Evolution of post-mortem coronary imaging: from selective coronary arteriography to post-mortem CT-angiography and beyond

Abstract

Since the 1970s, remarkable efforts have been made in the post-mortem coronary study, especially by angiography, as an added tool to diagnose heart-related deaths. In more recent times, post-mortem CT (PMCT) and post-mortem CT-angiography (PMCTA) have become an established practice in numerous forensic units, because of the undeniable advantages these diagnostic instruments can offer: data acquisition times are increasingly fast, costs have become lower and, once acquired, data can be re-utilized and re-evaluated at any given time. This review aims to chart the history of post-mortem cardiac imaging, highlighting its evolution both in terms of methodology and technology as well as the contribution that forensic radiology has been able to offer to forensic pathology, not as an alternative to autopsy but as a guide and aid when performing one. Finally, the latest advances in the study of cardiac deaths are explored, namely by cardiac post-mortem MRI (PMMR), able to visualize all the various stages of a myocardial infarction, post-mortem MRI-angiography (PMMRA), useful in investigating coronary artery pathology and post-mortem cardiac micro-CT, able to provide near-histological levels of myocardial, coronary and valvular detail.

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Hepatic cavernous hemangiomas: long-term (> 5 years) follow-up changes on contrast-enhanced dynamic computed tomography or magnetic resonance imaging and determinant factors of the size change

Abstract

Purpose

To investigate the very long-term (> 5 years) follow-up changes of hepatic cavernous hemangiomas and to evaluate possible determinant factors for the changes.

Materials and methods

Among 1115 consecutive patients suspected of having hepatic hemangiomas based on imaging features, 101 patients with comparable computed tomography or magnetic resonance imaging data during a 5-year follow-up interval in the Picture Archiving and Communication System were analyzed. Two radiologists independently determined the largest dimension of each lesion on axial images. In addition to background liver fibrosis or steatosis on imaging, histories of use of chemotherapeutic agents were checked from the patients' records. The final size change of the hemangioma was categorized into three groups compared with the initial diameter (increased, > 120%; no change, 80–120%; decreased, < 80%).

Results

Among the 101 hemangiomas, 32 lesions (31.7%) were enlarged and 21 lesions (20.8%) were shrunken during intervals of 60–157 (median, 81) months. Younger patients showed a higher prevalence of lesion enlargement (mean age: enlarged, 47.3 years; no change, 52.8 years; shrunken, 57.1 years; p = 0.003). In 15 patients with cirrhosis, the lesions (shrunken, n = 7; enlarged, n = 1) showed a higher tendency of size decrease (p = 0.009), whereas other factors did not show statistical significance (p > 0.05). Only a minor proportion (1%, n = 1) of the lesions showed size fluctuation during follow-up.

Conclusion

During the long-term (5–13 years) follow-up, about 50% of the hepatic hemangiomas were enlarged or shrunken to > 20% of the initial diameter. Aside from the cirrhosis and aging factors, the size changes seemed sporadic.

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Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus

Abstract

Purpose

The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants.

Methods

We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus.

Results

The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults.

Conclusions

The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

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Advanced Imaging Techniques in Skull Base Osteomyelitis Due to Malignant Otitis Externa

Abstract

Purpose of Review

To give an up-to-date overview of the strengths and weaknesses of current imaging modalities in diagnosis and follow-up of skull base osteomyelitis (SBO).

Recent Findings

CT and MRI are both used for anatomical imaging, and nuclear techniques aid in functional process imaging. Hybrid techniques PET-CT and PET-MRI are the newest modalities which combine imaging strengths.

Summary

No single modality is able to address the scope of SBO. A combination of functional and anatomical imaging is needed, in the case of newly suspected SBO we suggest the use of PET-MRI (T1, T2, T1-FS-GADO, DWI) and separate HRCT for diagnosis and follow-up.

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Functional MRI for Treatment Evaluation in Patients with Head and Neck Squamous Cell Carcinoma: A Review of the Literature from a Radiologist Perspective

Abstract

Purpose of review

To show the role of functional MRI in patients treated for head and neck squamous cell carcinoma.

Recent findings

MRI is commonly used for treatment evaluation in patients with head and neck tumors. However, anatomical MRI has its limits in differentiating between post-treatment effects and tumor recurrence. Recent studies showed promising results of functional MRI for response evaluation.

Summary

This review analyzes possibilities and limitations of functional MRI sequences separately to obtain insight in the post-therapy setting. Diffusion, perfusion and spectroscopy show promise, especially when utilized complimentary to each other. These functional MRI sequences aid in the early detection which might improve survival by increasing effectiveness of salvage therapy. Future multicenter longitudinal prospective studies are needed to provide standardized guidelines for the use of functional MRI in daily clinical practice.

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Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus

Abstract

Purpose

The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants.

Methods

We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus.

Results

The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults.

Conclusions

The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

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Mechanical birth-related trauma to the neonate: An imaging perspective

Abstract

Mechanical birth-related injuries to the neonate are declining in incidence with advances in prenatal diagnosis and care. These injuries, however, continue to represent an important source of morbidity and mortality in the affected patient population. In the United States, these injuries are estimated to occur among 2.6% of births. Although more usual in context of existing feto-maternal risk factors, their occurrence can be unpredictable. While often superficial and temporary, functional and cosmetic sequelae, disability or even death can result as a consequence of birth-related injuries. The Agency for Healthcare research and quality (AHRQ) in the USA has developed, through expert consensus, patient safety indicators which include seven types of birth-related injuries including subdural and intracerebral hemorrhage, epicranial subaponeurotic hemorrhage, skeletal injuries, injuries to spine and spinal cord, peripheral and cranial nerve injuries and other types of specified and non-specified birth trauma. Understandably, birth-related injuries are a source of great concern for the parents and clinician. Many of these injuries have imaging manifestations. This article seeks to familiarize the reader with the clinical spectrum, significance and multimodality imaging appearances of neonatal multi-organ birth-related trauma and its sequelae, where applicable.

Teaching points

• Mechanical trauma related to birth usually occurs with pre-existing feto-maternal risk factors.

• Several organ systems can be affected; neurologic, musculoskeletal or visceral injuries can occur.

• Injuries can be mild and transient or disabling, even life-threatening.

• Imaging plays an important role in injury identification and triage of affected neonates.

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Clinical significance of soluble programmed cell death ligand-1 (sPD-L1) in hepatocellular carcinoma patients treated with radiotherapy

To investigate the clinical implications of the soluble programmed cell death-ligand 1 (sPD-L1) level in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT).

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Palliative radiotherapy for locally advanced non-metastatic head and neck cancer: A survey of UK national practice

As highlighted in our systematic review on palliative radiotherapy for locally advanced head and neck cancer [1], there is a wide variation of dose fractionation regimes. We conducted an email based survey looking at the choice of dose fractionation of palliative radiotherapy in non-metastatic head and neck cancers across the UK. The primary objective was to describe the range of palliative radiotherapy dose fractionation regimens in use for head and neck cancer management across the United Kingdom.

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A prospective study of the safety and efficacy of liver stereotactic body radiotherapy in patients with and without prior liver-directed therapy

To evaluate the safety and efficacy of liver stereotactic body radiotherapy (SBRT), and examine potential factors impacting outcomes including prior liver-directed therapy.

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Uterine fibroid embolization efficacy and safety: 15 years experience in an elevated turnout rate center

Abstract

Objective

To evaluate effectiveness and safety of UFE as alternative to surgery, in treatment of uterine fibromatosis.

Methods/materials

255 patients (aged 26–55) with symptomatic UF, indication for surgery, followed in our center (2000–2014), single or multiple fibroids, pain and/or functional/compressive disorders, underwent embolization: injection of PVA particles (150–900 μm) from distal portion of uterine arteries (ascending section). Primary end-point: flow-stop distally to injection site, disappearance of lesion design, preservation of flow in main trunk of UA. Secondary end-point: control of pain and functional/compressive disorders during follow-up (2–7 years).

Results

Procedure was performed bilaterally in 250 patients (98%). Mean duration: 47 min (average fluoroscopy: 10:50 min). Post-embolization pelvic pain (according with VAS score) was on average 2.2 at discharge (24 h). Follow-up at 2 years: resolution of menstrual disorders in 78% of patients and improvement in 14%; pain disappeared in 66%; significant improvement of menstrual flow and HCT/HB levels, decrease in total uterine (57.7%)/dominant fibroid (76.1%) volume. Recurrence in 18 patients.

Conclusions

UFE represents an excellent alternative to surgical treatment: it is safe, tolerable and effective both in short and long term, with evident advantages in economic and social terms.

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Blood-threshold CMR volume analysis of functional univentricular heart

Abstract

Purpose

To validate a blood-threshold (BT) segmentation software for cardiac magnetic resonance (CMR) cine images in patients with functional univentricular heart (FUH).

Materials and methods

We evaluated retrospectively 44 FUH patients aged 25 ± 8 years (mean ± standard deviation). For each patient, the epicardial contour of the single ventricle was manually segmented on cine images by two readers and an automated BT algorithm was independently applied to calculate end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and cardiac mass (CM). Aortic flow analysis (AFA) was performed on through-plane images to obtain forward volumes and used as a benchmark. Reproducibility was tested in a subgroup of 24 randomly selected patients. Wilcoxon, Spearman, and Bland–Altman statistics were used.

Results

No significant difference was found between SV (median 57.7 ml; interquartile range 47.9–75.6) and aortic forward flow (57.4 ml; 48.9–80.4) (p = 0.123), with a high correlation (r = 0.789, p < 0.001). Intra-reader reproducibility was 86% for SV segmentation, and 96% for AFA. Inter-reader reproducibility was 85 and 96%, respectively.

Conclusion

The BT segmentation provided an accurate and reproducible assessment of heart function in FUH patients.

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The variable position of the inferior alveolar nerve (IAN) in the mandibular ramus: a computed tomography (CT) study.

The variable position of the inferior alveolar nerve (IAN) in the mandibular ramus: a computed tomography (CT) study.

Surg Radiol Anat. 2018 Jan 20;:

Authors: Yeh AYE, Finn BP, Jones RHB, Goss AN

Abstract
INTRODUCTION: This study was designed to quantify the important anatomical landmarks and the path of the inferior alveolar nerve (IAN) within the human mandibular body and ramus, in particular with reference to the bilateral sagittal split osteotomy (BSSO).
MATERIALS AND METHODS: Four hundred and eleven CT scans were studied, 299 of these were involved in determining the position of lingula; and 230 were involved in determining the course of IAN in the mandibular molar region, namely from the mesial of the mandibular first molar to the distal of the mandibular second molar; 118 were involved with both measurements.
RESULTS: On average, the lingula was located 17.0 ± 2.2 mm from the external oblique ridge; 11.6 ± 2.0 mm from the internal oblique ridge; 17.2 ± 2.7 mm from the sigmoid notch; and 15.6 ± 1.9 mm from the posterior border of the mandible. The course of the IAN in the mandibular molar region was found to descend vertically from the distal of the mandibular second molar (7) to reach its lowest point between the first and second molars (6 and 7), and then ascend towards the mesial of the first molar (6). Horizontally, the IAN was found to traverse medially between the distal of the 7 and the middle of the 7, and then changes its path laterally towards the mesial of the 6.
CONCLUSION: Precise knowledge of the individual's position of the IAN will help surgical planning.

PMID: 29353372 [PubMed - as supplied by publisher]

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Supporting parents through stillbirth: A qualitative study exploring the views of health professionals and health care staff in three hospitals in England.

Supporting parents through stillbirth: A qualitative study exploring the views of health professionals and health care staff in three hospitals in England.

Eur J Obstet Gynecol Reprod Biol. 2018 Jan 09;222:45-51

Authors: Brierley-Jones L, Crawley R, Jones E, Gordon I, Knight J, Hinshaw K

Abstract
OBJECTIVE: To investigate the views of a range of hospital based health professionals and health care staff involved in the management of stillbirth.
STUDY DESIGN: A qualitative pilot study informed by grounded theory conducted in three hospital trusts in the North East of England. In total, 21 consultant obstetricians, 3 trainees (including 1 senior trainee), 29 midwives, 3 midwife sonographers and 4 chaplains took part in six focus groups and two semi-structured interviews.
RESULTS: Two different approaches in stillbirth management could be detected in our study. One approach emphasised the existing evidence-base and patient directed choice whilst the other emphasised tradition and profession-directed care. These differences were particularly apparent in choices over mode of delivery, and the location of women as well as the time interval between diagnosis of an IUD and delivery. The existence of these two approaches was underscored by a lack of high quality evidence.
CONCLUSION: Robust, high quality evidence is needed regarding the longer term psychological and emotional sequelae of different modes of delivery and varying time intervals and locations of women between diagnosis and delivery in stillbirth. If the competing discourses demonstrated here are found elsewhere then such need to be considered in any future policy development, evidence implementation and training programmes.

PMID: 29353132 [PubMed - as supplied by publisher]

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Taking the heat or taking the temperature? A qualitative study of a large-scale exercise in seeking to measure for improvement, not blame.

Taking the heat or taking the temperature? A qualitative study of a large-scale exercise in seeking to measure for improvement, not blame.

Soc Sci Med. 2018 Jan 02;198:157-164

Authors: Armstrong N, Brewster L, Tarrant C, Dixon R, Willars J, Power M, Dixon-Woods M

Abstract
Measurement of quality and safety has an important role in improving healthcare, but is susceptible to unintended consequences. One frequently made argument is that optimising the benefits from measurement requires controlling the risks of blame, but whether it is possible to do this remains unclear. We examined responses to a programme known as the NHS Safety Thermometer (NHS-ST). Measuring four common patient harms in diverse care settings with the goal of supporting local improvement, the programme explicitly eschews a role for blame. The study design was ethnographic. We conducted 115 hours of observation across 19 care organisations and conducted 126 interviews with frontline staff, senior national leaders, experts in the four harms, and the NHS-ST programme leadership and development team. We also collected and analysed relevant documents. The programme theory of the NHS-ST was based in a logic of measurement for improvement: the designers of the programme sought to avoid the appropriation of the data for any purpose other than supporting improvement. However, organisational participants - both at frontline and senior levels - were concerned that the NHS-ST functioned latently as a blame allocation device. These perceptions were influenced, first, by field-level logics of accountability and managerialism and, second, by specific features of the programme, including public reporting, financial incentives, and ambiguities about definitions that amplified the concerns. In consequence, organisational participants, while they identified some merits of the programme, tended to identify and categorise it as another example of performance management, rich in potential for blame. These findings indicate that the search to optimise the benefits of measurement by controlling the risks of blame remains challenging. They further suggest that a well-intentioned programme theory, while necessary, may not be sufficient for achieving goals for improvement in healthcare systems dominated by institutional logics that run counter to the programme theory.

PMID: 29353103 [PubMed - as supplied by publisher]

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Adherence to practice guidelines is associated with reduced referral times for patients with ovarian cancer.

Adherence to practice guidelines is associated with reduced referral times for patients with ovarian cancer.

Am J Obstet Gynecol. 2018 Jan 15;:

Authors: Boac BM, Xiong Y, Apte SM, Wenham RM, Shahzad MM, Munroe DG, Lancaster JM, Chon HS

Abstract
BACKGROUND: Patients with ovarian cancer tend to receive the highest quality of care at high-volume cancer centers with gynecologic oncologists. However, the care that they receive prior to gynecologic oncology consult has not been examined. We investigated the quantity and quality of care given to patients with ovarian cancer before being seen by a gynecologic oncologist.
OBJECTIVES: We evaluated the variability, quantity, and quality of diagnostic testing and physician-referral patterns prior to consultation with a gynecologic oncologist, in women with suspicious pelvic masses seen on imaging.
STUDY DESIGN: A chart review was performed on patients treated for ovarian cancer at a single institution from 2001 to 2014. We evaluated their workup in 4 categories, drawn from National Comprehensive Care Network guidelines: provider visits, abdominal/pelvic imaging, chest imaging, and tumor markers. Workup was classified as guideline adherent or guideline nonadherent.
RESULTS: We identified 335 cases that met our criteria. In the provider visit category, 83.9% of patients received guideline adherent workup; 77% in the abdominal/pelvic imaging, 98.2% in the chest imaging, and 95.2% in the tumor marker categories. Each patient's workup was assessed as a compilation of the 4 categories, yielding 65.7% patients as having received an adherent workup and 34.3% of workup as nonadherent to guidelines. The timeframe to see a gynecologic oncologist for patients with guideline-adherent workup was significantly shorter than for those whose workup was nonadherant (20 versus 86 days, P < .001). A suspicious pelvic mass was identified by obstetrics/gynecology in only 23.9% of patients; 42.7% of patients did not have tumor marker testing before gynecologic oncologist consult. When an obstetrics/gynecology specialist discovered the suspicious pelvic mass, the remaining workup was more likely to be guideline adherent prior to gynecologic oncologist referral than when initial imaging was not ordered by an obstetrics/gynecology specialist (P = .18). Survival was not significantly different (P = .103).
CONCLUSIONS: With guideline-adherent workup, including tumor marker testing, gynecologic oncologist referral times can be shortened, minimizing cost inefficiencies and delays that can compromise the effectiveness of downstream care for patients with ovarian cancer. Guidelines should be disseminated beyond the obstetrics/gynecology field.

PMID: 29353030 [PubMed - as supplied by publisher]

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Assessing risk of bias in studies that evaluate health care interventions: recommendations in the misinformation age.

Assessing risk of bias in studies that evaluate health care interventions: recommendations in the misinformation age.

J Clin Epidemiol. 2018 Jan 15;:

Authors: Page MJ, Boutron I, Hansen C, Altman DG, Hróbjartsson A

Abstract
Methods to assess risk of bias in a way that is reliable, reproducible and transparent to readers, have evolved over time. Viswanathan et al. recently provided updated recommendations for assessing risk of bias in systematic reviews of health care interventions. We comment on their recommendations, and discuss new tools in development that we, as co-convenors and coordinators of the Cochrane Bias Methods Group, are leading, which complement the methods recommended.

PMID: 29352995 [PubMed - as supplied by publisher]

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Validity and reliability of the Palliative Care Transition Measure for Caregivers (PCTM-C).

Validity and reliability of the Palliative Care Transition Measure for Caregivers (PCTM-C).

Palliat Support Care. 2018 Jan 21;:1-6

Authors: D'Angelo D, Mastroianni C, Artico M, Biagioli V, Latina R, Guarda M, Piredda M, De Marinis MG

Abstract
OBJECTIVE: Patients suffering from advanced disease face different care transitions. The transition from acute to palliative care is challenging and may lead to the discontinuity of care. Family caregivers become important sources of information, as patients begin to experience difficulties in coping with emotional transition events. The Care Transition Measure was developed to evaluate care transitions as experienced by the elderly. It has never been used in palliative care. The aim of this study was to test the validity and reliability of a modified version of the Palliative Care Transition Measure, specifically the Palliative Care Transition Measure for Caregivers (PCTM-C).
METHOD: The study included two main phases. Phase I focused on the construction of a modified version of the Palliative Care Transition Measure through two focus groups and by computing the content validity index. Phase II focused on testing the psychometric properties of the PCTM-C on 272 family caregivers through confirmatory factor analysis. Result The content validity index for each of the items was higher than 0.80, whereas that for the scale was 0.95. The model tested with confirmatory factor analysis fitted the data well and confirmed that the transition measures referred to communication, integrated care and a trusting-relationship, and therefore the core dimensions of continuity according to existing conceptual models. The internal consistency was high (Cronbach's alpha = 0.94). Significance of results The PCTM-C proved to be a suitable measure of the quality of such transitions. It may be used in clinical practice as a continuity quality indicator and has the potential to guide interventions to enhance family caregivers' experience of care continuity.

PMID: 29352818 [PubMed - as supplied by publisher]

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On the properties of residual dipolar coupling alignment tensors: Simulations illuminate how residual dipolar couplings depend on the relative orientations of the magnetic field, the director of the alignment phase and the bond vectors

Abstract

The measurement of residual dipolar couplings (RDCs) exhibited by samples prepared in suitable alignment media can help in the elucidation of macromolecular structures. For any dipolar interactions that are not averaged to zero by molecular reorientations RDCs provide information about the possible orientations of the averaged interactions to the magnetic field. As such they contain information about the permitted relative positions of different motionally averaged bond vectors. This situation is often induced using nematic liquid crystalline phases with which the macromolecule under study interacts. While a single set of RDC measurements does not produce unique solutions for the orientation of each bond, multiple independent RDC datasets can be combined to restrict each bond to two diametrically opposed orientations. Attempts to obtain such datasets have primarily focused on performing experiments with multiple alignment media that interact with the macromolecule of interest in a different way. Other work has attempted to control the orientation of the media itself relative to that of the magnetic field. The latter has been explored using pre-formed gels and might also be potentially realized using the application of different external fields during signal acquisition. This article seeks to clarify which approaches might generate independent RDC datasets and their utility in further restricting possible bond orientations using pictorial representations of simulated data.

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On the properties of residual dipolar coupling alignment tensors: Simulations illuminate how residual dipolar couplings depend on the relative orientations of the magnetic field, the director of the alignment phase and the bond vectors

Abstract

The measurement of residual dipolar couplings (RDCs) exhibited by samples prepared in suitable alignment media can help in the elucidation of macromolecular structures. For any dipolar interactions that are not averaged to zero by molecular reorientations RDCs provide information about the possible orientations of the averaged interactions to the magnetic field. As such they contain information about the permitted relative positions of different motionally averaged bond vectors. This situation is often induced using nematic liquid crystalline phases with which the macromolecule under study interacts. While a single set of RDC measurements does not produce unique solutions for the orientation of each bond, multiple independent RDC datasets can be combined to restrict each bond to two diametrically opposed orientations. Attempts to obtain such datasets have primarily focused on performing experiments with multiple alignment media that interact with the macromolecule of interest in a different way. Other work has attempted to control the orientation of the media itself relative to that of the magnetic field. The latter has been explored using pre-formed gels and might also be potentially realized using the application of different external fields during signal acquisition. This article seeks to clarify which approaches might generate independent RDC datasets and their utility in further restricting possible bond orientations using pictorial representations of simulated data.

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Characterization of exosomes derived from Toxoplasma gondii and their functions in modulating immune responses

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IJMS, Vol. 19, Pages 320: Hereditary Fibrinogen Aα-Chain Amyloidosis in Asia: Clinical and Molecular Characteristics

IJMS, Vol. 19, Pages 320: Hereditary Fibrinogen Aα-Chain Amyloidosis in Asia: Clinical and Molecular Characteristics

International Journal of Molecular Sciences doi: 10.3390/ijms19010320

Authors: Masahide Yazaki Tsuneaki Yoshinaga Yoshiki Sekijima Fuyuki Kametani Nobuo Okumura

Hereditary fibrinogen Aα-chain amyloidosis (Aα-chain amyloidosis) is a type of autosomal dominant systemic amyloidosis caused by mutations in fibrinogen Aα-chain gene (FGA). Patients with Aα-chain amyloidosis have been mainly reported in Western countries but have been rarely reported in Asia, with only five patients with Aα-chain amyloidosis being reported in Korea, China, and Japan. Clinically, the most prominent manifestation in Asian patients with Aα-chain amyloidosis is progressive nephropathy caused by excessive amyloid deposition in the glomeruli, which is similar to that observed in patients with Aα-chain amyloidosis in Western countries. In molecular features in Asian Aα-chain amyloidosis, the most common variant, E526V, was found in only one Chinese kindred, and other four kindred each had a different variant, which have not been identified in other countries. These variants are located in the C-terminal region (amino acid residues 517–555) of mature Aα-chain, which was similar to that observed in patients with Aα-chain amyloidosis in other countries. The precise number of Asian patients with Aα-chain amyloidosis is unclear. However, patients with Aα-chain amyloidosis do exist in Asian countries, and the majority of these patients may be diagnosed with other types of systemic amyloidosis.

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IJMS, Vol. 19, Pages 326: Affinity Purification and Comparative Biosensor Analysis of Citrulline-Peptide-Specific Antibodies in Rheumatoid Arthritis

IJMS, Vol. 19, Pages 326: Affinity Purification and Comparative Biosensor Analysis of Citrulline-Peptide-Specific Antibodies in Rheumatoid Arthritis

International Journal of Molecular Sciences doi: 10.3390/ijms19010326

Authors: Eszter Szarka Petra Aradi Krisztina Huber Judit Pozsgay Lili Végh Anna Magyar Gergő Gyulai György Nagy Bernadette Rojkovich Éva Kiss Ferenc Hudecz Gabriella Sármay

Background: In rheumatoid arthritis (RA), anti-citrullinated protein/peptide antibodies (ACPAs) are responsible for disease onset and progression, however, our knowledge is limited on ligand binding affinities of autoantibodies with different citrulline-peptide specificity. Methods: Citrulline-peptide-specific ACPA IgGs were affinity purified and tested by ELISA. Binding affinities of ACPA IgGs and serum antibodies were compared by surface plasmon resonance (SPR) analysis. Bifunctional nanoparticles harboring a multi-epitope citrulline-peptide and a complement-activating peptide were used to induce selective depletion of ACPA-producing B cells. Results: KD values of affinity-purified ACPA IgGs varied between 10−6 and 10−8 M and inversely correlated with disease activity. Based on their cross-reaction with citrulline-peptides, we designed a novel multi-epitope peptide, containing Cit-Gly and Ala-Cit motifs in two–two copies, separated with a short, neutral spacer. This peptide detected antibodies in RA sera with 66% sensitivity and 98% specificity in ELISA and was recognized by 90% of RA sera, while none of the healthy samples in SPR. When coupled to nanoparticles, the multi-epitope peptide specifically targeted and depleted ACPA-producing B cells ex vivo. Conclusions: The unique multi-epitope peptide designed based on ACPA cross-reactivity might be suitable to develop better diagnostics and novel therapies for RA.

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IJMS, Vol. 19, Pages 318: Microglia and Aging: The Role of the TREM2–DAP12 and CX3CL1-CX3CR1 Axes

IJMS, Vol. 19, Pages 318: Microglia and Aging: The Role of the TREM2–DAP12 and CX3CL1-CX3CR1 Axes

International Journal of Molecular Sciences doi: 10.3390/ijms19010318

Authors: Carmen Mecca Ileana Giambanco Rosario Donato Cataldo Arcuri

Depending on the species, microglial cells represent 5–20% of glial cells in the adult brain. As the innate immune effector of the brain, microglia are involved in several functions: regulation of inflammation, synaptic connectivity, programmed cell death, wiring and circuitry formation, phagocytosis of cell debris, and synaptic pruning and sculpting of postnatal neural circuits. Moreover, microglia contribute to some neurodevelopmental disorders such as Nasu-Hakola disease (NHD), and to aged-associated neurodegenerative diseases, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and others. There is evidence that human and rodent microglia may become senescent. This event determines alterations in the microglia activation status, associated with a chronic inflammation phenotype and with the loss of neuroprotective functions that lead to a greater susceptibility to the neurodegenerative diseases of aging. In the central nervous system (CNS), Triggering Receptor Expressed on Myeloid Cells 2-DNAX activation protein 12 (TREM2-DAP12) is a signaling complex expressed exclusively in microglia. As a microglial surface receptor, TREM2 interacts with DAP12 to initiate signal transduction pathways that promote microglial cell activation, phagocytosis, and microglial cell survival. Defective TREM2-DAP12 functions play a central role in the pathogenesis of several diseases. The CX3CL1 (fractalkine)-CX3CR1 signaling represents the most important communication channel between neurons and microglia. The expression of CX3CL1 in neurons and of its receptor CX3CR1 in microglia determines a specific interaction, playing fundamental roles in the regulation of the maturation and function of these cells. Here, we review the role of the TREM2-DAP12 and CX3CL1-CX3CR1 axes in aged microglia and the involvement of these pathways in physiological CNS aging and in age-associated neurodegenerative diseases.

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IJMS, Vol. 19, Pages 321: Identification of a Rare Germline Heterozygous Deletion Involving the Polycistronic miR-17–92 Cluster in Two First-Degree Relatives from a BRCA 1/2 Negative Chilean Family with Familial Breast Cancer: Possible Functional Implications

IJMS, Vol. 19, Pages 321: Identification of a Rare Germline Heterozygous Deletion Involving the Polycistronic miR-17–92 Cluster in Two First-Degree Relatives from a BRCA 1/2 Negative Chilean Family with Familial Breast Cancer: Possible Functional Implications

International Journal of Molecular Sciences doi: 10.3390/ijms19010321

Authors: Tomás de Mayo Annemarie Ziegler Sebastián Morales Lilian Jara

Micro-RNAs (miRNAs) have emerged as novel gene expression regulators. Recent evidence strongly suggests a role for miRNAs in a large variety of cancer-related pathways. Different studies have shown that 18.7 to 37% of all human miRNA genes are clustered. miR-17–92 polycistronic cluster overexpression is associated with human hematolymphoid and solid malignancies including breast cancer (BC). Here, we report the identification of rs770419845, a rare 6 bp deletion located within the polycistronic miR-17–92 cluster, in two first-degree relatives from a Chilean family with familial BC and negative for point mutations in BRCA 1/2 genes. The deletion was identified by Sanger sequencing when 99 BRCA1/2 mutation-negative BC cases with a strong family history were initially screened. In silico analysis predicts that rs770419845 affects the secondary structure and stability of the pre-miR-17–pre-miR-18 region and the entire 17–92 cluster. The deletion was screened in 458 high-risk BRCA1/2-negative Chilean families and 480 controls. rs770419845 was not detected in any control but identified in a single family with two cases of BC and other cancers. Both BC cases, the mother and her daughter, carried the deletion. Based on bioinformatic analyses, the location of the deletion and its low frequency, we presume rs770419845 may be a pathogenic variant. Functional studies are needed to support this hypothesis.

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miR-204 inhibits angiogenesis and promotes sensitivity to cetuximab in head and neck squamous cell carcinoma cells by blocking JAK2-STAT3 signaling.

miR-204 inhibits angiogenesis and promotes sensitivity to cetuximab in head and neck squamous cell carcinoma cells by blocking JAK2-STAT3 signaling.

Biomed Pharmacother. 2018 Jan 17;99:278-285

Authors: Wu Q, Zhao Y, Wang P

Abstract
This study aims to investigate the roles of miR-204 in tumor angiogenesis of head and neck squamous cell carcinoma (HNSCC). Here, we found that miR-204 level was reduced in HNSCC tissues relative to that in normal adjacent tissues. Overexpression of miR-204 promoted tumor angiogenesis in HNSCC cells. Mechanistically, JAK2 was identified as a direct target of miR-204, and miR-204 overexpression blocked JAK2/STAT3 pathway. Moreover, overexpression of JAK2 attenuated the inhibition of miR-204 on tumor angiogenesis of HNSCC. Furthermore, overexpression of miR-204 enhanced sensitivity of cetuximab in HNSCC cells, this effect was attenuated by JAK2 overexpression too. Importantly, JAK2 expression was negatively correlated with miR-204 level in HNSCC tissues. Therefore, miR-204 acts as a tumor suppressor by blocking JAK2/STAT3 pathway in HNSCC cells.

PMID: 29353201 [PubMed - as supplied by publisher]

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Disentangling Somatosensory Evoked Potentials of the Fingers: Limitations and Clinical Potential.

Disentangling Somatosensory Evoked Potentials of the Fingers: Limitations and Clinical Potential.

Brain Topogr. 2018 Jan 20;:

Authors: Kalogianni K, Daffertshofer A, van der Helm FCT, Schouten AC, de Munck JC, 4DEEG consortium

Abstract
In searching for clinical biomarkers of the somatosensory function, we studied reproducibility of somatosensory potentials (SEP) evoked by finger stimulation in healthy subjects. SEPs induced by electrical stimulation and especially after median nerve stimulation is a method widely used in the literature. It is unclear, however, if the EEG recordings after finger stimulation are reproducible within the same subject. We tested in five healthy subjects the consistency and reproducibility of responses through bootstrapping as well as test-retest recordings. We further evaluated the possibility to discriminate activity of different fingers both at electrode and at source level. The lack of consistency and reproducibility suggest responses to finger stimulation to be unreliable, even with reasonably high signal-to-noise ratio and adequate number of trials. At sources level, somatotopic arrangement of the fingers representation was only found in one of the subjects. Although finding distinct locations of the different fingers activation was possible, our protocol did not allow for non-overlapping dipole representations of the fingers. We conclude that despite its theoretical advantages, we cannot recommend the use of somatosensory potentials evoked by finger stimulation to extract clinical biomarkers.

PMID: 29353446 [PubMed - as supplied by publisher]

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Exploring the genetic and adaptive diversity of a pan-Mediterranean crop wild relative: narrow-leafed lupin.

Exploring the genetic and adaptive diversity of a pan-Mediterranean crop wild relative: narrow-leafed lupin.

Theor Appl Genet. 2018 Jan 20;:

Authors: Mousavi-Derazmahalleh M, Bayer PE, Nevado B, Hurgobin B, Filatov D, Kilian A, Kamphuis LG, Singh KB, Berger JD, Hane JK, Edwards D, Erskine W, Nelson MN

Abstract
KEY MESSAGE: This first pan-Mediterranean analysis of genetic diversity in wild narrow-leafed lupin revealed strong East-West genetic differentiation of populations, an historic eastward migration, and signatures of genetic adaptation to climatic variables. Most grain crops suffer from a narrow genetic base, which limits their potential for adapting to new challenges such as increased stresses associated with climate change. Plant breeders are returning to the wild ancestors of crops and their close relatives to broaden the genetic base of their crops. Understanding the genetic adaptation of these wild relatives will help plant breeders most effectively use available wild diversity. Here, we took narrow-leafed lupin (Lupinus angustifolius L.) as a model to understand adaptation in a wild crop ancestor. A set of 142 wild accessions of narrow-leafed lupin from across the Mediterranean basin were subjected to genotyping-by-sequencing using Diversity Arrays Technology. Phylogenetic, linkage disequilibrium and demographic analyses were employed to explore the history of narrow-leafed lupin within the Mediterranean region. We found strong genetic differentiation between accessions from the western and eastern Mediterranean, evidence of an historic West to East migration, and that eastern Mediterranean narrow-leafed lupin experienced a severe and recent genetic bottleneck. We showed that these two populations differ for flowering time as a result of local adaptation, with the West flowering late while the East flowers early. A genome-wide association study identified single nucleotide polymorphism markers associated with climatic adaptation. Resolving the origin of wild narrow-leafed lupin and how its migration has induced adaptation to specific regions of the Mediterranean serves as a useful resource not only for developing narrow-leafed lupin cultivars with greater resilience to a changing climate, but also as a model which can be applied to other legumes.

PMID: 29353413 [PubMed - as supplied by publisher]

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Religion and Well-Being: The Mediating Role of Positive Virtues.

Religion and Well-Being: The Mediating Role of Positive Virtues.

J Relig Health. 2018 Jan 20;:

Authors: Sharma S, Singh K

Abstract
Researchers have consistently advocated positive associations between religion and well-being. The present research takes a step forward and explores potential mechanisms behind the same. The mediating role of a surprisingly neglected mechanism, positive virtues, specifically gratitude, forgiveness and altruism, is studied through a quantitative study on a sample of 220 adult respondents residing in Delhi NCR. The participants adhered to one of the six major religions present in India. Mediational analysis revealed that gratitude mediated the relationship between religiosity, spirituality and well-being via two pathways of forgiveness and altruism. The implications for researchers and practitioners working in the field of mental health are discussed.

PMID: 29353383 [PubMed - as supplied by publisher]

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Crystal structure of the NADP+ and tartrate-bound complex of L-serine 3-dehydrogenase from the hyperthermophilic archaeon Pyrobaculum calidifontis.

Crystal structure of the NADP+ and tartrate-bound complex of L-serine 3-dehydrogenase from the hyperthermophilic archaeon Pyrobaculum calidifontis.

Extremophiles. 2018 Jan 20;:

Authors: Yoneda K, Sakuraba H, Araki T, Ohshima T

Abstract
A gene encoding L-serine dehydrogenase (L-SerDH) that exhibits extremely low sequence identity to the Agrobacterium tumefaciens L-SerDH was identified in the hyperthermophilic archaeon Pyrobaculum calidifontis. The predicted amino acid sequence showed 36% identity with that of Pseudomonas aeruginosa L-SerDH, suggesting that P. calidifontis L-SerDH is a novel type of L-SerDH, like Ps. aeruginosa L-SerDH. The overexpressed enzyme appears to be the most thermostable L-SerDH described to date, and no loss of activity was observed by incubation for 30 min at temperatures up to 100 °C. The enzyme showed substantial reactivity towards D-serine, in addition to L-serine. Two different crystal structures of P. calidifontis L-SerDH were determined using the Se-MAD and MR method: the structure in complex with NADP+/sulfate ion at 1.18 Å and the structure in complex with NADP+/L-tartrate (substrate analog) at 1.57 Å. The fold of the catalytic domain showed similarity with that of Ps. aeruginosa L-SerDH. However, the active site structure significantly differed between the two enzymes. Based on the structure of the tartrate, L- and D-serine and 3-hydroxypropionate molecules were modeled into the active site and the substrate binding modes were estimated. A structural comparison suggests that the wide cavity at the substrate binding site is likely responsible for the high reactivity of the enzyme toward both L- and D-serine enantiomers. This is the first description of the structure of the novel type of L-SerDH with bound NADP+ and substrate analog, and it provides new insight into the substrate binding mechanism of L-SerDH. The results obtained here may be very informative for the creation of L- or D-serine-specific SerDH by protein engineering.

PMID: 29353380 [PubMed - as supplied by publisher]

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Secular trends in the appropriateness of empirical antibiotic treatment in patients with bacteremia: a comparison between three prospective cohorts.

Secular trends in the appropriateness of empirical antibiotic treatment in patients with bacteremia: a comparison between three prospective cohorts.

Eur J Clin Microbiol Infect Dis. 2018 Jan 20;:

Authors: Daitch V, Akayzen Y, Abu-Ghanem Y, Eliakim-Raz N, Paul M, Leibovici L, Yahav D

Abstract
The objective of this study was to explore whether the percentage of inappropriate empirical antibiotic treatment in patients with bacteremia changed over time and to understand the factors that brought on the change. Three prospective cohorts of patients with bacteremia in three different periods (January 1st, 1988 to December 31st, 1989; May 1st, 2004 to November 30, 2004; May 1st, 2010 to April 30, 2011) were compared. Analysis was performed on a total of 811 patients. In 2010-2011, 55.9% (76/136) of patients with bacteremia received inappropriate empirical treatment, compared with 34.5% (170/493) and 33.5% (55/164) in the first and second periods, respectively, in a significant upward trend (p = 0.001). Resistance to antibiotics increased significantly during the study period. The following variables were included in the multivariate analysis assessing risk factors for inappropriate empirical treatment: study period (third period) [odds ratio, OR = 2.766 (95% confidence interval, CI, 1.655-4.625)], gender (male) [OR = 1.511 (1.014-2.253)], pathogen carrying extended-spectrum beta-lactamases [OR = 10.426 (4.688-23.187)], multidrug-resistant Acinetobacter baumannii [OR = 5.428 (2.181-13.513)], and skin/soft infections [OR = 3.23 (1.148-9.084)]. A model excluding microbiological data included: gender (male) [OR = 1.648 (1.216-2.234)], study period (third period) [OR = 2.446 (1.653-3.620)], hospital-acquired infection [OR = 1.551 (1.060-2.270)], previous use of antibiotics [OR = 1.815 (1.247-2.642)], bedridden patient [OR = 2.019 (1.114-3.658)], and diabetes mellitus [OR = 1.620 (1.154-2.274)]. We have observed a worrisome increase in the rate of inappropriate empirical treatment of bacteremia. We need tools that will allow us better prediction of the pathogen and its susceptibilities during the first hours of managing a patient suspected of a severe bacterial infection.

PMID: 29353378 [PubMed - as supplied by publisher]

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Frailty Assessment in Heart Failure: an Overview of the Multi-domain Approach.

Frailty Assessment in Heart Failure: an Overview of the Multi-domain Approach.

Curr Heart Fail Rep. 2018 Jan 20;:

Authors: McDonagh J, Ferguson C, Newton PJ

Abstract
PURPOSE OF REVIEW: The study aims (1) to provide a contemporary description of frailty assessment in heart failure and (2) to provide an overview of multi-domain frailty assessment in heart failure.
RECENT FINDINGS: Frailty assessment is an important predictive measure for mortality and hospitalisation in individuals with heart failure. To date, there are no frailty assessment instruments validated for use in heart failure. This has resulted in significant heterogeneity between studies regarding the assessment of frailty. The most common frailty assessment instrument used in heart failure is the Frailty Phenotype which focuses on five physical domains of frailty; the appropriateness a purely physical measure of frailty in individuals with heart failure who frequently experience decreased exercise tolerance and shortness of breath is yet to be determined. A limited number of studies have approached frailty assessment using a multi-domain view which may be more clinically relevant in heart failure. There remains a lack of consensus regarding frailty assessment and an absence of a validated instrument in heart failure. Despite this, frailty continues to be assessed frequently, primarily for research purposes, using predominantly physical frailty measures. A more multidimensional view of frailty assessment using a multi-domain approach will likely be more sensitive to identifying at risk patients.

PMID: 29353333 [PubMed - as supplied by publisher]

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Transforaminal endoscopic decompression for thoracic spinal stenosis under local anesthesia.

Transforaminal endoscopic decompression for thoracic spinal stenosis under local anesthesia.

Eur Spine J. 2018 Jan 20;:

Authors: Jia ZQ, He XJ, Zhao LT, Li SQ

Abstract
BACKGROUND: Thoracic spinal stenosis is a common vertebral degenerative disease, and treatment remains challenging. In recent years, transforaminal endoscopic decompression has been widely used for treating lumbar degenerative diseases. However, the efficacy of this procedure for thoracic spinal stenosis has yet to be established. Herein, we report a case of thoracic spinal stenosis treated with transforaminal endoscopic decompression under local anesthesia.
CASE REPORT: An 88-year-old man presented with a 1-month history of progressive paralysis and dysesthesia in the bilateral lower extremities. A diagnosis of thoracic spinal stenosis was made, based on physical examination. A two-step percutaneous transforaminal endoscopic thoracic decompression was performed for spinal canal decompression. Over a follow-up of 1 year, a favorable outcome was noted.
CONCLUSION: Transforaminal endoscopic decompression is a safe and an effective surgical approach for the treatment of thoracic spinal stenosis. For patients with thoracic spinal stenosis, accurate diagnosis and elaborate surgical planning should be highlighted, and the surgical outcome can be favorable.

PMID: 29353327 [PubMed - as supplied by publisher]

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Whole grain intakes in Irish adults: findings from the National Adults Nutrition Survey (NANS).

Whole grain intakes in Irish adults: findings from the National Adults Nutrition Survey (NANS).

Eur J Nutr. 2018 Jan 20;:

Authors: O'Donovan CB, Devlin NF, Buffini M, Walton J, Flynn A, Gibney MJ, Nugent AP, McNulty BA

Abstract
PURPOSE: Observational studies link high whole grain intakes to reduced risk of many chronic diseases. This study quantified whole grain intakes in the Irish adult population and examined the major contributing sources. It also investigated potential dietary strategies to improve whole grain intakes.
METHODS: Whole grain intakes were calculated in a nationally representative sample of 1500 Irish adults using data from the most recent national food survey, the National Adult Nutrition Survey (NANS). Food consumption was assessed, at brand level where possible, using a 4-day semi-weighed food diary with whole grain content estimated from labels on a dry matter basis.
RESULTS: Mean daily whole grain intakes were 27.8 ± 29.4 g/day, with only 19% of the population meeting the quantity-specific recommendation of 48 g per day. Wheat was the highest contributor to whole grain intake at 66%, followed by oats at 26%. High whole grain intakes were associated with higher dietary intakes of fibre, magnesium, potassium, phosphorus, and a higher alternative Mediterranean Diet Score. Whole grain foods were most frequently eaten at breakfast time. Regression analysis revealed that consumption of an additional 10 g of whole grain containing 'ready-to-eat breakfast cereals', 'rice or pastas', or 'breads' each day would increase intake of whole grains by an extra 5, 3.5, and 2.7 g, respectively.
CONCLUSIONS: This study reveals low intakes of whole grains in Irish adults. Recommending cereals, breads, and grains with higher whole grain content as part of public health campaigns could improve whole grain intakes.

PMID: 29353315 [PubMed - as supplied by publisher]

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Metabolomics in Sepsis and Its Impact on Public Health.

Metabolomics in Sepsis and Its Impact on Public Health.

Public Health Genomics. 2018 Jan 19;:

Authors: Evangelatos N, Bauer P, Reumann M, Satyamoorthy K, Lehrach H, Brand A

Abstract
Sepsis, with its often devastating consequences for patients and their families, remains a major public health concern that poses an increasing financial burden. Early resuscitation together with the elucidation of the biological pathways and pathophysiological mechanisms with the use of "-omics" technologies have started changing the clinical and research landscape in sepsis. Metabolomics (i.e., the study of the metabolome), an "-omics" technology further down in the "-omics" cascade between the genome and the phenome, could be particularly fruitful in sepsis research with the potential to alter the clinical practice. Apart from its benefit for the individual patient, metabolomics has an impact on public health that extends beyond its applications in medicine. In this review, we present recent developments in metabolomics research in sepsis, with a focus on pneumonia, and we discuss the impact of metabolomics on public health, with a focus on free/libre open source software.

PMID: 29353273 [PubMed - as supplied by publisher]

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Wide variation in severe neonatal morbidity among very preterm infants in European regions.

Wide variation in severe neonatal morbidity among very preterm infants in European regions.

Arch Dis Child Fetal Neonatal Ed. 2018 Jan 20;:

Authors: Edstedt Bonamy AK, Zeitlin J, Piedvache A, Maier RF, van Heijst A, Varendi H, Manktelow BN, Fenton A, Mazela J, Cuttini M, Norman M, Petrou S, Reempts PV, Barros H, Draper ES, Epice Research Group

Abstract
OBJECTIVE: To investigate the variation in severe neonatal morbidity among very preterm (VPT) infants across European regions and whether morbidity rates are higher in regions with low compared with high mortality rates.
DESIGN: Area-based cohort study of all births before 32 weeks of gestational age.
SETTING: 16 regions in 11 European countries in 2011/2012.
PATIENTS: Survivors to discharge from neonatal care (n=6422).
MAIN OUTCOME MEASURES: Severe neonatal morbidity was defined as intraventricular haemorrhage grades III and IV, cystic periventricular leukomalacia, surgical necrotizing enterocolitis and retinopathy of prematurity grades ≥3. A secondary outcome included severe bronchopulmonary dysplasia (BPD), data available in 14 regions. Common definitions for neonatal morbidities were established before data abstraction from medical records. Regional severe neonatal morbidity rates were correlated with regional in-hospital mortality rates for live births after adjustment on maternal and neonatal characteristics.
RESULTS: 10.6% of survivors had a severe neonatal morbidity without severe BPD (regional range 6.4%-23.5%) and 13.8% including severe BPD (regional range 10.0%-23.5%). Adjusted inhospital mortality was 13.7% (regional range 8.4%-18.8%). Differences between regions remained significant after consideration of maternal and neonatal characteristics (P<0.001) and severe neonatal morbidity rates were not correlated with mortality rates (P=0.50).
CONCLUSION: Severe neonatal morbidity rates for VPT survivors varied widely across European regions and were independent of mortality rates.

PMID: 29353260 [PubMed - as supplied by publisher]

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Experiential learning to increase palliative care competence among the Indigenous workforce: an Australian experience.

Experiential learning to increase palliative care competence among the Indigenous workforce: an Australian experience.

BMJ Support Palliat Care. 2018 Jan 20;:

Authors: Shahid S, Ekberg S, Holloway M, Jacka C, Yates P, Garvey G, Thompson SC

Abstract
OBJECTIVES: Improving Indigenous people's access to palliative care requires a health workforce with appropriate knowledge and skills to respond to end-of-life (EOL) issues. The Indigenous component of the Program of Experience in the Palliative Approach (PEPA) includes opportunities for Indigenous health practitioners to develop skills in the palliative approach by undertaking a supervised clinical placement of up to 5 days within specialist palliative care services. This paper presents the evaluative findings of the components of an experiential learning programme and considers the broader implications for delivery of successful palliative care education programme for Indigenous people.
METHODS: Semistructured interviews were conducted with PEPA staff and Indigenous PEPA participants. Interviews were recorded, transcribed and key themes identified.
RESULTS: Participants reported that placements increased their confidence about engaging in conversations about EOL care and facilitated relationships and ongoing work collaboration with palliative care services. Management support was critical and placements undertaken in settings which had more experience caring for Indigenous people were preferred. Better engagement occurred where the programme included Indigenous staffing and leadership and where preplacement and postplacement preparation and mentoring were provided. Opportunities for programme improvement included building on existing postplacement and follow-up activities.
CONCLUSIONS: A culturally respectful experiential learning education programme has the potential to upskill Indigenous health practitioners in EOL care.

PMID: 29353253 [PubMed - as supplied by publisher]

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Systematic review of general practice end-of-life symptom control.

Systematic review of general practice end-of-life symptom control.

BMJ Support Palliat Care. 2018 Jan 20;:

Authors: Mitchell GK, Senior HE, Johnson CL, Fallon-Ferguson J, Williams B, Monterosso L, Rhee JJ, McVey P, Grant MP, Aubin M, Nwachukwu HT, Yates PM

Abstract
BACKGROUND: End of life care (EoLC) is a fundamental role of general practice, which will become more important as the population ages. It is essential that general practice's role and performance of at the end of life is understood in order to maximise the skills of the entire workforce.
OBJECTIVE: To provide a comprehensive description of the role and performance of general practitioners (GPs) and general practice nurses (GPNs) in EoLC symptom control.
METHOD: Systematic literature review of papers from 2000 to 2017 were sought from Medline, PsycINFO, Embase, Joanna Briggs Institute and Cochrane databases.
RESULTS: From 6209 journal articles, 46 papers reported GP performance in symptom management. There was no reference to the performance of GPNs in any paper identified. Most GPs expressed confidence in identifying EoLC symptoms. However, they reported lack of confidence in providing EoLC at the beginning of their careers, and improvements with time in practice. They perceived emotional support as being the most important aspect of EoLC that they provide, but there were barriers to its provision. GPs felt most comfortable treating pain, and least confident with dyspnoea and depression. Observed pain management was sometimes not optimal. More formal training, particularly in the use of opioids was considered important to improve management of both pain and dyspnoea.
CONCLUSIONS: It is essential that GPs receive regular education and training, and exposure to EoLC from an early stage in their careers to ensure skill and confidence. Research into the role of GPNs in symptom control needs to occur.

PMID: 29353252 [PubMed - as supplied by publisher]

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The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6-Year-Old Survivors of Periviable Births.

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6-Year-Old Survivors of Periviable Births.

J Am Heart Assoc. 2018 Jan 20;7(2):

Authors: Mohlkert LA, Hallberg J, Broberg O, Rydberg A, Halvorsen CP, Liuba P, Fellman V, Domellöf M, Sjöberg G, Norman M

Abstract
BACKGROUND: Preterm birth has been associated with increased risk of cardiovascular morbidity in adult life. We evaluated whether preterm birth is associated with deviating cardiac structure and function before school start.
METHODS AND RESULTS: In total, 176 children aged 6 years and born extremely preterm (EXPT; gestational age of 22-26 weeks) and 134 children born at term (control [CTRL]) were studied. We used echocardiography to assess left heart dimensions, geometry, and functions. Recording and off-line analyses of echocardiographic images were performed by operators blinded to group belonging. Body size, blood pressure, and heart rate were also measured. Rates of family history of cardiovascular disease and sex distribution were similar in the EXPT and CTRL groups. Heart rate and systolic blood pressure did not differ, whereas diastolic blood pressure was slightly higher in EXPT than CTRL participants. After adjusting for body surface area, left ventricular length, width, and aortic valve annulus diameter were 3% to 5% smaller in EXPT than CTRL participants. Left ventricular longitudinal shortening and systolic tissue velocity were 7% to 11% lower, and transversal shortening fraction was 6% higher in EXPT than CTRL participants. The EXPT group also exhibited lower atrial emptying velocities than the CTRL group. Sex, fetal growth restriction, or a patent ductus arteriosus in the neonatal period did not contribute to cardiac dimensions or performance.
CONCLUSIONS: Six-year-old children born extremely preterm exhibit a unique cardiac phenotype characterized by smaller left ventricles with altered systolic and diastolic functions than same-aged children born at term.

PMID: 29353231 [PubMed - in process]

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Characterization of acrylamide-induced oxidative stress and cardiovascular toxicity in zebrafish embryos.

Characterization of acrylamide-induced oxidative stress and cardiovascular toxicity in zebrafish embryos.

J Hazard Mater. 2018 Jan 08;347:451-460

Authors: Huang M, Jiao J, Wang J, Xia Z, Zhang Y

Abstract
Acrylamide (AA) is a high production volume chemical in industrial applications and widely found in baked or fried carbohydrate-rich foods. In this study, we unravelled that AA induced developmental toxicity associated with oxidative stress status and disordered lipid distribution in heart region of developing zebrafish. Treatment with AA caused a deficient cardiovascular system with significant heart malformation and dysfunction. We also found that AA could reduce the number of cardiomyocytes through the reduced capacity of cardiomyocyte proliferation rather than cell apoptosis. The cardiac looping and ballooning appeared abnormal though cardiac chamber-specific identity in the differentiated myocardium was maintained well after AA treatment through MF20/S46 immunofluorescence assay. Furthermore, treatment with AA disturbed the differentiation of atrioventricular canal, which was demonstrated by the disordered expressions of the atrioventricular boundary markers bmp4, tbx2b and notch1b and further confirmed by the ectopic expressions of the cardiac valve precursor markers has2, klf2a and nfatc1 through whole-mount in situ hybridization. Thus, our studies provide the evidence of cardiac developmental toxicity of AA in the cardiovascular system, and also raised health concern about the harm of trans-placental exposure to high level of AA for foetuses and the risk of high exposure to AA for the pregnant women.

PMID: 29353190 [PubMed - as supplied by publisher]

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Automated diagnosis of focal liver lesions using bidirectional empirical mode decomposition features.

Automated diagnosis of focal liver lesions using bidirectional empirical mode decomposition features.

Comput Biol Med. 2018 Jan 03;94:11-18

Authors: Acharya UR, Koh JEW, Hagiwara Y, Tan JH, Gertych A, Vijayananthan A, Yaakup NA, Abdullah BJJ, Bin Mohd Fabell MK, Yeong CH

Abstract
Liver is the heaviest internal organ of the human body and performs many vital functions. Prolonged cirrhosis and fatty liver disease may lead to the formation of benign or malignant lesions in this organ, and an early and reliable evaluation of these conditions can improve treatment outcomes. Ultrasound imaging is a safe, non-invasive, and cost-effective way of diagnosing liver lesions. However, this technique has limited performance in determining the nature of the lesions. This study initiates a computer-aided diagnosis (CAD) system to aid radiologists in an objective and more reliable interpretation of ultrasound images of liver lesions. In this work, we have employed radon transform and bi-directional empirical mode decomposition (BEMD) to extract features from the focal liver lesions. After which, the extracted features were subjected to particle swarm optimization (PSO) technique for the selection of a set of optimized features for classification. Our automated CAD system can differentiate normal, malignant, and benign liver lesions using machine learning algorithms. It was trained using 78 normal, 26 benign and 36 malignant focal lesions of the liver. The accuracy, sensitivity, and specificity of lesion classification were 92.95%, 90.80%, and 97.44%, respectively. The proposed CAD system is fully automatic as no segmentation of region-of-interest (ROI) is required.

PMID: 29353161 [PubMed - as supplied by publisher]

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Productivity losses due to premature mortality from cancer in Brazil, Russia, India, China, and South Africa (BRICS): A population-based comparison.

Productivity losses due to premature mortality from cancer in Brazil, Russia, India, China, and South Africa (BRICS): A population-based comparison.

Cancer Epidemiol. 2018 Jan 16;53:27-34

Authors: Pearce A, Sharp L, Hanly P, Barchuk A, Bray F, de Camargo Cancela M, Gupta P, Meheus F, Qiao YL, Sitas F, Wang SM, Soerjomataram I

Abstract
BACKGROUND: Over two-thirds of the world's cancer deaths occur in economically developing countries; however, the societal costs of cancer have rarely been assessed in these settings. Our aim was to estimate the value of productivity lost in 2012 due to cancer-related premature mortality in the major developing economies of Brazil, the Russian Federation, India, China and South Africa (BRICS).
METHODS: We applied an incidence-based method using the human capital approach. We used annual adult cancer deaths from GLOBOCAN2012 to estimate the years of productive life lost between cancer death and pensionable age in each country, valued using national and international data for wages, and workforce statistics. Sensitivity analyses examined various methodological assumptions.
RESULTS: The total cost of lost productivity due to premature cancer mortality in the BRICS countries in 2012 was $46·3 billion, representing 0·33% of their combined gross domestic product. The largest total productivity loss was in China ($28 billion), while South Africa had the highest cost per cancer death ($101,000). Total productivity losses were greatest for lung cancer in Brazil, the Russian Federation and South Africa; liver cancer in China; and lip and oral cavity cancers in India.
CONCLUSION: Locally-tailored strategies are required to reduce the economic burden of cancer in developing economies. Focussing on tobacco control, vaccination programs and cancer screening, combined with access to adequate treatment, could yield significant gains for both public health and economic performance of the BRICS countries.

PMID: 29353153 [PubMed - as supplied by publisher]

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Biomimetic and enzyme-responsive dynamic hydrogels for studying cell-matrix interactions in pancreatic ductal adenocarcinoma.

Biomimetic and enzyme-responsive dynamic hydrogels for studying cell-matrix interactions in pancreatic ductal adenocarcinoma.

Biomaterials. 2018 Jan 08;160:24-36

Authors: Liu HY, Korc M, Lin CC

Abstract
The tumor microenvironment (TME) governs all aspects of cancer progression and in vitro 3D cell culture platforms are increasingly developed to emulate the interactions between components of the stromal tissues and cancer cells. However, conventional cell culture platforms are inadequate in recapitulating the TME, which has complex compositions and dynamically changing matrix mechanics. In this study, we developed a dynamic gelatin-hyaluronic acid hybrid hydrogel system through integrating modular thiol-norbornene photopolymerization and enzyme-triggered on-demand matrix stiffening. In particular, gelatin was dually modified with norbornene and 4-hydroxyphenylacetic acid to render this bioactive protein photo-crosslinkable (through thiol-norbornene gelation) and responsive to tyrosinase-triggered on-demand stiffening (through HPA dimerization). In addition to the modified gelatin that provides basic cell adhesive motifs and protease cleavable sequences, hyaluronic acid (HA), an essential tumor matrix, was modularly and covalently incorporated into the cell-laden gel network. We systematically characterized macromer modification, gel crosslinking, as well as enzyme-triggered stiffening and degradation. We also evaluated the influence of matrix composition and dynamic stiffening on pancreatic ductal adenocarcinoma (PDAC) cell fate in 3D. We found that either HA-containing matrix or a dynamically stiffened microenvironment inhibited PDAC cell growth. Interestingly, these two factors synergistically induced cell phenotypic changes that resembled cell migration and/or invasion in 3D. Additional mRNA expression array analyses revealed changes unique to the presence of HA, to a stiffened microenvironment, or to the combination of both. Finally, we presented immunostaining and mRNA expression data to demonstrate that these irregular PDAC cell phenotypes were a result of matrix-induced epithelial-mesenchymal transition (EMT).

PMID: 29353105 [PubMed - as supplied by publisher]

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Impact of Targeted Scanning Protocols on Perinatal Outcomes in Pregnancies at Risk of Placenta Accreta Spectrum or Vasa Previa.

Impact of Targeted Scanning Protocols on Perinatal Outcomes in Pregnancies at Risk of Placenta Accreta Spectrum or Vasa Previa.

Am J Obstet Gynecol. 2018 Jan 15;:

Authors: Melcer Y, Jauniaux E, Maymon S, Tsviban A, Pekar-Zlotin M, Betser M, Maymon R

Abstract
BACKGROUND: Placenta accreta spectrum (PAS) and vasa previa (VP) are congenital disorders of placentation associated with high morbidity and mortality for both mothers and newborns when undiagnosed before delivery. Prenatal diagnosis of these conditions is essential to allow multidisciplinary management and thus improve perinatal outcomes.
OBJECTIVES: To compare perinatal outcome in women with PAS or VP before and after implementation of targeted scanning protocols.
METHODS: This retrospective study included two non-concurrent cohorts for each condition before and after implementation of the corresponding protocols (2004-1012 versus 2013-2016 for PAS and 1988-2007 versus 2008-2016 for VP). Clinical reports of women diagnosed with PAS and VP during the study periods were reviewed and outcomes were compared.
RESULTS: In total, there were 97 cases of PAS and 51 cases with VP, all confirmed at delivery. In both cohorts, the prenatal detection rate increased after implementation of the s scanning protocols (28/65 (43.1%) cases versus 31/32 (96.9%) cases; p<0.001 for PAS and 9/18 (50%) cases versus 29/33 (87.9%) cases, 87.9%; p<0.01 for VP). The perinatal outcome improved also significantly in both cohorts after implementation of the protocols. In PAS cohort, the estimated blood loss and the postoperative hospitalization stay decreased between periods (1520±845 versus 1168±707 ml, p<0.01 and 10.9 ± 14.1 versus 5.7± 2.2 days, p<0.05, respectively). In VP cohort, the number of 5 minute Apgar score ≤5 and umbilical cord pH<7 decreased between periods (5/18 (27.8%) cases versus 1/33 (3%) cases; p<0.05) and 4/18 (22.2%) cases versus 1/33 (3%) cases; p<0.05, respectively).
CONCLUSIONS: The implementation of standardized prenatal targeted scanning protocols for pregnant women with risk factors for PAS and VP was associated with improved maternal and neonatal outcomes. The continuous increases in the rates of caesarean deliveries and used of assisted reproductive technology highlights the need to develop training programs and introduce targeted scanning protocols at the national and international levels.

PMID: 29353034 [PubMed - as supplied by publisher]

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Topical drug delivery devices: A review.

Topical drug delivery devices: A review.

Exp Eye Res. 2018 Jan 15;:

Authors: Bertens CJF, Gijs M, Nuijts RMMA, van den Biggelaar FJHM

Abstract
For the treatment and prevention of ocular diseases, most patients are treated with conventional drug delivery formulations such as eye drops or ointments. However, eye drops and ointments suffer from low patient compliance and low effective drug concentration at the target site. Therefore, new medical devices are being explored to improve drug delivery to the eye. Over the years, various delivery devices have been developed including resorbable devices, oval- and ring-shaped devices, rod-shaped devices, punctum plugs, contact lenses and corneal shields. Only a few devices (eg. Mydriasert®, Ozurdex®, Surodex®, Iluvien®, Lacrisert® and Retisert®) have made it to the market while others are being investigated in clinical trials. Altogether, there is a need for enhanced topical drug delivery. Only by working together (academia, industry and authorities) and by exploring parallel strategies (new drug delivery devices, enhanced drug formulations, better understanding of the pharmacokinetic properties), the therapeutic effect of drug treatments can be improved.

PMID: 29352994 [PubMed - as supplied by publisher]

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Sustained Psoriasis Area and Severity Index, Dermatology Life Quality Index and EuroQol-5D response of biological treatment in psoriasis: 10 years of real-world data in the Swedish National Psoriasis Register

Summary

Patients with mild disease are usually treated with topical treatments, meaning applied to the skin, while patients with moderate to severe disease require systemic treatments (taken inside the body), which includes drugs called biologics. PsoReg is the Swedish national register established in 2006 to monitor the long term effectiveness and safety of biologics. PsoReg records patients’ Psoriasis Area and Severity Index (PASI), which is a way of measuring how severe and widespread a patient's psoriasis is at a given time, allowing doctors to see if symptoms are worsending or improving. PsoReg also records patients’ Health-Related Quality of Life (HRQoL), which takes into account how the disease is affecting their daily activities and emotional wellbeing. This study used data from 583 patients to see how switching to a biologic treatment, having not previously taken biologics, impacts on their PASI and HRQoL. PASI and HRQoL values were analysed at 3–5 months, 6–11 months, and at least once more after a year or more, up to 9 years after switch to biological treatment. The data showed significant improvement in these scores 3–5 months after the switch, and this improvement lasted the whole observation period. The results from this study may support clinicians in starting and continuing biological treatment for patients with disappointing results with other types of treatment.

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Alkylation of Ketones Catalyzed by Bifunctional Iron Complexes: From Mechanistic Understanding to Application

Cyclopentadienone iron dicarbonyl complexes were applied in the alkylation of ketones with various aliphatic and aromatic ketones and alcohols via the borrowing hydrogen strategy in mild reaction conditions. DFT calculations and experimental works highlight the role of the transition metal Lewis pairs and the base. These iron complexes demonstrated a broad applicability in mild conditions and extended the scope of substrates.

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Cross-Regulation of an Artificial Metalloenzyme

Cross-regulation of complex biochemical reaction networks is an essential feature of living systems. In a biomimetic spirit, we report on our efforts to program the temporal activation of an artificial metalloenzyme via cross-regulation by a natural enzyme. In the presence of urea, urease slowly releases ammonia that reversibly inhibits an artificial transfer hydrogenase. Addition of an acid, which acts as fuel, allows to maintain the system out of equilibrium.

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Artificial Metalloenzymes

While chemists are developing confined environments for catalysis, nature has evolved highly elaborate compartments to carry out reactions. Proteins offer such catalytic nano-environments that accept specific substrates to yield highly enantioenriched products. Metalloenzymes form a subclass that combines the functional diversity of proteins with the promiscuous activities of metals. In recent years, a variety of artificial metalloenzymes (ArMs) has been created upon incorporation of metal complexes into a protein scaffold. The following chapter discusses some of the protein scaffolds exploited for the creation of artificial metalloenzymes. Focus is laid on artificial metalloenzymes that catalyze abiotic and asymmetric reactions. Each subchapter presents the unique characteristics of a scaffold followed by a description of the reactions that were performed with it.

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Anion-π catalysis: Bicyclic products with four contiguous stereogenic centers from otherwise elusive diastereospecific domino reactions on π-acidic surfaces

Anion–π interactions have been introduced recently to catalysis. The idea of stabilizing anionic intermediates and transition states on π-acidic surfaces is a new fundamental concept. By now, examples exist for asymmetric enolate, enamine, iminium and transamination chemistry, and the first anion–π enzyme has been created. Delocalized over large aromatic planes, anion–π interactions appear particularly attractive to stabilize extensive long-distance charge displacements during domino processes. Moving on from the formation of cyclohexane rings with five stereogenic centers in one step on a π-acidic surface, we here focus on asymmetric anion–π catalysis of domino reactions that afford bicyclic products with quaternary stereogenic centers. Catalyst screening includes a newly synthesized, better performing anion–π version of classical organocatalysts from cinchona alkaloids, and anion–π enzymes. We find stereoselectivities that are clearly better than the best ones reported with conventional catalysts, culminating in unprecedented diastereospecificity. Moreover, we describe achiral salts as supramolecular chirality enhancers and report the first artificial enzyme that operates in neutral water with anion–π interactions, i.e., interactions that are essentially new to enzymes. Evidence in support of contributions of anion–π interactions to asymmetric catalysis include increasing diastereo- and enantioselectivity with increasing rates, i.e., asymmetric transition-state stabilization in the presence of π-acidic surfaces and inhibition with the anion selectivity sequence NO3− > Br− > BF4− > PF6−.

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Basal sympathetic predominance in periodic limb movements in sleep after continuous positive airway pressure

Abstract

Purpose

This study investigated the basal autonomic regulation in patients with obstructive sleep apnea (OSA) showing periodic limb movements in sleep (PLMS) emerging after therapy with continuous positive airway pressure (CPAP).

Methods

Data of patients with OSA undergoing a first polysomnography for diagnosis and a second polysomnography for therapy with CPAP were reviewed. Patients with OSA showing PLMS on the first polysomnography were excluded. By using heart rate variability analysis, epochs without any sleep events and continuous effects from the second polysomnography were retrospectively analyzed.

Results

Of 125 eligible patients, 30 with PLMS after therapy with CPAP (PLMS group) and 30 not showing PLMS on both polysomnography (non-PLMS group) were randomly selected for the analysis. No significant differences in the demographic characteristics and variables of polysomnographies were identified between the groups. Although one trend of low root mean square of successive differences (RMSSD) between intervals of adjacent normal heart beats (NN intervals) in the PLMS group was observed, patients in the PLMS group had significantly low normalized high-frequency (n-HF) and high-frequency (HF) values, but high normalized low frequency (n-LF) and high ratio of LF to HF (LF/HF ratio). After adjustment for confounding variables, PLMS on the second polysomnography was significantly associated with RMSSD (β = − 6.7587, p = 0.0338), n-LF (β = 0.0907, p = 0.0148), n-HF (β = − 0.0895, p = 0.0163), log LF/HF ratio (β = 0.4923, p = 0.0090), and log HF (β = − 0.6134, p = 0.0199).

Conclusions

Patients with OSA showing PLMS emerging after therapy with CPAP may have a basal sympathetic predominance with potential negative cardiovascular effects.

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Cosmetics, Vol. 5, Pages 14: Analysis of Ultraviolet Radiation Wavelengths Causing Hardening and Reduced Elasticity of Collagen Gels In Vitro

Cosmetics, Vol. 5, Pages 14: Analysis of Ultraviolet Radiation Wavelengths Causing Hardening and Reduced Elasticity of Collagen Gels In Vitro

Cosmetics doi: 10.3390/cosmetics5010014

Authors: Kazuhisa Maeda

Regular exposure of facial skin to sunlight promotes wrinkle formation; ultraviolet (UV) radiation causes the skin to harden and lose its elasticity. To study UV damage to the skin in vitro, a short-term in vitro photoaging model is required. Hence, the UV transmittance of excised human skin was measured. Changes in elasticity in the cheeks of humans of different ages were investigated. Moreover, changes in the hardness and elasticity of collagen gels following UV exposure were investigated. UV rays penetrated the upper layer of the dermis and UVA (330 nm) rays penetrated approximately 1.6 times farther than UVB (310 nm) rays. A correlation between age and lower cheek elasticity was observed. Upon exposure to UV rays, collagen gels hardened and their elasticity decreased; UVA rays exhibited a stronger effect than UVB rays. Wavelengths of 300–340 nm caused hardening and reduced elasticity of collagen gels; 330-nm radiation showed the most pronounced effect. These effects were not observed upon exposure to UV wavelengths over 350 nm. Investigating the UV-hardening mechanism of collagen showed increased tyrosine crosslinks (dityrosines) in the in vitro model of photodamage to collagen, suggesting that dityrosine formation contributes to hardening and reduced elasticity of collagen in photoaged skin.

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Automated Text Analysis Based on Skip-Gram Model for Food Evaluation in Predicting Consumer Acceptance

The purpose of this paper is to evaluate food taste, smell, and characteristics from consumers’ online reviews. Several studies in food sensory evaluation have been presented for consumer acceptance. However, these studies need taste descriptive word lexicon, and they are not suitable for analyzing large number of evaluators to predict consumer acceptance. In this paper, an automated text analysis method for food evaluation is presented to analyze and compare recently introduced two jjampong ramen types (mixed seafood noodles). To avoid building a sensory word lexicon, consumers’ reviews are collected from SNS. Then, by training word embedding model with acquired reviews, words in the large amount of review text are converted into vectors. Based on these words represented as vectors, inference is performed to evaluate taste and smell of two jjampong ramen types. Finally, the reliability and merits of the proposed food evaluation method are confirmed by a comparison with the results from an actual consumer preference taste evaluation.

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Influence of Altitude on the Spatiotemporal Variations of Meteorological Droughts in Mountain Regions of the Free State Province, South Africa (1960–2013)

The Standardized Precipitation Index (SPI) was computed for October to December (OND) and January to March (JFM) summer subseasons for Free State Province, South Africa, to assess the influence of altitude on drought severity and frequency. The observed spatiotemporal heterogeneity in the SPI variability revealed that factors governing drought interannual variability varied markedly within the region for the two subseasons. Strong correlations between and 0.93 across the clusters in both subseasons were observed. Significant shift in average SPI, towards the high during the OND subseason, was detected for the far western low-lying and central regions of the province around the 1990s. An ANOVA test revealed a significant relationship between drought severity and altitude during the OND subseason only. The impact of altitude is partly manifested in the strong relationship between meridional winds and SPI extremes. When the winds are largely northerly, Free State lies predominantly in the windward side of the Drakensberg Mountains but lies in the rain shadow when the winds are mostly southerly. The relationship between ENSO and SPI indicates stronger correlations for the early summer subseason than for the late summer subseason while overall presenting a diminishing intensity with height over the province.

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Modified Dynamic Time Warping Based on Direction Similarity for Fast Gesture Recognition

We propose a modified dynamic time warping (DTW) algorithm that compares gesture-position sequences based on the direction of the gestural movement. Standard DTW does not specifically consider the two-dimensional characteristic of the user’s movement. Therefore, in gesture recognition, the sequence comparison by standard DTW needs to be improved. The proposed gesture-recognition system compares the sequences of the input gesture’s position with gesture positions saved in the database and selects the most similar gesture by filtering out unrelated gestures. The suggested algorithm uses the cosine similarity of the movement direction at each moment to calculate the difference and reflects the characteristics of the gesture movement by using the ratio of the Euclidean distance and the proportional distance to the calculated difference. Selective spline interpolation assists in solving the issue of recognition-decline at instances of gestures. Through experiments with public databases (MSRC-12 and G3D), the suggested algorithm revealed an improved performance on both databases compared to other methods.

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Reliability-Security Trade-Off Analysis of Cognitive Radio Networks with Jamming and Licensed Interference

Cognitive radio networks (CRNs) allow coexistence of unlicensed users (UUs) and licensed users (LUs) and hence, mutual interference between UUs and LUs is neither ignored nor considered as Gaussian-distributed quantity. Additionally, exploiting jamming signals to purposely interfere with signal reception of eavesdroppers is a feasible solution to improve security performance of CRNs. This paper analyzes reliability-security trade-off, which accounts for maximum transmit power constraint, interference power constraint, jamming signal, and Rayleigh fading, and considers interference from LUs as non-Gaussian-distributed quantity. Toward this end, exact closed-form expressions of successful detection probability and successful eavesdropping probability, from which reliability-security trade-off is straightforwardly visible, are first suggested and then validated by Monte-Carlo simulations. Various results demonstrate that interference from LUs considerably decreases both probabilities while jamming signal enlarges the difference between them, emphasizing its effectiveness in improving security performance.

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Identification of a Novel Mutation in a Family with Pseudohypoparathyroidism Type 1a

Introduction. Pseudohypoparathyroidism type 1a is caused by GNAS mutations leading to target organ resistance to multiple hormones rather than parathyroid hormone, resulting not only in hypocalcemia, but also in Albright’s hereditary osteodystrophy phenotype. Materials and Methods. DNA sequencing of the GNAS gene identified a novel heterozygous mutation in peripheral blood leukocytes in the family presented in this case report. Results. We present a case of a 25-year-old woman with pseudohypoparathyroidism type 1a admitted with seizures, whose family presents an autosomal dominant transmission of a novel heterozygous GNAS mutation (c.524_530+3del). Conclusion. Pseudohypoparathyroidism type 1a is mostly caused by inactivating GNAS mutations that have been gradually reported in the literature that lead to a typical and complex clinical phenotype and resistance to multiple hormones. The deletion caused by the mutation identified in the presented case has not been reported previously.

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Effect Analysis of Early Warning for Abandoned Object on Highway Based on Internet-of-Vehicles CA Model

An early warning on the highway will effectively reduce traffic accidents. Considering the influence of an abandoned object on driving behavior, a Visual-based Asymmetric Two-lane Cellular Automata model with Abandoned Object (V-ATCA-AO) and an Internet-of-Vehicles-based Asymmetric Two-lane Cellular Automata model with Abandoned Object (IoV-ATCA-AO) are proposed. Based on the two models, two types of traffic accidents caused by an abandoned object are analyzed: rear-end collision caused by the abandoned object ahead and collision of the vehicle with the abandoned object. Simulation results show the following: the accidents occur when the road density is smaller, while the accidents will not occur when the density is larger. The results are different from the rear-end collision rate curve without abandoned object in a single lane. Compared with the visual-based avoidance pattern in V-ATCA-AO, the Internet-of-Vehicles-based avoidance pattern in IoV-ATCA-AO can create an early warning for the abandoned object and tell the vehicle to make an earlier lane change and decelerate in advance, thereby significantly reducing the accident rate. Spatiotemporal characteristics in front of the abandoned object directly affect the accident rate: the less the “stability” of a traffic jam in front of the abandoned object, the higher the accident rate.

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Noncoding RNAs in Health and Disease

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National changes in pediatric tracheotomy epidemiology during 36 years

Abstract

Background

Information on the incidence, indications and morbidity of pediatric tracheotomy from a nationwide setting is sparse.

Methods

From the nationwide Danish National Patient Registry, we identified all cases: 0–15-year-old children registered with a first-time tracheotomy from 1979 to 2014. We extracted the date of surgery, admission, discharge, age, gender, hospital, department, hospitalization length, hospital contacts, and diagnosis-code related to the surgery. We estimated age-adjusted incidence rates (AAIR) and annual (APC) and average annual percentage change (AAPC) of tracheotomy incidence.

Results

A total of 510 children (328 boys, 63%) underwent tracheotomy. The median age at surgery was 8 years. The AAIR was 1.4/100,000 person-years (range 1.0–1.8) from 1980 to 2014. During 1979–2014, the AAPC decreased − 0.9% (95% confidential interval – 2.4; 0.8, p < 0.3). From 1979 to 2003 the APC decreased − 4.1% (95% CI − 5.4; − 2.8, p < 0.001) and from 2003 to 2014 the APC increased 6.6% (95% CI 2.0; 11.5, p < 0.001). Infants had the highest incidence (4.0/100,000 years) compared with the 12–15-year-olds (AAIR: 0.4/100,000 years). From 1979 to 2014 the most common indication for tracheotomy among children aged 0–2 years was congenital malformations (n = 48, 30%) and among children aged 3–11 and 12–15 years the most common indication was trauma (respectively n = 67, 36% and n = 85, 52%). During 2006–2014 the most common indications for all ages was neurological impairment (n = 25, 21%) and neoplasms (n = 20, 17%).

Conclusions

Pediatric tracheotomy was a rare surgical procedure with decreasing incidence rates from 1980–89 to 1990–99 and increasing incidence rates from 2000–2009 to 2010–2014. Indications and postoperative morbidity have changed adjunct to the treatment of chronic disorders.

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