display a structural gradient can be an appealing strategy for cartilage tissue regeneration treatments. In the present study, a scaffold with an in-built discrete gradient in pore size was produced by additive manufacturing. Human mesenchymal stromal cells (hMSCs) were seeded within the gradient scaffolds and their proliferation, differentiation and ECM deposition was evaluated with respect to 2 non-gradient scaffolds. Glycosaminoglycan (GAG) deposition was significantly higher in gradient scaffolds and non-gradient scaffolds with the smallest pore size compared to non-gradient scaffolds with the largest pore size. A gradual increase of chondrogenic markers was observed within the gradient structures with decreasing pore size, which was also accompanied by an increasingly compact ECM formation. Therefore, scaffolds displaying a structural gradient in pore size seem to be a promising strategy to aid in the process of hMSC chondrogenic differentiation and could be considered for improved cartilage tissue regeneration applications.
STATEMENT OF SIGNIFICANCE: We present the development of a novel hierarchical scaffold obtained by additivemanufacturing. Structural hierarchy is obtained by changing pore size within the porenetwork characterizing the fabricated scaffolds and proves to be a functional elementin the scaffold to influence adult stem cell differentiation in the chondrogenic lineage.Specifically, in regions of the scaffolds presenting smaller pores an increasingdifferentiation of stem cells towards the chondrogenic differentiation is displayed.Taking inspiration from the zonal organization of articular cartilage tissue, pore size gradients could, therefore, be considered as a new and important element in designing3D scaffolds for regenerative medicine applications, in particular for all those tissues where gradient physical properties are present.

PMID: 26969523 [PubMed - as supplied by publisher]

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