Femoral artery ultrasound for improving the detection of atherosclerosis in psoriasis

Less painful and effective intralesional injection method for lichen simplex chronicus

Bullous disorders associated with anti-PD-1 and anti-PD-L1 therapy: A retrospective analysis evaluating the clinical and histopathologic features, frequency, and impact on cancer therapy

Bullous disorders associated with anti-PD-1/PD-L1 therapy are increasingly reported and may pose distinct therapeutic challenges. Their frequency and impact on cancer therapy are not well established.

Early Stage Melanoma and Hematopoietic Stem Cell Transplantation Outcomes

Umweltrecht kompakt

Is Abortion Included in Maternal and Child Health Curricula in the United States?

Abstract

Purpose The purpose of this study is to assess whether Maternal and Child Health (MCH) graduate programs address abortion content in their programs' foundational courses, elective courses, and general curricula. Description Between January and March 2017, we conducted a descriptive study with faculty from the 13 Centers of Excellence in Maternal and Child Health Education, Science and Practice (COEs). We reviewed syllabi and discussed foundational and elective course content via email and key informant interviews with COE faculty. We categorized abortion coverage in foundational courses as "transparent" or "tangential" depending on inclusion of the word "abortion" in course syllabi. We identified electives addressing abortion as "electives including abortion" and courses that focus on abortion as "abortion-specific electives." Assessment Evidence demonstrated that most programs do not transparently address abortion in required course curricula. Only one of 13 COEs transparently addresses abortion in the foundational course(s); seven COEs tangentially include abortion in foundational courses; and all programs address abortion in some capacity though no standard exists to ensure its inclusion. Despite barriers, including avoidance of controversy and fear of losing funding, COEs could address abortion by establishing shared curricular standards, facilitating values clarification and attitude transformation activities, utilizing information-sharing networks, strengthening relationships between MCH programs and abortion-related organizations, and using professional societies. The scope of our study does not allow us to conclude why abortion content is lacking nor the quality of current content. Conclusion MCH programs should transparently incorporate abortion content in foundational and electives courses to educate students on how to engage with complex and sometimes stigmatized public health issues.

The Interprofessional/Family-Centered-Care Observation Rubric (I-FOR): Results of a Multicenter Study of a New Measure of Educational Outcomes

Abstract

Introduction The ability to provide family-centered care (FCC) and the ability to work in interprofessional care teams (IPC) are essential educational outcomes in graduate training programs. Lack of standardized measures leave programs to rely on idiosyncratic methods to monitor outcomes. We developed a faculty observation tool as part of an effort to create a national quality improvement database. We present evidence for the feasibility and validity of the faculty observation tool. Methods Trainees and faculty at four independent training programs participated. Nineteen maternal and child health disciplines were represented. Faculty supervisors rated trainees using the new measure (I-FOR), and trainees completed related subscales of a previously developed self-report measure, the core competency measure (CCM). Faculty provided qualitative feedback regarding the I-FOR in a separate questionnaire. Results Faculty (n = 78) completed the I-FOR on 86 trainees (86/92 = 93%) and reported satisfaction with completing the measures. The I-FOR demonstrated good internal consistency (Cronbach's alpha > 0.930) and test–retest reliability (IPC r = 0.862, FCC r = 0.823, p < 0.001). Greater than 95% of participants reported that the I-FOR accurately addressed the relevant skills for each practice domain. The I-FOR showed no correlation with the CCM. Significant improvements over time in the I-FOR ratings were demonstrated in three out of four programs. Discussion The I-FOR demonstrated good internal consistency and test–retest reliability. Faculty responses provide evidence for the feasibility and validity of the instrument. Self-report and faculty-observation measures both increased with training but were not correlated with each other.

Investigation of Predictors of Newborn Screening Refusal in a Large Birth Cohort in North Dakota, USA

Abstract

Objectives The objective of this study was to identify maternal and provider predictors of newborn screening (NBS) refusal in North Dakota between 2011 and 2014. Methods Records of 40,440 live resident births occurring in North Dakota between 2011 and 2014 were obtained from the North Dakota Department of Health and included in the study. Factor-specific percentages of NBS refusals and 95% confidence intervals were computed for each predictor. Since the outcome is rare, multivariable Firth logistic regression was used to investigate maternal and provider predictors of NBS refusal. Model goodness-of-fit test was evaluated using the Hosmer–Lemeshow test. All analyses were conducted in SAS 9.4. Results Of the 40,440 live births, 135 (0.33%) were NBS refusals. 97% of the refusals were to white women, 94% were homebirths, and 93% utilized state non-credentialed birth attendants. The odds of NBS refusals were significantly higher among non-credentialed birth attendants (p < 0.0001), homebirths (p < 0.0001), and among those that refused Hepatitis B vaccination (HBV) at birth (p = 0.047). On the other hand, odds of NBS refusals were significantly (p < 0.0001) lower among women that had more prenatal visits. Conclusions for Practice This study provides preliminary evidence of association between NBS refusal and provider type, home births, and HBV refusal. Additional studies of obstetric providers, home births and women are needed to improve our understanding of the reasons for NBS refusal to better deliver preventive services to newborns.

Patient-, Hospital-, and Neighborhood-Level Factors Associated with Severe Maternal Morbidity During Childbirth: A Cross-Sectional Study in New York State 2013–2014

Abstract

Background The incidence of severe maternal morbidity (SMM) during childbirth is increasing in the United States. A better characterization of risk factors for SMM may identify targets for improving maternal outcomes. This study aims to characterize patient-, hospital-, and neighborhood-level factors associated with SMM during childbirth. Methods SMM during childbirth was identified in the 2013–2014 State Inpatients Database for New York. Hospital and neighborhood characteristics were abstracted from the American Hospital Association and the Area Health Resources files. Multilevel modeling was used to identify factors associated with SMM, with and without blood transfusion, and its between-hospital variation. Results 403,116 delivery-related discharges from 139 hospitals were analyzed; 1557 (0.39%) recorded SMM without blood transfusion. In the final multilevel model, 7 patient-level factors were associated with a greater than fourfold increase in the risk of SMM: pulmonary hypertension, postpartum hemorrhage, placenta accreta, chronic kidney disease, cardiac conduction disorders, emergent cesarean delivery, and preeclampsia. Three hospital-level factors were associated with SMM: proportion of non-White patients, proportion of Medicaid beneficiaries, and coding intensity. No neighborhood-level factors were predictive of SMM. The proportion of variation in SMM explained by the model was 23.5 with 23.2% related to patient-level factors. The model explained 55% of the between-hospital variation, primarily related to patient-level factors. Similar results were observed for SMM with blood transfusion. Conclusions This study confirms the association between patient-level factors and SMM. It identifies patient-level factors as the major driver of between-hospital variation in SMM. Efforts to improve maternal outcomes should target patient-level factors.

Evaluation of Community Programs for Early Childhood Development: Parental Perspectives and Recommendations

Abstract

Objectives Optimal early childhood development is crucial for promoting positive child health outcomes. Community programs supporting child development are available throughout the United States but general parental perceptions of such programs are not well understood. This study aimed to examine parental perceptions of community programs for early childhood development in a semi-urban city of the US. Methods Data were collected from focus groups (n = 4) composed of English-fluent parents from the local community with at least one child aged 0–5 years. After generation of verbatim transcripts, data were analyzed by two independent coders in order to identify themes. Results Parental perceptions were categorized into four areas: (1) Utilization of community services, (2) Helpful aspects of community services, (3) Negative aspects of community services and (4) Parental recommendations for improved resource utilization. Helpful aspects identified included social and economic support, provision of parental education, and developmental screening and medical support. Negative aspects included utilization of standardized assessment tools, awareness of agencies and resources, and access to services. In order to improve resource utilization, parents suggested improved communication with parents and the child's medical home, transparency, and translation of program information into other languages. Conclusions For Practice Overall, participants felt that community programs that support early childhood development and parenting were helpful. However, community agencies can improve on communication with parents and medical providers as well as translation of program information.

Correction to: Barriers Faced by the Health Workers to Deliver Maternal Care Services and Their Perceptions of the Factors Preventing Their Clients from Receiving the Services: A Qualitative Study in South Sudan

The original version of this article unfortunately contained a mistake in the funding statement.

Corrigendum

Cabral IV, Garcia ES, Sobrinho RN, et al. Increased Capacity for Work and Productivity After Breast Reduction. Aesthet Surg J. 2017; 37(1):57-62. DOI: 10.1093/asj/sjw175 Some values in Table 3 related to WLQ Productivity Loss Score were incorrect in the original publication of the table. These have been revised, and the corrected table appears below. The authors regret the error.

The Impact on Mortality and Societal Costs From Smoking Cessation in Aesthetic Plastic Surgery in the United States

Abstract

Background

It is common practice to require patients to stop smoking prior to elective plastic surgery procedures. Scarce research exists describing the impact on mortality and associated societal cost savings with regards to smoking cessation in aesthetic surgery.

Objective

Our objective is to demonstrate that smoking cessation in anticipation for aesthetic surgery significantly reduces mortality reduction and societal cost savings.

Methods

We performed a systematic literature review of five common aesthetic procedures (reduction mammaplasty, breast augmentation, facelift, rhinoplasty, and abdominoplasty) to determine patient smoking rates and subsequent recidivism. Sensitivity analyses estimated life years saved using ranges of recidivism from our literature review and assessed total lifetime savings, including direct and productivity costs, while adjusting for inflation (3%) and interest (5%). One life saved was equated to 45 life years saved.

Results

Between May 2008 to May 2013, 7,867 patients stopped smoking prior to undergoing aesthetic plastic surgery procedures. Assuming a reported recidivism rate of 68%, smoking cessation prior to aesthetic plastic surgery is associated with 429 lives saved and a total lifetime savings of $524.4 million over the five-year period. Total lives saved ranged from 214 (84% recidivism) to 885 (34% recidivism), and total lifetime cost savings ranged from $262.2 million (84% recidivism) to $1.08 billion (34% recidivism).

Conclusions

Presently, smoking cessation before aesthetic surgery significantly saves patient lives with yearly $104.9 million of societal cost savings in the United States. Future reductions in the presently high recidivism rate would lead to additional lives saved and reduced societal costs.

Physical activity of early stage melanoma survivors

Early stage melanoma survivors are typically otherwise healthy adults with a median age of 56.5 years for women at the time of diagnosis. Women have a projected lifespan of 20 to 30 additional years during which they should be able to enjoy and benefit from leisure outdoor physical activities while limiting their risk of a second melanoma from unprotected sun exposure.

Determining phytolith-occluded organic carbon sequestration using an upgraded optimized extraction method: indicating for a missing carbon pool

Abstract

Phytolith-occluded organic carbon (PhytOC) is considered one of the most promising terrestrial carbon (C) sinks. Different methods are used for phytolith extraction from wet-ashing techniques and the subsequent determination of PhytOC content from soil. This is in order to optimize the wet-ashing techniques and to improve estimation accuracy of C sequestration potential of phytoliths from soil. Results show that the organic matter removal and carbonate removal protocol, applying sonication, has a significant effect on phytolith extraction. Namely, the sequential removal of first organic matter and then carbonates applied to such methods could eliminate greater than 17.14, 46.68, and 26.17% extraneous material compared to other methods. Moreover, phytoliths extracted using methods that apply sonication eliminated 7.49, 42.70, and 17.57% more extraneous material than methods that did not. Additionally, the procedure associated with the second oxidation step significantly influenced the determination of PhytOC content, that is, 29.34, 33.75, 26.41, and 64.64% of excess organic C were oxidized during this step. The upgraded optimal method we recommend for phytolith extraction in association with wet-ashing techniques and the subsequent determination of PhytOC content is therefore to first apply sonication, then the second oxidation step, and finally the removal of organic matter. Using this optimal upgraded method, we estimated the C sequestration potential of phytoliths from the soil of slash pine in China at 0.51 Mt. C. Furthermore, using this upgraded optimal method increased the precision of the carbon sequestration potential of phytoliths from soil by up to 63.83%.

Pyoderma Gangrenosum: What Do We Know Now?

Abstract

Purpose of Review

To summarize the recent literature on the pathophysiology, diagnosis, and treatment of pyoderma gangrenosum.

Recent Findings

A complex interplay between both the innate and adaptive immune systems underlies the pathogenesis of pyoderma gangrenosum (PG). Diagnosis remains a challenge, as there is no gold standard test to confirm the presence of the disease. Efforts to establish diagnostic criteria based on clinical findings have recently been proposed. Definitive management strategies are also lacking; however, current trends in treatment have favored the use of immunosuppressive medications, wound care management, and analgesia.

Summary

PG is a complex disease that continues to pose a challenge. Current research on PG is focused on improving our understanding of the pathophysiology so that we might improve our diagnostic consistency and identify treatment approaches optimized for each individual patient's specific pathology.

Global trends and future prospects of food waste research: a bibliometric analysis

Abstract

The unregulated discharge reams of food waste (FW) causes severe resource loss and environmental pollution. In the present study, a bibliometric analysis was used for research activities and tendencies of food waste from 1991 to 2015. The results indicated that the amount of FW research continually grew by the years, and the number of publications rose significantly from 2012. Bioresource Technology and Waste Management were the two most frequently published journals in the field of FW research. China took a leading position and had a high h-index (38) out of 94 countries/territories, followed by the USA and South Korea. Presently, anaerobic digestion for methane and dark fermentation for hydrogen production are the mainstream techniques in FW disposal. Lactic and ethanol fermentation from FW received more and more attention in recent years. Life cycle assessment (LCA) was an ever-increasingly popular evaluation method for FW-related research. Moreover, cluster analysis indicated microbial community structure, food security, leachate, and pathogens were also the research hotspots.

Beneficial effects of dietary silver nanoparticles and silver nitrate on broiler nutrition

Abstract

This study was conducted to investigate the growth modulatory effects of dietary supplementation with silver nanoparticles (Ag NPs) and Ag nitrate on broiler chickens. Thirty 15-day-old chicks were equally divided into the control group (fed basal diets), the Ag-nano group (fed basal diets supplemented with 50 ppm/kg of Ag NPs for 12 d), and the Ag nitrate group (fed basal diets supplemented with 100 ppm/kg Ag nitrate for 12 days). Chicks fed Ag NPs showed increased body weight gain and muscle weight, improved feed efficiency, and increased ash digestibility, while Ag digestibility tend to increase but not significant. Plasma triiodothyronine contents, and muscle Ag and nitrogen contents as well as a significant increase in the following mRNA levels in muscle tissue: insulin-like growth factor-1 (IGF1), glucose transporters (Glut1, Glut3), citrate synthase (CS), and glutathione peroxidase (GPx), whereas the atrogin-1, fatty acid synthase (FAS), acetyl CoA carboxylase (ACC), lactate dehydrogenase (LDH), and carnitine palmitoyl transferase 1A (CPT1A) mRNA levels were unchanged. However, these chicks exhibited decreased levels of plasma cholesterol, triglyceride, and glucose. Dietary supplementation with Ag NPs improved the growth performance of broiler chickens.

Immunological association of inducible bronchus-associated lymphoid tissue organogenesis in Ag85B-rHPIV2 vaccine-induced anti-tuberculosis mucosal immune responses in mice

Abstract

We previously reported that Ag85B-expressing human parainfluenza type 2 virus (Ag85B-rHPIV2) was effective as a nasal vaccine against tuberculosis in mice; however, the mechanism by which it induces an immune response remains to be investigated. In the present study, we found that organogenesis of inducible bronchus-associated lymphoid tissue (iBALT) played a role in the induction of antigen-specific T cells and IgA antibody responses in the lung of mice intranasally administered Ag85B-rHPIV2. We found that expression of Ag85B was dispensable for the development of iBALT, suggesting that HPIV2 acted as iBALT-inducing vector. When iBALT organogenesis was disrupted in Ag85B-rHPIV2-immunized mice, either by neutralization of the lymphotoxin pathway or depletion of CD11b⁺ cells, Ag85B-specific immune responses (i.e., IFN-producing T cells and IgA antibody) were diminished in the lung. Furthermore, we found that immunization with Ag85B-rHPIV2 induced neutrophil and eosinophil infiltration temporally after the immunization in the lung. Thus, our results show that iBALT organogenesis contributes to the induction of antigen-specific immune responses by Ag85B-rHPIV2 and that Ag85B-rHPIV2 provokes its immune responses without inducing long-lasting inflammation.

Inactivation of influenza A virus via exposure to silver nanoparticle-decorated silica hybrid composites

Abstract

Influenza A virus (IFV-A) is one of the main cause of seasonal flu and can infect various of host species via the reassortment of segmented RNA genomes. Silver nanoparticles (AgNPs) have been known as excellent antiviral agent against IFV. However, the use of free AgNPs has several major drawbacks, including the inherent aggregation among AgNPs and unwanted cytotoxic or genotoxic damages for human body via inhalation or ingestion. In this study, we assessed the efficacy of our novel ~ 30-nm-diameter AgNP-decorated silica hybrid composite (Ag30-SiO₂; ~ 400 nm in diameter) for IFV-A inactivation. Ag30-SiO₂ particles can inhibit IFV-A effectively in a clear dose-dependent manner. However, when real-time RT-PCR assay was used, merely 0.5-log₁₀ reduction of IFV-A was observed at both 5 and 20 °C. Moreover, even after 1 h of exposure to Ag30-SiO₂ particles, more than 80% of hemagglutinin (HA) damage and 20% of neuraminidase (NA) activities had occurred, and the infection of Madin-Darby Canine Kidney (MDCK) cells by IFV-A was reduced. The results suggested that the major antiviral mechanism of Ag30-SiO₂ particles is the interaction with viral components located at the membrane. Therefore, Ag30-SiO₂ particles can cause nonspecific damage to various IFV-A components and be used as an effective method for inactivating IFV-A.

Distribution of polybrominated diphenyl ethers in the atmosphere of the Pearl River Delta region, South China

Abstract

Air samples were collected from 26 air-monitoring stations located in the Pearl River Delta (PRD) and two in Shaoguan, South China, to investigate the spatial distribution and temporal changes in polybrominated diphenyl ethers (PBDEs) after the production and use of PBDE commercial formulations was restricted in China and the "dual transfer strategy" implemented by Guangdong Province. The spatial distribution of PBDEs was inhomogeneous in the PRD region, with concentrations ranging from 26.3 to 634 pg/m³ and a mean value of 105 pg/m³. The PBDE levels in the five western cities (Guangzhou, Foshan, Zhaoqing, Zhongshan, and Jiangmen) were markedly higher than those in the four eastern cities (Dongguan, Huizhou, Shenzhen, and Zhuhai). BDE-209 was the predominant congener, accounting for 57.3–89.8% of the total measured PBDEs in this study. The proportion of penta- and nona-BDE congeners in the four eastern cities was markedly higher than those in five western cities. Principal component analysis showed that this elevation might be related to the debromination of BDE-209 during the thermal treatment process of products when PBDEs are used as flame retardants. Although the PBDE levels found in this study were markedly lower than those reported in previous studies, further efforts are still needed to clarify if there was a decreasing trend for PBDEs in the atmosphere of the PRD, in view of the increasing trends of PBDEs found by other researchers in mangrove sediments from Hong Kong and the Pearl River estuary in 2014 and 2015.

Effect of petroleum-derived substances on life history traits of bird cherry-oat aphid ( Rhopalosiphum padi L.) and on the growth and chemical composition of winter wheat

Abstract

The aim of the study was to determine the effects of various petroleum-derived substances (PDSs), namely petrol, diesel fuel, and spent engine oil, on life history traits of the bird cherry-oat aphid Rhopalosiphum padi L., and on the growth and chemical composition of its host plant—winter wheat Triticum aestivum L. Each substance was tested separately, using two concentrations (9 and 18 g kg⁻¹). Plants were cultivated in both control and contaminated soils. In early October 2013, soil was contaminated and after 1 week, winter wheat seeds, 'Batuta' cultivar, were sown. In early June 2014, observations of the effect of petroleum-derived substances on traits of three successive generations of aphids were conducted. Aphids were inoculated separately on leaves using cylindrical cages hermetically closed on both sides. Contamination of aphid occurred through its host plant. Results showed that all of the applied petroleum-derived substances have a generally adverse effect on the developmental parameters in aphids, resulting in the decrease of its fecundity, shortening its average life span, and most often lowering of the population intrinsic growth rate. PDSs caused the limitation of growth in wheat plants; whereas, changes in nutrient contents and heavy metals depended on the part of the plant analysed, the substance applied, and on its dose. The negative relationships between the contents of both some macro-elements (Ca, K, P) and heavy metals (Mn, Cd, Cu, and Zn) and the developmental parameters of particular generations of R. padi were observed. The high susceptibility of R. padi to the presence of PDSs in the substrate for the host plant should be emphasised—the clear-cut changes in the life span and fecundity, with relatively small changes in the chemical composition of the plant, constitute an evident indication that the developmental parameters of aphids have the potential for the use as bio-indicator to evaluate the state of the environment contaminated by PDSs.

Comparing electron leak in vertebrate muscle mitochondria

Abstract

Mitochondrial electron transfer for oxidative ATP regeneration is linked to reactive oxygen species (ROS) production in aerobic eukaryotic cells. Because they can contribute to signalling as well as oxidative damage in cells, these ROS have profound impact for the physiology and survival of the organism. Although mitochondria have been recognized as a potential source for ROS for about fifty years, the mechanistic understanding on molecular sites and processes has advanced recently. Most experimental approaches neglect thermal variability among species although temperature impacts mitochondrial processes significantly. Here we delineate the importance of temperature by comparing muscle mitochondrial ROS formation across species. Measuring the thermal sensitivity of respiration, electron leak rate (ROS formation) and the antioxidant capacity (measured as H₂O₂ consumption) in intact mitochondria of representative ectothermic and endothermic vertebrate species, our results suggest that using a common assay temperature is inappropriate for comparisons of organisms with differing body temperatures. Moreover, we propose that measuring electron leak relative to the mitochondrial antioxidant capacity (the oxidant ratio) may be superior to normalizing relative to respiration rates or mitochondrial protein for comparisons mitochondrial metabolism of ROS across species of varying mitochondrial respiratory capacities.

Nickel exposure has complex transgenerational effects in a butterfly

Abstract

Heavy metal pollution is a major problem in urban and industrial environments, and has a myriad of negative effects on animals. Quantifying the amount of population-level variation that exists for heavy metal tolerance and how plastic responses to heavy metals play out across generations are essential for understanding how animals respond to pollution. As an initial step towards studying transgenerational effects and population-level variation in concert, we brought cabbage white butterflies (Pieris rapae) from two populations – collected from St. Paul, Minnesota and Davis, California – into common conditions and fed them a diet dosed with nickel. To measure transgenerational effects, we reared a second generation in a fully factorial design, within each population, to achieve all combinations of parent and offspring exposure to nickel or control diets. Across both generations, we quantified survival and other fitness-related traits, including development time, body size, and egg size and number. We found both population differences and complex transgenerational effects, including a positive effect of nickel on survival and development time in one of the populations. Overall, nickel exposure was stressful in one population, mainly after two generations of exposure, and had neutral or slightly positive effects on the other. We found no evidence for costs of mismatch between parental and offspring environments. While the reasons for the differences observed between the two populations are unclear, the variation in nickel tolerance observed in this species suggests that some organisms may be less affected by low levels of heavy metal pollution in urban and industrial areas than expected.

Life history trade-offs within the context of mitochondrial hormesis

Abstract

Evolutionary biologists have been interested in the negative interactions among life history traits for nearly a century, but the mechanisms that would create this negative interaction remain poorly understood. One variable that has emerged as a likely link between reproductive effort and longevity is oxidative stress. Specifically, it has been proposed that reproduction generates free radicals that cause oxidative stress and, in turn, oxidative stress damages cellular components and accelerates senescence. We propose that there is limited support for the hypothesis because reactive oxygen species, the free radicals implicated in oxidative damage, are not consistently harmful. With this review, we define the hormetic response of mitochondria to reactive oxygen species, termed mitochondrial hormesis, and describe how to test for a mitohormetic response. We interpret existing data using our model and propose that experimental manipulations will further improve our knowledge of this response. Finally, we postulate how the mitohormetic response curve applies to variation in animal performance and longevity.

What is a Weapon?

Abstract

Animals utilise an incredible array of traits for offence and defence during conflict. These traits range from exaggerated morphological structures such as the antlers of stags and the horns of beetles, to an arsenal of noxious chemicals emitted, secreted and injected. However, the breadth of these traits appears to be underappreciated in our current thinking about aggression in animals. Use of the term 'weapon' in the current literature is largely restricted to studies of conspicuous morphological structures used by males during contests over access to females, and as a result, our understanding of other types of weapons is limited. In this paper, I explore the diversity of traits utilised by animals to manipulate and control the behaviour of other individuals in a number of agonistic contexts, with the aim to encourage a reappraisal of the way in which behavioural and evolutionary biologists view animal weapons. I discuss the advantages of including this broader range of traits in studies of animal weaponry and explore the unifying features that distinguish animal weapons from other traits.

Cellular self-assembly into 3D microtissues enhances the angiogenic activity and functional neovascularization capacity of human cardiopoietic stem cells

Abstract

While cell therapy has been proposed as next-generation therapy to treat the diseased heart, current strategies display only limited clinical efficacy. Besides the ongoing quest for the ideal cell type, in particular the very low retention rate of single-cell (SC) suspensions after delivery remains a major problem. To improve cellular retention, cellular self-assembly into 3D microtissues (MTs) prior to transplantation has emerged as an encouraging alternative. Importantly, 3D-MTs have also been reported to enhance the angiogenic activity and neovascularization potential of stem cells. Therefore, here using the chorioallantoic membrane (CAM) assay we comprehensively evaluate the impact of cell format (SCs versus 3D-MTs) on the angiogenic potential of human cardiopoietic stem cells, a promising second-generation cell type for cardiac repair. Biodegradable collagen scaffolds were seeded with human cardiopoietic stem cells, either as SCs or as 3D-MTs generated by using a modified hanging drop method. Thereafter, seeded scaffolds were placed on the CAM of living chicken embryos and analyzed for their perfusion capacity in vivo using magnetic resonance imaging assessment which was then linked to a longitudinal histomorphometric ex vivo analysis comprising blood vessel density and characteristics such as shape and size. Cellular self-assembly into 3D-MTs led to a significant increase of vessel density mainly driven by a higher number of neo-capillary formation. In contrast, SC-seeded scaffolds displayed a higher frequency of larger neo-vessels resulting in an overall 1.76-fold higher total vessel area (TVA). Importantly, despite that larger TVA in SC-seeded group, the mean perfusion capacity (MPC) was comparable between groups, therefore suggesting functional superiority together with an enhanced perfusion efficacy of the neo-vessels in 3D-MT-seeded scaffolds. This was further underlined by a 1.64-fold higher perfusion ratio when relating MPC to TVA. Our study shows that cellular self-assembly of human cardiopoietic stem cells into 3D-MTs substantially enhances their overall angiogenic potential and their functional neovascularization capacity. Hence, the concept of 3D-MTs may be considered to increase the therapeutic efficacy of future cell therapy concepts.

PDGF-BB regulates splitting angiogenesis in skeletal muscle by limiting VEGF-induced endothelial proliferation

Abstract

VEGF induces normal or aberrant angiogenesis depending on its dose in the microenvironment around each producing cell in vivo. This transition depends on the balance between VEGF-induced endothelial stimulation and PDGF-BB-mediated pericyte recruitment, and co-expression of PDGF-BB normalizes aberrant angiogenesis despite high VEGF doses. We recently found that VEGF over-expression induces angiogenesis in skeletal muscle through an initial circumferential vascular enlargement followed by longitudinal splitting, rather than sprouting. Here we investigated the cellular mechanism by which PDGF-BB co-expression normalizes VEGF-induced aberrant angiogenesis. Monoclonal populations of transduced myoblasts, expressing similarly high levels of VEGF alone or with PDGF-BB, were implanted in mouse skeletal muscles. PDGF-BB co-expression did not promote sprouting and angiogenesis that occurred through vascular enlargement and splitting. However, enlargements were significantly smaller in diameter, due to a significant reduction in endothelial proliferation, and retained pericytes, which were otherwise lost with high VEGF alone. A time-course of histological analyses and repetitive intravital imaging showed that PDGF-BB co-expression anticipated the initiation of vascular enlargement and markedly accelerated the splitting process. Interestingly, quantification during in vivo imaging suggested that a global reduction in shear stress favored the initiation of transluminal pillar formation during VEGF-induced splitting angiogenesis. Quantification of target gene expression showed that VEGF-R2 signaling output was significantly reduced by PDGF-BB co-expression compared to VEGF alone. In conclusion, PDGF-BB co-expression prevents VEGF-induced aberrant angiogenesis by modulating VEGF-R2 signaling and endothelial proliferation, thereby limiting the degree of circumferential enlargement and enabling efficient completion of vascular splitting into normal capillary networks despite high VEGF doses.

A systematic review of the prognostic value of texture analysis in 18 F-FDG PET in lung cancer

Abstract

Objective

The aim of this study was to perform a systematic review of the prognostic value of texture parameters derived by ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in patients with lung cancer.

Methods

PubMed and EMBASE databases were searched up to March 12, 2018, for original articles involving texture analysis for the prediction of prognosis in patients with lung cancer. Risk of bias in the studies was critically assessed using the QUIPS tool. The results of survival analysis in the included studies were compared.

Results

Of the 446 articles retrieved, 17 studies were eligible for inclusion. Our review suggests that the prognostic value of texture parameters in lung cancer remains unproven. Most studies had a moderate to high risk of bias. Texture parameters that described prognosis were not replicated across studies. Conflicting results on hazard ratios were found among the studies. This discrepancy is partly explained by false-positive findings originating from statistical error and variability caused by different methodologies used for image acquisition and processing in the included studies.

Conclusion

Based on currently available evidence, there is insufficient evidence to support the prognostic value of texture analysis in ¹⁸F-FDG PET in lung cancer. Further studies implementing well-established methodologies and statistical evidence are warranted for proper validation of these promising imaging biomarkers.

Prospective evaluation of incobotulinumtoxinA in the management of the masseter using two different injection techniques

Perspective pinhole model with planar source for augmented reality surgical navigation based on C-arm imaging

Abstract

Purpose

For augmented reality surgical navigation based on C-arm imaging, accuracy of the overlaid augmented reality onto the X-ray image is imperative. However, overlay displacement is generated when a conventional pinhole model describing a geometric relationship of a normal camera is adopted for C-arm calibration. Thus, a modified model for C-arm calibration is proposed to reduce this displacement, which is essential for accurate surgical navigation.

Method

Based on the analysis of displacement pattern generated for three-dimensional objects, we assumed that displacement originated by moving the X-ray source position according to the depth. In the proposed method, X-ray source movement was modeled as variable intrinsic parameters and represented in the pinhole model by replacing the point source with a planar source.

Results

The improvement which represents a reduced displacement was verified by comparing overlay accuracy for augmented reality surgical navigation between the conventional and proposed methods. The proposed method achieved more accurate overlay on the X-ray image in spatial position as well as depth of the object volume.

Conclusion

We validated that intrinsic parameters that describe the source position were dependent on depth for a three-dimensional object and showed that displacement can be reduced and become independent of depth by using the proposed planar source model.