Call for Neuroradiology Editor-in-Chief candidates

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Do Residency Selection Factors Predict Radiology Resident Performance?

Publication date: Available online 24 November 2017
Source:Academic Radiology
Author(s): Vikas Agarwal, Gregory M. Bump, Matthew T. Heller, Ling-Wan Chen, Barton F. Branstetter, Nikhil B. Amesur, Marion A. Hughes
Rationale and ObjectivesThe purpose of our study is to determine what information in medical student residency applications predicts radiology residency success as defined by objective clinical performance data.Materials and MethodsWe performed a retrospective cohort study of residents who entered our institution's residency program through the National Resident Matching Program as postgraduate year 2 residents and completed the program over the past 2 years. Medical school grades, selection to Alpha Omega Alpha (AOA) Honor Society, United States Medical Licensing Examination (USMLE) scores, publication in peer-reviewed journals, and whether the applicant was from a peer institution were the variables examined. Clinical performance was determined by calculating each resident's cumulative major discordance rate for on-call cases the resident read and gave a preliminary interpretation. A major discordance was defined as a difference between the preliminary resident and the final attending interpretations that could immediately impact the care of the patient. A multivariate logistic regression was performed to determine significant variables.ResultsTwenty-seven residents provided preliminary reports on call for 67,145 studies. The mean major discordance rate was 1.08% (range 0.34%–2.54%). Higher USMLE Step 1 scores, publication before residency, and election to AOA Honor Society were all statistically significant predictors of lower major discordance rates (P values 0.01, 0.01,  and <0.001, respectively).ConclusionsOverall resident performance was excellent. There are predictors that help select the better performing residents, namely higher USMLE Step 1 scores, one to two publications during medical school, and election to AOA in the junior year of medical school.



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Diagnostic Utility of 3T Lung MRI in Children with Interstitial Lung Disease

Publication date: Available online 24 November 2017
Source:Academic Radiology
Author(s): Kushaljit Singh Sodhi, Madhurima Sharma, Edward Y. Lee, Akshay Kumar Saxena, Joseph L. Mathew, Meenu Singh, Niranjan Khandelwal
Rationale and ObjectivesThe objective of this study was to assess the diagnostic utility of 3-tesla (3T) magnetic resonance imaging (MRI) of lungs in the detection of interstitial lung disease (ILD) in pediatric patients.Materials and MethodsTwelve children (mean: 8.5 years, range: 4–12 years) with ILD were consecutively enrolled in this prospective study. HRCT and 3T lung MRI were performed in all patients within 2 days of each other. The sensitivity, the specificity, the positive predictive value, and the negative predictive value of detecting lung abnormalities related to ILD with 3T lung MRI were calculated, with high-resolution computed tomography (HRCT) as a standard of reference. Agreement between HRCT and 3T lung MRI, as well as between two reviewers, was calculated with the kappa coefficient.Results3T lung MRI had low sensitivity (66.67%) and high specificity (97.33%) in the detection of abnormalities related to ILD when compared to HRCT in children. Although 3T lung MRI performed well in the detection of consolidation, parenchymal bands and fissural thickening with a sensitivity of 100%, the sensitivity of 3T lung MRI in the detection of septal thickening, ground-glass opacity, nodules, and cysts was relatively low (50.0%, 50.0%, 66.67%, and 25.0%, respectively). Substantial agreement was seen between HRCT and 3T lung MRI (k = 0.7), whereas perfect agreement was seen between two reviewers in detecting abnormalities related to pediatric ILD (k = 0.9–1.0).ConclusionsIn comparison to HRCT, 3T lung MRI with routinely available MRI protocols and sequences can also well detect abnormalities such as consolidation, parenchymal bands, and fissural thickening in children with ILD. However, evaluation of septal thickening, ground-glass opacity, nodules, and cysts is limited with 3T lung MRI.



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Delineation of the primary tumour Clinical Target Volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG Oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines

Few studies have reported large inter-observer variations in target volume selection and delineation in patients treated with radiotherapy for head and neck squamous cell carcinoma. Consensus guidelines have been published for the neck nodes (see Grégoire et al., 2003, 2014), but such recommendations are lacking for primary tumour delineation. For the latter, two main schools of thoughts are prevailing, one based on geometric expansion of the Gross Tumour Volume (GTV) as promoted by DAHANCA, and the other one based on anatomical expansion of the GTV using compartmentalization of head and neck anatomy.

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Adjuvant breast radiotherapy: How to trade-off cost and effectiveness?

Publication date: Available online 23 November 2017
Source:Radiotherapy and Oncology
Author(s): Chris Monten, Yolande Lievens
IntroductionA series of health economic evaluations (HEE) has analysed the efficiency of new fractionation schedules and techniques for adjuvant breast radiotherapy. This overview assembles the available evidence and evaluates to what extent HEE-results can be compared.MethodsBased on a systematic literature review of HEEs from 1/1/2000 to 30/10/2016, all cost comparison (CC) and cost-effectiveness analyses (CEA) comparing different adjuvant breast radiotherapy approaches were analysed. Costs were extracted and converted to Euro 2016 and costs per QALY were summarized in cost-effectiveness planes.ResultsTwenty-four publications are withheld, comparing different fractionation schedules and/or irradiation techniques or evaluating the value of adding radiotherapy. Normofractionation and intensity-modulated, interstitial or intraluminal techniques are important cost-drivers. Highest reimbursements are observed in the US, but may overestimate the real cost. Hypofractionation is cost-effective compared to normofractionation, the results of partial breast irradiation are less unequivocal. Intra-operative and external beam approaches seem the most cost-effective for favourable risk groups, but whole breast irradiation is superior in terms of health effect and omission of radiotherapy in terms of costs.ConclusionHypofractionation may be considered the most relevant comparator for new strategies in adjuvant breast radiotherapy, with omission of radiotherapy as an interesting alternative in the very favourable subcategories, especially for partial breast techniques. Although comparison of CC and CEA is hampered by the variability in clinical and economic settings, HEE-based evidence can guide decision-making to tailor-made strategies, allocating the optimal treatment in terms of effectiveness as well as efficiency to the right indication.



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IJERPH, Vol. 14, Pages 1451: Intuitionistic Linguistic Multiple Attribute Decision-Making with Induced Aggregation Operator and Its Application to Low Carbon Supplier Selection

IJERPH, Vol. 14, Pages 1451: Intuitionistic Linguistic Multiple Attribute Decision-Making with Induced Aggregation Operator and Its Application to Low Carbon Supplier Selection

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14121451

Authors: Jun Liu Xianbin Wu Shouzhen Zeng Tiejun Pan

The main focus of this paper is to investigate the multiple attribute decision making (MADM) method under intuitionistic linguistic (IL) environment, based on induced aggregation operators and analyze possibilities for its application in low carbon supplier selection. More specifically, a new aggregation operator, called intuitionistic linguistic weighted induced ordered weighted averaging (ILWIOWA), is introduced to facilitate the IL information. Some of its desired properties are explored. A further generalization of the ILWIOWA, called intuitionistic linguistic generalized weighted induced ordered weighted averaging (ILGWIOWA), operator is developed. Furthermore, by employing the proposed operators, a MADM approach based on intuitionistic linguistic information is presented. Finally, an illustrative example concerning low carbon supplier selection and comparative analyses are conducted to demonstrate the effectiveness and practicality of the proposed approach.

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Ablation of ATG4B Suppressed Autophagy and Activated AMPK for Cell Cycle Arrest in Cancer Cells.

Ablation of ATG4B Suppressed Autophagy and Activated AMPK for Cell Cycle Arrest in Cancer Cells.

Cell Physiol Biochem. 2017 Nov 23;44(2):728-740

Authors: Liu PF, Hsu CJ, Tsai WL, Cheng JS, Chen JJ, Huang IF, Tseng HH, Chang HW, Shu CW

Abstract
BACKGROUND/AIMS: ATG4B is a cysteine protease required for autophagy, which is a cellular catabolic pathway involved in energy balance. ATG4B expression is elevated during tumor growth in certain types of cancer, suggesting that ATG4B is an attractive target for cancer therapy. However, little is known about the mechanisms through which ATG4B deprivation suppresses the growth of cancer cells.
METHODS: Cancer cells were transfected with either siRNA against ATG4B or an expression vector encoding wild-type ATG4BWT or encoding catalytic mutant ATG4BC74A to determine cell cycle progression by propidium iodide staining or by BrdU incorporation assay using flow cytometry. The GFP-MAP1LC3-II puncta and protein levels in the cells were determined by immunofluorescence and immunoblotting, respectively.
RESULTS: Knockdown of ATG4B blocked cell proliferation, particularly at the G1-S phase transition, in various cancer cells. Moreover, knockdown of ATG4B or overexpression of the ATG4BC74A catalytic mutant reduced both autophagic flux and ATP levels and increased AMP-activated protein kinase (AMPK) phosphorylation in the cancer cells. Nevertheless, knockdown of ATG4B had only a minor effect on AMPK activation and G1 phase arrest in liver kinase B1 (LKB1)-deficient or AMPK-inhibited cancer cells.
CONCLUSION: These results imply that targeting ATG4B might inhibit autophagy and trigger the LKB1-AMPK energy-sensing pathway, resulting in tumor growth suppression.

PMID: 29169176 [PubMed - as supplied by publisher]

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Energy dissipation mapping of cancer cells.

Energy dissipation mapping of cancer cells.

Micron. 2017 Nov 14;105:24-29

Authors: Dutta D, Palmer XL, Kim J, Qian S, Stacey M

Abstract
The purpose of this study is to map the energy dissipation of Jurkat cells using a single 60 nanosecond pulse electric field (NsPEF), primarily through atomic force microscopy (AFM). The phase shift is generated by the sample elements that do not have a heterogeneous surface. Monitoring and manipulating the phase shift is a powerful way for determining the dissipated energy and plotting the topography. The dissipated energy is a relative value, so the silica wafer and cover slip are given a set reference while the transmission of energy between the tip of the cantilever and cell surfaces is measured. The most important finding is that the magnitude and the number of variations in the dissipated energy change with the strength of NsPEF applied. Utilizing a single low field strength NsPEF (15kV/cm), minor changes in dissipated energy were found. The application of a single high field strength NsPEF (60kV/cm) to Jurkat cells resulted in a higher dissipated energy change versus that of in the low field strength condition. Thus, the dissipated energy from the Jurkat cells changes with the strength of NsPEF. By analyzing the forces via investigation in the tapping mode of the AFM, the stabilization of the cytoskeleton and membrane of the cell are related to the strength of NsPEF applied. Furthermore, the strength of NsPEF indicates a meaningful relationship to the survival of the Jurkat cells.

PMID: 29169143 [PubMed - as supplied by publisher]

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Characterization and mechanism analysis of lincomycin biodegradation with Clostridium sp. strain LCM-B isolated from lincomycin mycelial residue (LMR).

Characterization and mechanism analysis of lincomycin biodegradation with Clostridium sp. strain LCM-B isolated from lincomycin mycelial residue (LMR).

Chemosphere. 2017 Nov 13;193:611-617

Authors: Wang M, Cai C, Zhang B, Liu H

Abstract
Lincomycin mycelial residue (LMR) is the restricted resource because it contains residual lincomycin, which is producing potential risks to the environment and human health. In this study, lincomycin-degrading strain LCM-B was isolated and identified as Clostridium sp. in the LMR. Strain LCM-B was able to degrade 62.03% of lincomycin at the initial concentration of 100 mg L(-1) after incubation for 10 d, while only 15.61% of lincomycin was removed at the initial concentration of 500 mg L(-1). The removal efficiency of lincomycin by strain LCM-B decreased as the initial concentration increased. Gene lnuB (which encodes the nucleotidyl transferase) was detected in the isolated strain, and it was proven to participate in lincomycin biodegradation based on the analysis of degradation products and pathway. The results provide a relatively complete understanding of lincomycin biodegradation mechanism. Strain LCM-B is promising to eliminate lincomycin from the LMR.

PMID: 29169137 [PubMed - as supplied by publisher]

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Alterations of mitochondrial antioxidant indexes and apoptosis in duck livers caused by Molybdenum or/and cadmium.

Alterations of mitochondrial antioxidant indexes and apoptosis in duck livers caused by Molybdenum or/and cadmium.

Chemosphere. 2017 Nov 14;193:574-580

Authors: Dai X, Xing C, Cao H, Luo J, Wang T, Liu P, Guo X, Hu G, Zhang C

Abstract
Cadmium (Cd) and high Molybdenum (Mo) can lead to adverse reactions on animals, but the co-induced toxicity of Mo and Cd to liver in ducks was not well understood. To investigate the co-induced toxic effects of Mo combined with Cd on mitochondrial oxidative stress and apoptosis in duck livers. 240 healthy 11-day-old ducks were randomly divided into 6 groups (control, LMo group, HMo group, Cd group, LMoCd group and HMoCd group). After being treated for 30, 60, 90 and 120 days, liver mitochondrial antioxidant indexes, ceruloplasmin (CP), metallothionein (MT), Bak-1 and Caspase-3 genes mRNA expression levels, and ultrastructural changes were evaluated. The results showed that total antioxidative capacity (T-AOC), catalase (CAT), superoxide dismutase (SOD) and xanthine oxidase (XOD) activities in experimental groups were decreased, whereas malondialdehyde (MDA) content and nitric oxide synthase (NOS) activity were increased compared with control group, and these changes of co-treated groups were more obvious in the later period of the experiment. The mRNA expression levels of CP, Bak-1 and Caspase-3 were up-regulated in experimental groups compared with control group and showed significant difference between co-treated groups and single treated groups. The mRNA expression level of MT in Cd group was higher than that in co-treated groups. Additionally, ultrastructural changes showed karyopyknosis, mitochondrial swelling, vacuolation and disruption of mitochondrial cristae in co-treated groups. Taken together, it was suggested that dietary Mo and Cd might lead to mitochondrial oxidative stress and apoptosis in duck livers, and it showed a possible synergistic relationship between the two elements.

PMID: 29169133 [PubMed - as supplied by publisher]

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Disorder of gut amino acids metabolism during CKD progression is related with gut microbiota dysbiosis and metagenome change.

Disorder of gut amino acids metabolism during CKD progression is related with gut microbiota dysbiosis and metagenome change.

J Pharm Biomed Anal. 2017 Nov 15;149:425-435

Authors: Liu Y, Li J, Yu J, Wang Y, Lu J, Shang EX, Zhu Z, Guo J, Duan J

Abstract
Chronic kidney disease (CKD) is a worldwide public health problem. Uremic retention solutes such as indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are accumulated in CKD patients and are associated with the incidence of CKD progression. Amino acids are the major precursors of uremic retention solutes in gut. The dynamic change of amino acid metabolism in the gut during CKD progression has not been reported previously. In this paper, we studied the dynamic change of gut IS/PCS precursor and amino acid metabolism profile during CKD progression in 5/6 nephrectomized (5/6Nx) rats model. The related gut microbiota and metagenome profile was also studied. Rat plasma, urine and feces were collected at different time points after nephrectomization. Plasma IS and PCS, fecal indole (the precursor of IS), p-cresol (the precursor of PCS) and 19 kinds of amino acids were analyzed by LC-MS. During CKD progression, 5/6 Nx rats showed increased plasma IS, PCS concentration and increased fecal indole, p-cresol concentration. 5/6 Nx rats also showed disordered gut amino acids metabolism profile which became more significant along with the progession of CKD. The abundance of some specific gut bacteria also changed significantly in 5/6 Nx rats. The 16S rDNA sequencing data of gut microbiota was further analyzed by an online tool PICRUSt, a large-scale computational method for metagenomes prediction with 16S rDNA sequencing data. The content of each gene was compared between the two groups by Mann-Whitney U test, and then the significantly regulated genes in 5/6 Nx group were subjected to KEGG website. The amino acid metabolism related genes were picked out. Most of these genes are more abundant in 5/6 Nx groups. Our study showed that gut amino acids metabolism profile was disordered with CKD progression, which was highly related to the gut microbiota dysbiosis and metagenome change. And that regulation of gut amino acids metabolism pathway may be a possible way to intervene the progression of CKD.

PMID: 29169110 [PubMed - as supplied by publisher]

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Reconciling ethical and economic conceptions of value in health policy using the capabilities approach: A qualitative investigation of Non-Invasive Prenatal Testing.

Reconciling ethical and economic conceptions of value in health policy using the capabilities approach: A qualitative investigation of Non-Invasive Prenatal Testing.

Soc Sci Med. 2017 Nov 16;195:97-104

Authors: Kibel M, Vanstone M

Abstract
When evaluating new morally complex health technologies, policy decision-makers consider a broad range of different evaluations, which may include the technology's clinical effectiveness, cost effectiveness, and social or ethical implications. This type of holistic assessment is challenging, because each of these evaluations may be grounded in different and potentially contradictory assumptions about the technology's value. One such technology where evaluations conflict is Non-Invasive Prenatal Testing (NIPT). Cost-effectiveness evaluations of NIPT often assess NIPT's ability to deliver on goals (i.e preventing the birth of children with disabilities) that social and ethical analyses suggest it should not have. Thus, cost effectiveness analyses frequently contradict social and ethical assessments of NIPT's value. We use the case of NIPT to explore how economic evaluations using a capabilities approach may be able to capture a broader, more ethical view of the value of NIPT. The capabilities approach is an evaluative framework which bases wellbeing assessments on a person's abilities, rather than their expressed preferences. It is linked to extra-welfarist approaches in health economic assessment. Beginning with Nussbaum's capability framework, we conducted a directed qualitative content analysis of interview data collected in 2014 from 27 Canadian women with personal experience of NIPT. We found that eight of Nussbaum's ten capabilities related to options, states, or choices that women valued in the context of NIPT, and identified one new capability. Our findings suggest that women value NIPT for its ability to provide more and different choices in the prenatal care pathway, and that a capabilities approach can indeed capture the value of NIPT in a way that goes beyond measuring health outcomes of ambiguous social and ethical value. More broadly, the capabilities approach may serve to resolve contradictions between ethical and economic evaluations of health technologies, and contribute to extra-welfarist approaches in the assessment of morally complex health technologies.

PMID: 29169104 [PubMed - as supplied by publisher]

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Using an electronic assessment system for nursing students on placements.

Using an electronic assessment system for nursing students on placements.

Br J Nurs. 2017 Nov 23;26(21):1192-1196

Authors: Smith J, Cambers W

Abstract
Electronic assessment is gaining popularity in clinically based elements of pre-registration nurse education. In this study, the authors explored student nurse and mentor experiences during transition from a paper to an electronic system. Mixed research methods used included survey questionnaires and focus groups. Student nurses and their mentors (both n=5) discussed and rated their confidence and skills in information technology and their experience of an electronic assessment document before and after two successive clinical placements. Students' self-reported confidence increased after both placements; mentors' confidence fell after the first placement. Students reported the fewest needs for additional support, while mentors expressed anxieties about system navigation and time required. The main barrier was lack of access to computers connected to the internet in the practice environment. Nevertheless, students and mentors were receptive to the change. Training and support was seen as essential. Serious challenges in up-scaling this system for complete student cohorts lie in wait if computer availability is not addressed.

PMID: 29168946 [PubMed - in process]

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Analysis of the experiences of nurses who return to nursing after cancer.

Analysis of the experiences of nurses who return to nursing after cancer.

Br J Nurs. 2017 Nov 23;26(21):1170-1175

Authors: Edward KL, Giandinoto JA, McFarland J

Abstract
BACKGROUND: understanding the impact of role ambiguity (both professional and patient) can be a factor in deepening the understanding of the ongoing personal, professional and organisational requirements of nurses who are cancer survivors.
PURPOSE: the aim of this qualitative study was to elucidate an in-depth description of nurses' experiences of surviving cancer.
METHOD: an exploratory qualitative research design was used (n=8), with participants recruited between September 2014 and December 2016.
DISCUSSION: data analysis led to the emergence of six themes: being practical about the diagnosis and treatment, empathy and compassion, a 'new normal' and the role of organisational support, medical knowledge and treatment experiences, coping in silence and denial, and being resilient.
CONCLUSION: nurses as cancer survivors who return to work offer a richness of experience related to enhanced empathetic responses to patients in their care and have the potential to be great practice role-models for other staff.

PMID: 29168945 [PubMed - in process]

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Synthesis, characterization, and biological properties of composites of hydroxyapatite and hexagonal boron nitride.

Synthesis, characterization, and biological properties of composites of hydroxyapatite and hexagonal boron nitride.

J Biomed Mater Res B Appl Biomater. 2017 Nov 23;:

Authors: Unal S, Ekren N, Sengil AZ, Oktar FN, Irmak S, Oral O, Sahin YM, Kilic O, Agathopoulos S, Gunduz O

Abstract
Hydroxyapatite (HA), obtained from bovine bones, was successfully reinforced with hexagonal boron nitrite (h-BN). h-BN/HA composites, with BN content up to 1.5 wt %, were sintered at various temperatures between 1000 and 1300°C, in air. Well-sintered samples were obtained after sintering at 1200 and 1300°C. The presence of h-BN contributed to dense, fine, and well-crystallized microstructure. The results of X-ray diffraction analysis and FT-IR spectroscopy showed that the produced composites comprised biphasic β-TCP/HCA (HCA: carbonate partially substituted HA). High values of mechanical properties were achieved, namely compression strength 155 MPa for the sample 0.5% h-BN/HA and Vickers microhardness of 716 HV for the samples 1.5% h-BN/HA, both sintered at 1300°C. U2OS human bone osteosarcoma proliferation and cell viability showed no adverse effect in the presence of h-BN/HA, suggesting the potential use of the produced materials as safe biomaterials in bone tissue engineering. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017.

PMID: 29168913 [PubMed - as supplied by publisher]

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Global scales for cognitive screening in Parkinson's disease: Critique and recommendations.

Global scales for cognitive screening in Parkinson's disease: Critique and recommendations.

Mov Disord. 2017 Nov 23;:

Authors: Skorvanek M, Goldman JG, Jahanshahi M, Marras C, Rektorova I, Schmand B, van Duijn E, Goetz CG, Weintraub D, Stebbins GT, Martinez-Martin P, members of the MDS Rating Scales Review Committee

Abstract
BACKGROUND: Cognitive impairment is a common nonmotor manifestation of Parkinson's disease, with deficits ranging from mild cognitive difficulties in 1 or more of the cognitive domains to severe dementia. The International Parkinson and Movement Disorder Society commissioned the assessment of the clinimetric properties of cognitive rating scales measuring global cognitive performance in PD to make recommendations regarding their use.
METHODS: A systematic literature search was conducted to identify the scales used to assess global cognitive performance in PD, and the identified scales were reviewed and rated as "recommended," "recommended with caveats," "suggested," or "listed" by the panel using previously established criteria.
RESULTS: A total of 12 cognitive scales were included in this review. Three scales, the Montreal Cognitive Assessment, the Mattis Dementia Rating Scale Second Edition, and the Parkinson's Disease-Cognitive Rating Scale, were classified as "recommended." Two scales were classified as "recommended with caveats": the Mini-Mental Parkinson, because of limited coverage of executive abilities, and the Scales for Outcomes in Parkinson's Disease-Cognition, which has limited data on sensitivity to change. Six other scales were classified as "suggested" and 1 scale as "listed."
CONCLUSIONS: Because of the existence of "recommended" scales for assessment of global cognitive performance in PD, this task force suggests that the development of a new scale for this purpose is not needed at this time. However, global cognitive scales are not a substitute for comprehensive neuropsychological testing. © 2017 International Parkinson and Movement Disorder Society.

PMID: 29168899 [PubMed - as supplied by publisher]

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Oral tolerance modulates the skin transcriptome in mice with induced atopic dermatitis.

Oral tolerance modulates the skin transcriptome in mice with induced atopic dermatitis.

Allergy. 2017 Nov 23;:

Authors: Baek JO, Lee JR, Roh JY, Jung Y

Abstract
Defective gut immune reactions have been implicated in the development of atopic dermatitis (AD), whereas oral tolerance (OT), i.e., the immune unresponsiveness induced by oral antigen administration, protects mice against AD. To investigate this protective role of OT, the transcriptomic profiles of skin were obtained by RNA sequencing from mice that were epicutaneously sensitized, orally tolerized prior to epicutaneous sensitization, or neither (control). OT inhibited the upregulation of keratin- and allergic inflammation-associated genes that occurred in the epicutaneously sensitized group. Compared to the controls, mice that were orally tolerized and epicutaneously sensitized showed an upregulation of genes that regulate inflammation or keratinocyte differentiation. Knocking down two of those genes, SCGB1A1 and TSC22D3, upregulated Th2 inflammatory mediators and downregulated a cornified cell envelope-related gene. Based on our findings, OT may protect skin against allergic inflammation by promoting the expression of genes that regulate Th2 inflammatory responses and skin barrier function. This article is protected by copyright. All rights reserved.

PMID: 29168893 [PubMed - as supplied by publisher]

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Probing impaired neurogenesis in human brain organoids exposed to alcohol.

Probing impaired neurogenesis in human brain organoids exposed to alcohol.

Integr Biol (Camb). 2017 Nov 23;:

Authors: Zhu Y, Wang L, Yin F, Yu Y, Wang Y, Shepard MJ, Zhuang Z, Qin J

Abstract
The fetal brain is highly vulnerable to ethanol exposure, which can trigger various long-term neuronal disabilities and cognitive dysfunctions. However, a comprehensive understanding of fetal brain development under ethanol exposure is challenging due to the limitations of animal models. Here, we propose a human induced pluripotent stem cell (hiPSC)-based 3D brain organoid model, and explore the mechanisms underlying neural dysfunctions in prenatal alcohol exposure (PAE) in vitro. Brain organoids were examined to resemble brain organogenesis in vivo at early stages during gestation, with specific features of neuronal differentiation, brain regionalization, and cortical organization. With ethanol exposure, the brain organoids displayed attenuated neurite outgrowth and skewed neural maturation. Transcriptome analysis identified a series of new markedly altered genes and enriched pathways, such as GSX2, RSPO2, and the Hippo signaling pathway. These genes or pathways, to our knowledge, were reported to be involved in ethanol-induced impaired neurogenesis for the first time. Our new findings might facilitate better understanding of the various postnatal neural disorders observed in individuals with PAE.

PMID: 29168871 [PubMed - as supplied by publisher]

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Verification of Non-Invasive Blood Glucose Measurement Method Based on Pulse Wave Signal Detected by FBG Sensor System.

Verification of Non-Invasive Blood Glucose Measurement Method Based on Pulse Wave Signal Detected by FBG Sensor System.

Sensors (Basel). 2017 Nov 23;17(12):

Authors: Kurasawa S, Koyama S, Ishizawa H, Fujimoto K, Chino S

Abstract
This paper describes and verifies a non-invasive blood glucose measurement method using a fiber Bragg grating (FBG) sensor system. The FBG sensor is installed on the radial artery, and the strain (pulse wave) that is propagated from the heartbeat is measured. The measured pulse wave signal was used as a collection of feature vectors for multivariate analysis aiming to determine the blood glucose level. The time axis of the pulse wave signal was normalized by two signal processing methods: the shortest-time-cut process and 1-s-normalization process. The measurement accuracy of the calculated blood glucose level was compared with the accuracy of these signal processing methods. It was impossible to calculate a blood glucose level exceeding 200 mg/dL in the calibration curve that was constructed by the shortest-time-cut process. In the 1-s-normalization process, the measurement accuracy of the blood glucose level was improved, and a blood glucose level exceeding 200 mg/dL could be calculated. By verifying the loading vector of each calibration curve to calculate the blood glucose level with a high measurement accuracy, we found the gradient of the peak of the pulse wave at the acceleration plethysmogram greatly affected.

PMID: 29168773 [PubMed - in process]

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Lanthanide-Doped Nanoparticles for Diagnostic Sensing.

Lanthanide-Doped Nanoparticles for Diagnostic Sensing.

Nanomaterials (Basel). 2017 Nov 23;7(12):

Authors: Lee SY, Lin M, Lee A, Park YI

Abstract
Lanthanide-doped nanoparticles exhibit unique optical properties, such as a long luminescence lifetime (up to several milliseconds), sharp emission peaks, and upconversion luminescence over the range of wavelengths from near-infrared to visible. Exploiting these optical properties, lanthanide-doped nanoparticles have been widely utilized for cellular and small animal imaging with the absence of background autofluorescence. In addition, these nanoparticles have advantages of high signal-to-noise ratio for highly sensitive and selective diagnostic detection. In this review, we summarize and discuss recent progress in the development of highly sensitive diagnostic methods using lanthanide-doped nanoparticles. Combined with a smartphone, portable luminescence detecting platforms could be widely applied in point-of-care tests.

PMID: 29168770 [PubMed]

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The Content of Structural and Trace Elements in the Knee Joint Tissues.

The Content of Structural and Trace Elements in the Knee Joint Tissues.

Int J Environ Res Public Health. 2017 Nov 23;14(12):

Authors: Roczniak W, Brodziak-Dopierała B, Cipora E, Mitko K, Jakóbik-Kolon A, Konieczny M, Babuśka-Roczniak M

Abstract
Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead.

PMID: 29168758 [PubMed - in process]

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Contents

Publication date: December 2017
Source:Health Policy, Volume 121, Issue 12





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Editorial Board

Publication date: December 2017
Source:Health Policy, Volume 121, Issue 12





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Demographic factors and attitudes that influence the support of the general public for the introduction of universal healthcare in Ireland: A national survey

Publication date: Available online 24 November 2017
Source:Health Policy
Author(s): Catherine D. Darker, Erica Donnelly-Swift, Lucy Whiston
Ireland is still struggling to end the inequitable two-tiered health system and introduce universal healthcare (UHC). Public opinion can influence health policy choice and implementation. However, the public are rarely asked for their views. This study describes the demographic and attitudinal factors that influence the support of the public for the introduction of UHC. It provides data on a nationally representative survey sample of n=972. There are high levels of support for the introduction of UHC (n=846 87.0%). Logistic regression analyses indicated that demographic factors, such as, the location of respondent, whether the respondent was in receipt of Government supported healthcare, a purchaser of private health insurance or neither; plus attitudinal factors, such as, opinions on the Government prioritising healthcare, healthcare being free at the point of access, taxes being increased to provide care free at the point of access and how well informed participants felt about UHC were associated with agreeing with the introduction of UHC in Ireland. This paper is timely for policy leaders both in Ireland and internationally as countries with UHC, such as the United Kingdom, are facing difficulties maintaining health services in the public realm.



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Out-of-pocket health expenditure differences in Chile: Insurance performance or selection?

Publication date: Available online 20 November 2017
Source:Health Policy
Author(s): Pablo Villalobos Dintrans
Chile has a mixed health system with public and private actors engaged in provision and insurance. This dual system generates important differences in health expenditure between private and public insurances. Selection is a preeminent feature of the Chilean insurance system. In order to explain the role of the insurance in out-of-pocket expenditures between households for different insurance schemes, decomposition methods are applied to disentangle the effect of household ‘composition and insurance’ degree of financial protection on health expenditures. Health expenditure patterns have not changed in the last 10 years with drugs, outpatient care, and dental health representing 60% of the health expenditure. Health expenditure/income is similar for different income groups in the public insurance, but decreases with income in households with private coverage, reflecting regressivity in health expenditure. On the other hand, health expenditure as share of expenditure increases with income for both groups.Per capita health expenditure in households with private coverage is four times the expenditure of households with public insurance; this gap is mostly explained by differences in households’ expenditure and demographics. Roughly 80% of the difference in expenditure is explained by the model, showing the role of selection in understanding the expenditure gap between insurance schemes.



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The importance of population differences: Influence of individual characteristics on the Australian public’s preferences for emergency care

Publication date: Available online 17 November 2017
Source:Health Policy
Author(s): Paul Harris, Jennifer A. Whitty, Elizabeth Kendall, Julie Ratcliffe, Andrew Wilson, Peter Littlejohns, Paul A. Scuffham
A better understanding of the public’s preferences and what factors influence them is required if they are to be used to drive decision-making in health. This is particularly the case for service areas undergoing continual reform such as emergency and primary care. Accordingly, this study sought to determine if attitudes, socio-demographic characteristics and healthcare experiences influence the public’s intentions to access care and their preferences for hypothetical emergency care alternatives. A discrete choice experiment was used to elicit the preferences of Australian adults (n=1529). Mixed logit regression analyses revealed the influence of a range of individual characteristics on preferences and service uptake choices across three different presenting scenarios. Age was associated with service uptake choices in all contexts, whilst the impact of other sociodemographics, health experience and attitudinal factors varied by context. The improvements in explanatory power observed from including these factors in the models highlight the need to further clarify their influence with larger populations and other presenting contexts, and to identify other determinants of preference heterogeneity. The results suggest social marketing programs undertaken as part of demand management efforts need to be better targeted if decision-makers are seeking to increase community acceptance of emerging service models and alternatives. Other implications for health policy, service planning and research, including for workforce planning and the possible introduction of a system of co-payments are discussed.



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Three year Experience of Non-Melanoma Skin Cancer in a General Practice.

Three year Experience of Non-Melanoma Skin Cancer in a General Practice.

Ir Med J. 2017 Aug 12;110(7):616

Authors: Maguire J, Maguire N

Abstract
We report 85 lesions of non-melanoma skin cancer in 58 patients, representing 9% of the minor surgical workload of a single general practitioner. Cases were studied in order to describe pathology, management and outcomes. Eighteen percent of lesions were referred, mainly because of central facial site and larger size. Of the lesions treated in the surgery, all but four were treated surgically. Quantitative margins of lateral and deep excision were reported for 50% and 30% of specimens respectively. Lateral histological margins of clearance were narrower for head and neck lesions. Incomplete excision occurred in 4%. There was one recurrent lesion after two years of follow-up. A majority of non-melanoma skin cancers at this clinic were managed safely without referral to secondary care. Quantitative reporting of tumour free margins for skin cancer is lacking.

PMID: 29168998 [PubMed - in process]

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In Vitro Evaluation of PCL and P(3HB) as Coating Materials for Selective Laser Melted Porous Titanium Implants.

In Vitro Evaluation of PCL and P(3HB) as Coating Materials for Selective Laser Melted Porous Titanium Implants.

Materials (Basel). 2017 Nov 23;10(12):

Authors: Grau M, Matena J, Teske M, Petersen S, Aliuos P, Roland L, Grabow N, Murua Escobar H, Gellrich NC, Haferkamp H, Nolte I

Abstract
Titanium is widely used as a bone implant material due to its biocompatibility and high resilience. Since its Young's modulus differs from bone tissue, the resulting "stress shielding" could lead to scaffold loosening. However, by using a scaffold-shaped geometry, the Young's modulus can be adjusted. Also, a porous geometry enables vascularisation and bone ingrowth inside the implant itself. Additionally, growth factors can improve these effects. In order to create a deposit and release system for these factors, the titanium scaffolds could be coated with degradable polymers. Therefore, in the present study, synthetic poly-ε-caprolactone (PCL) and the biopolymer poly(3-hydroxybutyrate) (P(3HB)) were tested for coating efficiency, cell adhesion, and biocompatibility to find a suitable coating material. The underlying scaffold was created from titanium by Selective Laser Melting (SLM) and coated with PCL or P(3HB) via dip coating. To test the biocompatibility, Live Cell Imaging (LCI) as well as vitality and proliferation assays were performed. In addition, cell adhesion forces were detected via Single Cell Force Spectroscopy, while the coating efficiency was observed using environmental scanning electron microscopy (ESEM) and energy-dispersive X-ray (EDX) analyses. Regarding the coating efficiency, PCL showed higher values in comparison to P(3HB). Vitality assays revealed decent vitality values for both polymers, while values for PCL were significantly lower than those for blank titanium. No significant differences could be observed between PCL and P(3HB) in proliferation and cell adhesion studies. Although LCI observations revealed decreasing values in cell number and populated area over time on both polymer-coated scaffolds, these outcomes could be explained by the possibility of coating diluent residues accumulating in the culture medium. Overall, both polymers fulfill the requirements regarding biocompatibility. Nonetheless, since only PCL coating ensured the maintenance of the porous implant structure, it is preferable to be used as a coating material for creating a deposit and release system for growth factors.

PMID: 29168794 [PubMed]

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A prognostic scoring system using inflammatory response biomarkers in oral cavity squamous cell carcinoma patients who underwent surgery-based treatment.

A prognostic scoring system using inflammatory response biomarkers in oral cavity squamous cell carcinoma patients who underwent surgery-based treatment.

Acta Otolaryngol. 2017 Nov 23;:1-6

Authors: Park YM, Oh KH, Cho JG, Baek SK, Kwon SY, Jung KY, Woo JS

Abstract
BACKGROUND: The aim of this study was to evaluate the effectiveness of a scoring system based on the lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio for predicting disease-specific survival of oral cancer patients treated by surgery.
METHODS: From January 2007 to December 2016, we retrospectively analyzed data from 69 oral cancer patients who received surgery.
RESULTS: Lymphocyte-to-monocyte ratio was significantly associated with T classification, N classification, and pathologic stage. Neutrophil-to-lymphocyte ratio was significantly associated with T classification and pathologic stage. Platelet-to-lymphocyte ratio was significantly associated with N classification and pathologic stage. In multivariate analysis, only a higher score on this scoring system was significantly associated with poorer disease-specific survival.
CONCLUSIONS: We found that the prognostic score system based on these three values was significantly associated with disease-specific survival of oral cancer patients who received surgery, indicating that the prognostic scoring system was effective in indirectly predicting systemic inflammatory response.

PMID: 29168424 [PubMed - as supplied by publisher]

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Evaluation of choroidal thickness measurements in pediatric obstructive sleep apnea syndrome patients.

Evaluation of choroidal thickness measurements in pediatric obstructive sleep apnea syndrome patients.

Turk J Pediatr. 2017;59(1):62-67

Authors: Bayraktar C, Şimşek A

Abstract
Bayraktar C, Şimşek A. Evaluation of choroidal thickness measurements in pediatric obstructive sleep apnea syndrome patients. Turk J Pediatr 2017; 59: 62-67. Choroidal vascular impairment and obstructive sleep apnea syndrome (OSAS) related disorders have been shown in adults, but there have been no investigations with regard to the choroidal thickness measurements in children with OSAS. Our aim was to investigate this relationship in the early childhood period, which correlates with OSAS peak incidence due to adenotonsillar enlargement. One-hundred and nine pediatric OSAS patients and 42 age-sex matched controls were enrolled in this study. Nocturnal pulse oximetry was used to define the OSAS patients. Demographic data like age, sex and body-mass index were recorded. All of the subjects underwent complete otolaryngologic and ophthalmologic examination including visual acuity, intraocular pressure, central corneal thickness, axial length and choroidal thickness measurements. Overall, the 1,000 μm and 1,500 μm nasal choroid measurements were found to be significantly lower in the patient group (p < 0.05). However, only a poor inverse correlation emerged between the body-mass index (BMI) and the foveal center measurements in the patients. Observed alterations in the choroid may signify the initial impairment of known OSAS-related eye disorders, like glaucoma, floppy eyelid syndrome, and non-arteritic ischemic optic neuropathy. Ophthalmologists, otolaryngologists and pediatricians working together as a team may be able to prevent future eye diseases.

PMID: 29168365 [PubMed - in process]

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Percutaneous bone anchored hearing system implant survival after 550 primary implant surgeries.

Percutaneous bone anchored hearing system implant survival after 550 primary implant surgeries.

Clin Otolaryngol. 2017 Nov 23;:

Authors: Calon TGA, van Tongeren J, Heuft AME, Brunings JW, Bollen D, Hof JR, Stokroos RJ

Abstract
The Bone Anchored Hearing System (BAHS) has become an established option for rehabilitation of several type of hearing impairment such as conductive hearing loss, mixed hearing loss and single sided deafness (1) . Overall good outcomes have been reported. Nevertheless, complications such as inflammation of the skin around the percutaneous abutment, pain and implant loss are related to BAHS (2) . This article is protected by copyright. All rights reserved.

PMID: 29168329 [PubMed - as supplied by publisher]

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6-shogaol induces apoptosis and enhances radiosensitivity in head and neck squamous cell carcinoma cell lines.

6-shogaol induces apoptosis and enhances radiosensitivity in head and neck squamous cell carcinoma cell lines.

Phytother Res. 2017 Nov 23;:

Authors: Kotowski U, Kadletz L, Schneider S, Foki E, Schmid R, Seemann R, Thurnher D, Heiduschka G

Abstract
Ginger (Zingiber officinale Roscoe) is used for a wide array of conditions in traditional medicine in Asia, but little is known about the effect on head and neck cancer. In this study, the effect of two major pharmacologically active compounds of ginger, 6-gingerol and 6-shogaol, were studied on head and neck cancer cell lines. Furthermore, experiments in combination with established treatment methods for head and neck cancer were performed. Proliferation assays showed a dose-dependent reduction of cell viability. Flow cytometry analysis revealed the induction of apoptosis. Western blot analysis indicated that the antiapoptotic protein survivin was suppressed after treatment. Although a combination of 6-shogaol with cisplatin exhibited no synergistic effect, the combination with irradiation showed a synergistic reduction of clonogenic survival. In conclusion, ginger compounds have many noteworthy effects on head and neck cancer cell lines. In particular, the enhancement of radiosensitivity is remarkable.

PMID: 29168275 [PubMed - as supplied by publisher]

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Waardenburg syndrome type IIE in a Japanese patient caused by a novel non-frame-shift duplication mutation in the SOX10 gene.

Waardenburg syndrome type IIE in a Japanese patient caused by a novel non-frame-shift duplication mutation in the SOX10 gene.

J Dermatol. 2017 Nov 23;:

Authors: Hemmi A, Okamura K, Tazawa R, Abe Y, Hayashi M, Izumi S, Tohyama J, Shimomura Y, Hozumi Y, Suzuki T

PMID: 29168219 [PubMed - as supplied by publisher]

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A Case of Glomangiopericytoma at the Nasal Septum.

A Case of Glomangiopericytoma at the Nasal Septum.

Head Neck Pathol. 2017 Nov 22;:

Authors: Anzai T, Saito T, Tsuyama S, Toh M, Ikeda K, Ito S

Abstract
Glomangiopericytoma (GPC) is a rare sinonasal perivascular tumor that accounts for < 0.5-1% of all sinonasal tumors. GPC is categorized as a low-grade neoplasm with borderline malignancy and a tendency of local recurrence. GPC is a rare mesenchymal neoplasm characterized by the perivascular proliferation of tumor cells, and it requires being distinguished from solitary fibrous tumors. Here, we report a case of GPC in a 68-year-old male patient who presented at the emergency room of our hospital with a complaint of sudden epistaxis. A small, reddish, protruding tumor was observed on the right nasal septum. A biopsy revealed a possible perivascular tumor such as a GPC or solitary fibrous tumor. Thus, we performed complete resection with endoscopic surgery. The size of the resected tumor was 12 × 5 mm, and it showed a uniform proliferation of oval-to-short spindle-shaped cells with slightly branching vascular structures. The tumor cells showed minimal cytologic atypia and there were an average of 3 mitoses in 10 high power fields. Necrosis was not observed. The tumor cells showed strong and diffuse nuclear immunostaining with beta catenin and were negative with STAT6, CD34 and bcl-2. The MIB-1 labeling index was approximately 5%. Genetic testing revealed CTNNB1 mutation (p.S33C). Thus, a diagnosis of low grade GPC was made on the biopsy and the patient could be successfully treated with endoscopic resection.

PMID: 29168109 [PubMed - as supplied by publisher]

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Relationship between the severity of laryngopharyngeal reflux and sleep apnea: using drug-induced sleep endoscopy (DISE).

Relationship between the severity of laryngopharyngeal reflux and sleep apnea: using drug-induced sleep endoscopy (DISE).

Eur Arch Otorhinolaryngol. 2017 Nov 22;:

Authors: Lee JS, Heo SJ, Kim JS, Ahn D, Sohn JH, Kim H

Abstract
OBJECTIVES: The aim of the study is to identify the following associations: (1) severity of obstructive sleep apnea syndrome (OSAS) and laryngopharyngeal reflux (LPR)-related clinical parameters, such as reflux finding score (RFS), reflux symptom index (RSI), and LPR-health-related quality of life (LPR-HRQOL) and (2) complete obstruction on drug-induced sleep endoscopy (DISE) and LPR-related clinical parameters.
MATERIALS AND METHODS: Subjects included the OSAS patients without surgery history and all patients perform the polysomnography (PSG) and DISE for their OSAS. Demographics, polysomnographic data, DISE results, and LPR-related parameters were collected prospectively. The patients were divided into age-, sex-, and BMI-matched two groups, according to numbers of complete obstruction on DISE (complete obstruction at 0-1 subsites (unilevel) vs. 2-4 subsites (multilevel). Finally, 19 patients with unilevel complete obstruction and 38 patients with multilevel complete obstruction were compared. The multiple linear regression analysis was employed to determine the predictors of LPR-related quality of life.
RESULTS: Among 88 patients, 19 patients demonstrated unilevel complete obstruction, and 69 patients demonstrated multilevel complete obstruction on DISE. There were no significant correlation between OSAS severity and RFS, RSI, and scores of LPR-HRQOL. Multilevel complete obstruction on DISE did not affect the LPR-related clinical parameters (p > 0.05). The result of multiple linear regression demonstrated complete obstruction at the epiglottis had a strong influence on the high scores of LPR-HRQOL.
CONCLUSION: LPR is commonly developing disease with OSAS, but the OSAS severity did not affect the LPR-related parameters. The multilevel complete obstruction on DISE was not associated with the LPR-related clinical parameters.

PMID: 29168025 [PubMed - as supplied by publisher]

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Prevalence, Characteristics, and Treatment Patterns of Hearing Difficulty in the United States.

Prevalence, Characteristics, and Treatment Patterns of Hearing Difficulty in the United States.

JAMA Otolaryngol Head Neck Surg. 2017 Nov 22;:

Authors: Mahboubi H, Lin HW, Bhattacharyya N

Abstract
Importance: Hearing loss is one of the most prevalent chronic conditions in the United States and has been associated with negative physical, social, cognitive, economic, and emotional consequences. Despite the high prevalence of hearing loss, substantial gaps in the utilization of amplification options, including hearing aids and cochlear implants (CI), have been identified.
Objective: To investigate the contemporary prevalence, characteristics, and patterns of specialty referral, evaluation, and treatment of hearing difficulty among adults in the United States.
Design, Setting, and Participants: A cross-sectional analysis of responses from a nationwide clustered representative sample of adults who participated in the 2014 National Health Interview Survey and responded to the hearing module questions was carried out.
Main Outcomes and Measures: Data regarding demographics as well as self-reported hearing status, functional hearing, laterality, onset, and primary cause of the hearing loss were collected. In addition, specific data regarding hearing-related clinician visits, hearing tests, referrals to hearing specialist, and utilization of hearing aids and CIs were analyzed.
Results: Among 239.6 million adults, 40.3 million (16.8%) indicated their hearing was less than "excellent/good," ranging from "a little trouble hearing" to "deaf." The mean (SD) age of participants was 47 (0.2) years with 48.2% being men and 51.8% women. Approximately 48.8 million (20.6%) had visited a physician for hearing problems in the preceding 5 years. Of these, 32.6% were referred to an otolaryngologist and 27.3% were referred to an audiologist. Functional hearing was reported as the ability to hear "whispering" or "normal voice" (225.4 million; 95.5%), to "only hear shouting" (8.0 million; 3.4%), and "not appreciating shouting" (2.8 million; 1.1%). Among the last group, 5.3% were recommended to have a CI, of which 22.1% had received one. Of the adults who indicated their hearing from "a little trouble hearing" to being "deaf," 12.9 million (32.2%) had never seen a clinician for hearing problems and 11.1 million (28.0%) had never had their hearing tested.
Conclusions and Relevance: There are considerable gaps between self-reported hearing loss and patients receiving medical evaluation and recommended treatments for hearing loss. Improved awareness regarding referrals to otolaryngologists and audiologists as well as auditory rehabilitative options among clinicians may improve hearing loss care.

PMID: 29167904 [PubMed - as supplied by publisher]

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Association of Neurocognitive Deficits With Radiotherapy or Chemoradiotherapy for Patients With Head and Neck Cancer.

Association of Neurocognitive Deficits With Radiotherapy or Chemoradiotherapy for Patients With Head and Neck Cancer.

JAMA Otolaryngol Head Neck Surg. 2017 Nov 22;:

Authors: Zer A, Pond GR, Razak ARA, Tirona K, Gan HK, Chen EX, O'Sullivan B, Waldron J, Goldstein DP, Weinreb I, Hope AJ, Kim JJ, Chan KKW, Chan AK, Siu LL, Bernstein LJ

Abstract
Importance: Neurocognitive deficits (NCD) have been observed in noncentral nervous system cancers, yet short- and long-term neurocognitive data on patients treated for head and neck cancer (HNC) are lacking.
Objective: To assess objective neurocognitive function before and after definitive radiation therapy for HNC.
Design, Setting, and Participants: In a prospective, longitudinal study, neurocognitive function and self-reported symptoms were assessed in 80 patients with histologically proven HNC requiring definitive chemoradiotherapy or radiotherapy and in 40 healthy controls 4 times (baseline, 6, 12, and 24 months after baseline) prior to commencing treatment at Princess Margaret Cancer Centre, Toronto, Canada.
Main Outcomes and Measures: Neurocognitive test scores were converted to age-corrected z scores (mean, 0; standard deviation, 1) and reported as mean scores, standardized regression-based scores, and frequencies of impairments in intellectual capacity, concentration, memory, executive function, processing speed, and motor dexterity. Multivariable analysis was used to identify factors associated with NCD 2 years after treatment.
Results: Eighty patients and 40 healthy controls enrolled. Analyses revealed significant differences between patient and control mean performance in some domains, with patient deficits increasing over time: intellectual capacity (Cohen d, effect sizes [95% CIs] of -0.46 [-0.64 to 0.30], -0.51 [-0.72 to -0.30], and -0.70 [-0.92 to -0.49] for time points 6, 12, and 24 months, respectively); concentration/short-term attention span (-0.19 [-0.37 to 0.00], -0.38 [-0.55 to -0.21], -0.54 [-0.71 to -0.37]); verbal memory (-0.16 [-0.33 to 0.02], -0.38 [-0.64 to -0.12], -0.53 [-0.74 to -0.32]); executive function (-0.14 [-0.27 to 0.00], -0.34 [-0.52 to -0.16], -0.43 [-0.64 to -0.22]), and global cognitive function composite (-0.38 [-0.55 to -0.22], -0.75 [-0.92 to -0.58], -1.06 [-1.26 to -0.86]). There was an increased rate of impaired global neurocognitive functioning among patients (38%) at 24 months compared with controls (0%). Neurocognitive deficits were not associated with baseline cytokines.
Conclusions and Relevance: Head and neck cancer survivors have neurocognitive sequelae up to 2 years after definitive chemoradiotherapy or radiation treatment. Patients and health care teams should know about such potential risks. Further research is warranted in search of strategies to avoid, reduce, and compensate for declines.

PMID: 29167901 [PubMed - as supplied by publisher]

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Worsening Respiratory Distress in a 7-Month-Old Infant.

Worsening Respiratory Distress in a 7-Month-Old Infant.

JAMA Otolaryngol Head Neck Surg. 2017 Nov 22;:

Authors: Nation J, Mickelson R

PMID: 29167893 [PubMed - as supplied by publisher]

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Hybrid Cartilage-Modifying Otoplasty Technique and Outcomes.

Hybrid Cartilage-Modifying Otoplasty Technique and Outcomes.

JAMA Facial Plast Surg. 2017 Nov 22;:

Authors: Markey J, Mace J, Anderson Y, Wang TD

Abstract
Importance: Otoplasty is performed to correct prominauris, one of the most common head and neck congenital deformities. Advances in combination hybrid approaches enable surgeons to achieve greater precision and accuracy.
Objective: To describe a hybrid cartilage-modifying approach and evaluate the procedure's effectiveness and safety.
Design, Setting, and Participants: Medical record review including patients undergoing otoplasty by the present technique from January 2006 to December 2016 as performed by the senior author at a tertiary academic referral center. Twenty-three patients underwent 24 total procedures including both bilateral (n = 17) and unilateral (n = 7) procedures. Two procedures were revisions.
Interventions: Hybrid cartilage-modifying otoplasty procedure.
Main Outcomes and Measures: Preoperative and postoperative measurements were recorded. Paired sample t testing was performed to assess changes between preoperative superior, middle, and inferior helical measurements and corresponding postoperative measurements for all operated ears. Two-tailed, independent sample t testing was performed to compare postoperative differences between right and left ears within separate superior, middle, and inferior measurements in patients undergoing bilateral otoplasty.
Results: Twenty-four surgeries were performed on 23 patients. The mean (SD) age at surgery was 16.3 (13.6) years with 13 patients (58%) between the ages of 4 and 10 years. Preoperatively, the mean (SD) superior, middle, and inferior helical rim-to-mastoid distance of the 41 discrete ears measured 16.5 (3.1) mm, 24.1 (3.8) mm, and 19.3 (4.4) mm, respectively. Mean (SD) postoperative measurements were 12.1 (2.4) mm, 14.7 (2.5) mm, and 14.0 (2.8) mm, respectively, for mean (SD) decreases of 4.4 (2.7) mm, 9.4 (3.4) mm, and 5.3 (3.6) mm. For the 17 bilateral procedures, the mean (standard error) postoperative scores between ears measured 0.7 (0.9) mm for the superior, 0.5 (0.9) mm for the middle, and 0.2 (1.0) mm for the inferior. The unaffected ear was measured in 4 of 7 (57%) of patients undergoing unilateral otoplasty, and the mean (SD) postoperative differences between left and right ears were 1.3 (0.8) mm, 3.0 (1.2) mm, and 1.0 (0.7) mm for the superior, middle, and inferior, respectively. Preoperative-to-postoperative differences for all ears (n = 41) were significant (P < .001 for all) for superior, middle, and inferior measurements. There were no significant absolute differences identified for superior (P = .41), middle (P = .58), and inferior (P = .88) measurements regarding left vs right postoperative comparisons for bilateral otoplasties. One patient undergoing bilateral repair required subsequent revision surgery of 1 ear. Two patients developed chronic suture site irritation, and 1 patient developed a hematoma.
Conclusions and Relevance: The present technique allows multiple opportunities to adjust the auricular parameters. The results indicate a low revision rate and high degree of symmetry.
Level of Evidence: 4.

PMID: 29167864 [PubMed - as supplied by publisher]

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Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

Front Surg. 2017;4:65

Authors: Ramakers GGJ, Kraaijenga VJC, Smulders YE, van Zon A, Stegeman I, Stokroos RJ, Free RH, Frijns JHM, Huinck WJ, Van Zanten GA, Grolman W

Abstract
Importance: There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus.
Objective: To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years).
Study design: This study is a secondary analysis as part of a multicenter randomized controlled trial.
Methods: Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ).
Results: The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total suppression of tinnitus compared with their unilateral situation.
Conclusion: While bilateral cochlear implantation can have a positive effect on preoperative tinnitus complaints, the induction of (temporary or permanent) tinnitus was also reported.
Clinical Trial Registration: Dutch Trial Register NTR1722.

PMID: 29167796 [PubMed]

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Cervical oesophageal perforation secondary to food consumption in a well-appearing patient.

Cervical oesophageal perforation secondary to food consumption in a well-appearing patient.

BMJ Case Rep. 2017 Nov 21;2017:

Authors: Schneider AL, Hicks KE, Matsuoka AJ

Abstract
A 71-year-old woman presented to the emergency department 8 days after ingesting fish with mild neck pain but otherwise demonstrated no signs of infection. X-rays were negative but CT imaging demonstrated a curvilinear radiodense object extending from the posterior cervical oesophagus through the right thyroid lobe terminating in the neck just a few millimetres from the external carotid artery. Rigid oesophagoscopy and direct laryngoscopy were negative and the neck was explored for the foreign body, which ultimately was encountered after a painstaking dissection of the right neck that included skeletonisation of the recurrent laryngeal nerve. Her postoperative recovery was uneventful and after a 3-day course of intravenous antibiotics she was discharged on oral antibiotics, in good condition and tolerating a soft diet.

PMID: 29167221 [PubMed - in process]

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Noise exposure while commuting in Toronto - a study of personal and public transportation in Toronto.

Noise exposure while commuting in Toronto - a study of personal and public transportation in Toronto.

J Otolaryngol Head Neck Surg. 2017 Nov 23;46(1):62

Authors: Yao CMKL, Ma AK, Cushing SL, Lin VYW

Abstract
BACKGROUND: With an increasing proportion of the population living in cities, mass transportation has been rapidly expanding to facilitate the demand, yet there is a concern that mass transit has the potential to result in excessive exposure to noise, and subsequently noise-induced hearing loss.
METHODS: Noise dosimetry was used to measure time-integrated noise levels in a representative sample of the Toronto Mass Transit system (subway, streetcar, and buses) both aboard moving transit vehicles and on boarding platforms from April - August 2016. 210 measurements were conducted with multiple measurements approximating 2 min on platforms, 4 min within a vehicle in motion, and 10 min while in a car, on a bike or on foot. Descriptive statistics for each type of transportation, and measurement location (platform vs. vehicle) was computed, with measurement locations compared using 1-way analysis of variance.
RESULTS: On average, there are 1.69 million riders per day, who are serviced by 69 subway stations, and 154 streetcar or subway routes. Average noise level was greater in the subway and bus than in the streetcar (79.8 +/- 4.0 dBA, 78.1 +/- 4.9 dBA, vs 71.5 +/-1.8 dBA, p < 0.0001). Furthermore, average noise measured on subway platforms were higher than within vehicles (80.9 +/- 3.9 dBA vs 76.8 +/- 2.6 dBA, p < 0.0001). Peak noise exposures on subway, bus and streetcar routes had an average of 109.8 +/- 4.9 dBA and range of 90.4-123.4 dBA, 112.3 +/- 6.0 dBA and 89.4-128.1 dBA, and 108.6 +/- 8.1 dBA and 103.5-125.2 dBA respectively. Peak noise exposures exceeded 115 dBA on 19.9%, 85.0%, and 20.0% of measurements in the subway, bus and streetcar respectively.
CONCLUSIONS: Although the mean average noise levels on the Toronto transit system are within the recommended level of safe noise exposure, cumulative intermittent bursts of impulse noise (peak noise exposures) particularly on bus routes have the potential to place individuals at risk for noise induced hearing loss.

PMID: 29166946 [PubMed - in process]

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Postoperative radiotherapy with or without concurrent chemotherapy for oral squamous cell carcinoma in patients with three or more minor risk factors: a propensity score matching analysis.

Postoperative radiotherapy with or without concurrent chemotherapy for oral squamous cell carcinoma in patients with three or more minor risk factors: a propensity score matching analysis.

Radiat Oncol. 2017 Nov 22;12(1):184

Authors: Fan KH, Chen YC, Lin CY, Kang CJ, Lee LY, Huang SF, Liao CT, Ng SH, Wang HM, Chang JT

Abstract
BACKGROUND: To investigate the advantage of concurrent chemotherapy with postoperative radiotherapy (RT) of oral squamous cell carcinoma (OSCC) in patients with three or more minor risk factors.
METHODS: Minor risk factors included pT4 disease, pN1 disease, margin ≤ 4 mm, poor differentiation, perineural invasion, vessel or lymphatic invasion, and tumor invasion depth ≥ 11 mm. Surgery was the primary treatment, followed by RT or concurrent chemoradiation (CCRT). After propensity score matching, 34 patients in each treatment group were selected for comparison.
RESULTS: The median follow-up for living patients was 86.4 months (range: 47-189 months). The 5-year overall survival of the RT and CCRT groups was 35.3% and 67.2% (p = 0.018), respectively. The 5-year recurrence-free survival of the RT group and CCRT group was 42.6% and 75.4% (p < 0.01).
CONCLUSION: Postoperative CCRT for patients with three or more minor risk factors increased recurrence-free and overall survival.

PMID: 29166942 [PubMed - in process]

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Sinonasal SMARCB1 (INI1) Deficient Carcinoma With Yolk Sac Tumor Differentiation: Report of a Case and Comparison With INI1 Expression in Gonadal Germ Cell Tumors.

Sinonasal SMARCB1 (INI1) Deficient Carcinoma With Yolk Sac Tumor Differentiation: Report of a Case and Comparison With INI1 Expression in Gonadal Germ Cell Tumors.

Int J Surg Pathol. 2017 Nov 01;:1066896917741549

Authors: Zamecnik M, Rychnovsky J, Syrovatka J

Abstract
SMARCB1 (INI1) deficient sinonasal carcinoma is a recently recognized entity with wide histomorphologic spectrum. We present a case of this carcinoma that contained, in addition to a "common" morphology, scattered foci of yolk sac tumor differentiation. The tumor occurred in paranasal sinuses in a 44-year-old woman. Immunohistochemically, it was diffusely negative for INI1, whereas an expression of yolk sac tumor markers (α-fetoprotein, glypican-3, CDX2) was limited to the yolk sac tumor component. For comparison with the present case, we performed INI1 immunostaining on a series of 11 gonadal germ cell tumors with yolk sac tumor differentiation. All of these cases showed strong and diffuse expression of INI1, in contrast with the present sinonasal tumor. Our findings expand the morphologic spectrum of SMARCB1 (INI1) deficient sinonasal carcinoma. In addition, we show preliminarily that gonadal germ cell tumors with yolk sac tumor differentiation are not SMARCB1/INI1-deficient.

PMID: 29166820 [PubMed - as supplied by publisher]

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Pilocytic astrocytoma with leptomeningeal spread in a patient with incontinentia pigmenti presenting with unilateral nystagmus

Abstract

Incontinentia pigmenti (IP) is a genetic disorder caused by mutations in IKBKG, leading to functional loss of nuclear factor kappa B (NF-ĸB). We report the case of a 6-month-old female child with IP who presented with unilateral nystagmus and was found to have a pilocytic astrocytoma with leptomeningeal spread. Enhanced understanding of the relationship between NF-ĸB, along with its upstream regulators, and tumorigenesis may shed light on whether a subset of patients with IP may be at increased risk for neoplasia.

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Subjective Assessment of Sleep in Huntington Disease: Reliability of Sleep Questionnaires Compared to Polysomnography.

Subjective Assessment of Sleep in Huntington Disease: Reliability of Sleep Questionnaires Compared to Polysomnography.

Neurodegener Dis. 2017 Nov 24;17(6):330-337

Authors: Piano C, Della Marca G, Losurdo A, Imperatori C, Solito M, Calandra-Buonaura G, Provini F, Cortelli P, Bentivoglio AR

Abstract
INTRODUCTION: The aim of the study was to evaluate the clinical reliability of subjective sleep evaluation, based on sleep and psychometric questionnaires, by comparing the results with those obtained with laboratory-based video-polysomnography (V-PSG).
PATIENTS AND METHODS: Thirty consecutive Huntington disease (HD) patients were enrolled. Subjective evaluation of sleep included the Pittsburgh Sleep Quality Index (PSQI), the sleep questionnaire for HD (HDQ), the Epworth Sleepiness Scale, the Bologna questionnaire for sleepiness (BQ), the Berlin questionnaire, and the RBD questionnaire; the International Restless Legs Syndrome Study Group scale was administered to patients with positive screening. The psychometric evaluation included the Zung Anxiety Scale, the short form of the Beck Depression Inventory, and the Maudsley Obsessive-Compulsive Inventory. All patients underwent V-PSG.
RESULTS: In sleepiness evaluation, the Epworth score was above the cutoff in 6 subjects, and the BQ detected a "high risk" of sleepiness in 7 cases. The results were concordant in 24 and discordant in 5 cases. In the evaluation of sleep quality, the PSQI score was above the cutoff in 18 subjects. According to the HDQ, 10 subjects were poor sleepers. The results were concordant with the PSQI in 20 subjects.
DISCUSSION: All comparisons between scale scores and PSG results showed poor or totally absent concordance between subjective and objective measures.
SIGNIFICANCE: The subjective evaluation of sleep in HD patients shows a poor correlation with PSG results.

PMID: 29169178 [PubMed - as supplied by publisher]

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Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU)

Objective To determine the effect of low dose aspirin on ulcer healing in patients with venous leg ulcers.Design Pragmatic, community based, parallel group, double blind, randomised controlled...

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RT @Simple_Trials : This is our latest #drugrepurposing review in @ecancer . This time on the potential of chloroquine and hydroxychloroquine…

RT @Simple_Trials : This is our latest #drugrepurposing review in @ecancer . This time on the potential of chloroquine and hydroxychloroquine…

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RT @OphiraG : Congratulations Bishal! Superb decision @ecancer ! We need more like this: fearless & rigorous analysis with a clear voice. #c…

RT @OphiraG : Congratulations Bishal! Superb decision @ecancer ! We need more like this: fearless & rigorous analysis with a clear voice. #c…

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Viruses, Vol. 9, Pages 358: The Heterologous Expression of the p22 RNA Silencing Suppressor of the Crinivirus Tomato Chlorosis Virus from Tobacco Rattle Virus and Potato Virus X Enhances Disease Severity but Does Not Complement Suppressor-Defective Mutant Viruses

Viruses, Vol. 9, Pages 358: The Heterologous Expression of the p22 RNA Silencing Suppressor of the Crinivirus Tomato Chlorosis Virus from Tobacco Rattle Virus and Potato Virus X Enhances Disease Severity but Does Not Complement Suppressor-Defective Mutant Viruses

Viruses doi: 10.3390/v9120358

Authors: Yazmín Landeo-Ríos Jesús Navas-Castillo Enrique Moriones M. Cañizares

To counteract host antiviral RNA silencing, plant viruses express suppressor proteins that function as pathogenicity enhancers. The genome of the Tomato chlorosis virus (ToCV) (genus Crinivirus, family Closteroviridae) encodes an RNA silencing suppressor, the protein p22, that has been described as having one of the longest lasting local suppressor activities when assayed in Nicotiana benthamiana. Since suppression of RNA silencing and the ability to enhance disease severity are closely associated, we analyzed the effect of expressing p22 in heterologous viral contexts. Thus, we studied the effect of the expression of ToCV p22 from viral vectors Tobacco rattle virus (TRV) and Potato virus X (PVX), and from attenuated suppressor mutants in N. benthamiana plants. Our results show that although an exacerbation of disease symptoms leading to plant death was observed in the heterologous expression of ToCV p22 from both viruses, only in the case of TRV did increased viral accumulation occur. The heterologous expression of ToCV p22 could not complement suppressor-defective mutant viruses.

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IJMS, Vol. 18, Pages 2521: Altered Leukocyte Sphingolipid Pathway in Breast Cancer

IJMS, Vol. 18, Pages 2521: Altered Leukocyte Sphingolipid Pathway in Breast Cancer

International Journal of Molecular Sciences doi: 10.3390/ijms18122521

Authors:Larissa MaiaPaula SantosPatrícia AlvesCláudia RodriguesThaíse AraújoYara MaiaAlinne CâmaraDonizeti SantosLuiz Goulart

Sphingolipid metabolism pathway is essential in membrane homeostasis, and its dysfunction has been associated with favorable tumor microenvironment, disease progression, and chemotherapy resistance. Its major components have key functions on survival and proliferation, with opposing effects. We have profiled the components of the sphingolipid pathway on leukocytes of breast cancer (BC) patients undergoing chemotherapy treatment and without, including the five sphingosine 1-phosphate (S1P) receptors, the major functional genes, and cytokines, in order to better understand the S1P signaling in the immune cells of these patients. To the best of our knowledge, this is the first characterization of the sphingolipid pathway in whole blood of BC patients. Skewed gene profiles favoring high SPHK1 expression toward S1P production during BC development was observed, which was reversed by chemotherapy treatment, and reached similar levels to those found in healthy donors. Such levels were also correlated with high levels of TNF-α. Our data revealed an important role of the sphingolipid pathway in immune cells in BC with skewed signaling of S1P receptors, which favored cancer development even under chemotherapy, and may probably be a trigger of cancer resistance. Thus, these molecules must be considered as a target pathway for combined BC therapeutics.

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IJMS, Vol. 18, Pages 2522: Impact of Antibiotics on the Proliferation and Differentiation of Human Adipose-Derived Mesenchymal Stem Cells

IJMS, Vol. 18, Pages 2522: Impact of Antibiotics on the Proliferation and Differentiation of Human Adipose-Derived Mesenchymal Stem Cells

International Journal of Molecular Sciences doi: 10.3390/ijms18122522

Authors:Aleksandra SkubisJoanna GolaBartosz SikoraJolanta HybiakMonika Paul-SamojednyUrszula MazurekMarek Łos

Adipose tissue is a promising source of mesenchymal stem cells. Their potential to differentiate and regenerate other types of tissues may be affected by several factors. This may be due to in vitro cell-culture conditions, especially the supplementation with antibiotics. The aim of our study was to evaluate the effects of a penicillin-streptomycin mixture (PS), amphotericin B (AmB), a complex of AmB with copper (II) ions (AmB-Cu2+) and various combinations of these antibiotics on the proliferation and differentiation of adipose-derived stem cells in vitro. Normal human adipose-derived stem cells (ADSC, Lonza) were routinely maintained in a Dulbecco’s Modified Eagle Medium (DMEM) that was either supplemented with selected antibiotics or without antibiotics. The ADSC that were used for the experiment were at the second passage. The effect of antibiotics on proliferation was analyzed using the 3-[4,5,[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) and sulforhodamine-B (SRB) tests. Differentiation was evaluated based on Alizarin Red staining, Oil Red O staining and determination of the expression of ADSC, osteoblast and adipocyte markers by real-time RT-qPCR. The obtained results indicate that the influence of antibiotics on adipose-derived stem cells depends on the duration of exposure and on the combination of applied compounds. We show that antibiotics alter the proliferation of cells and also promote natural osteogenesis, and adipogenesis, and that this effect is also noticeable in stimulated osteogenesis.

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IJMS, Vol. 18, Pages 2519: Molecular Mechanisms of GPCR Signaling: A Structural Perspective

IJMS, Vol. 18, Pages 2519: Molecular Mechanisms of GPCR Signaling: A Structural Perspective

International Journal of Molecular Sciences doi: 10.3390/ijms18122519

Authors:Vsevolod GurevichEugenia Gurevich

G protein-coupled receptors (GPCRs) are cell surface receptors that respond to a wide variety of stimuli, from light, odorants, hormones, and neurotransmitters to proteins and extracellular calcium. GPCRs represent the largest family of signaling proteins targeted by many clinically used drugs. Recent studies shed light on the conformational changes that accompany GPCR activation and the structural state of the receptor necessary for the interactions with the three classes of proteins that preferentially bind active GPCRs, G proteins, G protein-coupled receptor kinases (GRKs), and arrestins. Importantly, structural and biophysical studies also revealed activation-related conformational changes in these three types of signal transducers. Here, we summarize what is already known and point out questions that still need to be answered. Clear understanding of the structural basis of signaling by GPCRs and their interaction partners would pave the way to designing signaling-biased proteins with scientific and therapeutic potential.

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Photocatalytic decomposition of N 2 O over g-C 3 N 4 /WO 3 photocatalysts

Abstract

Although the nitrous oxide belongs among three of the most contributing greenhouse gases to global warming, it is quite neglected by photocatalytic society. The g-C₃N₄ and WO₃ composites were therefore tested for the photocatalytic decomposition of N₂O for the first time. The pure photocatalysts were prepared by simple calcination of precursors, and the composites were prepared by mixing of suspension of pure components in water followed by calcination. The structural (X-ray diffraction, X-ray photoelectron spectroscopy, high-resolution transmission electron microscopy), textural (N₂ physisorption), and optical properties (diffuse reflectance spectroscopy, photoluminescence spectroscopy, photoelectrochemical measurements) of all composites were correlated with photocatalytic activity. The experimental results and results from characterization techniques confirmed creation of Z-scheme in the WO₃/g-C₃N₄ composites, which was confirmed by hydroxyl radicals’ trapping measurements. The photocatalytic decomposition of N₂O was carried out in the presence of UVA light (peak intensity at 365 nm) and the 1:2 WO₃/g-C₃N₄ composite was the most active one, but the photocatalytic activity was just negligibly higher than that of pure WO₃. This is caused by relatively weak interaction between WO₃ and g-C₃N₄ which was revealed from XPS.

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Are shocks to renewable energy consumption permanent or temporary? Evidence from 54 developing and developed countries

Abstract

The renewable energy sources are considered as the important factor to decrease the level of carbon emissions and to promote the global green economy. Understanding the dynamics of renewable energy consumption, this paper analyzes whether there is a unit root in renewable energy consumption in 54 countries over the period 1971–2016. To this end, the unit root test of Narayan–Popp with two endogenous (unknown) breaks is implemented. The paper finds that renewable energy consumption series are stationary around a level and the time trend in 45 of 54 countries. In other words, renewable energy consumption follows a unit root process only in nine countries: Brazil, China, Colombia, India, Israel, Japan, the Netherlands, Spain, and Turkey. The evidence implies that renewable energy demand policies, which aimed to decrease the carbon emissions, will only have permanent effects in those nine countries.

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Midgut Volvulus CT

Case Report  – 7 yrs child presents with chronic abdominal discomfort & pain with increase in severity & vomiting since 3 days. CT scan revealed  3^rd part of duodenum is not seen crossing the midline to left side. SMV is seen to left of SMA. Twisting of collapsed 3^rd & 4^th parts of duodenum & mesenteric vessels is seen around the axis of SMA (whirlpool sign) with mild dilatation of stomach & 1^st/2^nd parts of duodenum. DJ junction seen in right lumbar quadrant, jejual loops in right lumbar quadrant, ileal loops in left lumbar quadrant, medial position of right colon & low/ posterior location of transverse colon. Left colon is normally located & collapsed. Findings suggestive of malrotation of small bowel loops with midgut volvulus.

Discussion by Dr MGK Murthy, Dr Pritam, Dr GA Prasad

Intestinal malrotation is described as abnormal positioning of the bowel loops within the peritoneal cavity in the intrauterine life. It is caused by defective rotation of primitive intestinal loop around the axis of SMA during embryogenesis.

Midgut volvulus is a complication of malrotation in which clockwise twisting of the bowel around the superior mesenteric artery axis occurs because of the narrowed mesenteric attachment. Degree of twisting is variable & determines symptoms. Severe volvulus = 3& ½ turns, can lead to bowel necrosis.

Age at presentation – usually neonate or young infant. Occasionally older child or adult.

Associations  ( in 20%) -

-       Duodenal atresia.

-       Duodenal web.

-       Duodenal stenosis.

-       Annular pancreas.

Acute symptoms in new born (medical emergency) - bilious vomiting (intermittent / post prandial /projectile), abdominal distension, shock.

Subacute obstruction with intermittent symptoms in older child – recurrent attacks of nausea, vomiting, pain abdomen.

X ray – Dilated air filled duodenal bulb or double bubble sign with air – fluid levels in duodenum & stomach.

Barium study– DJ junction located to the right. Spiral course of midgut loops (corkscrew appearance or apple peel or twisted ribbon appearance). Duodenal fold thickening & thumb printing (mucosal edema & hemorrhage). Abnormally high position of cecum.

USG – SMV to left of SMA, clockwise whirlpool sign with twisting of mesenteric vessels.

CT - a swirling of vessels in the mesenteric root may be seen at the site of the volvulus, abnormal relationship between the superior mesenteric artery and vein, an ectopic location of the majority of small bowel loops, and an abnormal position of the ligament of Treitz.

Midgut volvulus if not promptly diagnosed and treated, can lead to death or a lifelong dependence on total parenteral nutrition in survivors so surgical correction is the mainstay of treatment.

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