Benefits of Integrated RIS / PACS / Reporting Due To Automatic Population of Templated Reports

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Mark D. Kovacs, Maximilian Y. Cho, Philip Burchett, Michael Trambert
With integration of the RIS, PACS, and reporting systems, patient identifiers and exam information can automatically map into exam reports. There are many potential benefits of report automation to radiologists including improvements in efficiency, accuracy, and fatigue. In this paper we describe a two part study, with the first part being an anonymous survey of radiologists concerning report automation. 13 staff radiologists and 9 radiology residents at a single institution completed an anonymous survey. Respondents were asked if automatic population of exam description, comparison exam data, indications, CT dose, technique, and copy to physician data saved time, decreased fatigue, and increased accuracy. Respondents were asked if a "copy findings" function saved time. The second objective part of the study was a mock exam experiment to assess time savings of report automation and to assess error rates. 9 radiologists were asked to dictate fields for 8 mock exams. Subjects were timed and reporting errors monitored. Estimated daily time savings and error rates were calculated assuming a mix of 80 studies. 95% surveyed responded that report automation saved time; 91% that report automation improved accuracy of dictations; 82% that report automation decreased fatigue. 83% of copy finding function users reported time savings. Average time to dictate these pre-populated fields was 51 seconds per study. Average error rate per report was 0.86, with an average of 0.26 errors remaining uncorrected upon report completion. Estimated average time per day saved per radiologist from report automation was 68 minutes. Estimated average corrected errors was 48 per day. Estimated average uncorrected/missed errors was 21 per day. These estimated benefits from report automation result from tight integration of RIS, PACS, and reporting systems.



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Evaluating Resident On-Call Performance: Does Volume Affect Discrepancy Rate?

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Benjamin Wildman-Tobriner, Brendan Cline, Christopher Swenson, Brian C. Allen, Charles M. Maxfield




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Bronchiectasis Revisited: Imaging Based Pattern Approach to Diagnosis

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Anuradha Singh, Ashu Seith Bhalla, Manisha Jana
Bronchiectasis is one of the causes of non-resolving, persistent or recurrent pulmonary infection which, if uncorrected may have deleterious consequences on the lung parenchyma and pulmonary circulation. Chest radiograph is done at the initial suspicion which is supplemented by HRCT to confirm the diagnosis. Imaging diagnosis supplemented by the recognition of the pattern of involvement is essential to outline the differential diagnosis, map the complications and, hence, guiding the further management. Identification of the causative aetiology may not only prevent its further progression but obviate recurrent insults to the lung parenchyma as well. This article focuses on an algorithmic approach to bronchiectasis based on the distribution on imaging.



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Customized Residency Leadership Tracks: A Review of What Works, What We’re Doing and Ideas for the Future

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): S.A. Matalon, S.A. Howard, G. Gaviola, O. Johnson, C.H. Phillips, S.E. Smith, W.W. Mayo-Smith




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Why is this Auntminnie a Diagnostic Conundrum? - A Knowledge-Based Approach to Balo’s Concentric Sclerosis from Reports of Three Cases and Pooled Data from Sixty-Eight other Patients in The Literature

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Mohit Agarwal, John L. Ulmer, Andrew P. Klein, Leighton P. Mark
We came across three cases of Balo′s concentric sclerosis (BCS). The first of these patients presented to an outside hospital and was transferred to our institution due to complications resulting from a biopsy. The other two patients, despite having a characteristic imaging appearance and despite insistence on our part on the diagnosis of BCS, underwent a surgical procedure, which could have been prevented. This led us to review the available literature on BCS. 68 patients diagnosed with BCS between 1995 and 2015 were studied and the data collected for the clinical presentation and course, imaging, spinal fluid analysis, treatment, and clinical and imaging outcome. A 25% surgery rate (biopsy or resection) was found in the study. We concluded that this relatively high surgery rate in this auntminnie non-surgical disease is multifactorial; and includes factors like non-familiarity with the disease, anxiety on the part of patients and physicians, due to a sometimes rapidly deteriorating clinical picture; and resemblance of the disease with other entities such as tumor and infection. However, characteristic imaging appearance combined with acute/subacute presentation and dramatic improvement in clinical status after high dose steroid chemotherapy; are highly suggestive of the disease, and can prevent unnecessary surgery.



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Thyroid Fine Needle Aspiration: Successful Prospective Implementation of Strategies to Eliminate Unnecessary Biopsy in the Veteran Population

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Sean D. Raj, Rohit Ram, David J. Sabbag, Mark A. Sultenfuss, Rebecca Matejowsky
ObjectiveThyroid nodules are prevalent in over half the general population. Several multi-disciplinary societies have management recommendations. However, the majority of data to support these guidelines are derived from studies of predominantly younger and female populations. This study′s aim was to evaluate characteristics of thyroid nodules in a largely older and male Veteran population and apply these findings prospectively to reduce unnecessary thyroid fine needle aspiration (FNA).Materials and MethodsOver a 4-year period, all ultrasound-guided FNA of thyroid nodules performed in our department were reviewed. Sonographic features, patterns, and histopathology were evaluated. A prospective strategy of avoiding FNA in all lesions matching imaging patterns of benignity was implemented and positive predictive value of malignancy was calculated and compared to the retrospective data.ResultsRetrospectively, FNA was performed on 351 successive thyroid nodules, 9 of which were malignant. Statistically significant malignant features include presence of microcalcifications, irregular/amorphous morphology, taller-than-wide shape, spiculated margins, vascularity, and lymphadenopathy. Positive predictive value (PPV) of thyroid FNA was 2.6% in this period. Four sonographic patterns were 100% specific for benignity, including: "spongiform", "cyst with a colloid clot", "giraffe", and "white knight" patterns. Over 23 months, prospective avoidance of FNA of lesions characterized as a benign pattern (159 nodules) was implemented and PPV was calculated as 7.2% resulting in a cost savings of $477,000.ConclusionFour sonographic patterns were 100% specific for benignity in the older and predominantly male Veteran population. Strict prospective application of avoiding biopsy in these benign patterns resulted in a decrease of unnecessary biopsies, decrease in patient morbidity and improved allocation of healthcare resources.



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Patient Knowledge Regarding Colorectal Cancer Risk, Opinion of Screening, and Preferences for a Screening Test

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Courtney C. Moreno, Thomas Jarrett, Brianna L. Vey, Pardeep K. Mittal, Elizabeth A. Krupinski, David L. Roberts
A survey assessing knowledge about colorectal cancer incidence and prognosis as well as willingness to undergo screening with various tests (e.g., optical colonoscopy, stool-based tests, CT colonography) was administered to consecutive patients of a general academic-based internal medicine clinic. Survey response rate was 86.3%. A majority of respondents (55%) reported being aware of general information about colorectal cancer, and 99% indicated a belief that colorectal cancer screening was a good idea. A majority of respondents (73%) were willing to undergo optical colonoscopy, and some were willing to undergo stool-based tests (48%) or CT colonography (40%). A majority reported being more willing to undergo a colorectal cancer screening test if the test did not involve radiation (86%), did not involve insertion of a tube or device into the rectum (78%), did not involve a pre-procedural bowel cleansing regimen (73%), or did not involve sedation (60%). In conclusion, improved patient education about the negligible radiation risk associated with CT colonography and/or development of a non-invasive imaging test that did not involve a pre-procedural bowel cleansing regimen may increase rates of colorectal cancer screening.



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Diffusion Tensor Imaging of the Ankle as a Possible Predictor of Chemotherapy Induced Peripheral Neuropathy: Pilot Study

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Lana Hirai Gimber, Linda Garland, Elizabeth A. Krupinski, Tyson S. Chadaz, Michael Schwenk, Bijan Najafi, Mihra S. Taljanovic
PurposeChemotherapy induced peripheral neuropathy (CIPN) is seen in up to 75% of treated cancer patients and can drastically limit their medical management and affect quality of life. Clinical and electrodiagnostic testing for CIPN have many pitfalls. Magnetic resonance neurography (MRN) is being increasingly utilized in the evaluation of peripheral nerves. Diffusion tensor imaging (DTI) shows promise in the workup of peripheral nerves. In this prospective pilot study, we investigated a possible relationship between DTI and peripheral neuropathy of the ankle and foot in cancer patients treated with chemotherapy.MethodsNine cancer patients with and without CIPN were clinically evaluated using vibratory perception threshold (VPT) testing. VPT score of >25Volts defined presence of CIPN. The posterior tibial nerve and branches in both feet were imaged using MRN and DTI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured at the posterior tibial, medial plantar, and lateral plantar nerves. Measurements for the CIPN group were compared to without CIPN by VPT cut-off. Correlations and possible relationships between DTI parameters and CIPN were analyzed.ResultsA total of 16 feet of nine enrolled patients were imaged (9 feet with CIPN, 7 feet without CIPN). Average age was 60.6±13.4 years (range=33–74). Posterior tibial nerve ADC values were significantly lower than the medial plantar nerve ADC values in all feet (F=3.50, p=0.04). We found a correlation with FA and ADC values at specific nerve locations with CIPN, with the left medial plantar nerve FA value and left lateral plantar nerve ADC value demonstrating the strongest positive correlations (0.73 and 0.62, respectively).ConclusionsThe use of DTI for assessing CIPN is challenging but promising. This pilot study provides preliminary data showing correlations between FA and ADC measurements with CIPN and potential utility of DTI as a predictive marker of onset and severity of CIPN in the ankle and foot which could aid in preventive strategies. Larger, prospective DTI studies are needed to draw definitive conclusions.Clinical RelevanceMRN with DTI shows promising results as a potential predictive marker of CIPN in the ankle and foot.



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Common resident errors when interpreting CT of the abdomen and pelvis: A review of types, pitfalls, and strategies for improvement

Publication date: Available online 6 January 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Benjamin Wildman-Tobriner, Brian C. Allen, Charles M. Maxfield
ObjectiveThe purpose of this study was to identify common errors that radiology residents make when interpreting abdominopelvic (AP) CT while on call, to review the typical imaging findings of these cases, and to discuss strategies for improvement.Materials and MethodsAP (or chest, abdomen, pelvis) CTs from 518 weekend senior call shifts (R3 or R4) were retrospectively reviewed. Discrepancies between preliminary and final reports were identified and then rated by whether the miss could impact short-term management. The imaging findings from the cases were reviewed.Results4695 CTs were reviewed, revealing a total of 145 discrepancies that could affect short-term clinical management (miss rate 3.1%). The most common misses were related to blood clots (13.8%), colitis (8.3%), misplaced lines/tubes (6.9%), or pyelonephritis (5.5%). Common pitfalls and strategies from improved detection are discussed using image examples.ConclusionsThrough increased attention to the vasculature, colon, devices, and kidneys, trainees may improve their discrepancy rates and improve on-call reporting.



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Letter to the Editor on Nevens et al.

We found the article by Nevens et al. [1] very original. In most of the series with up-front neck dissection (UFND), late toxicities were poorly reported [2], which is properly done in the current publication. Besides, this is the first study reporting the HPV status for the oropharyngeal subsites. However, the cohort was probably not large enough to look for any predictive role of HPV status for treatment selection.

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Proton beam therapy for skull base chordomas in 106 patients: A dose adaptive radiation protocol

To evaluate clinical results and safety of a dose adaptive protocol based on tumor volume coverage and critical structure constraints, for the treatment of skull base chordomas.

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Prognostic value of radiologically enlarged lymph nodes in patients with metastatic colorectal cancer: subgroup findings of the randomized, open-label FIRE-3/AIO KRK0306 trial

Publication date: Available online 6 January 2018
Source:European Journal of Radiology
Author(s): Felix O. Hofmann, Julian W. Holch, Volker Heinemann, Ingrid Ricard, Maximilian F. Reiser, Alena B. Baumann, Nina Hesse, Melvin D'Anastasi, Dominik P. Modest, Sebastian Stintzing, Wieland H. Sommer
PurposeTo determine the prognostic impact of radiologically enlarged lymph nodes ≥ 10 mm on the survival of patients with metastatic colorectal cancer.Materials and methodsThe prospective, randomized, open-label FIRE-3/AIO KRK0306 trial evaluated the first-line therapy of patients with KRAS exon 2 wild-type metastatic colorectal cancer with fluorouracil, folinic acid and irinotecan plus either cetuximab or bevacizumab. In the RAS wild-type population (n = 400), adequately evaluable baseline computed tomographies (n = 339) were reviewed for enlarged regional and distant lymph nodes. Their prognostic relevance was retrospectively analyzed in uni- and multivariable Cox proportional hazard regressions.ResultsMedian overall survival was 21.7 months in patients with enlarged lymph nodes and 33.2 months in patients without (hazard rate ratio [HR] = 1.61, 95% confidence interval [CI], 1.23-2.09; P < 0.001). This was confirmed in multivariable analysis (HR = 1.37, 95% CI, 1.02-1.83; P = 0.036). Progression-free survival of patients with enlarged lymph nodes showed a consistent but insignificant trend (9.9 vs. 11.1 months; HR = 1.23, 95% CI, 0.98-1.54; P = 0.072). Enlarged lymph nodes were also associated with BRAF-mutations (P = 0.004).ConclusionThe presence of radiologically enlarged lymph nodes in baseline staging has a negative prognostic value beyond established and potential prognostic parameters.



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A method for pre-operative single-subject thalamic segmentation based on probabilistic tractography for essential tremor deep brain stimulation

Abstract

Purpose

Deep brain stimulation is a common treatment for medication-refractory essential tremor. Current coordinate-based targeting methods result in variable outcomes due to variation in thalamic structure and the optimal patient-specific functional location. The purpose of this study was to compare the coordinate-based pre-operative targets to patient-specific thalamic segmentation utilizing a probabilistic tractography methodology.

Methods

Using available diffusion MRI of 32 subjects from the Human Connectome Project database, probabilistic tractography was performed. Each thalamic voxel was coded based on one of six predefined cortical targets. The segmentation results were analyzed and compared to a 2-mm spherical target centered at the coordinate-based location of the ventral intermediate thalamic nucleus.

Results

The traditional coordinate-based target had maximal overlap with the junction of the region most connected to primary motor cortex (M1) (36.6 ± 25.7% of voxels on left; 58.1 ± 28.5% on right) and the area connected to the supplementary motor area/premotor cortex (SMA/PMC) (44.9 ± 21.7% of voxels on left; 28.9 ± 22.2% on right). There was a within-subject coefficient of variation from right-to-left of 69.4 and 63.1% in the volume of overlap with the SMA/PMC and M1 regions, respectively.

Conclusion

Thalamic segmentation based on structural connectivity measures is a promising technique that may enhance traditional targeting methods by generating reproducible, patient-specific pre-operative functional targets. Our results highlight the problematic intra- and inter-subject variability of indirect, coordinate-based targets. Future prospective clinical studies will be needed to validate this targeting methodology in essential tremor patients.

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A method for pre-operative single-subject thalamic segmentation based on probabilistic tractography for essential tremor deep brain stimulation

Abstract

Purpose

Deep brain stimulation is a common treatment for medication-refractory essential tremor. Current coordinate-based targeting methods result in variable outcomes due to variation in thalamic structure and the optimal patient-specific functional location. The purpose of this study was to compare the coordinate-based pre-operative targets to patient-specific thalamic segmentation utilizing a probabilistic tractography methodology.

Methods

Using available diffusion MRI of 32 subjects from the Human Connectome Project database, probabilistic tractography was performed. Each thalamic voxel was coded based on one of six predefined cortical targets. The segmentation results were analyzed and compared to a 2-mm spherical target centered at the coordinate-based location of the ventral intermediate thalamic nucleus.

Results

The traditional coordinate-based target had maximal overlap with the junction of the region most connected to primary motor cortex (M1) (36.6 ± 25.7% of voxels on left; 58.1 ± 28.5% on right) and the area connected to the supplementary motor area/premotor cortex (SMA/PMC) (44.9 ± 21.7% of voxels on left; 28.9 ± 22.2% on right). There was a within-subject coefficient of variation from right-to-left of 69.4 and 63.1% in the volume of overlap with the SMA/PMC and M1 regions, respectively.

Conclusion

Thalamic segmentation based on structural connectivity measures is a promising technique that may enhance traditional targeting methods by generating reproducible, patient-specific pre-operative functional targets. Our results highlight the problematic intra- and inter-subject variability of indirect, coordinate-based targets. Future prospective clinical studies will be needed to validate this targeting methodology in essential tremor patients.

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Oxidative Stress and Apoptosis in Benzo[a]pyrene-Induced Neural Tube Defects

Publication date: Available online 5 January 2018
Source:Free Radical Biology and Medicine
Author(s): Shanshan Lin, Linlin Wang, Yun Huang, Yuanyuan Wang, Caiyun Wang, Nicholas D.E. Greene, Aiguo Ren
Neural tube defects (NTDs) are among the most common and severe congenital malformations and result from incomplete closure of the neural tube during early development. Maternal exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested to be a risk factor for NTDs and previous studies imply that the mechanism underlying the association between PAH exposure and NTDs may involve oxidative stress and apoptosis. The objectives of this study were to investigate whether there is a direct effect of maternal benzo[α] pyrene (BaP) exposure on the closure of the neural tube in mice, and to examine the underlying mechanisms by combining animal experiments and human subject studies. We found that intraperitoneal injection of BaP from embryonic day 7 at a dose of 250 mg kg^-1 induced NTDs (13.3% frequency) in ICR mice. BaP exposure significantly increased expression of genes associated with oxidative stress, Cyp1a1, Sod1 and Sod2, while repressing Gpx1. Elevated apoptosis and higher protein expression of cleaved caspase-3 in the neuroepithelium of treated embryos were observed. Pre-treatment with vitamin E, added to food, significantly protected against BaP-induced NTDs (1.4% frequency) (P < 0.05). Vitamin E also partly normalized oxidative stress related gene expression and excess apoptosis in BaP-treated embryos. Examination of human neural tissues revealed that increased levels of protein carbonyl and apoptosis were related with maternal exposure to PAHs and the risk of NTDs. Collectively, these results suggest that BaP exposure could induce NTDs and that this may involve increased oxidative stress and apoptosis, while vitamin E may have a protective effect.

Graphical abstract

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More to NAD+ than meets the eye: a regulator of metabolic pools and gene expression in Arabidopsis

Publication date: Available online 5 January 2018
Source:Free Radical Biology and Medicine
Author(s): Bertrand Gakière, Alisdair R. Fernie, Pierre Pétriacq
Since its discovery more than a century ago, nicotinamide adenine dinucleotide (NAD⁺) is recognised as a fascinating cornerstone of cellular metabolism. This ubiquitous energy cofactor plays vital roles in metabolic pathways and regulatory processes, a fact emphasised by the essentiality of a balanced NAD⁺ metabolism for normal plant growth and development. Research on the role of NAD in plants has been predominantly carried out in the model plant Arabidopsis thaliana (Arabidopsis) with emphasis on the redox properties and cellular signalling functions of the metabolite. This review examines the current state of knowledge concerning how NAD can regulate both metabolic pools and gene expression in Arabidopsis. Particular focus is placed on recent studies highlighting the complexity of metabolic regulations involving NAD, more particularly in the mitochondrial compartment, and of signalling roles with respect to interactions with environmental fluctuations most specifically those involving plant immunity.

Graphical abstract

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Cognitive determinants of healthcare system evaluations – A comparison of Eastern and Western European countries

Publication date: Available online 5 January 2018
Source:Health Policy
Author(s): Simone Schneider, Tamara Popic
Knowing the public opinion of healthcare is essential when assessing healthcare system performance; but little research has focussed on the links between the public’s general attitude to the healthcare system and its perceptions and expectations of specific healthcare-related aspects. Using data from the fourth round of the European Social Survey 2008/09, we explore the cognitive determinants of global evaluations of the healthcare system in 12 Eastern and 16 Western European countries. We find that healthcare evaluations follow a coherent cognitive reasoning. They are associated with (i) perceptions of the performance of healthcare systems (i.e. efficiency, equality of treatment, health outcomes), (ii) expectations of the government’s role in providing healthcare, and (iii) reflections on demographic pressures (i.e. aging populations). Contrary to the general assumption that normative expectations are responsible for differences in healthcare evaluations between Eastern and Western Europe, our results suggest that regional differences are largely due to a more negative perception of the performance of healthcare systems within Eastern Europe. To enhance the public opinion of healthcare, policy makers should improve the efficiency of healthcare systems and take measures to assure equality in health treatment.



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Implementing the Medicines Reconciliation Tool in Practice: Challenges and Opportunities for Pharmacists in Kuwait

Publication date: Available online 5 January 2018
Source:Health Policy
Author(s): Maram G. Katoue, Jean Ker
BackgroundUsing the medicines reconciliation tool which involves preparing an updated list of the patient’s medications at each transition of care can significantly enhance patient safety. The pharmacist has been leading this process in western healthcare systems. Little is known about pharmacists’ role in medicines reconciliation in Middle Eastern Countries.ObjectivesTo explore the implementation of medicines reconciliation in Kuwait hospitals, pharmacists’ role in this process and perceptions of the challenges in implementing it in their practice.MethodsThis was an exploratory descriptive study of medicines reconciliation practices at eleven secondary/tertiary hospitals in Kuwait. A mixed-method research design was used whereby 110 hospital pharmacists participated in 11 focus groups and completed self-administered surveys.ResultsParticipants reported that medicines reconciliation is poorly applied in hospitals and that they had limited role in the process. The current medicines reconciliation policy does not assign any responsibilities for pharmacists in this process. The most significant barriers to applying medicines reconciliation by pharmacists were inadequate staff numbers, lack of time, difficult access to patient information, lack of policy to support pharmacist role and patients’ lack of knowledge about their medications.ConclusionsHospital pharmacists in Kuwait advocate implementing medicines reconciliation but report significant strategic/operational barriers to its application. Efforts are needed in policy reform and team training to enable pharmacists provide effective services including medicines reconciliation.



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Physicochemical, techno-functional, and antioxidant properties of a novel bacterial exopolysaccharide in cooked beef sausage

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Imen Trabelsi, Naourez Ktari, Mehdi Triki, Intidhar Bkhairia, Sirine Ben Slima, Sameh Sassi Aydi, Samir Aydi, Asehraou Abdeslam, Riadh Ben Salah
This work investigates the effects of partial replacement of vitamin C (Vit C) with a purified exopolysaccharide (EPS-Ca6) produced by Lactobacillus sp. Ca6, on the antioxidant activities of cooked beef sausages during refrigerated storage. The physicochemical, techno-functional and viscosity properties of EPS-Ca6 were also studied. Functional properties of EPS-Ca6 were determined based on Water Holding Capacity (WHC), Oil Holding Capacity (OHC), emulsification activity, and foaming ability.EPS-Ca6 demonstrated excellent emulsifying and emulsion stabilizing properties. It was able to emulsify several food-grade oils and hydrophobic compounds, particularly corn oil and diesel with emulsification indexes of 90 and 100%, respectively at a concentration of 0.5%. The effect of EPS-Ca6 on oxidative processes in cooked beef sausages during storage up to 12days at 4°C was evaluated. The obtained results showed a high rate (p<0.05) of oxymyoglobin (OxyMb) and low lipid oxidation. Overall, our findings provided evidence that EPS-Ca6 could be used as a natural additive for maintaining storage stability of cooked beef sausages, and could replace synthetic polymer in several industrial applications.



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Thermal properties, crystallization and antimicrobial activity of chitosan biguanidine grafted poly(3-hydroxybutyrate) containing silver nanoparticles

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Hend Ezzat Salama, Mohamed Samir Abdel Aziz, Gamal Riad Saad
Green synthesis of novel nanocomposites series based on chitosan biguanidine grafted poly(3-hydroxybutyrate) copolymer (ChG-g-PHB) and silver nanoparticles (AgNPs) was successfully done via in situ reduction of AgNO3 in the copolymer matrix. Transmission electron microscopy verified the homogeneous dispersion of spherical shape of the AgNPs with an average particle size 12.3 to 19.2nm. X-ray diffraction pattern revealed face centered cubic structure of AgNPs. The thermal stability was improved upon increasing the AgNPs content up to 2.0%, then declined upon loading with 3.0%. Coats-Redfern model showed that the sample with 2.0% AgNPs has the highest activation energy of the thermal degradation with values of 264 and 270kJmol⁻¹ for the 1st and 2nd degradation steps, respectively. Differential scanning calorimetry indicated that AgNPs acts as a nucleating agent for the nonisothermal melt crystallization of PHB component. Avrami equation described well the crystallization of PHB segments, with average Avrami exponent of 3.10 and 3.36 for ChG-g-PHB and its 2.0% nanocomposite, respectively. Regardless of the content of AgNPs, the antimicrobial activity of the nanocomposites is better than the neat copolymer. The sample loaded with 3.0% AgNPs showed the best antimicrobial activity with MIC value range of 0.98–1.95μgmL⁻¹.



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Dextrin-uricase conjugate: Preparation, characterization, and enzymatic properties

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Xiuting Hu, Yu Wang, Chengmei Liu, Zhengyu Jin, Yaoqi Tian
Uricase was conjugated with dextrin to improve its stability. Firstly, dextrin was succinylated into dextrin monosuccinate with the functional group, carboxylic acid, and dextrin monosuccinates with different degree of substitution (DS) were prepared. Secondly, dextrin-uricase conjugate was synthesized by uricase and dextrin monosuccinate, which was verified by size-exclusion chromatography and anion exchange chromatography. Thirdly, it was found that the conjugate degree of the dextrin-uricase conjugate was positively related to the DS of dextrin monosuccinate, but the activity was seriously lost and difficult to recover by α-amylase. When the molar ratio of dextrin monosuccinate (DS=0.283) to uricase was 30:1, the conjugate degree of dextrin-uricase conjugate reached 22.1% and the activity was decreased to 40.4%. After triggered by α-amylase, the activity was recovered to 83.4%. Finally, the enzymatic properties of this dextrin-uricase conjugate were investigated and compared with those of free uricase. The optimal pH and temperature of the dextrin-uricase conjugate was 9.0 and 45°C, respectively, whereas the optimal pH and temperature of free uricase was 8.5 and 45°C, respectively. Furthermore, dextrin-uricase conjugate was more resistant to simulated physiological conditions and trypsin. These results suggested that the stability of uricase could be ameliorated by conjugation with dextrin.



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Binding investigation between M2-1protein from hRSV and acetylated quercetin derivatives: 1H NMR, fluorescence spectroscopy, and molecular docking

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Giovana C. Guimarães, Hemily R.M. Piva, Gabriela C. Araújo, Caroline S. Lima, Luis O. Regasini, Fernando A. de Melo, Marcelo A. Fossey, Ícaro P. Caruso, Fátima P. Souza
The human Respiratory Syncytial Virus (hRSV) is the main responsible for occurrences of respiratory diseases as pneumonia and bronchiolitis in children and elderly. M2-1 protein from hRSV is an important antitermination factor for transcription process that prevents the premature dissociation of the polymerase complex, making it a potential target for developing of inhibitors of the viral replication. The present study reports the interaction of the M2-1 tetramer with pera (Q1) and tetracetylated (Q2) quercetin derivatives, which were synthesized with the objective of generating stronger bioactive compounds against oxidation process. Fluorescence experiments showed binding constants of the M2-1/compounds complexes on order of 10⁴M⁻¹ with one ligand per monomeric unit, being the affinity of Q2 stronger than Q1. The thermodynamic analysis revealed values of ΔH>0 and ΔS>0, suggesting that hydrophobic interactions play a key role in the formation of the complexes. Molecular docking calculations indicated that binding sites for the compounds are in contact interfaces between globular and zinc finger domains of the monomers and that hydrogen bonds and stacking interactions are important contributions for stabilization of the complexes. Thus, the interaction of the acetylated quercetin derivatives in the RNA-binding sites of M2-1 makes these potential candidates for viral replication inhibitors.



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Isolation, purification and characterization of proteinaceous fungal α-amylase inhibitor from rhizome of Cheilocostus speciosus (J.Koenig) C.D.Specht

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Abinaya Balasubramanian, Manish Bhattacharjee, Meenakumari Sakthivel, Munusamy Thirumavalavan, Thirumurthy Madhavan, Santhosh Kumar Nagarajan, Velusamy Palaniyandi, Pachaiappan Raman
As the aim of this present study, a proteinaceous α-amylase inhibitor has been isolated from the rhizome of Cheilocostus specious (C. speciosus) and was purified using DEAE cellulose anion exchange chromatography followed by gel filtration using Sephacryl-S-200 column. The purity and molecular mass of the purified inhibitor was determined by SDS-PAGE and LC-MS respectively. The molecular mass of the purified inhibitor was determined to be 31.18kDa. Protein-protein docking was also carried out as molecular model. Model validation methods such as Ramachandran plot and Z-score plot were adopted to validate the structural description (sequence analysis) of proteins. The inhibitory activity was confirmed using spectrophotometric and reverse zymogram analyses. This 31.18kDa protein from C. speciosus inhibited the activity of fungal α-amylase by 71% at the level of ion exchange chromatography and 96% after gel filtration. The inhibition activity of the α-amylase inhibitor was stable and high at optimum pH6 (52.2%) and temperatures of 30–40°C (72.2%). Thus it was suggested that the main responsible for the versatile biological and pharmacological activities of C. speciosus is due to its primary metabolites (proteins) only.



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Behavior of bovine serum albumin in the presence of locust bean gum

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Hongmei Zhang, Ying Wang, Yanqing Wang, Shixin Sun, Jian Cao
In the present work, we have studied the structure and thermal stability of bovine serum albumin (BSA)-locust bean gum (LBG) mixture. It was found from the spectral results that the presence of LBG resulted in slightly decreasing the α–helical content and the partly unfolding of the skeleton of BSA. LBG binds to the neighboring amino acids of Trp and partly disturbs the microenvironment around Trp residues of BSA. The molecular docking confirms that there are more than one possible binding sites to bind with LBG by multi non-covalent forces. During the thermal unfolding process, LBG led to increase the secondary structure stability of protein by assembling each other. In addition, BSA even has good reversibility of the unfolding process in the presence of LBG promoting the thermal-induced tertiary structural degeneration of BSA. Collectively, our results provide evidence that LBG induces some behavior changes of BSA.



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DNA binding, artificial nuclease activity and cytotoxic studies of newly synthesized steroidal pyrimidines

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Ayaz Mahmood Dar, Bilal Rah, Shafia Mir, Rizwan Nabi, Shamsuzzaman, Manzoor Ahmad Gatoo, Ashraf Mashrai, Yusuf Khan
The new steroidal pyrimidine derivatives (4–6) were synthesized by the reaction of steroidal thiosemicarbazones with (2-methyl) diethyl malonate in absolute ethanol. After characterization by spectral and analytical data, the DNA interaction studies of compounds (4–6) were carried out by UV–vis, fluorescence spectroscopy, hydrodynamic measurements, molecular docking and gel electrophoresis. The compounds bind to DNA preferentially through electrostatic and hydrophobic interactions with Kb; 2.31×10³M⁻¹, 1.93×10³M⁻¹ and 2.05×10³M⁻¹, respectively indicating the higher binding affinity of compound 4 towards DNA. Gel electrophoresis demonstrated that compound 4 showed a strong interaction during the concentration dependent cleavage activity with pBR322 DNA. The molecular docking study suggested the intercalation of steroidal pyrimidine moiety in the minor groove of DNA. During in vitro cytotoxicity, compounds (4–6) revealed potential toxicity against the different human cancer cells (MTT assay). During DAPI staining, the nuclear fragmentations on cells occurred after treatment with compounds 4 and 5. Western blotting analysis clearly indicates that compound 4 causes apoptosis in MCF-7 cancer cells. The results revealed that compound 4 has better prospectus to act as a cancer chemotherapeutic candidate, which warrants further in vivo anticancer investigations.



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Mucoadhesive alginate pastes with embedded liposomes for local oral drug delivery

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Yarden Shtenberg, Mor Goldfeder, Hodaya Prinz, Janna Shainsky, Yasmine Ghantous, Imad Abu El-Naaj, Avi Schroeder, Havazelet Bianco-Peled
Oral cancers are extremely common among adults with increasing incidences due to human papillomavirus, while treatment modalities are limited. This study aims to develop a new oral mucoadhesive delivery system based on the combination of alginate and liposomes. The polymer provides adhesion properties and induces local release of the drug-loaded carriers, while the liposomes protect the drug from degradation and improve its absorption into the cells. Three hybrid alginate/liposomes delivery systems were investigated: a hybrid paste, which presented excellent adhesive capabilities, yet fast burst release of 90% after 2h; a hybrid hydrogel, demonstrating controllable release rates of 5%, 30% or 60% after 2h but poor mucoadhesive properties. These findings led to the development of a hybrid cross-linked paste. Polymer retention studies demonstrated that 80% of the crosslinked paste was retained on tongue tissue compared to 50% retention of the non-cross-linked pastes, verifying its superior mucoadhesion. The hybrid cross-linked paste presented controllable release rate of 20% after 2h. Alginate paste incorporating doxorubicin loaded liposomes presented similar release rates and were highly effective in promoting cancer cell death. Thus, our innovative formulation, including both desired characteristics of mucoadhesion and sustained liposomes release, is an important milestone in the development of a new potential treatment for oral cancer.

Graphical abstract

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The first two mitochondrial genomes from Taeniopterygidae (Insecta: Plecoptera): Structural features and phylogenetic implications

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Zhi-Teng Chen, Yu-Zhou Du
The complete mitochondrial genomes (mitogenomes) of Taeniopteryx ugola and Doddsia occidentalis (Plecoptera: Taeniopterygidae) were firstly sequenced from the family Taeniopterygidae. The 15,353-bp long mitogenome of T. ugola and the 16,020-bp long mitogenome of D. occidentalis each contained 37 genes including 13 protein-coding genes (PCGs), 22 transfer RNA genes (tRNAs), two ribosomal RNA genes (rRNAs) and a control region (CR). The mitochondrial gene arrangement of the two taeniopterygids and other stoneflies was identical with the putative ancestral mitogenome of Drosophila yakuba. Most PCGs used standard ATN start codons and TAN termination codons. Twenty-one of the 22 tRNAs in each mitogenome could fold into the cloverleaf secondary structures, while the dihydrouridine (DHU) arm of trnSer (AGN) was reduced or absent. Stem-loop (SL) structures, poly-T stretch, poly-[AT]n stretch and tandem repeats were found in the CRs of the two mitogenomes. The phylogenetic analyses using Bayesian inference (BI) and maximum likelihood methods (ML) generated identical results, both supporting the monophyly of all stonefly families and the two infraorders, Systellognatha and Euholognatha. Taeniopterygidae was grouped with another two families from Euholognatha. The relationships within Plecoptera were recovered as (((Perlidae+Peltoperlidae)+((Pteronarcyidae+Chloroperlidae)+Styloperlidae))+((Capniidae+Taeniopterygidae)+Nemouridae))+Gripopterygidae.



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Intrinsic viscosity of binary gum mixtures with xanthan gum and guar gum: Effect of NaCl, sucrose, and pH

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): J.H. Bak, B. Yoo
The intrinsic viscosity ([η]) values of binary gum mixtures with xanthan gum (XG) and guar gum (GG) mixed with NaCl and sucrose at different concentrations as well as in the presence of different pH levels were examined in dilute solution as a function of XG/GG mixing ratio (100/0, 75/25, 50/50, and 0/100). Experimental values of concentration (C) and relative viscosity (ηrel) or specific viscosity (ηsp) of gums in dilute solution were fitted to five models to determine [η] values of binary gum mixtures including individual gums. A [η] model (ηrel=1+[η]C) of Tanglertpaibul and Rao is recommended as the best model to estimate [η] values for the binary gum mixtures with XG and GG as affected by NaCl, sucrose, and pH. Overall, the synergistic interaction of XG-GG mixtures in the presence of NaCl and sucrose showed a greatly positive variation between measured and calculated values of [η]. In contrast, the binary gum mixtures showed synergy only under an acidic condition (pH3). These results suggest that the NaCl and sucrose addition or acidic condition appears to affect the intermolecular interaction occurred between XG and GG at different gum mixing ratios.



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Selective glycosidase inhibitors: A patent review (2012–present)

Publication date: May 2018
Source:International Journal of Biological Macromolecules, Volume 111
Author(s): Abdul Wadood, Mehreen Ghufran, Ajmal Khan, Syed Sikander Azam, Musharraf Jelani, Reaz Uddin
In the recent decades, the interest on glycosidases has dramatically increased, mainly because these enzymes play a vital role in many biological processes. Based on the biological potential associated to these enzymes, several glycosidase inhibitors have been developed. In this review, the most important inhibitors targeting these enzymes, including the disaccharides, iminosugars, monocyclic iminosugars, bicyclic iminosugars, thiosugars and carbasugars will be discussed and special attention will be given to the ones that are currently used clinically. This review summarizes and characterizes the current knowledge regarding the classes of glycosidase inhibitors that have therapeutic potential in a wide range of diseases. It highlights the patents, relevant research and patent applications filed in the past years in the field. Since the glycosidase inhibitors are involved in several chronic diseases and possibly pandemic, the pharmaceutical research towards developing new generations of these molecules is very important to public health. Most of the glycosidase inhibitors mimics the structures of monosaccharides or oligosaccharides and are well accepted by the organisms since they benefit from privileged drug-like properties. Disaccharides, iminosugars, carbasugars and thiosugars derivatives are the most popular inhibitors among the glycosidase inhibitors.



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Antioxidants, Vol. 7, Pages 7: Exercise and Mitochondrial Dynamics: Keeping in Shape with ROS and AMPK

Antioxidants, Vol. 7, Pages 7: Exercise and Mitochondrial Dynamics: Keeping in Shape with ROS and AMPK

Antioxidants doi: 10.3390/antiox7010007

Authors: Adam Trewin Brandon Berry Andrew Wojtovich

Exercise is a robust stimulus for mitochondrial adaptations in skeletal muscle which consequently plays a central role in enhancing metabolic health. Despite this, the precise molecular events that underpin these beneficial effects remain elusive. In this review, we discuss molecular signals generated during exercise leading to altered mitochondrial morphology and dynamics. In particular, we focus on the interdependence between reactive oxygen species (ROS) and redox homeostasis, the sensing of cellular bioenergetic status via 5’ adenosine monophosphate (AMP)-activated protein kinase (AMPK), and the regulation of mitochondrial fission and fusion. Precisely how exercise regulates the network of these responses and their effects on mitochondrial dynamics is not fully understood at present. We highlight the limitations that exist with the techniques currently available, and discuss novel molecular tools to potentially advance the fields of redox biology and mitochondrial bioenergetics. Ultimately, a greater understanding of these processes may lead to novel mitochondria-targeted therapeutic strategies to augment or mimic exercise in order to attenuate or reverse pathophysiology.

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IJMS, Vol. 19, Pages 172: Synergistic Association of Valproate and Resveratrol Reduces Brain Injury in Ischemic Stroke

IJMS, Vol. 19, Pages 172: Synergistic Association of Valproate and Resveratrol Reduces Brain Injury in Ischemic Stroke

International Journal of Molecular Sciences doi: 10.3390/ijms19010172

Authors: Lara Faggi Giuseppe Pignataro Edoardo Parrella Vanessa Porrini Antonio Vinciguerra Pasquale Cepparulo Ornella Cuomo Annamaria Lanzillotta Mariana Mota Marina Benarese Paolo Tonin Lucio Annunziato PierFranco Spano Marina Pizzi

Histone deacetylation, together with altered acetylation of NF-κB/RelA, encompassing the K310 residue acetylation, occur during brain ischemia. By restoring the normal acetylation condition, we previously reported that sub-threshold doses of resveratrol and entinostat (MS-275), respectively, an activator of the AMP-activated kinase (AMPK)-sirtuin 1 pathway and an inhibitor of class I histone deacetylases (HDACs), synergistically elicited neuroprotection in a mouse model of ischemic stroke. To improve the translational power of this approach, we investigated the efficacy of MS-275 replacement with valproate, the antiepileptic drug also reported to be a class I HDAC blocker. In cortical neurons previously exposed to oxygen glucose deprivation (OGD), valproate elicited neuroprotection at 100 nmol/mL concentration when used alone and at 1 nmol/mL concentration when associated with resveratrol (3 nmol/mL). Resveratrol and valproate restored the acetylation of histone H3 (K9/18), and they reduced the RelA(K310) acetylation and the Bim level in neurons exposed to OGD. Chromatin immunoprecipitation analysis showed that the synergistic drug association impaired the RelA binding to the Bim promoter, as well as the promoter-specific H3 (K9/18) acetylation. In mice subjected to 60 min of middle cerebral artery occlusion (MCAO), the association of resveratrol 680 µg/kg and valproate 200 µg/kg significantly reduced the infarct volume as well as the neurological deficits. The present study suggests that valproate and resveratrol may represent a promising ready-to-use strategy to treat post-ischemic brain damage.

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IJMS, Vol. 19, Pages 170: CPT-11-Induced Delayed Diarrhea Develops via Reduced Aquaporin-3 Expression in the Colon

IJMS, Vol. 19, Pages 170: CPT-11-Induced Delayed Diarrhea Develops via Reduced Aquaporin-3 Expression in the Colon

International Journal of Molecular Sciences doi: 10.3390/ijms19010170

Authors: Risako Kon Yuika Tsubota Moe Minami Saki Kato Yukari Matsunaga Hiroshi Kimura Yuta Murakami Tetsuya Fujikawa Ryoya Sakurai Rei Tomimoto Yoshiaki Machida Nobutomo Ikarashi Kiyoshi Sugiyama

While irinotecan (CPT-11) has a potent anti-cancer effect, it also causes serious diarrhea as an adverse reaction. In this study, we analyzed the pathogenic mechanism of CPT-11-induced delayed diarrhea by focusing on water channel aquaporin-3 (AQP3) in the colon. When rats received CPT-11, the expression level of AQP3 was reduced during severe diarrhea. It was found that the expression levels of inflammatory cytokines and the loss of crypt cells were increased in the colon when CPT-11 was administered. When celecoxib, an anti-inflammatory drug, was concomitantly administered, both the diarrhea and the reduced expression of AQP3 induced by CPT-11 were suppressed. The inflammation in the rat colon during diarrhea was caused via activated macrophage by CPT-11. These results showed that when CPT-11 is administered, the expression level of AQP3 in the colon is reduced, resulting in delayed diarrhea by preventing water transport from the intestinal tract. It was also suggested that the reduced expression of AQP3 might be due to the inflammation that occurs following the loss of colonic crypt cells and to the damage caused by the direct activation of macrophages by CPT-11. Therefore, it was considered that anti-inflammatory drugs that suppress the reduction of AQP3 expression could prevent CPT-11-induced delayed diarrhea.

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The General Adaptation Syndrome: A Foundation for the Concept of Periodization

Abstract

Recent reviews have attempted to refute the efficacy of applying Selye’s general adaptation syndrome (GAS) as a conceptual framework for the training process. Furthermore, the criticisms involved are regularly used as the basis for arguments against the periodization of training. However, these perspectives fail to consider the entirety of Selye’s work, the evolution of his model, and the broad applications he proposed. While it is reasonable to critically evaluate any paradigm, critics of the GAS have yet to dismantle the link between stress and adaptation. Disturbance to the state of an organism is the driving force for biological adaptation, which is the central thesis of the GAS model and the primary basis for its application to the athlete’s training process. Despite its imprecisions, the GAS has proven to be an instructive framework for understanding the mechanistic process of providing a training stimulus to induce specific adaptations that result in functional enhancements. Pioneers of modern periodization have used the GAS as a framework for the management of stress and fatigue to direct adaptation during sports training. Updates to the periodization concept have retained its founding constructs while explicitly calling for scientifically based, evidence-driven practice suited to the individual. Thus, the purpose of this review is to provide greater clarity on how the GAS serves as an appropriate mechanistic model to conceptualize the periodization of training.

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Vascular pattern of the dentate gyrus is regulated by neural progenitors

Abstract

Neurogenesis is a vital process that begins during early embryonic development and continues until adulthood, though in the latter case, it is restricted to the subventricular zone and the subgranular zone of the dentate gyrus (DG). In particular, the DG’s neurogenic properties are structurally and functionally unique, which may be related to its singular vascular pattern. Neurogenesis and angiogenesis share molecular signals and act synergistically, supporting the concept of a neurogenic niche as a functional unit between neural precursors cells and their environment, in which the blood vessels play an important role. Whereas it is well known that vascular development controls neural proliferation in the embryonary and in the adult brain, by releasing neurotrophic factors; the potential influence of neural cells on vascular components during angiogenesis is largely unknown. We have demonstrated that the reduction of neural progenitors leads to a significant impairment of vascular development. Since VEGF is a potential regulator in the neurogenesis–angiogenesis crosstalk, we were interested in assessing the possible role of this molecule in the hippocampal neurovascular development. Our results showed that VEGF is the molecule involved in the regulation of vascular development by neural progenitor cells in the DG.

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Diffusion-Weighted Imaging of Brain Metastasis from Lung Cancer: Correlation of MRI Parameters with the Histologic Type and Gene Mutation Status.

Related Articles

Diffusion-Weighted Imaging of Brain Metastasis from Lung Cancer: Correlation of MRI Parameters with the Histologic Type and Gene Mutation Status.

AJNR Am J Neuroradiol. 2018 Jan 04;:

Authors: Jung WS, Park CH, Hong CK, Suh SH, Ahn SJ

Abstract
BACKGROUND AND PURPOSE: Development of noninvasive imaging biomarkers indicating the histology and the gene mutation status of brain metastasis from lung cancer is important. We aimed to investigate diffusion-weighted imaging parameters as predictors of the histology and gene mutations of brain metastasis from lung cancer.
MATERIALS AND METHODS: DWI data for 74 patients with brain metastasis from lung cancer were retrospectively reviewed. The patients were first grouped according to the primary tumor histology (adenocarcinoma, small-cell lung cancer, squamous cell carcinoma), and those with adenocarcinoma were further divided into epidermal growth factor receptor (EFGR) mutation-positive and wild type groups. Sex; age; number, size, and location of brain metastasis; DWI visual scores; the minimum ADC; and the normalized ADC ratio were compared among groups using χ2 and ANOVA. Multiple logistic regression analysis was performed to determine independent predictors of the EGFR mutation.
RESULTS: The minimum ADC was lower in the small-cell lung cancer group than in the other 2 groups, though the difference was not significant. Furthermore, minimum ADC and the normalized ADC ratio were significantly lower in the EGFR mutation-positive group than in the wild type group (P = .021 and .014, respectively). Multivariate analysis revealed that minimum ADC and the normalized ADC ratio were independently associated with the EGFR mutation status (P = .028 and .021, respectively).
CONCLUSIONS: Our results suggest that DWI parameters (minimum ADC and normalized ADC ratio) for the solid components of brain metastasis from lung cancer are not correlated with their histology, whereas they can predict the EGFR mutation status in brain metastasis from lung adenocarcinoma.

PMID: 29301782 [PubMed - as supplied by publisher]

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Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis.

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Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis.

AJNR Am J Neuroradiol. 2018 Jan 04;:

Authors: Sakata A, Okada T, Yamamoto Y, Fushimi Y, Dodo T, Arakawa Y, Mineharu Y, Schmitt B, Miyamoto S, Togashi K

Abstract
BACKGROUND AND PURPOSE: Amide proton transfer imaging has been successfully applied to brain tumors, however, the relationships between amide proton transfer and other quantitative imaging values have yet to be investigated. The aim was to examine the additive value of amide proton transfer imaging alongside [18F] FDG-PET and DWI for preoperative grading of gliomas.
MATERIALS AND METHODS: Forty-nine patients with newly diagnosed gliomas were included in this retrospective study. All patients had undergone MR imaging, including DWI and amide proton transfer imaging on 3T scanners, and [18F] FDG-PET. Logistic regression analyses were conducted to examine the relationship between each imaging parameter and the presence of high-grade (grade III and/or IV) glioma. These parameters included the tumor-to-normal ratio of FDG uptake, minimum ADC, mean amide proton transfer value, and their combinations. In each model, the overall discriminative power for the detection of high-grade glioma was assessed with receiver operating characteristic curve analysis. Additive information from minimum ADC and mean amide proton transfer was also evaluated by continuous net reclassification improvement. P < .05 was considered significant.
RESULTS: Tumor-to-normal ratio, minimum ADC, and mean amide proton transfer demonstrated comparable diagnostic accuracy in differentiating high-grade from low-grade gliomas. When mean amide proton transfer was combined with the tumor-to-normal ratio, the continuous net reclassification improvement was 0.64 (95% CI, 0.036-1.24; P = .04) for diagnosing high-grade glioma and 0.95 (95% CI, 0.39-1.52; P = .001) for diagnosing glioblastoma. When minimum ADC was combined with the tumor-to-normal ratio, the continuous net reclassification improvement was 0.43 (95% CI, -0.17-1.04; P = .16) for diagnosing high-grade glioma, and 1.36 (95% CI, 0.79-1.92; P < .001) for diagnosing glioblastoma.
CONCLUSIONS: Addition of amide proton transfer imaging to FDG-PET/CT may improve the ability to differentiate high-grade from low-grade gliomas.

PMID: 29301781 [PubMed - as supplied by publisher]

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Multiparametric Analysis of Permeability and ADC Histogram Metrics for Classification of Pediatric Brain Tumors by Tumor Grade.

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Multiparametric Analysis of Permeability and ADC Histogram Metrics for Classification of Pediatric Brain Tumors by Tumor Grade.

AJNR Am J Neuroradiol. 2018 Jan 04;:

Authors: Vajapeyam S, Brown D, Johnston PR, Ricci KI, Kieran MW, Lidov HGW, Poussaint TY

Abstract
BACKGROUND AND PURPOSE: Accurate tumor grading is essential for treatment planning of pediatric brain tumors. We hypothesized that multiparametric analyses of a combination of permeability metrics and ADC histogram metrics would differentiate high- and low-grade tumors with high accuracy.
MATERIALS AND METHODS: DTI and dynamic contrast-enhanced MR imaging using T1-mapping with flip angles of 2°, 5°, 10°, and 15°, followed by a 0.1-mmol/kg body weight gadolinium-based bolus was performed on all patients in addition to standard MR imaging. Permeability data were processed and transfer constant from the blood plasma into the extracellular extravascular space, rate constant from the extracellular extravascular space back into blood plasma, extravascular extracellular volume fraction, and fractional blood plasma volume were calculated from 3D tumor volumes. Apparent diffusion coefficient histogram metrics were calculated for 3 separate tumor volumes derived from T2-FLAIR sequences, T1 contrast-enhanced sequences, and permeability maps, respectively.
RESULTS: Results from 41 patients (0.3-16.76 years of age; mean, 6.22 years) with newly diagnosed contrast-enhancing brain tumors (16 low-grade; 25 high-grade) were included in the institutional review board-approved retrospective analysis. Wilcoxon tests showed a higher transfer constant from blood plasma into extracellular extravascular space and rate constant from extracellular extravascular space back into blood plasma, and lower extracellular extravascular volume fraction (P < .001) in high-grade tumors. The mean ADCs of FLAIR and enhancing tumor volumes were significantly lower in high-grade tumors (P < .001). ROC analysis showed that a combination of extravascular volume fraction and mean ADC of FLAIR volume differentiated high- and low-grade tumors with high accuracy (area under receiver operating characteristic curve = 0.918).
CONCLUSIONS: ADC histogram metrics combined with permeability metrics differentiate low- and high-grade pediatric brain tumors with high accuracy.

PMID: 29301780 [PubMed - as supplied by publisher]

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What Have We Learned from MR Imaging in Multiple Sclerosis?

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What Have We Learned from MR Imaging in Multiple Sclerosis?

AJNR Am J Neuroradiol. 2018 Jan 04;:

Authors: Lapointe E, Li DKB, Traboulsee AL, Rauscher A

Abstract
Using MR imaging, perfusion can be assessed either by dynamic susceptibility contrast MR imaging or arterial spin-labeling. Alterations of cerebral perfusion have repeatedly been described in multiple sclerosis compared with healthy controls. Acute lesions exhibit relative hyperperfusion in comparison with normal-appearing white matter, a finding mostly attributed to inflammation in this stage of lesion development. In contrast, normal-appearing white and gray matter of patients with MS has been mostly found to be hypoperfused compared with controls, and correlations with cognitive impairment as well as fatigue in multiple sclerosis have been described. Mitochondrial failure, axonal degeneration, and vascular dysfunction have been hypothesized to underlie the perfusion MR imaging findings. Clinically, perfusion MR imaging could allow earlier detection of the acute focal inflammatory changes underlying relapses and new lesions, and could constitute a marker for cognitive dysfunction in MS. Nevertheless, the clinical relevance and pathogenesis of the brain perfusion changes in MS remain to be clarified.

PMID: 29301779 [PubMed - as supplied by publisher]

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Reply.

Related Articles

Reply.

AJNR Am J Neuroradiol. 2018 Jan 04;:

Authors: Byrne D, Walsh JP, MacMahon PJ

PMID: 29301778 [PubMed - as supplied by publisher]

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"Delayed Pial Vessels" in Multiphase CT Angiography Aid in the Detection of Arterial Occlusion in Anterior Circulation.

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"Delayed Pial Vessels" in Multiphase CT Angiography Aid in the Detection of Arterial Occlusion in Anterior Circulation.

AJNR Am J Neuroradiol. 2018 Jan 04;:

Authors: Singh RJ, Zerna C, Menon BK

PMID: 29301777 [PubMed - as supplied by publisher]

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Summary of the Italian inter-society recommendations for radiation protection optimization in interventional radiology

Abstract

Objectives

A Working Group coordinated by the Italian National Institute of Health (Istituto Superiore di Sanità) and the National Workers Compensation Authority (Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro, INAIL) and consisting of 11 Italian scientific/professional societies involved in the fluoroscopically guided interventional practices has been established to define recommendations for the optimization of patients and staff radiation protection in interventional radiology. A summary of these recommendations is here reported.

Materials and methods

A multidisciplinary approach was used to establish the Working Group by involving radiologists, interventional radiologists, neuroradiologists, interventional cardiologists, occupational health specialists, medical physicists, radiation protection experts, radiographers and nurses. The Group operated as a "Consensus Conference". Three main topics have been addressed: patient radiation protection (summarized in ten "golden rules"); staff radiation protection (summarized in ten "golden rules"); and education/training of interventional radiology professionals.

Results

In the "golden rules", practical and operational recommendations were provided to help the professionals in optimizing dose delivered to patients and reducing their own exposure. Operative indications dealt also with continuing education and training, and recommendations on professional accreditation and certification.

Conclusions

The "Consensus Conference" was the methodology adopted for the development of these recommendations. Involvement of all professionals is a winning approach to improve practical implementation of the recommendations, thus getting a real impact on the optimization of the interventional radiology practices.

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Analysis of CT features and quantitative texture analysis in patients with thymic tumors: correlation with grading and staging

Abstract

Objectives

To evaluate potential relationship between qualitative CT features, quantitative texture analysis (QTA), histology, WHO staging, Masaoka classification and myasthenic syndrome in patients with thymic tumors.

Materials and methods

Sixteen patients affected by histologically proven thymic tumors were retrospectively included in the study population. Clinical information, with special regard to myasthenic syndrome and serological positivity of anti-AchR antibodies, were recorded. Qualitative CT evaluation included the following parameters: (a) location; (b) tumor edges; (c) necrosis; (d) pleural effusion; (e) metastases; (f) chest wall infiltration; (g) tumor margins. QTA included evaluation of "Mean" (M), "Standard Deviation" (SD), "Kurtosis" (K), "Skewness" (S), "Entropy" (E), "Shape from Texture" (TX_sigma) and "average of positive pixels" (MPP). Pearson–Rho test was used to evaluate the relationship of continuous non-dichotomic parameters, whereas Mann–Whitney test was used for dichotomic parameters.

Results

Histological evaluation demonstrated thymoma in 12 cases and thymic carcinoma in 4 cases. Tumor necrosis was significantly correlated with QTA Mean (p = 0.0253), MPP (p = 0.0417), S (p = 0.0488) and K (p = 0.0178). WHO staging was correlated with Mean (p = 0.0193), SD (p = 0.0191) and MPP (p = 0.0195). Masaoka classification was correlated with Mean (p = 0.0322), MPP (p = 0.0315), skewness (p = 0.0433) and Kurtosis (p = 0.0083). Myasthenic syndrome was significantly associated with Mean (p = 0.0211) and MPP (p = 0.0261), whereas tumor size was correlated with Mean (p = 0.0241), entropy (p = 0.0177), MPP (p = 0.0468), skewness (p = 0.009) and Kurtosis (p = 0.006).

Conclusion

Our study demonstrates significant relationship between radiomics parameters, histology, grading and clinical manifestations of thymic tumors.

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Anti-Müllerian hormone in pre-menopausal females after ablative radioiodine treatment for differentiated thyroid cancer.

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Anti-Müllerian hormone in pre-menopausal females after ablative radioiodine treatment for differentiated thyroid cancer.

Endocrine. 2018 Jan 04;:

Authors: Giusti M, Mittica M, Comite P, Campana C, Gay S, Mussap M

Abstract
PURPOSE: In recent years, anti-Mullerian hormone (AMH) has been considered a reliable index of ovarian reserve. There are few data on AMH values in thyroid cancer. The aim of this study was to evaluate AMH levels in pre-menopausal women with a history of low-risk thyroid cancer.
METHODS: Thirty-four women (aged 40.7 ± 6.7 years) were studied 7.1 ± 0.9 years after surgery and at least one RAI treatment. A group of 23 thyroid cancer women (41.6 ± 7.4 years) who had undergone only thyroidectomy served as controls. AMH, follicle-stimulating hormone (FSH) and estradiol were assayed on days 2-3, and prolactin and progesterone levels on days 21-24 of the menstrual cycle.
RESULTS: Pregnancy (RAI group 62%; control group 61%) and miscarriage rates (18% and 26%) were similar. AMH levels were similar in the RAI (10.7 ± 1.7 pmol/l) and control (17.5 ± 4.7 pmol/l) groups. Regular menses were reported in 41% and 52% of RAI and control subjects, respectively. Non-ovulatory cycles were noted in 26% and 35% of RAI and control women, respectively. AMH levels were found to be negatively correlated with age (RAI group P = 0.0003; control group P = 0.0001) and FSH, and positively correlated with progesterone, but not with the other hormonal parameters.
CONCLUSIONS: AMH should replace FSH in the evaluation of gonadal reserve in pre-menopausal thyroid cancer women. At present, age is the only predictor of AMH levels. About one out of two women with a history of thyroid cancer suffers from menstrual dysregulation, but infertility must be considered a low risk.

PMID: 29302874 [PubMed - as supplied by publisher]

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An ectopic intrathyroidal thymic tissue and intrathymic parathyroid tissue in a patient with Graves disease.

Related Articles

An ectopic intrathyroidal thymic tissue and intrathymic parathyroid tissue in a patient with Graves disease.

Gland Surg. 2017 Dec;6(6):726-728

Authors: O'Connor K, Alzahrani H, Murad F, Daroca P, Kandil E

Abstract
Ectopic intrathyroidal thymic tissue, with coinciding intrathymic parathyroid tissue, is a very rare occurrence that is most often found incidentally in adults during surgery. We report a 23-year-old female who presented with Graves disease refractory to medical treatment. Radioactive iodine uptake demonstrated increased, diffuse uptake in the region of the thyroid. The patient underwent a total thyroidectomy and right inferior parathyroidectomy which was found enlarged intraoperatively. Histopathologically, surgical specimen demonstrated characteristics of intrathyroidal thymic tissue and intrathymic parathyroid tissue. Intrathyroidal thymic tissue can be identified preoperatively on ultrasonography, but the significance of this finding is unknown.

PMID: 29302491 [PubMed]

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Genomic correlates of response to everolimus in aggressive radioiodine-refractory thyroid cancer: a phase II study.

Related Articles

Genomic correlates of response to everolimus in aggressive radioiodine-refractory thyroid cancer: a phase II study.

Clin Cancer Res. 2018 Jan 04;:

Authors: Hanna GJ, Busaidy NL, Chau NG, Wirth LJ, Barletta JA, Calles A, Haddad RI, Kraft S, Cabanillas ME, Rabinowits G, O'Neill A, Limaye SA, Alexander EK, Moore FD, Misiukiewicz K, Thomas T, Nehs MA, Marqusee E, Lee SL, Janne PA, Lorch JH

Abstract
PURPOSE: Targeting mutations leading to PI3K/mTOR/Akt activation are of interest in thyroid cancer (TC). We evaluated the efficacy of everolimus in aggressive, radioactive iodine refractory (RAIR) TC and correlated tumor mutational profiling with response. Exploratory medullary and anaplastic TC cohorts were included.
EXPERIMENTAL DESIGN: This single-arm, multi-institutional phase II study was conducted from 2009-2013 in patients with incurable RAIR TC who had radiographic progression six months prior to enrollment. The primary endpoint was progression-free survival (PFS) with a median follow-up of 31.8 months. The study is closed to enrollment but treatment and follow-up are ongoing. A targeted next-generation sequencing platform was used for mutational analysis.
RESULTS: Thirty-three patients with differentiated TC (DTC), 10 with medullary TC (MTC), and 7 with anaplastic TC (ATC) enrolled. For the DTC cohort, median PFS was 12.9 months (95% CI, 7.3-18.5) with a 2-year PFS of 23.6% (95% CI, 10.5-39.5). Median OS was not reached; 2-year OS was 73.5% (95% CI, 53.8-85.8). Among ATC patients, 1 had a partial response and was progression-free until 17.9 months post study entry and one had disease stability for 26 months, respectively. The genomically profiled cohort enriched for PI3K/mTOR/Akt alterations. PI3K/mTOR/Akt mutated ATC subgroups appeared to benefit from everolimus. Treatment-related adverse events were as anticipated.  Conclusions: Everolimus has significant anti-tumor activity in TC. While genomic profiling does not currently guide therapeutic selection in TC patients, these data have important implications when considering the use of an mTOR inhibitor in an era of precision medicine.

PMID: 29301825 [PubMed - as supplied by publisher]

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Emergency department imaging of pediatric trauma patients during combat operations in Iraq and Afghanistan

Abstract

Background

Military hospitals in Iraq and Afghanistan treated children with traumatic injuries during the recent conflicts. Diagnostic imaging is an integral component of trauma management; however, few published data exist on its use in the wartime pediatric population.

Objective

The authors describe the emergency department (ED) utilization of radiology resources for pediatric trauma patients in Iraq and Afghanistan.

Materials and methods

We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients admitted to military fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. We retrieved ED data on ultrasound (US), radiographic and computed tomography (CT) studies.

Results

During the study period, there were 3,439 pediatric encounters, which represented 8.0% of all military hospital trauma admissions. ED providers obtained a total of 12,376 imaging studies on 2,920 (84.9%) children. Of the 12,376 imaging studies, 1,341 (10.8%) were US, 4,868 (39.3%) were radiographic and 6,167 (49.8%) were CT exams. Most children undergoing radiographic evaluation were boys (77.8%) and located in Afghanistan (70.4%), and they sustained penetrating injuries (68.0%). Children who underwent imaging had higher composite injury severity scores in comparison to those who did not undergo imaging (10 versus 9).

Conclusion

Military health care providers frequently utilized radiographic studies in the evaluation of pediatric trauma casualties in Iraq and Afghanistan. Deployed military hospitals that treat children would benefit from dedicated pediatric-specific imaging training and protocols.

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Inter-rater and intra-rater reliability of the airway diameter measured by sonography

Abstract

Introduction

Sonography has gained a broad field of applications in current anesthetic practice. During airway management, it could have an important role, because it allows real-time measurement of anatomical aspects and a functional evaluation with high safety profile. However, assessment of the reliability and precision of these measurements is critical if sonography is used as a clinical diagnostic tool. The aim of the study was to estimate inter-rater and intra-rater reliability of the airway diameter measured by sonography in heathy volunteers.

Methods

We conducted a cross-sectional study during 2015 on healthy adult volunteers. Using sonography, transverse internal diameter of subglottic space was measured twice by two blinded sonographers.

Results

Agreement was classified as very good for intra-rater measurements (ICC = 0.84) and good for the inter-rater measurements (ICC = 0.71). The 95% CI of agreement limits for the intra-rater measurements were inferior to those for the inter-rater measurements.

Conclusions

Ultrasound measurement is a reliable and precise method to measure the internal subglottic diameter of the airway. Ultimately, this method may provide clinicians valuable information regarding airway diameter in adults and may help to guide treatment options.

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Three-dimensional echocardiography for the assessment of left ventricular geometry and papillary muscle morphology in hypertrophic cardiomyopathy

Abstract

Background

Hypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. The aim of this study was to evaluate the utility of three-dimensional echocardiography (3DE) for the geometric assessment of LV hypertrophy and PM morphology.

Methods

The study included 24 patients with an established diagnosis of HC and 31 healthy controls. 3DE was performed using an iE33 or EPIQ 7C ultrasound system with an X5-1 transducer. QLAB software was used for the 3D analysis of LV wall thickness (LVWT) and PM morphology and hypertrophy; the number and cross-sectional area (CSA) of anterolateral and posteromedial PMs; and the presence of bifid or accessory PMs.

Results

Patients with HC had a larger LVWT compared to controls in all segments (p < 0.001), and LVWT was largest in the midventricular septal segment (2.12 ± 0.68 cm). The maximum LVWT followed a spiral pattern from the LV base to the apex. The CSA of both anterolateral and posteromedial PMs was larger in patients with HC than in controls (1.92 vs. 1.15 cm²; p = 0.001 and 1.46 vs. 1.08 cm²; p = 0.033, respectively). The CSA of the posteromedial PM was larger in patients with LVOT obstruction than in those without (2.64 vs 1.16 cm², p = 0.021).

Conclusions

3DE allows the assessment of LV geometry and PM abnormalities in patients with HC. 3DE demonstrated that the maximum hypertrophy was variable and generally located in a spiral from the LV base to the apex.

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IJERPH, Vol. 15, Pages 84: Neighborhood Perceptions and Cumulative Impacts of Low Level Chronic Exposure to Fine Particular Matter (PM2.5) on Cardiopulmonary Health

IJERPH, Vol. 15, Pages 84: Neighborhood Perceptions and Cumulative Impacts of Low Level Chronic Exposure to Fine Particular Matter (PM2.5) on Cardiopulmonary Health

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010084

Authors: Kristen Malecki Amy Schultz Rachel Bergmans

Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built environment that may exacerbate effects of air pollution on cardiopulmonary health outcomes, particularly among general population based cohorts. This study examined associations between low-level chronic exposure to fine particulate matter (PM2.5) and cardiopulmonary health, and the potential mediating or modifying effects of adverse neighborhood perceptions. Using data from the Survey of the Health of Wisconsin (SHOW), 2230 non-asthmatic adults age 21–74 were included in the analyses. The overall goals of this study were to assess if individuals who experience stress from neighborhood environments in which they live were more sensitive to low levels of fine particular matter (PM2.5 μg/m3). Demographic predictors of air pollution exposure included younger age, non-White race, lower education and middle class income. After adjustments, objective lung function measures (FEV1 and FEV1 to FVC ratio) were the only cardiopulmonary health indicators significantly associated with chronic three-year annual averages of PM2.5. Among all non-asthmatics, a ten unit increase in estimated three year annual average PM2.5 exposure was significantly associated with lower forced expiratory volume (L) in one second FEV1 (β = −0.40 μg/L; 95% CI −0.45, −0.06). Among all individuals, adverse perceptions of the neighborhood built environment did not appear to statistically moderate or mediate associations. However, stratified analysis did reveal significant associations between PM2.5 and lung function (FEV1) only among individuals with negative perceptions and increased reports of neighborhood stressors. These findings included individuals who felt their neighborhoods were poorly maintained (β = −0.82; 95% CI −1.35, −0.28), experienced stress from crime (β = −0.45; 95% CI −0.94, 0.04) or reported neighborhood is not well maintained (β = −1.13, CI −2.04, −0.24). These significant associations were similar for FEV1 to FVC ratio. Multi-pronged approaches addressing both neighborhood built environment aesthetics and air pollution regulation may be necessary to protect vulnerable and susceptible individuals and reduce persistent inequalities.

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IJERPH, Vol. 15, Pages 86: Optimization of Location-Routing Problem for Cold Chain Logistics Considering Carbon Footprint

IJERPH, Vol. 15, Pages 86: Optimization of Location-Routing Problem for Cold Chain Logistics Considering Carbon Footprint

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010086

Authors: Songyi Wang Fengming Tao Yuhe Shi

In order to solve the optimization problem of logistics distribution system for fresh food, this paper provides a low-carbon and environmental protection point of view, based on the characteristics of perishable products, and combines with the overall optimization idea of cold chain logistics distribution network, where the green and low-carbon location–routing problem (LRP) model in cold chain logistics is developed with the minimum total costs as the objective function, which includes carbon emission costs. A hybrid genetic algorithm with heuristic rules is designed to solve the model, and an example is used to verify the effectiveness of the algorithm. Furthermore, the simulation results obtained by a practical numerical example show the applicability of the model while provide green and environmentally friendly location-distribution schemes for the cold chain logistics enterprise. Finally, carbon tax policies are introduced to analyze the impact of carbon tax on the total costs and carbon emissions, which proves that carbon tax policy can effectively reduce carbon dioxide emissions in cold chain logistics network.

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IJERPH, Vol. 15, Pages 85: Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China

IJERPH, Vol. 15, Pages 85: Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010085

Authors: Zheng Sun Jiajun Chen

The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (Igeo), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and Igeo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased (p &lt;  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China.

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quality of care; +1883 new citations

1883 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

quality of care

These pubmed results were generated on 2018/01/06

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

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Aεροπλάνο απογειώθηκε το 2018 και προσγειώθηκε το 2017

Δύο φορές γιόρτασαν την αλλαγή του έτους οι επιβάτες μιας πτήσης από το Όκλαντ της Νέας Ζηλανδίας προς τη Χονολουλού της Χαβάης, λόγω της διαφοράς ώρας. Πιο συγκεκριμένα, η πτήση της αεροπορικής εταιρίας Hawaiian Airlines με αριθμό HA446 από το Όκλαντ στη Χονολουλού, προγραμματίστηκε για να απογειωθεί στις 23.55 το βράδυ της Παραμονής Χριστουγέννων και να προσγειωθεί στις 9.45 […]

Source

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Therapeutic approaches for induction of tolerance and immune quiescence in corneal allotransplantation

Abstract

The cornea is the most commonly transplanted tissue in the body. Corneal grafts in low-risk recipients enjoy high success rates, yet over 50% of high-risk grafts (with inflamed and vascularized host beds) are rejected. As our understanding of the cellular and molecular pathways that mediate rejection has deepened, a number of novel therapeutic strategies have been unveiled. This manuscript reviews therapeutic approaches to promote corneal transplant survival through targeting (1) corneal lymphangiogenesis and hemangiogenesis, (2) antigen presenting cells, (3) effector and regulatory T cells, and (4) mesenchymal stem cells.

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health technology; +249 new citations

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

health technology

These pubmed results were generated on 2018/01/06

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

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Local changes in computational non-rapid eye movement sleep depth in infants.

Local changes in computational non-rapid eye movement sleep depth in infants.

Clin Neurophysiol. 2017 Oct 16;129(2):448-454

Authors: Satomaa AL, Saarenpää-Heikkilä O, Huupponen E, Kirjavainen T, Heinonen J, Himanen SL

Abstract
OBJECTIVE: Deep NREM sleep and its hallmark EEG phenomenon slow wave activity (SWA) are under homeostatic control in adults. SWA is also locally regulated as it increases in the brain areas that have been used intensively. Moreover, in children, SWA is a marker of cortical maturation. In the present study the local properties of NREM sleep depth were evaluated using the quantitative mean frequency method. We aimed to study if age is related to NREM sleep depth in young infants. In addition, we studied if young infants have local differences in their NREM sleep.
METHODS: Ambulatory over-night polysomnographies were recorded in 59 healthy and full-term infants at the age of one month. The infants were divided into two age groups (<44 weeks and ≥44 weeks) to allow maturational evaluations.
RESULTS: The quantitative sleep depth analysis showed differences between the age groups. In addition, there were local sleep depth differences within the age groups.
CONCLUSIONS: The sleep depth change with age is most likely related to cortical maturation, whereas the local sleep depth gradients might also reflect the use-dependent properties of SWA.
SIGNIFICANCE: The results support the idea that young infants have frontal cortical processing.

PMID: 29304420 [PubMed - as supplied by publisher]

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Factors associated with insomnia in pregnancy: A prospective Cohort Study.

Factors associated with insomnia in pregnancy: A prospective Cohort Study.

Eur J Obstet Gynecol Reprod Biol. 2017 Dec 07;221:70-75

Authors: Román-Gálvez RM, Amezcua-Prieto C, Salcedo-Bellido I, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A

Abstract
OBJECTIVE: To quantify insomnia and their components in a longitudinal cohort of pregnant women and factors associated with insomnia.
STUDY DESIGN: A prospective cohort of 486 healthy singleton pregnancies assembled before the 14th gestational week (February 2013 to March 2016). Insomnia data were collected pre-gestationally, in each trimester and six months post-partum, analysing five different moments. Multiple logistic regression analysis was performed to generate adjusted Odds Ratios (aOR) with 95% confidence intervals (CI) of determinants of insomnia in each trimester, defined using Athens Insomnia Scale (AIS) as score ≥8.
RESULTS: Insomnia prevalence was 6.1% (3.9-8.9) pre-gestational, 44.2% (39.3-49.6) in first trimester (T1), 46.3% (41.9-51.3) in second (T2) and 63.7% (57.7-67.8) in third trimester (T3). Post-gestational insomnia was 33.2% (28.2-37.9) (p < 0.001 pre-gestational vs T1, T2 vs T3 and T3 vs after pregnancy). There was worsening mean AIS score, from: 2.34 before pregnancy to 9.87 in T3 because the deterioration of nighttime sleep, in absolute terms, but daytime impact was higher in T1. Previous trimester insomnia was associated with insomnia in T2 (aOR = 4.21, 95% CI 2.78-6.37) and T3 (aOR = 4.43, 95% CI 2.77-7.08). Pre-gestational insomnia was determinant of insomnia in T1 (aOR 12.50, 95% CI 3.58-43.60) and obesity was associated with insomnia in T3 (aOR = 2.30, 95% CI 0.99-5.32). On the contrary, moderate physical activity reduced the odds of insomnia in T3 (aOR 0.65, 95% CI 0.40-1.03).
CONCLUSIONS: Insomnia prevalence was high from the beginning of pregnancy, associated with pre-gestational insomnia. In late pregnancy, two out of three pregnant women suffering insomnia. Insomnia prevention should be targeted particularly to those with high body mass index and pre-gestational insomnia.

PMID: 29304393 [PubMed - as supplied by publisher]

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High body mass index is a risk factor for difficult deep sedation in percutaneous mitral valve repair.

High body mass index is a risk factor for difficult deep sedation in percutaneous mitral valve repair.

PLoS One. 2018;13(1):e0190590

Authors: Hellhammer K, Afzal S, Tigges R, Spieker M, Rassaf T, Zeus T, Westenfeld R, Kelm M, Horn P

Abstract
BACKGROUND: The safety and efficacy of deep sedation (DS) in MitraClip® procedures have been shown previously. However, clinical experience demonstrates that in some patients DS is difficult to achieve. We hypothesize that some patient characteristics can predict difficult DS.
METHODS: We prospectively analysed 69 patients undergoing MitraClip® procedures using DS. Application of DS was graded as simple (group 1) or difficult (group 2) depending on a cumulative score based on one point for each of the following criteria: decrease in oxygen saturation, retention of carbon dioxide, disruptive body movements, and the need for catecholamines. Patients with one point or less were classified as group 1, and patients with two or more points were classified as group 2.
RESULTS: In 58 of 69 patients (84.1%), the performance of DS was simple, while in 11 patients (15.9%), DS was difficult to achieve. Patients with difficult DS were characterized by a higher body mass index (33.7 ± 6.0 kg/m2 vs. 26.1 ± 4.1; p = 0.001), younger age (67 ± 13 years vs. 75 ± 13 years; p = 0.044), and reduced left ventricular ejection fraction (36% ± 10 vs. 45% ± 14; p = 0.051) and presented more often with an obstructive sleep apnoea syndrome (6.9% vs. 45.5%; p = 0.003). In the multivariate analysis, body mass index was an independent predictor of difficult DS. Using a body mass index of 31 kg/m2 as a cut-off value, the sensitivity of predicting difficult DS was 73%, and the specificity was 88%. Using a body mass index of 35 kg/m2 as a cut-off value, the specificity increased to 97%, with a sensitivity of 36%.
CONCLUSION: In patients with a higher body mass index who undergo MitraClip® procedures, DS might be difficult to perform.

PMID: 29304185 [PubMed - in process]

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Combination of near-infrared and thermal imaging techniques for the remote and simultaneous measurements of breathing and heart rates under sleep situation.

Combination of near-infrared and thermal imaging techniques for the remote and simultaneous measurements of breathing and heart rates under sleep situation.

PLoS One. 2018;13(1):e0190466

Authors: Hu M, Zhai G, Li D, Fan Y, Duan H, Zhu W, Yang X

Abstract
To achieve the simultaneous and unobtrusive breathing rate (BR) and heart rate (HR) measurements during nighttime, we leverage a far-infrared imager and an infrared camera equipped with IR-Cut lens and an infrared lighting array to develop a dual-camera imaging system. A custom-built cascade face classifier, containing the conventional Adaboost model and fully convolutional network trained by 32K images, was used to detect the face region in registered infrared images. The region of interest (ROI) inclusive of mouth and nose regions was afterwards confirmed by the discriminative regression and coordinate conversions of three selected landmarks. Subsequently, a tracking algorithm based on spatio-temporal context learning was applied for following the ROI in thermal video, and the raw signal was synchronously extracted. Finally, a custom-made time-domain signal analysis approach was developed for the determinations of BR and HR. A dual-mode sleep video database, including the videos obtained under environment where illumination intensity ranged from 0 to 3 Lux, was constructed to evaluate the effectiveness of the proposed system and algorithms. In linear regression analysis, the determination coefficient (R2) of 0.831 had been observed for the measured BR and reference BR, and this value was 0.933 for HR measurement. In addition, the Bland-Altman plots of BR and HR demonstrated that almost all the data points located within their own 95% limits of agreement. Consequently, the overall performance of the proposed technique is acceptable for BR and HR estimations during nighttime.

PMID: 29304152 [PubMed - in process]

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The organization of melanopsin-immunoreactive cells in microbat retina.

The organization of melanopsin-immunoreactive cells in microbat retina.

PLoS One. 2018;13(1):e0190435

Authors: Jeong MJ, Kim HG, Jeon CJ

Abstract
Intrinsically photosensitive retinal ganglion cells (ipRGCs) respond to light and play roles in non-image forming vision, such as circadian rhythms, pupil responses, and sleep regulation, or image forming vision, such as processing visual information and directing eye movements in response to visual clues. The purpose of the present study was to identify the distribution, types, and proportion of melanopsin-immunoreactive (IR) cells in the retina of a nocturnal animal, i.e., the microbat (Rhinolophus ferrumequinum). Three types of melanopsin-IR cells were observed in the present study. The M1 type had dendritic arbors that extended into the OFF sublayer of the inner plexiform layer (IPL). M1 soma locations were identified either in the ganglion cell layer (GCL, M1c; 21.00%) or in the inner nuclear layer (INL, M1d; 5.15%). The M2 type had monostratified dendrites in the ON sublayer of the IPL and their cell bodies lay in the GCL (M2; 5.79%). The M3 type was bistratified cells with dendrites in both the ON and OFF sublayers of the IPL. M3 soma locations were either in the GCL (M3c; 26.66%) or INL (M3d; 4.69%). Additionally, some M3c cells had curved dendrites leading up towards the OFF sublayer of the IPL and down to the ON sublayer of the IPL (M3c-crv; 7.67%). Melanopsin-IR cells displayed a medium soma size and medium dendritic field diameters. There were 2-5 primary dendrites and sparsely branched dendrites with varicosities. The total number of the neurons in the GCL was 12,254.17 ± 660.39 and that of the optic nerve axons was 5,179.04 ± 208.00 in the R. ferrumequinum retina. The total number of melanopsin-IR cells was 819.74 ± 52.03. The ipRGCs constituted approximately 15.83% of the total RGC population. This study demonstrated that the nocturnal microbat, R. ferrumequinum, has a much higher density of melanopsin-IR cells than documented in diurnal animals.

PMID: 29304147 [PubMed - in process]

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