Abstract
Urothelial malignancies, including carcinomas of the bladder, ureters, and renal pelvis comprised approximately 8% of new cancer cases in the United States in 2016. In the metastatic setting, 15% of patients exhibit long-term survival following cisplatin-based chemotherapy and in patients with recurrent disease, response rates to second-line chemotherapy are generally 15-20% with a 3-month progression-free survival. However, recent advances in immunotherapy represent an opportunity to significantly improve patient outcomes. Moreover, the advent of next-generation sequencing (NGS) has resulted in both an improved understanding of the fundamental genetic changes that characterize urothelial carcinoma (UC) and identification of several candidate biomarkers of response to various therapies. Incorporation of prospective genotyping into clinical trials will allow for the identification and enrichment of patients most likely to respond to specific targeted therapies and chemotherapy. Combining different therapeutic classes to enhance outcomes is also an area of active research in UC.Τετάρτη 18 Ιουλίου 2018
Migraine and greater pain symptoms at 10-year follow-up among patients with major depressive disorder
No study has investigated the associations of migraine with pain symptoms over a ten-year period among outpatients with major depressive disorder (MDD). This study aimed to investigate this issue.
Vitamin D deficiency in patients with cluster headache: a preliminary study
Cluster headache is famous for attacks with seasonal and diurnal periodicity. This diurnal and seasonal variation might be related to sunlight and vitamin D metabolism. We investigated the serum vitamin D leve...
Increased thalamic glutamate/glutamine levels in migraineurs
Increased cortical excitability has been hypothesized to play a critical role in various neurological disorders, such as restless legs syndrome, epilepsy and migraine. Particularly for migraine, local hyperexc...
Illuminating Endocrine Evolution: The Power and Potential of Large-Scale Comparative Analyses
Abstract
Hormones are central mediators of genotype-phenotype and organism-environment interactions. Despite these important functions, the role of selection in shaping hormonal mediators of phenotype remains poorly understood. Thanks to decades of work by endocrinologists, circulating hormone levels have been measured in a diversity of organisms. Variation in other endocrine traits and mediators (e.g., receptor expression, binding globulins), and the hormonal response to standardized challenges (e.g., restraint, pharmacological challenges) are also increasingly measured in both captive and free-living populations. Large-scale comparative analyses of the multitude of available endocrine data represent a particularly promising approach to addressing the function and evolution of these key phenotypic mediators, and their potential to serve as indicators of disturbance. Several recent phylogenetic comparative analyses and meta-analyses have begun to reveal the power and potential of these approaches to address key questions in integrative biology. Here we highlight two recent developments that are facilitating such analyses: increasingly powerful and flexible phylogenetic comparative methods, and the release of two endocrine trait databases – HormoneBase (currently 474 species) and the Wildlife Endocrinology Information Network (currently 25 species) – that contain compiled measures of endocrine traits across vertebrates. Increasingly comprehensive comparative analyses of endocrine data could provide insight into many interesting questions, including how rapidly changing environments are impacting phenotypes, why endocrine traits differ so remarkably within and across populations, and the evolution of plasticity.Non-branching personal persistence
Abstract
Given reductionism about people, personal persistence must fundamentally consist in some kind of impersonal continuity relation. Typically, these continuity relations can hold from one to many. And, if they can, the analysis of personal persistence must include a non-branching clause to avoid non-transitive identities or multiple occupancy. It is far from obvious, however, what form this clause should take. This paper argues that previous accounts are inadequate and develops a new proposal.
2-hydroxyglutarate MR Spectroscopy for Prediction of Isocitrate Dehydrogenase Mutant Glioma: A Systemic Review and Meta-analysis using Individual Patient Data
Abstract
Background
Noninvasive and accurate modality to predict Isocitrate dehydrogenase (IDH) mutant glioma may have great potential in routine clinical practice. We aimed to investigate the diagnostic performance of 2-hydroxyglutarate (2HG) magnetic resonance spectroscopy (MRS) for prediction of IDH mutant glioma and provide an optimal cut-off value for 2HG. Methods
A systematic literature search of Ovid-MEDLINE and EMBASE was performed to identify original articles investigating the diagnostic performance of 2HG MRS up to March 20, 2018. Pooled sensitivity and specificity were calculated using a bivariate random-effects model. Subgroup analysis and meta-regression was performed to explain heterogeneity effects. An optimal cut-off value for 2HG was calculated from studies providing individual patient data. Results
Fourteen original articles with 460 patients were included. The pooled sensitivity and specificity for the diagnostic performance of 2HG MRS for prediction of IDH mutant glioma were 95% (95% CI, 85–98%) and 91% (95% CI, 83–96%), respectively. The Higgins I2 statistic demonstrated that heterogeneity was present in the sensitivity (I2 = 50.69%), but not in the specificity (I2 = 30.37%). In the meta-regression, echo time (TE) was associated with study heterogeneity. Among the studies using point-resolved spectroscopy (PRESS), a long TE (97 ms) resulted in higher sensitivity (92%) and specificity (97%) than a short TE (30–35 ms; sensitivity of 90%, specificity of 88%; p < 0.01). The optimal 2HG cut-off value of 2HG using individual patient data was 1.76 mM. Conclusion
2HG MRS demonstrated excellent specificity for prediction of IDH mutant glioma, with TE being associated with heterogeneity in the sensitivity.Humean laws, explanatory circularity, and the aim of scientific explanation
Abstract
One of the main challenges confronting Humean accounts of natural law is that Humean laws appear to be unable to play the explanatory role of laws in scientific practice. The worry is roughly that if the laws are just regularities in the particular matters of fact (as the Humean would have it), then they cannot also explain the particular matters of fact, on pain of circularity. Loewer (Philoso Stud 160:115–137, 2012) has defended Humeanism, arguing that this worry only arises if we fail to distinguish between scientific and metaphysical explanations. However, Lange (Philoso Stud 165:255–261, 2013, Synthese 195:1337–1353, 2018) has argued that scientific and metaphysical explanations are linked by a transitivity principle, which would undercut Loewer's defense and re-ignite the circularity worry for the Humean. I argue here that the Humean has antecedent reasons to doubt that there are any systematic connections between scientific and metaphysical explanations. The reason is that the Humean should think that scientific and metaphysical explanation have disparate aims, and therefore that neither form of explanation is beholden to the other in its pronouncements about what explains what. Consequently, the Humean has every reason to doubt that Lange's transitivity principle obtains.
RECOTOX, a French initiative in ecotoxicology-toxicology to monitor, understand and mitigate the ecotoxicological impacts of pollutants in socioagroecosystems
Abstract
RECOTOX is a cross-cutting initiative promoting an integrated research to respond to the challenges of monitoring, understanding, and mitigating environmental and health impacts of pesticides in agroecosystems. The added value of RECOTOX is to develop a common culture around spatial ecotoxicology including the whole chain of pressure-exposure-impact, while strengthening an integrated network of in natura specifically equipped sites. In particular, it promotes transversal approaches at relevant socioecological system scales, to capitalize knowledge, expertise, and ongoing research in ecotoxicology and, to a lesser extent, environmental toxicology. Thus, it will open existing research infrastructures in environmental sciences to research programs in ecotoxicology of pesticides.
Hepatozelluläres Karzinom – Stellenwert von Resektion, Lebertransplantation und Immunsuppression
Zusammenfassung
Das hepatozelluläre Karzinom (HCC) kann im Stadium BCLC 0 und A (Barcelona Classification of Liver Cancer) sowohl mittels Resektion als auch mittels Lebertransplantation innerhalb der Mailand-Kriterien erfolgreich kurativ behandelt werden. Bei Patienten ohne Zirrhose sollte immer eine Resektion angestrebt werden. Problematisch bei der Beurteilung der Therapie mittels Resektion und Lebertransplantation ist die Vergleichbarkeit. Die Berücksichtigung der portalen Hypertension zur Indikationsstellung muss in der Risiko-Nutzen-Bewertung für die Resektion streng beachtet werden. Multiple Analysen zeigen, dass beide Verfahren zu ähnlichen Ergebnissen führen. Der Überlebensvorteil für die Transplantation ist allerdings erst nach 10 Jahren erreicht. Die Implementation der Werte für AFP (α-Fetoprotein) hilft bei der Risikoabschätzung. Bezüglich der immunsuppressiven Therapie scheint eine niedrig dosierte Langzeitimmunsuppression und die Gabe eines mTOR-Inhibitors (mTORi) positive Effekte auf das Langzeitüberleben zu haben.
Novel magnetic graphene oxide functionalized cyanopropyl nanocomposite as an adsorbent for the removal of Pb(II) ions from aqueous media: equilibrium and kinetic studies
Abstract
This work presents the synthesis of the novel silica-cyanopropyl functionalized magnetic graphene oxide (MGO/SiO2-CN) hybrid nanomaterial derived by sol–gel method as a cheap efficient magnetic sorbent for the removal of extremely hazardous lead ions from aqueous media. The integration of the magnetic property, the carbon substrate, and the nitrile (–C ≡ N) containing organic grafted silica matrix promoted the adsorption capability against lead ions along with its simple synthesis recovery and low cost. The prepared nanocomposite was comprehensively characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Adsorption of lead was found to be pH dependent because of the charged nature of both analyte and adsorbent surface. Adsorption experiments were conducted under the optimum conditions, and the obtained experimental data from atomic absorption spectroscopy were analyzed using the popular isothermal models namely Langmuir, Freundlich, and Dubinin–Radushkevich isotherms as well as kinetically studied and evaluated for adsorption standard free energy (E). The experimental results have demonstrated the enhanced adsorption capability of the proposed sorbent nanocomposite for lead ion removal with the maximum adsorption capacity of 111.11 mg/g at pH 5.0. The proposed mechanism of lead adsorption was mainly attributed to the complexation of lead positive ions with the grafted –C ≡ N bond. The synergistic effect of the combination of three components (i.e., the magnetic graphene oxide matrix, the triple bond containing organic moiety, and the inorganic porous silica framework) excelled the adsorption capability and proved to be a good candidate as adsorbent for the removal of lead ions.
Study on the removal effect and influencing factors of nitrobenzene reduction by iron carbonate precipitates
Abstract
To investigate the activity of iron carbonate precipitates produced by long-term operation of Fe0 permeable reactive barriers, three kinds of precipitates, namely Fe6(OH)12CO3, Fe2(OH)2CO3, and FeCO3, were prepared to reduce the pollutant nitrobenzene. We studied the reduction effects of these iron carbonate precipitates on nitrobenzene by considering three factors, namely the initial nitrobenzene concentration, initial pH, and precipitate dosage, and established the kinetic degradation using pseudo-first-order kinetics model. The results showed that all three precipitates can reduce nitrobenzene, and the order of reducing capability is Fe6(OH)12CO3 > Fe2(OH)2CO3 > FeCO3; moreover, the removal efficiency values of nitrobenzene are 68.08, 53.00, and 50.29%. A high initial nitrobenzene concentration and high pH value are beneficial to nitrobenzene reduction, and removal efficiency was increased when pH was increased from 4 to 9. In addition, the increased precipitate addition in the Fe6(OH)12CO3 and Fe2(OH)2CO3 systems increased removal efficiency. Furthermore, the dosage did not significantly influence the removal rate in the FeCO3 system. Fe6(OH)12CO3 and Fe2(OH)2CO3 mainly relied on the precipitate itself with the structural Fe(II) to reduce nitrobenzene, and FeCO3 mainly relied on the dissolved Fe2+. The reaction of all three precipitates in reducing nitrobenzene followed the first-order reaction kinetics.
Τρίτη 17 Ιουλίου 2018
Nonvisualization of Sentinel Lymph Nodes by Lymphoscintigraphy in Primary Cutaneous Melanoma – Incidence, Risk Factors, and a Review of Management Options
PURPOSE: Lymphoscintigraphy (LS) is often obtained prior to sentinel lymph node biopsy (SLNB), especially in areas likely to have multiple or aberrant drainage patterns. This study aims to determine the incidence and characteristics of melanoma patients with a negative LS and to review the management options and surgical recommendations. METHODS: This is a retrospective study of patients with primary cutaneous melanoma who underwent SLNB between 2005 and 2016. Patients with nonvisualized lymph nodes on preoperative LS were compared in a 1:4 ratio with a randomly selected unmatched cohort drawn from all melanoma patients who underwent preoperative LS within the time period of the study. Demographic, clinical and outcome data were compared between these groups. RESULTS: A negative LS was seen in 2.3% of all cases (25 in 1073). In both univariate and multivariate analyses, predictive patient and tumor-specific factors for negative LS included older age and head and neck location. Patients with a non-visualized SLN had significantly worse overall survival compared with patients who had a visualized SLN, but there was no difference in melanoma-specific survival. In 16 of the 25 cases (64%), at least one SLN was found intraoperatively despite the negative LS. CONCLUSION: Older patients with head and neck melanomas are more likely to experience nodal nonvisualization on LS. In patients who have nodal nonvisualization, the surgeon should attempt SLNB at the time of excision of the primary lesion since a SLN can still be found in a majority of cases, and it offers prognostic information. CONFLICTS OF INTEREST AND SOURCE OF FUNDING: None of the authors have a financial interest in or a commercial association with any of the products, devices, or drugs mentioned in this manuscript. There was no source of funding for this manuscript. CORRESPONDING AUTHOR: Dr. Deepak Narayan, Yale University School of Medicine, Section of Plastic Surgery, 330 Cedar Street, P.O. Box 208041, New Haven, CT, 06520-8041, United States. Phone number: (203) 785-2570, Fax number: (203) 785-5714, deepak.narayan@yale.edu ©2018American Society of Plastic Surgeons
“Anatomic Basis of the Gastroepiploic Vascularized Lymph Node Transfer: A Radiographic Evaluation Using Computed Tomography Angiography (CTA)”
PURPOSE: The omentum, nourished by the gastroepiploic vessels, has gained popularity as an option for vascularized lymph node transfer (VLNT). The anatomy of the gastroepiploic vessels, omentum, and lymph nodes (LN) has not been investigated. The purpose of this study is to describe the right gastroepiploic artery (GEA) and related structures by using computed tomography angiography (CTA). MATERIALS AND METHODS: A retrospective analysis was conducted on 34 patients who received CTA. Statistical models were applied to identify right GEA and LN anatomical characteristics. RESULTS: The right GEA was identified in 33 of 34 patients. It was found to have a diameter of 2.49mm at its origin (SD 0.66). The gastroduodenal artery length prior to right GEA takeoff was 3.09cm (SD 1.31). Twenty-five patients had lymph nodes in the right GEA lymphosome. There were 2.7 LNs identified per patient (SD 2.12). The distance from the right GEA origin to the most proximal LN was 3.99cm (SD 2.21). The distance from the GEA origin to the third LN was 9.12cm (SD 5.06). Each LN was within 7.00mm (SD 6.2) of the right GEA. CONCLUSIONS: When using the right GEA donor site for VLNT, the plastic surgeon should anticipate using a pedicle length of 4cm, a total flap length of 9cm with 3cm of surrounding tissue in order to obtain at least 3 lymph nodes for transfer. CTA is an effective imaging modality that can be used for patient-specific surgical navigation prior to vascularized lymph node transfer. Financial Disclosure Statement: Ketan Patel is a consultant for Novadaq Corp and receives textbook royalties from Elsevier Corp. All other authors have no disclosures. Corresponding Author: Ketan M. Patel, M.D., Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033, ketan.patel@med.usc.edu ©2018American Society of Plastic Surgeons
Comparison of Pediatric Intercalary Allograft Reconstructions With and Without a Free Vascularized Fibula
Introduction: Lower extremity intercalary allograft reconstruction has traditionally been used to facilitate limb salvage. Combing the allograft with a vascularized fibula graft (FVFG) has been described; however there is a paucity of data comparing the outcome of these reconstructions. Material and Methods: 29 pediatric patients (15 males, 14 females) underwent lower extremity limb salvage with the use of intercalary cadaveric allograft at a mean age of 12 years. The most common diagnosis was osteosarcoma (n=18). Patients were reconstructed with an allograft alone (n=11) or supplemented with a FVFG (n=18). Results: The mean time to union of the allograft was 11 months, with 10 patients requiring additional bone grafting. There was no difference in the need for an additional bone graft (OR 0.87, P=1.0) between patients with a FVFG and those without. The allograft was revised in 3 patients due to fracture (n=2) and fracture and infection (n=1). In all these patients the allograft was not supplemented with a FVFG (P
Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema
Background: Vascularized lymph node transfer (VLNT) has shown promising results in the treatment of lower limb lymphedema, but little is known about the number of lymph nodes needed for the transfer to achieve optimal results. This study investigated the correlation between number of transferred lymph nodes in submental VLNT and outcomes regarding limb circumference reduction and cellulitis incidence. Methods: Thirty-five patients who had received submental VLNT to an ankle for lower limb lymphedema, post-gynecological cancer treatment, were included in the study. Limb circumference was determined via tape measurement pre- and postoperatively and was used to calculate the circumferential difference. Ultrasonography was performed postoperatively to determine the number of lymph nodes within the transferred flap. Patients were divided into groups A-C depending on the number of transferred lymph nodes: 1-2 (n=10), 3-4 (n=14) and 5-8 (n=11), respectively. Results: The mean age was 60.0 ± 9.2 years. All flaps survived. The mean improvement of circumferential difference for the whole cohort was 19.8 ± 9.2 %. Groups B and C both had significantly higher improvements in the circumferential difference than group A (p=0.04 and p=0.02, respectively), but when compared to each other, the difference was non-significant. All groups had significant reductions in cellulitis incidence postoperatively. Conclusions: Submental VLNT for lower limb lymphedema reduced the incidence of cellulitis, regardless of the number of transferred lymph nodes. The transfer of 3 or more lymph nodes provided significantly better outcome regarding limb circumference reduction than the transfer of 2 or fewer lymph nodes. FINANCIAL DISCLOSURE STATEMENT: The authors have nothing to disclose. No funding was received for this article. AUTHOR CONTRIBUTIONS: JG and MHC were responsible for the study idea, design and follow-through. JG, SYC and WHC were responsible for data collection. All authors were involved in the interpretation of results. JG and MHC were responsible for statistical analysis. All authors were involved in critical review and approval of the final result. IRB NUMBER: 101-3481B ACKNOWLEDGMENTS: The authors would like to thank Miffy Chia-yu Lin, M. Sc., for her assistance in the preparation of tables and figures for this manuscript. CORRESPONDING AUTHOR: Ming-Huei Cheng, MD, MBA, FACS, Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Center of Tissue Engineering, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan , Telephone: +886 3 281200 ext. 2172, Fax: +886 3 3972681, E-mail: minghueicheng@gmail.com, minghuei@adm.cgmh.org.tw ©2018American Society of Plastic Surgeons
Influence of Repaired Cleft Lip and Palate on Layperson Perception following Orthognathic Surgery
Background: Facial scarring and disharmony due to clefting is associated with psychosocial stress which may be improved by orthognathic surgery. The authors examine how a history of clefting influences change in layperson perception of a patient following orthognathic surgery. Methods: 1000 laypeople were recruited through Mechanical Turk to evaluate patient photographs pre- and post-orthognathic surgery. Nineteen patients – 5 with unilateral and 4 with bilateral clefting – were included. Respondents assessed 6 personality traits, 6 emotional expressions, and likelihood of 7 interpersonal experiences on a scale from 1-7. Results: Using Mann-Whitney U and independent samples t-tests, changes in all aspects of social perception post-procedure differed significantly between cleft vs. non-cleft cohorts (p
“Incidents of Mandibular Distraction Osteogenesis for Hemifacial Microsomia.”
Background: This article mainly focused on the safety and unexpected incidents of mandibular distraction osteogenesis in treating patients with hemifacial microsomia. Methods: Records of 71 patients with hemifacial microsomia treated by mandibular distraction osteogenesis from February 2010 to March 2015 were examined in this retrospective study. The modified mandibular osteotomy was conducted under the assistance of three-dimensional (3D) reconstruction, computer-aided design and rapid prototyping technique. Distraction was conducted 4-7 days postoperatively at a frequency of 1 mm/d; moreover, the distractor was kept in place for 4 to 13 months after the first operation before it was removed. The scope of distraction ranged from 20 to 40 mm. All incidents encountered during and following the mandibular distraction process were documented in the medical records of patients. The patients were followed up for an average of 34.4 months after the second-stage operation. Results: The overall rate of incidents was 36.6%. Of them, minor incidents, which could be resolved with or without noninvasive therapy, were observed in 18.3% of all procedures in this series. Meanwhile, the rate of moderate incidents necessitating invasive therapy was reported to be 12.7%, while that of major incidents that could not be resolved with invasive therapy was 5.6%. Conclusions: Mandibular distraction osteogenesis is a widely used procedure for treating patients with hemifacial microsomia. It is extremely important to be fully aware of variety of incidents occurring during and following the surgical procedure to minimize the incidence of such incidents. Financial Disclosure Statement: All authors has no financial conflict to disclose. The study was funder by Special Fund for Scientific Research in the Public Interest from National Health and Family Planning Commission of the People's Republic of China (No. 201502016), and 2015 Major Project of School/Institution of Plastic Surgery Hospital, Chinese Academic of Medical Sciences (No.Z2015008). Corresponding author: Zhiyong Shi, MD, Department of maxillofacial surgery, Plastic Surgery Hospital (Institude), Chinese Academy of Medical Sciences, Peking Union Medical College; No.33 Badachu Road, Shijingshan District, Beijing, 100144, China. zhangzy1011@163.com ©2018American Society of Plastic Surgeons
“Interposition Vein Grafting in Head and Neck Free Flap Reconstruction”
Background: Many surgeons are hesitant to use interposition vein grafting in head and neck microvascular free flap surgery due to concerns for elevated risk of flap loss. Methods: We conducted a review of patients who underwent head and neck free flap reconstruction between 2005 and 2015. The effect of vein grafts on flap compromise and flap loss were analyzed using univariate and multivariate models. Results: A total of 3240 free flaps were performed. Vein grafts were used in 241 flaps (7.4%). The free flap compromise rate was 14.5% with vein grafts and 3.4% without vein grafts (p
Long-term results in isolated metopic synostosis- the Oxford experience in 22 years.
Background: Metopic synostosis causing trigonocephaly is treated by fronto-orbital-advancement and remodelling to correct the deformity, cerebral distortion and to treat intracranial hypertension in a small number of cases. This study's aim was to evaluate complications, revisions and long-term outcomes. Methods: A retrospective chart review was performed on consecutive metopic craniosynostosis patients treated between February 1995 and February 2017 at the Oxford Craniofacial Unit. Results: 245 patients with isolated metopic synostosis were seen. 202 patients underwent fronto-orbital-advancement and remodelling. 50 (25%) female; 152 (75%) male. Mean age at surgery was 16.8 months. Mean weight preoperatively was 12kg. All patients received blood transfusion. Mean postoperative stay was 6 days. Average follow-up time was 8 years (range 0.5-22 years). There were 8 (4%) major complications. 6 (2.9%) patients required secondary calvarial-expansion for late raised intracranial pressure. 31 (15%) had other subsequent procedures including wire removal (8%) and forehead shape contouring (4%) with alloplastic onlay. Raised intracranial pressure prior to surgery was confirmed in 2 cases by intracranial pressure monitoring. Conclusion: Trigonocephaly is caused by metopic synostosis and is treated by fronto-orbital advancement and remodelling in order to restore both internal and external skull configuration. Following surgery, we identified a 2.9% risk of late raised intracranial pressure requiring a secondary calvarial-expansion, necessitating prolonged follow up in all cases. Temporal hollowing and forehead contour defects were not uncommon, resulting in a need for onlay recontouring in selected cases. This is the largest reported series of metopic synostosis. Financial disclosure statement: The authors have no financial disclosures. Presented at: 17th biennal congress of the International Society of Craniofacial Surgery (ISCFS), 24th-28th October 2017, Cancun, Mexico. Correspondence should be address to: Hamidreza Natghian M.D., Oxford Craniofacial Unit, Level LG1, West Wing, John Radcliffe Hospital, Headley Way, Headington, OX3 9DU, Oxford, United Kingdom. Email: Hamidreza.natghian@gmail.com ©2018American Society of Plastic Surgeons
“Targeted Muscle Reinnervation in the Lower Leg: An Anatomic Study.”
Introduction: Targeted muscle reinnervation (TMR) re-routes the ends of cut nerves to re-innervate small motor nerves of nearby muscles, with the goal of reducing neuroma pain and/or improving prosthesis function. Anatomical roadmaps for TMR have been established in the upper extremity and thigh, but not for the lower leg. Methods: The major branch points (MBPs) of motor nerves and the motor entry points (MEPs) to muscles of the leg were dissected in five cadaver specimens. Leg length was defined as distance from lateral femoral condyle to lateral malleolus. The distances from the lateral femoral condyle to MBPs and MEPs were recorded as a percentage of leg length to identify targets for TMR. Results: The tibialis anterior and extensor digitorum longus were both acceptable targets in the anterior compartment, with an average 4.4 MEPs within 10-80% and 3 MEPs within 20-80% leg length, respectively. The peroneus longus was the best target in the lateral compartment, with an average 5.8 MEPs within 20-70% leg length. The gastrocnemius and soleus were both acceptable targets in the superficial posterior compartment, with an average 4.4 MEPs within 0-40% and 6.2 MEPs within 20-80% leg length, respectively for each muscle. The flexor digitorum longus was the best target in the deep posterior compartment, with an average 6 MEPs within 30-90% leg length. Conclusions: TMR is technically feasible in the lower leg. This cadaveric study provides a roadmap for incision placement and identification of motor nerve targets. Financial Disclosure Statement: Dr. Ko is a speaker for Checkpoint Surgical, Cleveland OH. Dr. Dumanian is a speaker for Axogen, Inc. Alachua, FL. No funding was received for this article. Corresponding author: Gregory Dumanian, MD, ivision of Plastic Surgery, Northwestern Memorial Hospital, 675 N. St. Clair St, Suite19-250, Chicago, IL 60611 USA. email: gdumania@nm.org ©2018American Society of Plastic Surgeons
Sphenoid Dysplasia in Neurofibromatosis: Patterns of Presentation and Outcomes of Treatment
Introduction: Sphenoid wing dysplasia in patients with neurofibromatosis type 1 (NF-1) may result in challenging and significant changes, including ultimately vision loss. We describe the radiographic patterns of sphenoid dysmorphology with time and age, and the impact of surgical intervention on preservation of vision. Methods: A retrospective study was performed at a single pediatric hospital, identifying subjects with NF-1. Records were reviewed in their entirety for each subject, with attention to opthamalogic evaluation. Radiographic images were digitally analyzed and scored for sphenoid transformations on a grade of 0-3. Results: Fifty-two subjects were identified. On initial imaging, 42.31% had a normal sphenoid (grade 0), 32.69% had an abnormal contour (grade 1), 11.54% had thinning (grade 2), and 13.46% had a gross defect (grade 3). Among the 45 subjects with serial imaging, 55.56% demonstrated progression of the deformity of at least one grade. Deformity progression correlated with length of imaging interval. Enucleation was noted to occur more often in subjects with a gross sphenoid defect (p
Leaching of metals from asphalt pavement incorporating municipal solid waste incineration fly ash
Abstract
Rising municipal solid waste incineration (MSWI) makes it imperative to recycle the fly ash (FA). FA can be solidified by asphalt and then applied in the asphalt road. However, little information on the metal leaching and associated with risks from asphalt solidified forms for FA is available. In the present study, metal leaching characteristics and long-term leaching potential from the asphalt-based FA matrices was determined based on the national standard method and simulating the actual using of the solidified forms in highways, respectively. The immobilization effect of asphalt on MSWI FA is well. Leaching velocity was in the order of magnitude of 10~10−6 cm h−1 during the entire leaching period. At the early age, leaching velocity of metals is high, especially Zn, Cd, and Ba. Cumulative leaching concentration of metals and leaching time has positive correlation. Only considering the leaching of simulating acid, leaching of metals in asphalt-based matrices is very slow, and the leaching toxicity of metals is lower than the Chinese National Standard.
Real-world cost-effectiveness of cetuximab in the third-line treatment of metastatic colorectal cancer based on patient chart review in the Netherlands
To assess the cost effectiveness of cetuximab in third-line treatment of patients with KRAS wild-type (wt) metastatic colorectal cancer (mCRC) in routine clinical practice compared with best supportive care (BSC)...
Pilomatricome : corrélation dermatopathologie-dermatoscopie
Publication date: Available online 17 July 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): P. Huet, G. Barnéon, B. Cribier
Fabrication of pure and moxifloxacin functionalized silver oxide nanoparticles for photocatalytic and antimicrobial activity
Publication date: Available online 17 July 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Sirajul Haq, Wajid Rehman, Muhammad Waseem, Vera Meynen, Saif Ullah Awan, Shaukat Saeed, Naseem Iqbal
Abstract
This paper reports the synthesis of silver oxide (Ag2O) and moxifloxacin functionalized silver oxide (M-Ag2O) nanoparticles for photocatalytic and antimicrobial activity. The Ag2O nanoparticles were synthesized by using 2 dimethyl amino ethanol as reducing agent. The BET surface area measured from N2 adsorption method was found to be 16.89 m2/g. The mix (cubic and hexagonal) phase of silver oxide (Ag2O) nanoparticles was confirmed by X-rays diffraction (XRD). The extra diffracted peaks were observed after moxifloxacin fictionalization. The scanning electron micrographs display spherical shaped particles of different sizes. The elemental composition and weight percent of both samples were studied by energy dispersive X-ray (EDX). The decrease in the weight percent of silver with the subsequent increase in the weight percent of carbon and oxygen revealed the successful loading of moxifloxacin onto Ag2O NPs. The two stages of weight loss due to the removal of physisorbed and chemisorbed water was examined during thermogravimetric analysis (TGA). The optical band gap derived from the diffuse reflectance spectrum (DRS) was 1.83 eV, which corresponds to the transmittance edge of 676 nm. The Fourier transform infrared (FTIR) band at 668.56 cm−1 confirms the successful synthesis of moxifloxacin functionalized silver oxide (Ag2O) nanoparticles. The pure Ag2O nanoparticles were used for the degradation of rhodamine 6G and 98.56% dye was degraded in 330 min. The bacterial species selected for the present study were Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans and Aspergillus Niger. Both pure and functionalized Ag2O NPs were screened against selected bacterial and fungal species and they showed improved activity with the volume of samples taken in wells. However, the activity of Ag2O NPs against fungi was found less effective than bacteria which may be due to the difference in the composition of the cell wall. Further gram-positive bacteria showed more resistance toward both samples as compared to the gram-negative bacteria. It was concluded that Ag2O NPs upon conjugation with moxifloxacin displayed promising antimicrobial activity.
Less painful and effective intralesional injection method for lichen simplex chronicus
Publication date: Available online 17 July 2018
Source: Journal of the American Academy of Dermatology
Author(s): Han Mi Jung, Sung Hye Eun, Ji Hae Lee, Gyong Moon Kim, Jung Min Bae
Femoral artery ultrasound for improving the detection of atherosclerosis in psoriasis
Publication date: Available online 17 July 2018
Source: Journal of the American Academy of Dermatology
Author(s): Alvaro Gonzalez-Cantero, Jorge Gonzalez-Cantero, Ana Isabel Sanchez-Moya, Cristina Perez-Hortet, Salvador Arias-Santiago, Jose Luis Martin-Rodriguez, Cristina Schoendorff-Ortega, Jorge Luis Gonzalez-Calvin
Early Stage Melanoma and Hematopoietic Stem Cell Transplantation Outcomes
Publication date: Available online 17 July 2018
Source: Journal of the American Academy of Dermatology
Author(s): Charles J. Puza, Paul J. Mosca, Adela R. Cardones
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
Publication date: Available online 17 July 2018
Source: Journal of the American Academy of Dermatology
Author(s): Jacob Siegel, Mariam Totonchy, William Damsky, Juliana Berk-Krauss, Frank Castiglione, Mario Sznol, Daniel P. Petrylak, Neal Fischbach, Sarah B. Goldberg, Roy H. Decker, Angeliki M. Stamatouli, Navid Hafez, Earl J. Glusac, Mary M. Tomayko, Jonathan S. Leventhal
Abstract
Background
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.
Objective
To evaluate the clinical and histopathologic findings, frequency, and impact on cancer therapy of bullous eruptions due to anti-PD-1/PD-L1 therapy.
Methods
We retrospectively reviewed the medical records of patients evaluated by the onco-dermatology clinic and consultative service of Yale New Haven Hospital from 2016 to 2018.
Results
We identified 9 patients who developed bullous eruptions of 853 patients (∼1%) treated with anti-PD-1/PD-L1 therapy at our institution during the study period: 7 presented with bullous pemphigoid, 1 presented with bullous lichenoid dermatitis, and 1 presented with linear IgA bullous dermatosis in the context of vancomycin therapy. 8 patients required systemic steroids, 5 required maintenance therapy, and 8 required interruption of immunotherapy. All 9 patients had an initial positive tumor response or stable disease, but 4 went on to develop disease progression.
Limitations
This was a retrospective study from a single tertiary care center.
Conclusion
Bullous disorders developed in approximately 1% of patients treated with anti-PD-1/PD-L1 therapy at our institution and frequently resulted in interruption of immune therapy and management with systemic corticosteroids and occasionally steroid-sparing agents.
Combination of paromomycin plus human anti-TNF-α antibodies to control the local inflammatory response in BALB/ mice with cutaneous leishmaniasis lesions
Cutaneous leishmaniasis (CL) is caused by a broad range of species of the genus Leishmania. In the skin lesions that appear following the phlebotomine bite, pro- and anti-inflammatory cytokines play different roles in resistance/susceptibility and determine the immunopathogenesis of Leishmania spp. infection [1]. Therefore, T helper 1 (Th1) inflammatory cytokines, especially interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and interleukin (IL)-12, are crucial in the initiation of protective immunity against L.
Religion and the Plastic Surgeon: an Imam, a Minister, and a Rabbi Walk into a Surgical Centre
Abstract
Cultural competency has become a keystone in forming a successful doctor–patient relationship to provide culturally appropriate services that respect patients' ethno-cultural beliefs, values, attitudes, and conventions. In cosmetic surgery, an often-overlooked aspect of a patient's cultural is his and her religious beliefs. In response to this paucity of resources for cosmetic surgeons to enable them to properly service their religious patients, this project was undertaken. This review article covers the three main Abrahamic religions (Judaism, Christianity, and Islam) and was written with the assistance of a prominent bioethicist from each religion (see Acknowledgements). In discussing each religion, the article has been divided into two sections. The first section is a general overview of the religion's relationship with cosmetic surgery as summary provided by the consulting bioethicist. The second portion is an annotated review of additional resources providing the reader further details on that religion. For example, our bioethicists provide a general perspective on Christianity as a whole, and the annotated review focuses on differences between Catholics and Protestants. We recognize the heterogeneity that is inherent in religion and the cultural and geographic biases that affect it. However, we aim to provide the reader a broad and basic foundation of the relationship between Judaism, Christianity, and Islam with cosmetic surgery to begin to create common ground between the physician and the patient and improve the process of shared decision-making and thus our outcomes. This paper should be seen as a foundation to build upon rather than an authoritative source, and specific patient concerns should be addressed with the patient's own religious advisor.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Performance of ceria/iron oxide nano-composites based on chitosan as an effective adsorbent for removal of Cr(VI) and Co(II) ions from aqueous systems
Abstract
A novel chitosan/ceria/iron oxide (CS/ceria/Fe3O4) nano-composite adsorbent was synthesized for removal of Cr(VI) and Co(II) ions from aqueous systems in a batch system. The adsorbents were characterized by field emission scanning electron microscopy (FESEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM), thermal gravimetric analysis (TGA), and Brunauer- Emmett-Teller (BET) analyses. The behavior of swelling kinetics was also studied. The effect of several adsorption parameters including CeO2 and Fe3O4 contents, initial pH, contact time, initial Cr(VI) and Co(II) concentration, and temperature on the adsorption capacity was studied. The double exponential model revealed a better fit with the kinetic data of Cr(VI) and Co(II) ions. The Cr(VI) and Co(II) adsorption process well fitted the Langmuir model. The maximum adsorption capacities estimated from Langmuir isotherm model were 315.4 and 260.6 mg/g for Cr(VI) and Co(II) ions, respectively. Also, thermodynamic parameters were used to distinguish the nature of Cr(VI) and Co(II) adsorption. The reusability of CS/ceria/Fe3O4 nano-composite was evaluated with stripping agents of 0.1 M NaOH and 0.1 M HNO3. Finally, the evaluation of Cr(VI)-Co(II) coexisting system confirmed that the presence of Co(II) ions played an inhibitor role on the Cr(VI) adsorption.
A Randomized, Placebo-Controlled, Double-Blind, Prospective Clinical Trial of Botulinum Toxin Type A in Prevention of Hypertrophic Scar Development in Median Sternotomy Wound
Abstract
Background
Linear hypertrophic scar is a common surgical problem that can be difficult to manage, especially for the median sternotomy scar. Botulinum toxin type A (BTA) is widely used in cosmetic surgery and has been shown to improve scar quality recently. The aim of this study was to evaluate the efficacy of BTA injected in the early postoperative of median sternotomy on preventing scar formation.
Methods
In this prospective randomized controlled trial, 19 consecutive patients who underwent median sternotomy were enrolled. The median sternotomy wound in each patient was divided into the upper half and the lower half. Both halves of the wound were randomized to receive the treatment with either BTA or normal saline. At 6-month follow-up, scars were assessed using the Vancouver Scar Scale, scar widths were measured, and patients were asked to evaluate their overall satisfaction.
Results
Seventeen patients with median sternotomy wounds completed the entire study. At 6-month follow-up, the mean Vancouver Scar Scale score for the BTA-treated group was 3.44 ± 1.68 and for the normal saline control group was 6.29 ± 2.39, and there was a statistically significant difference between the two groups (P < 0.05). There were also significant improvements in scar width and patient satisfaction for the BTA-treated halves of the wounds (P < 0.05).
Conclusions
The study demonstrates that early postoperative BTA injection can decrease scar formation and reduce scar width in median sternotomy wounds, and the overall appearance is more satisfactory.
Level of Evidence I
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Systematic Review of Quality-of-Life Measurement After Aesthetic Rhinoplasty
Abstract
Introduction
The assessment of outcomes in aesthetic rhinoplasty is highly relevant because patient satisfaction and improved health-related quality of life (QoL) are the predominant factors in determining success. The patient-reported outcome measures (PROMs) employed in rhinoplasty research studies are remarkably diverse, thus yielding difficulties with data analysis. The aim of this article is to provide a comprehensive review of the literature to reveal the relevance of the QoL assessment for rhinosurgeons.
Methods
A systematic literature search with the terms "Rhinoplasty" and "Quality of Life" was conducted using PubMed/MEDLINE, Google Scholar and Cochrane databases. Primarily, all publications related to QoL following aesthetic rhinoplasty between 2002 and 2017 were identified. As a secondary selection, we focused on articles with a prospective study design, a significant cohort size (at least 50 patients) and a follow-up period of at least 6 months after aesthetic rhinoplasty.
Results
A total of 62 PROM studies assessing QoL following aesthetic rhinoplasties were obtained. We ascertained an increasing publication rate of QoL articles over the last 15 years. Only 17 studies satisfied comprehensive inclusion criteria of a high qualitative study selection. The Rhinoplasty Outcome Evaluation was the most frequently used QoL questionnaire of the secondary selection (70.6%). The total number of 16 various questionnaires exhibit high heterogeneity.
Conclusion
Our data strengthen the increasing importance of the assessment of QoL after rhinoplasty. Despite a lack of reliable publications with considerable heterogeneity and large variability in outcomes, functional-aesthetic rhinoplasty leads to a significant improvement of patient's health-related QoL.
Level of Evidence II
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Surfactants in the sea surface microlayer, subsurface water and fine marine aerosols in different background coastal areas
Abstract
This study aims to determine the concentrations of surfactants in the surface microlayer (SML), subsurface water (SSW) and fine mode aerosol (diameter size < 1.5 μm) at different coastal stations in Peninsular Malaysia. The concentrations of anionic and cationic surfactants were determined through colorimetric methods as methylene blue active substances (MBAS) and disulphine blue active substances (DBAS), respectively. Water-soluble ions, for the determination of fine mode aerosol sources, were determined using ion chromatography (IC) for anions (SO42−, NO3−, Cl− and F−) and cations (Na+, K+, Ca2+ and Mg2+). Principal component analysis (PCA), combined with multiple linear regression (MLR), was used to identify the possible sources of surfactants in fine aerosol. The results showed the concentrations of surfactants as MBAS and DBAS in the SML ranged between 0.23 ± 0.03 and 0.35 ± 0.01 μmol L−1 and between 0.21 ± 0.02 and 0.29 ± 0.01 μmol L−1, respectively. The enrichment factors (Efs) ratios between MBAS and DBAS in the SML and SSW ranged between 1.04 ± 0.01 and 1.32 ± 0.04, respectively. The station that is located near to tourism and industrial activities recorded the highest concentrations of surfactants in SML and SSW. The concentrations of surfactants in fine aerosol ranged between 62.29 and 106.57 pmol m−3. The three possible sources of fine aerosol during the northeast monsoon were aged sea spray/biomass burning (which accounted for 69% of the atmospheric aerosol), nitrate/mineral dust (23%) and sulphate/fresh sea salt (8%). During the southwest monsoon, the three main sources of atmospheric aerosol were biomass burning (71%), secondary inorganic aerosol (23%) and sea spray (6%). This study suggests anthropogenic sources are main contributors to the concentrations of surfactants in SML, SSW and fine aerosols.
Ecological and human health risk assessments in the context of soil heavy metal pollution in a typical industrial area of Shanghai, China
Abstract
The purpose of this study was to identify the concentrations, sources, and potential ecological and health risks of heavy metals in soils from a typical industrial area in Shanghai, China. A total of 28 surface soil samples were collected and analyzed for As, Cd, Cr, Cu, Pb, Ni, Zn, and Hg from the BAO steel industry in June and July 2016. Classic multivariate statistical and geostatistical analysis methods were used to detect the sources of heavy metals, and the ecological risk index (RI) and hazard index (HI) were calculated to assess the potential ecological and health risks. The results showed significant pollution levels, which were derived from the industrial production process and closely related to the spatial layout of the functional areas of the industry. The ecological risk assessment indicated that a very high concentration zone with values ranging from 2045 to 3417 mg kg−1 represented considerable ecological risk in the range of 300 to 600. The main dominant factor affecting the ecological risk is toxicity rather than concentration. The health risk assessment indicated that noncarcinogenic risk was mainly caused by Cr, and the average HI value for adults was 6.48, while it was 39.01 for children. Thus, children face higher threats to heavy metals in soils. The average carcinogenic risk values for Ni, Cr, Cd, and As were 7.97E-09, 5.2E-07, 2.1E-10, and 2.1E-09, respectively, all of which were below the threshold values (1.0E − 04). These results provide basic information for the control and environmental management of heavy metal pollution in steel industrial regions.
Assessment, Truth and Religious Studies
Abstract
This paper addresses the question of what should determine whether students' answers to closed questions are marked as correct or incorrect in the context of formal religious education, and when their answers to open ended questions should be given more or less credit. Drawing on insights from Craig Bourne, Emily Caddick Bourne and Clare Jarmy, I argue that a combination of judged truth, and a range of well-argued cases about what ought to be believed given certain premises should constrain these assessment practices. Furthermore, I argue that if we cannot find any consistent, nonarbitrary account of how judgements of correctness and merit are in fact being made in the context of formal religious education, then this tells more against current practice's inconsistency and arbitrariness than against these constraints on how judgements of correctness and merit should be made.
The Relation Between the Lower Lateral Cartilages and the Function of the External Nasal Valve
Abstract
Introduction
The position of the lower lateral cartilages (LLC) is closely related to the function of the external nasal valve (ENV). When there is a cephalic malposition of these cartilages, the nasal alae have inadequate support, which leads to ENV insufficiency during deep inspiration.
Methods
Retrospective study with 60 patients evaluated: the positioning of the LLC and the occurrence of ENV insufficiency; the effectiveness of structuring the medial and lateral walls of the ENV; and the frequency of the grafts used for structuring it.
Results
Of the 60 operated cases, 37 patients (62%) had ENV insufficiency, in 23 cases there was cephalic malposition of the LLC, and in the latter group 17 patients (74%) presented this insufficiency. A structured ENV was effective in the treatment of this insufficiency (p = 0.001). A lateral crural strut graft was performed in 24 cases (40%) of 60 patients operated. The alar contour graft was performed from 2013 to 2015 in 4 patients (22%) of 18 cases operated, and between 2016 and 2018 it was performed in 29 patients (69%) out of 42 cases. The columellar strut was routinely used from 2013 to mid-2016 in 33 cases (100%), and after that period until the present day the tongue-in-groove technique was performed in 11 cases (41%) and in the remaining 16 cases (59%) the caudal septal extension graft was performed.
Conclusion
Cephalic malposition of the LLC is an important red flag of ENV insufficiency. This insufficiency should be treated by structuring the walls of the ENV.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Talking our way to systematicity
Abstract
Do we think in a language-like format? Taking the marker of language-like formats to be the property of unconstrained systematicity, this paper considers the following master argument for the claim that we do: (1) language is unconstrainedly systematic, (2) if language is unconstrainedly systematic then so is thought, (3) so thought is unconstrainedly systematic. It is easy to feel that there is something right about this argument, that there will be some way of filling in its details that will vindicate the idea that our thought must be unconstrainedly systematic given that the language in which we express it is. Clearly, however, the second premise needs support—we need a principled reason for moving from the unconstrained systematicity of language to the unconstrained systematicity of thought. This paper gives three passes at formulating such a principle. This turns out to be much harder than it might seem. We should, I conclude, resist falling too easily for the lure of this master argument for the language-like format of thought.
Investigation on spatiotemporal distribution of aerosol optical properties over two oceanic regions surrounding Indian subcontinent during summer monsoon season
Abstract
Columnar spectral aerosol optical depths (AODs) and total suspended particulate matter (TSPM) concentrations were collected on board the Oceanographic Research Vessel (ORV) of Sagar Kanya (SK) during 7–21 June 2014 (SK-313) and 31 July–14 August 2015 (SK-323) over the Arabian Sea (AS) and Bay of Bengal (BoB), respectively, for the two successive years during summer monsoon season. AOD measured at 500 nm (AOD500) varied significantly from 0.08 to 0.66 (0.07 to 0.60), with a mean of 0.48 ± 0.13 (0.34 ± 0.13) over the BoB (AS) during SK-313 (SK-323). It simply implies that aerosol load was higher over BoB, not variability as the standard deviations of AOD over both oceans are identical (0.13). Daily AOD500 ranged between 0.15 and 0.60 accounted for 70–75% of the total occurrences over two oceanic regions. Mean Ångström exponent (α or alpha) and Ångström turbidity coefficient (β or beta) were found to be 0.43 ± 0.17 (0.39 ± 0.19) and 0.37 ± 0.15 (0.27 ± 0.13), respectively, which are higher over the AS during SK-323 (SK-313) that indicate predominance of coarse-relative to fine-mode particles. On the other hand, the spectral curvature and second derivative of alpha (α′) also showed significant contribution of coarse-mode particles over fine during the two campaigns. Further, column aerosol size distribution (CSD) derived from the King's inversion also exhibited bimodal distribution with a predominant peak observed in the coarse mode (~1.0 μm) compared to the fine mode at a geometric mean radius at ~0.1 μm over two oceans. The observed data showed that the two marine regions are significantly influenced by various types of aerosols with a predominance of mixed type (MT) of aerosols. From the morphological study, it is inferred that the particles are a flake, spherical, irregular, and in flower and aggregated shapes conducted for the TSPM samples collected during SK-323 over the AS. Finally, the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model is used to study the impact of long-distance transported aerosols and identify their sources.
Multicenter, randomized controlled, observer‐blinded study of a nitric oxide generating treatment in foot ulcers of patients with diabetes—ProNOx1 study
Wound Repair and Regeneration, EarlyView.
Technical feasibility, radiation dosimetry and clinical use of 18 F-sodium fluoride (NaF) in evaluation of metastatic bone disease in pediatric population
Abstract
Purpose
The role of 18F-fluoride (18F-NaF) PET-CT for the detection of bone metastases in adults is well established and is considered superior to conventional bone scintigraphy. However, data pertaining use of 18F-NaF PET-CT in pediatric oncology is relatively sparse. The aim of the present study is to retrospectively analyze and share a single-center experience of 18F-NaF PET-CT in pediatric population and to provide preliminary information regarding imaging technique, feasibility of this modality in young patients and radiation dosimetry measurements in pediatric oncology cases.
Materials and methods
Twenty-four pediatric patients (mean age 8.0 ± 3.9) were included in the study for retrospective analysis. All patients were referred for primary staging or restaging for potential osseous metastatic disease and PET-CT scan was performed by injecting 2.2 MBq/kg (0.06 mCi/kg) of 18F-NaF.
Results
Nine patients were imaged for primary staging and in all cases increase osteoblastic activity was seen in the primary tumor and of these, metastatic bone disease was identified in 2/9 patients. In the restaging group comprising 15/24 patients, metastatic deposits were identified in 3/15 whilst no disease was seen in the remaining 12 patients. Patients were injected a mean dose of 90.35 ± 22.9 MBq with an estimated mean effective absorbed doses of 2.98 ± 0.75 mSv for 18F-NaF and 3.37 ± 2.4 mSv for CT alone. Mean cumulative effective dose of 18F-NaF PET-CT scan was 5.11 ± 2.7 mSv.
Conclusions
18F-NaF PET-CT may be a feasible alternative to 99mTc MDP for radionuclide bone scintigraphy in the evaluation of pediatric bone pathology. Due to its better pharmacokinetics, there is potential that osseous staging can be achieved with relatively low doses and with a similar radiation burden as with 99mTc-MDP imaging.
Examining Risk of Workplace Violence in Canada: A Sex/Gender-Based Analysis
Abstract
Objectives
Workplace violence (WPV) is a serious issue, resulting in significant negative health outcomes. Understanding sex/gender differences in risk of WPV has important implications for primary prevention activities. Methods
Utilizing two waves of the Canadian General Social Survey on Victimization (N = 27,643), we examined the likelihood of WPV, and sub-categories of WPV, for women relative to men. Using a sex/gender analytical approach, a series of logistic regression models examined how the associations between being a woman and each of the outcomes changed upon adjustment for work and socio-demographic characteristics. Results
After adjustment for work hours, women were at more than twice the risk of WPV compared to men (odds ratio = 2.12, 95% confidence interval 1.52–2.95). Adjustment for work characteristics attenuated, but did not eliminate this risk. Differences in associations were observed across sub-categories of violence, with adjustment for work characteristics attenuating sex/gender differences in physical WPV, but having minimal impact on sex/gender differences in sexual WPV. Conclusions
Work characteristics explain a substantial proportion of the sex/gender differences in risk of physical WPV. However, even after adjustment for work characteristics, women still showed an elevated risk relative to men for almost all types of violence (as defined by nature of the violence, sex of the perpetrator, and relationship to the perpetrator) examined in this study. Future investigations should examine why these differences between women and men remain, even within similar occupational contexts.Δευτέρα 16 Ιουλίου 2018
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.
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.
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.
Κυριακή 15 Ιουλίου 2018
Plumbagin, a vitamin K3 analogue ameliorate malaria pathogenesis by inhibiting oxidative stress and inflammation
Abstract
Plumbagin, a vitamin K3 analogue is the major active constituent in several plants including root of Plumbago indica Linn. This compound has been shown to exhibit a wide spectrum of pharmacological activities. The present investigation was to evaluate the ameliorative effects of plumbagin (PL) against severe malaria pathogenesis due to involvement of oxidative stress and inflammatory response in Plasmodium berghei infected malaria in mice. Malaria pathogenesis was induced by intra-peritoneal injection of P. berghei infected red blood cells into the Swiss albino mice. PL was administered orally at doses of 3, 10 and 30 mg/kg/day following Peter's 4 day suppression test. Oral administration of PL showed significant reduction of parasitaemia and increase in mean survival time. PL treatment is also attributed to significant increase in the blood glucose and haemoglobin level when compared with vehicle-treated infected mice. Significant inhibition in level of oxidative stress and pro-inflammation related markers were observed in PL treated group. The trend of inhibition in oxidative stress markers level after oral treatment of PL was MPO > LPO > ROS in organ injury in P. berghei infected mice. This study showed that plumbagin is able to ameliorate malaria pathogenesis by augmenting anti-oxidative and anti-inflammatory mechanism apart from its effect on reducing parasitaemia and increasing mean survival time of malaria-induced mice.
Graphical Abstract
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