No abstract available
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Τρίτη 18 Απριλίου 2017
Distributed Leaderless and Leader-Following Consensus Control of Multiple Euler-Lagrange Systems with Unknown Control Directions
Abstract
This paper investigates leaderless and leader-following consensus control problems for a group of Euler-Lagrange systems with unknown identical control directions under an undirected connected and time-invariant graph in the presence of parametric uncertainties. For both leaderless and leader-following consensus cases, distributed adaptive controllers are presented using the backstepping technique and a Nussbaum-type function. Moreover, these controllers are distributed in the sense that the controller design for each system only requires relative information between itself and its neighbors. The projection algorithm is applied to guarantee that the estimated parameters remain in some known bounded sets. Lyapunov stability analysis shows that the consensus errors converge to zero asymptotically. Simulation results on multiple two-link planar elbow manipulators are provided to illustrate the performance of the proposed algorithms.
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Cross-national investigation of the drivers of obesity: Re-assessment of past findings and avenues for the future
Source:Appetite, Volume 114
Author(s): Katrien Cooremans, Maggie Geuens, Mario Pandelaere
In this paper we question whether prior cross-national differences in food attitudes still exist and if so, to what extent. Due to societal evolutions such as sedentarism and globalization, international variations in food attitudes may not be as pronounced as currently believed. A cross-sectional web-based survey was carried out in the United States, the United Kingdom, France and Belgium. A total of 2167 respondents (52% women; mean age = 39.0 years, SD = 11.4) participated. To successfully combat obesity, a joint approach focusing on food choice and physical activity is required; therefore we included behavioral measures by means of choice tasks for these two important drivers. Further, the extent to which respondents subscribe to the unhealthy = tasty intuition, together with health and taste interest were investigated. Socio-demographic information and self-reported heights and weights were also incorporated. Logistic regressions were fitted with weight status as the dependent variable and the attitudinal and behavioral measures as independent variables. Our findings indicate that having a higher interest in healthy eating decreases the chance of being overweight (odds = 0.88) and believing that unhealthy food is tasty significantly increases the chance of being obese by 1.18 times. Overall, we find that food attitudes have largely converged across the countries we investigated.
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Consumer motivations toward buying local rice: The case of northern Iranian consumers
Source:Appetite, Volume 114
Author(s): Hassan Rahnama
This research had two purposes. The first aim was to identify Iranian and Non-Iranian rice consumers based on demographic characteristics and examine difference of these features with buying behaviors. The second purpose of study was to investigate consumer's motivation to buy local rice in Iran. The sample were 1500 people (men and women). The data was collected by using questionnaire based on a face-to-face survey. Chi-square, confirmatory factor analysis, and multiple linear regression were applied to assess collected data by a questionnaire survey. Regarding Iranian local rice buyers, 884 people buy local rice. Chi-square test showed that there is a significant difference between gender, having children, and marital status in buying local rice. Habitual Iranian local rice buyers include: female (51%), people who are more than 45 years old (51%), people with children (63%), people who are living urban (61%), married people (48%) and individuals that their monthly income is between 321.5 and 625 Dollars (53%). Regarding non-Iranian rice buyers, 616 people buy it. Also there is a significant difference between gender, location, marital status, and income in buying local rice. For considering consumers motivation toward buying local rice the econometrical model is used. Model had three aspects including; quality aspects (taste, good appearance), economic aspects (price, convenience, consumer's ethnocentrism), and safety aspects (health, not using pesticides and environment protection) and seven subset. The results of analysis indicated that quality aspects, economic aspects and safety aspects have positive effects on buying Iranian local rice. Also, indicative variables including; taste, good appearance, price, convenience, consumer's ethnocentrism, health, not using pesticides and environment have significant effects on buying it.
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Sleep-Induced Apraxia of Eyelid Opening.
Background: Apraxia of eyelid opening (AEO) primarily has been described as bilateral loss of volitional ability to open the eyes at certain times and often associated with neurodegenerative disease. Rarely, it can occur in isolation and as an idiopathic phenomenon. There are a few reports of unilateral AEO only on awakening from sleep. We report an additional 11 patients with this unusual variation of AEO. Methods: Retrospective, observational case series of patients collected from 3 separate neuro-ophthalmology practices. Results: All 11 patients were Caucasian women with a mean age of 59 years (range 35-80 years). All experienced AEO on awakening from sleep. Eight patients had unilateral AEO, and 3 had bilateral symptoms. The duration of episodes ranged from 3 weeks to several years. Ten of the patients reported manually elevating the eyelid to open it, while 1 patient waited for the eyelid to open spontaneously. After initial manual elevation, all patients reported normal function and position of the eyelids for the remainder of the day. Seven patients had a history of autoimmune disease. Slit-lamp and fundus examinations were negative for ocular pathology to explain the patients' symptoms, and 9 patients had unremarkable brain imaging. Conclusions: AEO occurring only on awakening from sleep is a rare entity. Neuroimaging and extensive laboratory testing are not indicated without associated neurologic or ocular findings. There may be a Caucasian female preponderance and autoimmune link in patients with AEO, but further studies are required. (C) 2017 by North American Neuro-Ophthalmology Society
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Optical Coherence Tomography in Neuroretinitis: Epipapillary Infiltrates and Retinal Folds.
Neuroretinitis is a form of papillitis associated with the delayed onset of an exudative macular star among other inflammatory ocular findings. We describe 4 patients with neuroretinitis who displayed several distinctive and novel findings on spectral-domain optical coherence tomography (OCT) that include "epipapillary infiltrates" and an atypical pattern of inner retinal folds. The recognition of these findings on OCT may help in the early diagnosis of neuroretinitis. (C) 2017 by North American Neuro-Ophthalmology Society
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http://ift.tt/2pyPWjy
Simultaneous detection of chlorinated polycyclic aromatic hydrocarbons with polycyclic aromatic hydrocarbons by gas chromatography–mass spectrometry
Abstract
Chlorinated polycyclic aromatic hydrocarbons (ClPAHs), including polychlorinated naphthalenes (PCNs), are hazardous and widespread in the environment, but studies of these substances in the wastewater environment are lacking. In this study, five typical PCNs and five typical ClPAHs (other than PCNs) were simultaneously detected along with their parent polycyclic aromatic hydrocarbons in wastewater samples. All these compounds could be analyzed by gas chromatography– electron ionization mass spectrometry in selected ion monitoring mode and separated on a DB-17ms column. Calibration curves were created both in pure solvent and in wastewater matrix samples. The coefficients of determination for most compounds were greater than 0.99, indicating a satisfactory degree of linearity in the complex matrix samples. The influence of the matrix on the true concentrations of the environmental samples was corrected by use of the matrix calibration curve. The recoveries of all compounds were between 58% and 127%, with standard deviations lower than 20%. The method detection and quantification limits were less than 27.6 ng/L and less than 91.9 ng/L respectively in the aqueous phase, and less than 0.18 ng/L and less than 0.61 ng/L respectively in the solid phase of 4-L wastewater samples. This analytical method was successfully used to detect PCNs and ClPAHs in the water from a river receiving effluent from a wastewater treatment plant. The concentrations of each compound ranged from 3.1 to 29.6 ng/L. This method could also be used for detection of other polycyclic aromatic hydrocarbon derivatives with similar physical and chemical properties in different matrix samples.
Graphical Abstract
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Preparation of polysulfone materials on nickel foam for solid-phase microextraction of floxacin in water and biological samples
Abstract
Solid-phase microextraction with polysulfone and molecularly imprinted polymers as coating on nickel foam were used to adsorb and enrich floxacin drugs. The preparation method is simple and reproducible to obtain the materials with controlled thickness. After evaluation by scanning electron microscope and various adsorption experiments, the materials were used to adsorb analytes in water samples and biological samples. Coupling with chromatographic analysis, the method recoveries are satisfactory with 90.0–104.8% and 79.31–107.1% for water and biological samples. The method repeatability by intra- and interday experiments shows that the RSD values for water and biological samples were 1.0–9.9% and 1.7–10.3%, with the quantitative limits of three floxacin drugs as 3.0–6.2 μg L−1.
Graphical Abstract
Preparation diagram of polysulfone material
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Hydrazide-functionalized affinity on conventional support materials for glycopeptide enrichment
Abstract
In affinity chromatography, enrichment of biomolecules is dependent on the selection of affinity sites immobilized onto a suitable support material. A few hydrazide - functionalized materials with surface modification protocols compatible to conventional support materials like silica and cellulose are reported. The study demonstrates the modification/derivatization pathways that can be adopted to modify the support materials with similar surface chemistry like cellulose, poly(GMA/DVB), or diamond. Poly(GMA/DVB) and cellulose represent hydrophilic supports whereas diamond is a hydrophobic support material. SEM images of three materials provide surface morphology whereas FT-IR confirms reaction completion and derivatization. These hydrazide - functionalized materials are applied to fetuin digest for glycopeptides enrichment and subsequently for selectivity and sensitivity assessment. Statistically, poly(GMA/DVB) shows 85.7% sensitivity with specificity of 88.8% in the enrichment experiments. Diamond offers hydrophobic interactions to non-glycopeptides and they co-elute with glycopeptides, resulting in reduced sensitivity down to 69.2%. Poly(GMA/DVB) shows recovery up to 89%, while recovery for cellulose and diamond is 83 and 71%, respectively. The materials enrich mono-N-linked-glycosylated peptide from tryptic digest of chicken avidin spiked in fetuin digest. The hydrazide group density on cellulose, poly(GMA/DVB), and diamond is 2.8, 2.3, and 2.1 mmol/g, respectively; this contributes towards the specificity and sensitivity of designed materials. The materials are also applied to serum samples and enriched glycopeptides characteristic of serum glycoproteins of clinical importance. Therefore this study provides routes for the economical surface modifications of support materials and to fabricate affinity materials with improved efficiency.
Graphical Abstract
Glycopeptides enrichment by hydrazine affinity
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Non-invasive identification of organic materials in historical stringed musical instruments by reflection infrared spectroscopy: a methodological approach
Abstract
The analysis of historical musical instruments is becoming more relevant and the interest is increasingly moving toward the non-invasive reflection FTIR spectroscopy, especially for the analysis of varnishes. In this work, a specific infrared reflectance spectral library of organic compounds was created with the aim of identifying musical instrument materials in a totally non-invasive way. The analyses were carried out on pure organic compounds, as bulk samples and laboratory wooden models, to evaluate the diagnostic reflection mid-infrared (MIR) bands of proteins, polysaccharides, lipids, and resins by comparing reflection spectra before and after the KK correction. This methodological approach was applied to real case studies represented by four Stradivari violins and a Neapolitan mandolin.
http://ift.tt/2pwVUEl
Signal Enhancement in the HPLC-ESI-MS/MS analysis of spironolactone and its metabolites using HFIP and NH 4 F as eluent additives
Abstract
This paper describes an LC-MS/MS method to determine the concentration of spironolactone and its metabolites 7-alpha-methylthiospironolactone and canrenone in blood plasma samples. The resulting assay is simple (using protein precipitation for sample preparation) and sensitive (the lower limit of quantification is close to 0.5 ng/ml) while requiring only 50 μl of plasma, making it especially suitable for analyzing samples obtained from pediatric and neonatal patients where sample sizes are limited. The sensitivity is achieved by using ammonium fluoride as an eluent additive, which in our case amplifies the signal from our analytes in the plasma solution on average about 70 times. The method is fully validated according to the European Medicines Agency's guideline and used for the measurement of pediatric patients' samples in clinical trials for evaluating oral spironolactone's and its metabolites' pharmacokinetics in children up to 2 years of age.
http://ift.tt/2okzylv
Predictive detection areas for identifying additional MRI-detected breast lesions on second-look ultrasonography
Abstract
Purpose
Identifying an additional MRI-detected breast lesion on second-look ultrasonography (US) is technically challenging because of lesion displacement with the patient's position change. The aim of this study is to help identify MRI-detected lesions on second-look US by developing a probing area, called "the predictive detection area" (PDA), and by assessing the PDA.
Methods
We measured the nipple-to-lesion distances (NLDs) for 16 breast lesions on prone- and supine-position MRI sets and calculated the difference and angle between the two NLD vectors, representing the lesion displacement. The minimum and maximum differences and angles were chosen to form the PDA. Another 22 breast lesions, detected in the prone MRI, were identified on US by probing the PDA to evaluate the probability of existence.
Results
The width between the minimum and maximum differences in two NLDs and the angle to form the PDA for the upper-inner, upper-outer, and lower-outer quadrants were 23.0 mm and 95.0°, 29.0 mm and 41.0°, and 18.0 mm and 17.0°, respectively. The respective probabilities of existence were 100, 80, and 100%.
Conclusions
The PDA had a high probability of existence and was acceptably accurate; therefore, the PDA in a second-look US has the potential to help operators to quickly identify additional MRI-detected lesions.
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Characteristics and prognosis of rectal gastrointestinal stromal tumors: an analysis of registry data
Abstract
Purpose
Rectal gastrointestinal stromal tumors (GISTs) are rare. Accordingly, their clinical features are not well-documented and optimal treatment has not been established. The objective of this study is to clarify the rates and patterns of recurrence after surgical resection of rectal GISTs, with a focus on outcomes and therapeutic modalities.
Methods
The registry was designed to collect data on rectal GISTs recorded between January, 2003 and December, 2007 at 40 participating institutions of the Kinki GIST Study Group. The principal variables were the rates and patterns of recurrence of rectal GISTs. Other study variables were age, sex, tumor size, mitotic count, distance from the anal verge, tumor location, surgical procedures, surgical margins, and recurrence-free survival.
Results
Twenty-four cases were registered, 11 (45.8%) of which were classified as high-risk by the modified NIH criteria. Locoregional recurrence (7/23, 30.4%) was the predominant recurrence pattern after curative resection, with rates that did not differ after local excision (33.3%; 3/9) vs. extended resection (28.6%; 4/14). The recurrence rates were high (25.0%) even for patients with low-risk disease. There was only one case of recurrence among patients who received perioperative treatment with imatinib.
Conclusions
Rectal GISTs showed high rates of local recurrence regardless of the surgical procedure. Perioperative treatment with imatinib may improve outcomes.
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TU-100 exerts a protective effect against bacterial translocation by maintaining the tight junction
Abstract
Purpose
We previously reported that TU-100 suppresses irinotecan hydrochloride (CPT-11)-induced inflammatory cytokines and apoptosis. However, the mechanism underlying this effect has not been fully elucidated. The aim of this study was to further clarify the mechanism of CPT-11-induced bacterial translocation (BT) and the effect of TU-100 on BT.
Methods
Cell cytotoxicity was assessed in vitro by a WST-8 assay. For the in vivo experiments, rats were randomly divided into 3 groups: the control group, the CPT-11 group (250 mg/kg i.p. for 2 days), and the CPT-11 and TU-100 co-treated group (1000 mg/kg, p.o. for 5 days). All of the rats were sacrificed on day 6 and their tissues were collected.
Results
CPT-11 and TU-100 co-treatment improved CPT-11 the related cytotoxicity in vitro. All CPT-11-treated rats developed different grades of diarrhea and BT was observed in 80% of the rats. CPT-11 caused a significant increase in the expression of TLR4, IL-6, TNF-α, IL-1β and caspase-3 mRNAs in the large intestine. The expression of tight junction (TJ) marker mRNAs (occludin, claudin-1 and 4, and ZO-1) was significantly decreased in comparison to the control group. TU-100 co-treatment significantly reversed diarrhea, BT, and the expression of TLR2, IL-6, TNF-α, IL-1β and caspase-3, and improved the expression of occludin, claudin-4 and ZO-1.
Conclusions
TU-100 can suppress the adverse effects associated with CPT-11 and improve the function of the TJ. It is possible that this occurs through the TLR pathway.
http://ift.tt/2okICH8
The basal nutritional state of PDAC patients is the dominant factor for completing adjuvant chemotherapy
Abstract
Purpose
Pancreatic ductal adenocarcinoma (PDAC) is highly lethal, and several clinical trials have shown that adjuvant chemotherapy after curative resection can improve the prognosis of these patients. However, the adjuvant chemotherapy completion rate is less than satisfactory. If this rate could be increased then the overall prognosis of PDAC might be improved; however, reports addressing this problem are insufficient. To elucidate the factors, we retrospectively investigated PDAC patients.
Methods
Various factors of 121 PDAC patients undergoing R0 resection, including preoperatively treated patients, were investigated. Univariate and multivariate analyses were performed to investigate the factors that were associated with the completion of adjuvant chemotherapy.
Results
The analysis identified age and the prognostic nutritional index (PNI) as significant independent factors. A receiver operating characteristic curve analysis of age yielded a cutoff value of 67 years (sensitivity, 64%; specificity, 78%). Univariate and multivariate analyses of the 61 patients who were over 67 years of age revealed that the PNI (odds ratio, 0.85; P = 0.048) and Evans grade (odds ratio, 0.041; P = 0.0010) were significant factors for the completion of chemotherapy.
Conclusions
The results of our investigation suggest that nutrition should be controlled in older PDAC patients to facilitate the completion of adjuvant chemotherapy.
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Creating a Global Acute Care Surgery Fellowship to Meet International Need
Publication date: Available online 17 April 2017
Source:Journal of Surgical Education
Author(s): Amina I. Merchant, Camila B. Walters, Julie Valenzuela, Kelly A. McQueen, Addison K. May
IntroductionExisting Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity. The Global Acute Care Surgery (Global ACS) fellowship produces a surgeon who focuses on capacity building and systems development across the world.MethodsAt Vanderbilt University, the current American Association for the Surgery of Trauma-Acute Care Surgery (AAST-ACS) fellowship was adapted to create an academic Global Acute Care Surgery (Global ACS) fellowship. This fellowship specifically enhances fellowship trainee's skills in needs assessment and performing research to facilitate the development and implementation of trauma and acute care surgery systems in low- and middle income countries. This research will foster context-appropriate data, collected and based in low- and middle-income countries, to guide practice and policy.Results and ConclusionTwo fellows have completed the Global ACS fellowship at Vanderbilt University. The fellowship requirements, clinical skills, project development and overall goals are outlined within the article. Challenges, funding, and mentorship must also be addressed to develop a comprehensive fellowship. A sample two-year timeline is provided to complete the fellowship track and meet the defined goals. A structured global acute care surgery fellowship enables fellows to reduce the surgical burden of disease and contribute to surgical systems development at both local and international levels by creating meaningful research and developing sustainable change in LMIC countries.
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Quality of life in patients with intermittent claudication
Abstract
Background
Intermittent claudication (IC) is a common condition that causes pain in the lower limbs when walking and has been shown to severely impact the quality of life (QoL) of patients. The QoL is therefore often regarded as an important measure in clinical trials investigating intermittent claudication. To date, no consensus exits on the type of life questionnaire to be used. This review aims to examine the QoL questionnaires used in trials investigating peripheral arterial disease (PAD).
Material and methods
A systematic review of randomised clinical trials including a primary analysis of QoL via questionnaire was performed. Trials involving patients with diagnosed PAD were included (either clinically or by questionnaire). Any trial which had QoL as the primary outcome data was included with no limit being placed on the type of questionnaire used.
Results
The search yielded a total of 1845 articles of which 31 were deemed appropriate for inclusion in the review. In total, 14 different QoL questionnaires were used across 31 studies. Of the questionnaires 24.06% were missing at least one domain when reported in the results of the study. Mean standard deviation varied widely based on the domain reported, particularly within the SF36.
Discussion
Despite previous recommendations for Europewide standardisation of quality of life assessment, to date no such tool exists. This review demonstrated that a number of different questionnaires remain in use, that their completion is often inadequate and that further evidence-based guidelines on QoL assessment are required to guide future research.
http://ift.tt/2oknNvC
Krankheitsspezifische Lebensqualität bei Patienten mit Beinulzera
Zusammenfassung
Hintergrund
Die Erfassung der gesundheitsbezogenen Lebensqualität ist als relevanter Gesundheitsindikator in der Medizin, so auch in der Dermatologie, akzeptiert und hat dort eine große Bedeutung erzielt. Chronische Wunden mit entsprechenden körperlichen und psychischen Auswirkungen sind mit erheblichen Einschränkungen der physischen, emotionalen und sozialen Lebensqualität Betroffener verbunden.
Ziel der Arbeit
Der vorliegende Artikel führt in das Konstrukt der Lebensqualität und ihrer Messung ein. Es werden krankheitsspezifische deutschsprachige Messinstrumente für chronische Beinwunden vorgestellt sowie bisherige Ergebnisse zur krankheitsspezifischen Lebensqualität von Patienten mit chronischen Beinwunden dargestellt.
Material und Methoden
Es wurde eine Literaturrecherche zu krankheitsspezifischer Lebensqualität bei Ulcera crurum und entsprechenden Messinstrumenten in Datenbanken wie MEDLINE und EMBASE durchgeführt.
Ergebnisse
Für den deutschsprachigen Raum liegen verschiedene psychometrisch geprüfte Instrumente zur Erfassung der krankheitsspezifischen Lebensqualität bei Menschen mit chronischen Wunden vor. Häufig eingesetzte Instrumente sind der „Freiburg Life Quality Assessment Wunden", der „Cardiff Wound Impact Schedule", der „Würzburger Wundscore" sowie der „Wound-QoL". Anhand dieser Instrumente wurden erhebliche Einschränkungen der Lebensqualität bei Ulcera crurum belegt.
Diskussion
Die Lebensqualität bei Patienten mit chronischen Wunden sollte systematisch erfasst werden, um wichtige Einblicke in die Bedürfnisse der Betroffenen zu gewinnen und die Behandlung optimieren zu können.
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Chemopreventive efficacy of curcumin-loaded PLGA microparticles in a transgenic mouse model of HER-2-positive breast cancer
Abstract
Curcumin has shown promising inhibitory activity against HER-2-positive tumor cells in vitro but suffers from poor oral bioavailability in vivo. Our lab has previously developed a polymeric microparticle formulation for sustained delivery of curcumin for chemoprevention. The goal of this study was to examine the anticancer efficacy of curcumin-loaded polymeric microparticles in a transgenic mouse model of HER-2 cancer, Balb-neuT. Microparticles were injected monthly, and mice were examined for tumor appearance and growth. Initiating curcumin microparticle treatment at 2 or 4 weeks of age delayed tumor appearance by 2–3 weeks compared to that in control mice that received empty microparticles. At 12 weeks, abnormal (lobular hyperplasia, carcinoma in situ, and invasive carcinoma) mammary tissue area was significantly decreased in curcumin microparticle-treated mice, as was CD-31 staining. Curcumin treatment decreased mammary VEGF levels significantly, which likely contributed to slower tumor formation. When compared to saline controls, however, blank microparticles accelerated tumorigenesis and curcumin treatment abrogated this effect, suggesting that PLGA microparticles enhance tumorigenesis in this model. PLGA microparticle administration was shown to be associated with higher plasma lactic acid levels and increased activation of NF-κΒ. The unexpected side effects of PLGA microparticles may be related to the high dose of the microparticles that was needed to achieve sustained curcumin levels in vivo. Approaches that can decrease the overall dose of curcumin (for example, by increasing its potency or reducing its clearance rate) may allow the development of sustained release curcumin dosage forms as a practical approach to cancer chemoprevention.
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Metastatic squamous cell carcinoma of colon from esophageal cancer
Abstract
Background
Esophageal cancer including squamous cell carcinoma (SCC) and adenocarcinoma represents 4% of all cancers in the United States. Patients with esophageal cancer frequently present with locally advanced disease, and about 40% of patients have evidence of metastatic disease on presentation. Common sites of metastasis include liver, lung and bone. Here, we present a rare case of colonic metastasis from primary esophageal SCC.
Case presentation
A 60-year-old Caucasian male with a history of 20-pack-year cigarette smoking received surgery and adjuvant chemoradiotherapy for locally advanced SCC of larynx. Approximately 9 months later, he developed dysphagia, and found to have a esophageal SCC in the mid-esophagus with regional lymph node involvement. He underwent chemoradiation treatment with good response and improved symptoms but declined subsequent surgical resection for esophageal cancer. About 1 year after the diagnosis of esophageal cancer, he developed blood streaked bowel movement and severe anemia. Colonoscopy showed a 3-cm mass in the proximal ascending colon; biopsy showed metastatic SCC, consistent with metastasis from esophageal primary. He subsequently received palliative radiation to the ascending colon metastatic tumor with improvement of anemia, and remained transfusion independent for more than 3 months.
Conclusions
Colonic metastasis from esophageal SCC is rare, and associated with poor prognosis. There are no definite features in terms of location, histological differentiation etc. that contribute to colonic metastasis from primary esophageal SCC. The goal of treatment is palliative and data from our and other case reports support the use of chemotherapy and radiation for symptom improvement and disease control.
http://ift.tt/2opVOdj
Waveform Integrity in Atrial Fibrillation: The Forgotten Issue of Cardiac Electrophysiology
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice with an increasing prevalence of about 15% in the elderly. Despite other alternatives, catheter ablation is currently considered as the first-line therapy for the treatment of AF. This strategy relies on cardiac electrophysiology systems, which use intracardiac electrograms (EGM) as the basis to determine the cardiac structures contributing to sustain the arrhythmia. However, the noise-free acquisition of these recordings is impossible and they are often contaminated by different perturbations. Although suppression of nuisance signals without affecting the original EGM pattern is essential for any other later analysis, not much attention has been paid to this issue, being frequently considered as trivial. The present work introduces the first thorough study on the significant fallout that regular filtering, aimed at reducing acquisition noise, provokes on EGM pattern morphology. This approach has been compared with more refined denoising strategies. Performance has been assessed both in time and frequency by well established parameters for EGM characterization. The study comprised synthesized and real EGMs with unipolar and bipolar recordings. Results reported that regular filtering altered substantially atrial waveform morphology and was unable to remove moderate amounts of noise, thus turning time and spectral characterization of the EGM notably inaccurate. Methods based on Wavelet transform provided the highest ability to preserve EGM morphology with improvements between 20 and beyond 40%, to minimize dominant atrial frequency estimation error with up to 25% reduction, as well as to reduce huge levels of noise with up to 10 dB better reduction. Consequently, these algorithms are recommended as a replacement of regular filtering to avoid significant alterations in the EGMs. This could lead to more accurate and truthful analyses of atrial activity dynamics aimed at understanding and locating the sources of AF.
http://ift.tt/2pORUeY
Emergence of CTNNB1 mutation at acquired resistance to KIT inhibitor in metastatic melanoma
Abstract
Purpose
The KIT inhibitor, imatinib, has shown promising efficacy in patients with KIT-mutated melanoma; however, acquisition of resistance to imatinib occurs rapidly in the majority of patients. The mechanisms of acquired resistance to imatinib in melanoma remain unclear.
Methods
We analyzed biopsy samples from paired baseline and post-treatment tumor lesions in one patient with KIT-mutated melanoma who had had an initial objective tumor regression in response to imatinib treatment followed by disease progression 8 months later.
Results
Targeted deep sequencing from post-treatment biopsy samples detected an additional mutation in CTNNB1 (S33C) with original KIT L576P mutation. We examined the functional role of the additional CTNNB1 S33C mutation in resistance to imatinib indirectly using the Ba/F3 cell model. Ba/F3 cell lines transfected with both the L576P KIT mutation and the CTNNB1 S33C mutation demonstrated no growth inhibition despite imatinib treatment, whereas growth inhibition was observed in the Ba/F3 cell line transfected with the L576 KIT mutation alone.
Conclusions
We report the first identification of the emergence of a CTNNB1 mutation that can confer acquired resistance to imatinib. Further investigation into the causes of acquired resistance to imatinib will be essential to improve the prognosis for patients with KIT-mutated melanoma.
http://ift.tt/2pdLDxb
11 C-methionine PET/CT findings in benign brain disease
Abstract
11C-methionine (MET) is one of the most commonly used positron emission tomography (PET) tracers for evaluation of malignant brain tumor, with MET-PET being a sensitive technique for visualization of primary and recurrent malignant brain tumors. However, previous reports have demonstrated MET uptake in lesions associated with benign brain diseases. These diseases usually show an increase in MET uptake similar to that of malignant tumors. This pitfall in MET-PET image interpretation is important not only for nuclear medicine professionals, but also for radiologists. In this review, we demonstrate the imaging characteristics of MET uptake in benign brain disease, and recommend physician interpretation of imaging findings and disease characteristics for optimal patient management. Benign uptake must be identified to prevent misdiagnosis and unnecessary surgical operations.
http://ift.tt/2nZUe6l
Clinical interpretation of asymptomatic medial collateral ligament injury observed on magnetic resonance imaging in adolescent baseball players
Abstract
Purpose
Magnetic resonance imaging (MRI) of medial collateral ligament (MCL) injury of the elbow was often observed in asymptomatic adolescent baseball players. We aimed to clarify the clinical interpretation of "asymptomatic MCL injury observed on MRI" by comparing MRI, ultrasonography (US), and physical findings.
Materials and methods
Sixty-four asymptomatic adolescent baseball players (mean 11.2 years) were enrolled. An open-type 0.2T MRI was used. MCL function was evaluated by measuring the opening of the ulnohumeral joint using US. Physical findings included MCL tenderness, the moving valgus test, and the Milking test. The correlation between MRI and US, and MRI and physical findings were analyzed.
Results
Thirty-four subjects (53.1%) showed MCL injury by MRI. The mean laterality of the ulnohumeral joint opening showed no significant difference (P = 0.16) between the group with (0.29 ± 1.06 mm) and without (0.08 ± 0.96 mm) MCL injury on MRI. There was no correlation between MRI and physical findings except for a weak correlation between subjects with positive Milking test and MCL injury on MRI (φ coefficient = 0.3, P = 0.02).
Conclusion
'Asymptomatic MCL injury on MRI' had little correlation to ligament dysfunction. It might represent the transition period to MCL thickening called "adaptation."
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Comparison between the four-field box and field-in-field techniques for conformal radiotherapy of the esophagus using dose–volume histograms and normal tissue complication probabilities
Abstract
Purpose
We evaluated and compared the performance of the field-in-field (FIF) to that of the four-field box (4FB) technique regarding dosimetric and radiobiological parameters for radiotherapy of esophageal carcinoma.
Materials and methods
Twenty patients with esophageal cancer were selected. For each patient, two treatment plans were created: 4FB and FIF. The parameters compared included the conformity index (CI), homogeneity index (HI), D mean, D max, tumor control probability (TCP), V 20Gy and V 30Gy of the heart and lungs, normal tissue complication probability (NTCP), and monitor units per fraction (MU/fr).
Results
A paired t-test analysis did not show any significant differences (p > 0.05) between the two techniques in terms of the CI and TCP. However, the HI significantly improved when the FIF was applied. D max of the PTV, lung, and spinal cord were also significantly better with the FIF. Moreover, the lung V 20Gy as well as the NTCPs of the lung and spinal cord significantly reduced when the FIF was used, and the MU/fr was significantly decreased.
Conclusions
The FIF showed evident advantages over 4FB: a more homogeneous dose distribution, lower D max values, and fewer required MUs, while it also retained PTV dose conformality. FIF should be considered as a simple technique to use clinically in cases with esophageal malignancies, especially in clinics with no IMRT.
http://ift.tt/2o05mQA
Metal–DNA Interactions Improve signal in High-Resolution Melting of DNA for Species Differentiation of Plasmodium Parasite
Abstract
The success of high-resolution melting (HRM) analysis for distinguishing similar DNAs with minor base mismatch differences is limited. Here, metal-mediated structural change in DNA has been exploited to amplify HRM signals leading to differentiation of target DNAs in an orthologous gene corresponding to four Plasmodium species. Conserved 26-mer ssDNAs from ldh gene of the four Plasmodium species were employed as targets. A capture probe (CP) that is fully complementary to the Plasmodium falciparum target (FT) and has two base mismatches each, with the targets of Plasmodium vivax (VT), Plasmodium malariae, (MT), and Plasmodium ovale (OT), was considered. The DNA duplexes were treated with metal ions for structural perturbation and analyzed by HRM. Distinct resolution of melting fluorescence signal in otherwise identical HRM profiles for each of the DNA duplexes was achieved by using Ca+2 or Mg+2 ions, where, Ca+2 conferred higher resolution. The increase in resolution for CP-FT versus CP-OT, CP-FT versus CP-VT, CP-FT versus CP-MT, CP-VT versus CP-OT, and CP-MT versus CP-OT with Ca–DNA as compared to control was 67.3-, 20.4-, 22.0-, 10.9-, and 8.3-fold, respectively. The signal resolution was the highest at pH 8. The method could detect 0.25 pmol/µl of the target DNA. Structural analysis showed that Ca+2 and Mg+2 ions perturbed the structure of DNA. This perturbation helped to improve HRM signal resolution among DNA targets corresponding to the orthologous gene of four Plasmodium species. This novel approach has potential application not only for Plasmodium species-specific diagnosis but also for differentiation of DNAs with minor sequence variation.
Graphical Abstract
http://ift.tt/2pyjwWp
Dose to organ at risk and dose prescription in liver SBRT
Publication date: Available online 17 April 2017
Source:Reports of Practical Oncology & Radiotherapy
Author(s): Rives Michel, Izar Françoise, Parent Laure, Modesto Anouchka, Portier Guillaume, Kirzin Sylvain
Stereotactic body radiation therapy (SBRT) is delivered in a curative intent to many primary and secondary tumors.Concerning liver metastasis, SBRT can be safely delivered using one to five fractions. An excellent local control is obtained with doses from 20 to 60Gy. For primary hepatic tumors, results are also good, but the risk of hepatic toxicity related to liver pre-existent pathology must be taken into account. Radiation induced liver disease (RILD) is not frequent in its classical presentation, but modifications of liver enzymes are often observed. Other toxicities of SBRT on the duodenum, small bowel and biliary tract are also described. With respect to contraindications and dose limitations on surrounding structures, SBRT is well tolerated and takes place among curative treatment of liver tumors, as surgery, radiofrequency and embolization.
http://ift.tt/2pe9nBd
Differential intratumoral distributions of CD8 and CD163 immune cells as prognostic biomarkers in breast cancer
Abstract
Background
Tumor immune cell infiltrates are essential in hindering cancer progression and may complement the TNM classification. CD8+ and CD163+ cells have prognostic impact in breast cancer but their spatial heterogeneity has not been extensively explored in this type of cancer. Here, their potential as prognostic biomarkers was evaluated, depending on their combined densities in the tumor center (TC) and the tumor invasive margin (IM).
Methods
CD8+ and CD163+ cells were quantified by immunohistochemistry of formalin-fixed, paraffin-embedded (FFPE) tumor tissue samples from a cohort totaling 162 patients with histologically-confirmed primary invasive non-metastatic ductal breast cancer diagnosed between 2000 and 2015. Clinical follow-up (median 6.9 years) was available for 97 of these patients.
Results
Differential densities of CD8+ and CD163+ cells in the combined TC and IM compartments (i.e., high(H)/low(L), respectively for CD8+ cells and the reverse L/H combination for CD163+ cells) were found to have significant prognostic value for survival, and allowed better patient stratification than TNM stage, tumor size, lymph node invasion and histological grade. The combined evaluation of CD8+ and CD163+ cell densities jointly in TC and IM further improves prediction of clinical outcomes based on disease-free and overall survival. Patients having the favorable immune signatures had favorable clinical outcomes despite poor clinicopathological parameters.
Conclusions
Given the important roles of CD8+ and CD163+ cells in regulating opposing immune circuits, adding an assessment of their differential densities to the prognostic biomarker armamentarium in breast cancer would be valuable. Larger validation studies are necessary to confirm these findings.
Trial registrations
Study code: IRB-ID 6079/448/10-6-13
Date of approval: 10/06/2013
Retrospective study (2000–2010)
First patient prospectively enrolled 14/2/2014
http://ift.tt/2oIIfst
Study protocol: Insight 46 – a neuroscience sub-study of the MRC National Survey of Health and Development
Abstract
Background
Increasing age is the biggest risk factor for dementia, of which Alzheimer's disease is the commonest cause. The pathological changes underpinning Alzheimer's disease are thought to develop at least a decade prior to the onset of symptoms. Molecular positron emission tomography and multi-modal magnetic resonance imaging allow key pathological processes underpinning cognitive impairment – including β-amyloid depostion, vascular disease, network breakdown and atrophy – to be assessed repeatedly and non-invasively. This enables potential determinants of dementia to be delineated earlier, and therefore opens a pre-symptomatic window where intervention may prevent the onset of cognitive symptoms.
Methods/design
This paper outlines the clinical, cognitive and imaging protocol of "Insight 46", a neuroscience sub-study of the MRC National Survey of Health and Development. This is one of the oldest British birth cohort studies and has followed 5362 individuals since their birth in England, Scotland and Wales during one week in March 1946. These individuals have been tracked in 24 waves of data collection incorporating a wide range of health and functional measures, including repeat measures of cognitive function. Now aged 71 years, a small fraction have overt dementia, but estimates suggest that ~1/3 of individuals in this age group may be in the preclinical stages of Alzheimer's disease. Insight 46 is recruiting 500 study members selected at random from those who attended a clinical visit at 60–64 years and on whom relevant lifecourse data are available. We describe the sub-study design and protocol which involves a prospective two time-point (0, 24 month) data collection covering clinical, neuropsychological, β-amyloid positron emission tomography and magnetic resonance imaging, biomarker and genetic information. Data collection started in 2015 (age 69) and aims to be completed in 2019 (age 73).
Discussion
Through the integration of data on the socioeconomic environment and on physical, psychological and cognitive function from 0 to 69 years, coupled with genetics, structural and molecular imaging, and intensive cognitive and neurological phenotyping, Insight 46 aims to identify lifetime factors which influence brain health and cognitive ageing, with particular focus on Alzheimer's disease and cerebrovascular disease. This will provide an evidence base for the rational design of disease-modifying trials.
http://ift.tt/2oIQ3e5
Improving Pressure Ulcer Reconstruction: Our Protocol and the COP (Cone of Pressure) Flap
http://ift.tt/2nitRbt
Situational prevention of domestic violence: A review of security-based programs
Source:Aggression and Violent Behavior
Author(s): Tim Prenzler, Lauren Fardell
This paper assesses the effectiveness of security-based programs to reduce repeat domestic violence. A systematic search was conducted of the scientific literature, as well as an electronic newspaper database and the Internet, for published reports of domestic violence prevention programs involving security applications. The study was unable to identify cases with full experimental designs showing clear evidence of positive effects. However, five types of applications were identified with promising evidence of reduced violence – Offender GPS tracking, shelter security, home security, personal duress alarms, and combined home security and duress alarms. Within this framework the study identified six specific programs showing evidence of success. An emerging potential model of good practice – which requires further empirical investigation – involves the deployment of home security and mobile duress alarms within a coordinated program of professional support for clients.
http://ift.tt/2oIBneI
A multistage-dialysis microdevice for extraction of cryoprotectants
Abstract
In this study, we present a multistage-dialysis microdevice (MDM) for extraction of cryoprotectants (CPAs) from a CPA-laden cell suspension. We confirmed the functions of the key designs of the MDM using a fluorescence solution, we assessed the performance of the MDM by using the MDM to unload glycerin from glycerin-loaded swine erythrocytes, and we investigated the effects of the cell suspension flow rate, glycerin concentration, cell density, and membrane pore size on the clearance efficiency of glycerin (CG), the survival rate of cells (SC), and the recovery rate of cells (RC). Under the designed conditions, CG, SC, and RC reached ~60%, ~90%, and ~70%, respectively. In addition, a high flow rate causes high SC and RC but a low CG. For a low glycerin concentration, CG, SC, and RC are all high. If a low cell density or a large pore membrane is used, CG is high, whereas both SC and RC are low. This work provides insight into the development of microfluidic devices for the inline extraction of cryoprotectants from a small volume of cryopreserved cells prior to the use of the cells in lab-on-a-chip applications.
http://ift.tt/2oJCOZ0
Liquid marbles as bioreactors for the study of three-dimensional cell interactions
Abstract
Liquid marble as a bioreactor platform for cell-based studies has received significant attention, especially for developing 3D cell-based assays. This platform is particularly suitable for 3D in-vitro modeling of cell-cell interactions. For the first time, we demonstrated the interaction of olfactory ensheathing cells (OECs) with nerve debris and meningeal fibroblast using liquid marbles. As the transplantation of OECs can be used for repairing nerve injury, degenerating cell debris within the transplantation site can adversely affect the survival of transplanted OECs. In this paper, we used liquid marbles to mimic the hostile 3D environment to analyze the functional behavior of the cells and to form the basis for cell-based therapy. We show that OECs interact with debris and enhanced cellular aggregation to form a larger 3D spheroidal tissue. However, these spheroids indicated limitation in biological functions such as the inability of cells within the spheroids to migrate out and adherence to neighboring tissue by fusion. The coalescence of two liquid marbles allows for analyzing the interaction between two distinct cell types and their respective environment. We created a microenvironment consisting of 3D fibroblast spheroids and nerve debris and let it interact with OECs. We found that OECs initiate adherence with nerve debris in this 3D environment. The results suggest that liquid marbles are ideal for developing bioassays that could substantially contribute to therapeutic applications. Especially, insights for improving the survival and adherence of transplanted cells.
http://ift.tt/2pe5lsJ
KLF15 Inhibits Cell Proliferation in Gastric Cancer Cells via Up-Regulating CDKN1A/p21 and CDKN1C/p57 Expression
Abstract
Background
Krüppel-like factors (KLFs) have been identified in multi-cancers and act as oncogenes or tumor suppressors. The function of KLF15, one member of KLFs, has not been well elucidated, especially in gastric cancer (GC).
Aims
This study was designed to investigate the prognostic value and biological functions of KLF15 in GC.
Methods
KLF15 protein expression in GC patients was evaluated by immunohistochemistry assays in 50 paired GC tissues and adjacent normal tissues, and correlations between KLF15 expression and clinicopathological characteristics and prognosis were analyzed. Then, we investigated the over-expression of KLF15 on cell proliferation and its mechanism in GC cells.
Results
KLF15 expression levels were significantly down-regulated in GC tissues compared to adjacent normal tissues. And KLF15 expression was negatively correlated with clinical stage, lymphatic metastasis, and distant metastasis. Furthermore, KLF15 expression could predict prognosis in patients with GC. Moreover, over-expression of KLF15 could inhibit cell proliferation partly via regulating CDKN1A/p21 and CDKN1C/p57.
Conclusion
These findings demonstrate that KLF15 plays a significant role in GC progression and could be a therapeutic target for GC.
http://ift.tt/2oJswba
Filling the Void: A Review of Intragastric Balloons for Obesity
Abstract
Endoscopic bariatric therapies are predicted to become much more widely used in North America for obese patients who are not candidates for bariatric surgery. Of all the endoscopic bariatric therapies, intragastric balloons (IGBs) have the greatest amount of clinical experience and published data supporting their use. Three IGBs are FDA approved and are now commercially available in the USA (Orbera, ReShape Duo, and Obalon) with others likely soon to follow. They are generally indicated for patients whose BMI ranges from 30 to 40 mg/kg2 and who have failed to lose weight with diet and exercise. IGBs have been shown to be safe, effective, and relatively straightforward to place and remove. Accommodative symptoms commonly occur within the initial weeks post-placement; however, major complications are rare. Gastric ulceration can occur in up to 10% of patients, while balloon deflation with migration and bowel obstruction occurs in <1% of patients. The effectiveness of the Orbera and ReShape Duo IGBs ranges from 25 to 50% EWL (excess weight loss) after 6 months of therapy. The use of IGBs is likely to grow dramatically in the USA, and gastroenterologists and endoscopists should be familiar with their indications/contraindications, efficacy, placement/removal, and complications.
http://ift.tt/2oIFCXV
Editorial Board
Source:Critical Reviews in Oncology/Hematology, Volume 113
http://ift.tt/2pOOqJm
Quantitative cancer risk assessment and local mortality burden for ambient air pollution in an eastern Mediterranean City
Abstract
Health risks posed by ambient air pollutants to the urban Lebanese population have not been well characterized. The aim of this study is to assess cancer risk and mortality burden of non-methane hydrocarbons (NMHCs) and particulates (PM) based on two field-sampling campaigns conducted during summer and winter seasons in Beirut. Seventy NMHCs were analyzed by TD-GC-FID. PM2.5 elemental carbon (EC) components were examined using a Lab OC-EC aerosol Analyzer, and polycyclic aromatic hydrocarbons were analyzed by GC-MS. The US EPA fraction-based approach was used to assess non-cancer hazard and cancer risk for the hydrocarbon mixture, and the UK Committee on Medical Effects of Air Pollutants (COMEAP) guidelines were followed to determine the PM2.5 attributable mortality burden. The average cumulative cancer risk exceeded the US EPA acceptable level (10−6) by 40-fold in the summer and 30-fold in the winter. Benzene was found to be the highest contributor to cancer risk (39–43%), followed by 1,3-butadiene (25–29%), both originating from traffic gasoline evaporation and combustion. The EC attributable average mortality fraction was 7.8–10%, while the average attributable number of deaths (AD) and years of life lost (YLL) were found to be 257–327 and 3086–3923, respectively. Our findings provide a baseline for future air monitoring programs, and for interventions aiming at reducing cancer risk in this population.
http://ift.tt/2op569l
Selective adsorption of Pb (II) over the zinc-based MOFs in aqueous solution-kinetics, isotherms, and the ion exchange mechanism
Abstract
Two series of metal–organic frameworks (MOFs) with similar formula units but different central metal ions (M) or organic linkers (L), M-BDC (BDC = terephthalate, M = Zn, Zr, Cr, or Fe), or Zn-L (L = imidazolate-2-methyl, BDC, BDC-NH2), were prepared and employed as the receptors for adsorption lead ions. It was found that the Zn-BDC exhibited a much higher adsorption capacity than the other M-BDC series with various metal ions which have very closely low capacities at same conditions. Furthermore, the Zn-L (L = imidazolate-2-methyl, BDC, BDC-NH2) still have highly efficient adsorption capacity of lead ions, although the adsorption capacity varies with different ligand, as well as the adsorption rate and the equilibrium pH of the solution. This significant high adsorption over Zn-L, different from other M-BDC series with various metal ions (Zr, Cr, or Fe), can be explained by ion exchange between the central metal ions of Zn-L and lead ion in solution. Based on the analysis of FT-IR, X-ray diffraction pattern, the nitrogen adsorption isotherms, the zeta potentials, and the results, a plausible adsorption mechanism is proposed. When equivalent Zn-L were added to equal volume of aqueous solution with different concentration of lead ion, the content of zinc ion in the solution increases with the increase of the initial concentration of lead ions. The new findings could provide a potential way to fabricate new metal organic frameworks with high and selective capacities of the heavy metal ions.
http://ift.tt/2pweFI2
Individual and combined inhibition of phenol and thiocyanate on microbial activity of partial nitritation
Abstract
This study evaluated the individual and interactive effect of phenol and thiocyanate (SCN−) on partial nitritation (PN) activity using batch test and response surface methodology. The IC50 of phenol and SCN− on PN sludge were 5.6 and 351 mg L−1, respectively. The PN sludge was insensitive to phenol and SCN− at levels lower than 1.77 and 43.3 mg L−1, respectively. A regression model equation was developed and validated to predict the relative specific respiration rate (RSRR) of PN sludge exposed to different phenol and SCN− concentrations. In the range of independent variables, the most severe inhibition was observed with a valley value (17%) for RSRR, when the phenol and SCN− concentrations were 4.08 and 198 mg L−1, respectively. An isobole plot was used to judge the combined toxicity of phenol and SCN−, and the joint inhibitory effect was variable depending on the composition and concentration of the toxic components. Furthermore, the toxic compounds showed independent effects, which is the most common type of combined toxicity.
http://ift.tt/2oJukRi
Empirical research on coordination evaluation and sustainable development mechanism of regional logistics and new-type urbanization: a panel data analysis from 2000 to 2015 for Liaoning Province in China
Abstract
As the largest developing country in the world, China has witnessed fast-paced urbanization over the past three decades with rapid economic growth. In fact, urbanization has been not only shown to promote economic growth and improve the livelihood of people but also can increase demands of regional logistics. Therefore, a better understanding of the relationship between urbanization and regional logistics is important for China's future sustainable development. The development of urban residential area and heterogeneous, modern society as well regional logistics are running two abreast. The regional logistics can promote the development of new-type urbanization jointly by promoting industrial concentration and logistics demand, enhancing the residents' quality of life and improving the infrastructure and logistics technology. In this paper, the index system and evaluation model for evaluating the development of regional logistics and the new-type urbanization are constructed. Further, the econometric analysis is utilized such as correlation analysis, co-integration test, and error correction model to explore relationships of the new-type urbanization development and regional logistics development in Liaoning Province. The results showed that there was a long-term stable equilibrium relationship between the new-type urbanization and regional logistics. The findings have important implications for Chinese policymakers that on the path towards a sustainable urbanization and regional reverse, this must be taken into consideration. The paper concludes providing some strategies that might be helpful to the policymakers in formulating development policies for sustainable urbanization.
http://ift.tt/2oRwZuo
Response of marine benthic fauna to thin-layer capping with activated carbon in a large-scale field experiment in the Grenland fjords, Norway
Abstract
A field experiment with thin-layer capping was conducted in the Grenland fjords, Norway, for remediation in situ of mercury and dioxin-contaminated sediments. Experimental fields at 30 and 95 m depth were capped with (i) powdered activated carbon (AC) mixed with clay (AC+cla`y), (ii) clay, and (iii) crushed limestone. Ecological effects on the benthic community and species-feeding guilds were studied 1 and 14 months after capping, and a total of 158 species were included in the analyses. The results show that clay and limestone had only minor effects on the benthic community, while AC+clay caused severe perturbations. AC+clay reduced the abundance, biomass, and number of species by up to 90% at both 30 and 95 m depth, and few indications of recovery were found during the period of this investigation. The negative effects of AC+clay were observed on a wide range of species with different feeding strategies, although the suspension feeding brittle star Amphiura filiformis was particularly affected. Even though activated carbon is effective in reducing sediment-to-water fluxes of dioxins and other organic pollutants, this study shows that capping with powdered AC can lead to substantial disturbances to the benthic community.
http://ift.tt/2pwfuR6
Calcite precipitates in Slovenian bottled waters
Abstract
Storage of bottled waters in varying ambient conditions affects its characteristics. Different storage conditions cause changes in the initial chemical composition of bottled water which lead to the occurrence of precipitates with various morphologies. In order to assess the relationship between water composition, storage conditions and precipitate morphology, a study of four brands of Slovenian bottled water stored in PET bottles was carried out. Chemical analyses of the main ions and measurements of the physical properties of water samples were performed before and after storage of water samples at different ambient conditions. SEM/EDS analysis of precipitates was performed after elapsed storage time. The results show that the presence of Mg2+, SO42−, SiO2, Al, Mn and other impurities such as K+, Na+, Ba and Sr in the water controlled precipitate morphology by inhibiting crystal growth and leading to elongated rhombohedral calcite crystal forms which exhibit furrowed surfaces and calcite rosettes. Different storage conditions, however, affected the number of crystallization nuclei and size of calcite crystals. Hollow calcite spheres composed of cleavage rhombohedrons formed in the water with variable storage conditions by a combination of evaporation and precipitation of water droplets during high temperatures or by the bubble templating method.
http://ift.tt/2pwwd6Z
Evaluation of passive sampling of gaseous mercury using different sorbing materials
Abstract
Atmospheric mercury monitoring is essential because of its potential human health and ecological impacts. Current automated monitoring systems include limitations such as high cost, complicated configuration, and electricity requirements. Passive samplers require no electric power and are more appropriate for screening applications and long-term monitoring. Sampling rate is a major factor to evaluate the performance of a passive sampler. In this study, laboratory experiments were carried out using an exposure chamber to search for high efficiency sorbents for gaseous mercury. Four types of sorbents, including sulfur-impregnated carbon (SIC), chlorine-impregnated carbon (CIC), bromine-impregnated carbon (BIC), and gold-coated sand (GCS) were evaluated under a wide range of meteorological parameters, including temperature, relative humidity, and wind speed. The results showed that the four sorbents all have a high sampling rate above 0.01 m3g−1 day−1, and wind speed has a positive correlation with the sampling rate. Under different temperature and relative humidity, the sampling rate of SIC keeps stable. The sampling rate of CIC and BIC shows a negative correlation with temperature, and GCS is influenced by all the three meteorological factors. Furthermore, long-term experiments were carried out to investigate the uptake capacity of GCS and SIC. Uptake curves show that the mass amount of sorbent in a passive sampler can influence uptake capacity. In the passive sampler, 0.9 g SIC or 0.9 g GCS can achieve stable uptake efficiency for at least 110 days with gaseous mercury concentration at or below 2 ng/m3. For mercury concentration at or below 21 ng/m3, 0.9 g SIC can maintain stable uptake efficiency for 70 days, and 0.9 g GCS can maintain stability for 45 days.
http://ift.tt/2oJwfpk
Glibenclamide treatment blocks metabolic dysfunctions and improves vagal activity in monosodium glutamate-obese male rats
Abstract
Background/Aims
Autonomic nervous system imbalance is associated with metabolic diseases, including diabetes. Glibenclamide is an antidiabetic drug that acts by stimulating insulin secretion from pancreatic beta cells and is widely used in the treatment of type 2 diabetes. Since there is scarce data concerning autonomic nervous system activity and diabetes, the aim of this work was to test whether glibenclamide can improve autonomic nervous system activity and muscarinic acetylcholine receptor function in pre-diabetic obese male rats.
Methods
Pre-diabetes was induced by treatment with monosodium L-glutamate in neonatal rats. The monosodium L-glutamate group was treated with glibenclamide (2 mg/kg body weight /day) from weaning to 100 days of age, and the control group was treated with water. Body weight, food intake, Lee index, fasting glucose, insulin levels, homeostasis model assessment of insulin resistance, omeostasis model assessment of β-cell function, and fat tissue accumulation were measured. The vagus and sympathetic nerve electrical activity were recorded. Insulin secretion was measured in isolated islets challenged with glucose, acetylcholine, and the selective muscarinic acetylcholine receptor antagonists by radioimmunoassay technique.
Results
Glibenclamide treatment prevented the onset of obesity and diminished the retroperitoneal (18%) and epididymal (25%) fat pad tissues. In addition, the glibenclamide treatment also reduced the parasympathetic activity by 28% and glycemia by 20% in monosodium L-glutamate-treated rats. The insulinotropic effect and unaltered cholinergic actions in islets from monosodium L-glutamate groups were increased.
Conclusion
Early glibenclamide treatment prevents monosodium L-glutamate-induced obesity onset by balancing autonomic nervous system activity.
http://ift.tt/2py76Oq
Genetic interaction of DGAT2 and FAAH in the development of human obesity
Abstract
Purpose
DGAT2 is the critical catalyzing enzyme for triglyceride biosynthesis, and excess triglyceride accumulation in fat tissues is a fundamental process for obesity. Mutations in DGAT2 or other genes interacting with DGAT2 associated with adiposity have not been reported in human to date.
Methods
DGAT2 mutation was identified based on our in-home database-exome sequencing 227 young obese subjects (body-mass index (BMI), 35.1–61.7 kg/m2) and 219 lean controls (BMI, 17.5–23.0 kg/m2), further validated in 1190 lean subjects and the pedigree of the proband. The trios of the proband were further subjected to whole-exome sequencing to explore the candidate genes for obesity. The mutations in DGAT2 and FAAH were functionally evaluated in vitro.
Results
We detected two rare variants in DGAT2 with no significant difference between obese and lean individuals. One novel heterozygous nonsense variant c.382C > T (p.R128*) was identified in one obese subject but not in 219 lean subjects and another 1190 lean subjects. Notably, in vitro study showed that R128* mutation severely damaged the TG-biosynthesis ability of DGAT2, and all other R128* carriers in the pedigree were lean. Thus, we further identified a loss-of-function variant c. 944G > T (p.R315I) in FAAH in the proband inheriting from his obese father. Importantly, FAAH overexpression inhibited DGAT2 expression and TG synthesis, while R315I mutant largely eliminated this inhibitory effect.
Summary
We first report loss-of-function mutations in DGAT2 and FAAH in one obese subject, which may interact with each other to affect the adiposity penetrance, providing a model of genetic interaction associated with human obesity.
http://ift.tt/2py4no6
Hypercoagulability in patients with Cushing disease detected by thrombin generation assay is associated with increased levels of neutrophil extracellular trap-related factors
Abstract
Patients with Cushing disease (CD) are at increased risk of venous thromboembolism (VTE). It was surmised, but not conclusively shown that the risk is related to plasma hypercoagulability secondary to the glucocorticoids effect. This study is aimed at detecting hypercoagulability in patients with CD. Case-control study of 48 CD patients and controls enrolled at two Italian clinics for whom we assessed the thrombin-forming-potential in the presence of optimal activation of protein C obtained by adding into the assay system its main endothelial activator, thrombomodulin. These experimental conditions mimic more closely than any other test the in vivo situation. We observed enhanced thrombin-generation in CD patients, as shown by the modification of thrombin-generation parameters [i.e., shortened lag-time and time-to-peak, increased thrombin peak and endogenous thrombin potential (ETP)]. Moreover, the ETP ratio (with/without thrombomodulin), recognized as an index of hypercoagulability, was increased in patients as compared to controls. We attempted to explain such hypercoagulability by measuring both procoagulant and anticoagulant factors, and some other non-coagulation parameters (i.e., neutrophil extracellular traps (NET), recently associated with the VTE risk and/or increased hypercoagulability. We showed that the hypercoagulability in patients with CD is associated with increased levels of factor VIII and NET-related variables. We detected plasma hypercoagulability in patients with CD and found experimental explanation for its occurrence. Whether this hypercoagulability can entirely explain the occurrence of VTE in patients with CD should be investigated by ad-hoc clinical trials. However, until these studies will be available the evidence supports the concept that patients with CD are candidates for antithrombotic prophylaxis.
http://ift.tt/2pxNA4e
Interference in ACTH immunoassay negatively impacts the management of subclinical hypercortisolism
Abstract
Purpose
Low plasma corticotropin is considered a useful parameter for the diagnosis of subclinical hypercortisolism in patients with an adrenal incidentaloma. However, immunoassays are vulnerable to interference from endogenous antibodies. In this study, subjects who underwent Hypothalamus-pituitary-adrenal axis evaluation for the assessment of subclinical hypercortisolism were evaluated. The objective of the study was to ascertain whether antibody interference in corticotropin immunoassay affected the diagnostic work-up and clinical decisions.
Methods
The 437 consecutive patients with incidentally discovered adrenal adenomas were included in this single centre study. Patients who had a combination of a nonsuppressed corticotropin concentration (>4.4 pmol/L) and a non-suppressed cortisol concentration after 1 mg overnight dexamethasone suppression test (>50 nmol/L) were selected. Eight eligible subjects without specific features of Cushing's syndrome were identified and recruited for interference studies and follow-up. Nine controls including one patient with unilateral adrenalectomy and one patient with Cushing's disease were recruited as well.
Measurements
Eligible subjects and controls were subjected to hormonal tests and investigations for suspected interference. Interference studies included measurement of corticotropin on a different analytical platform, serial dilutions, polyethylene glycol precipitation and heterophilic antibody analysis. Patients were followed with clinical and laboratory parameters for a median duration of 30 (12–90) months.
Results
Antibody interference was identified in four patients. Rheumatoid factor was responsible for the interference in one patient. Clinical management of the patients was affected by the erroneous results. Interference tests were negative in control subjects.
Conclusions
Erroneous results associated with analytical interference negatively impacted on clinical decision making in this patient group. This should be considered particularly in conditions such as subclinical hypercortisolism which decisions depend on laboratory investigations mainly. Analytical interference could explain the high variability observed both in field measurements from patients who were expected to have lower corticotropin concentrations and in subclinical hypercortisolism prevalence reported by different studies. Many problems can be resolved by ensuring good communication between clinical and laboratory staff.
http://ift.tt/2oRUKCQ
Alkyne-linked reduction-activated protecting groups for diverse functionalization on the backbone of oligonucleotides
Publication date: Available online 17 April 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Hisao Saneyoshi, Kazuhiko Kondo, Koichi Iketani, Akira Ono
A versatile conjugatable/bioreduction-responsive protecting group for phosphodiester moieties was designed, synthesized and incorporated into oligonucleotide strands. Subsequently, controlled pore glass-supported oligonucleotides were conjugated to a variety of functional molecules using a copper-catalyzed azide-alkyne cycloaddition reaction. The functionalized protecting groups were deprotected by a nitroreductase/NADH reduction system to give "naked" oligonucleotides. This method allowed the synthesis of oligonucleotide prodrugs bearing the functionalized protecting group at the desired sites and desired residues on oligodeoxyribonucleotide (ODN) backbones.
Graphical abstract
http://ift.tt/2pdYUpD
Design, synthesis, and evaluation of multitarget-directed ligands against Alzheimer’s disease based on the fusion of donepezil and curcumin
Publication date: Available online 18 April 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Jun Yan, Jinhui Hu, Anqiu Liu, Lin He, Xingshu Li, Hui Wei
By fusing donepezil and curcumin, a novel series of compounds were obtained as multitarget-directed ligands against Alzheimer's disease. Among them, compound 11b displayed potent acetylcholinesterase (AChE) inhibition (IC50 = 187 nM) and the highest BuChE/AChE selectivity (66.3). Compound 11b also inhibited 45.3% Aβ1−42 self-aggregation at 20 μM and displayed remarkable antioxidant effects. The metal-chelating property of compound 11b was elucidated by determining the 1:1 stoichiometry for the 11b−Cu(II) complex. The excellent blood−brain barrier permeability of 11b also indicated the potential for the compound to penetrate the central nervous system.
Graphical abstract
http://ift.tt/2pdMbTH
Forest recreation as a governance problem: four case studies from Switzerland
Abstract
Recreational activities have undergone a change from mainly passive forms (e.g. rest, relaxation, reinvigoration, solitude and escape) to more active forms (e.g. mountain biking, climbing and running). Correspondingly, the demand for forest recreation infrastructure to support the more active forms has increased. However, very little is known about what features characterise the planning and management of forest recreation infrastructure. This study takes four in-depth mountain-bike trail cases in Switzerland to characterise the planning and management of forest recreation infrastructure. The analysis is performed using the institutional analysis and development framework (Ostrom in Governing the commons: the evolution of institutions for collective action, Cambridge University Press, New York, 1990) and qualitative data based on cases and interviews. We argue that by considering the identified external features (formal and informal rules, location) and process features (partnerships, public participation, conflicts, profitability perspectives, time frame of process, funding of process and approval), we can better plan and manage active forms of forest recreation. Conflict situations and response strategies associated with mountain-bike-trail planning and management are also identified. The findings are relevant for other regions facing the growing use of forests for recreational and leisure activities.
http://ift.tt/2pvMglC
A prospective comparison of intra-arterial chemotherapy combined with intravesical chemotherapy and intravesical chemotherapy alone after transurethral resection with a thulium laser in high-risk non-muscle invasive bladder cancer
Abstract
Objective To compare intra-arterial chemotherapy combined with intravesical chemotherapy with intravesical chemotherapy alone in the treatment of high-risk non-muscle invasive bladder cancer (HRBC) after thulium laser resection of a bladder tumor (TmLRBT).
Materials and methods
From January 2009 to December 2013, 283 patients with HRBC were randomly assigned to the combined group (group A, n = 141) or intravesical chemotherapy–alone group (group B, n = 142) after TmLRBT. Intra-arterial chemotherapy was administered after initial TmLRBT, with 3 courses at 4-week intervals. Each course consisted of cisplatin (50 mg/m2) and epirubicin (30 mg/m2). Intravesical chemotherapy was administered in both groups, including an immediate 50 mg of epirubicin instillation after TmLRBT and weekly maintenance for 8 weeks, followed by monthly maintenance for 1 year.
Results
The recurrence rate was 29.1% (41/141) in group A and 42.9% (61/142) in group B, with a significant difference (p = 0.01). The progression rate was 15.6% (22/141) in group A and 25.3% (36/142) in group B, with a significant difference (p = 0.039). Patients with concomitant carcinoma in situ (CIS) also had a lower recurrence rate and progression rate in group A compared to those in group B (p = 0.006 and p = 0.03, respectively). On univariate and multivariate logistic regression analyses, patients with low-grade histology had a higher reccurrence-free rate. Multivariate COX analysis of tumor-related factors suggested that concomitant CIS was the only significant prognostic factor associated with poorer recurrence-free survival and progression-free survival.
Conclusions
Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in HRBC.
http://ift.tt/2ok2vhM
Effect of oral carbohydrate with amino acid solution on serum oxidative/anti-oxidative status in healthy volunteers
Abstract
The aim of this work was to investigate the effect of oral carbohydrate with amino acid [oral nutritional supplement (ONS)] solution on oxidative stress in healthy persons. Fourteen healthy volunteers were segregated into control and ONS groups. Volunteers in the ONS group ingested 250 ml of Arginaid Water (Nestle Japan, Tokyo, Japan) in the evening before the experiment and at 7:00 am on the day of the experiment. Volunteers in the control group fasted after dinner and drank only water until 7:00 am on the day of the experiment. In both groups, blood was collected at 9:00 am. The serum total oxidant levels and antioxidant capacity were assessed by d-ROMs (derivatives of reactive oxygen metabolites) test and BAP (biological antioxidant potential) test, respectively. In the ONS group, the serum d-ROMs level was significantly lower than in the control group (297 ± 43 and 327 ± 41 U.CARR, respectively, p = 0.018), while the serum BAP level was significantly higher than the control group (2410 ± 432 and 1979 ± 397 µmol/l, respectively, p = 0.005). The OXY level of Arginaid Water was much higher than preOp drink (Nutricia, Ireland). In conclusion, our study showed that an ONS with arginine loading could decrease oxidative stress and increase antioxidant capacity in healthy volunteers.
http://ift.tt/2pvT9Da
The impact of body mass index on the risk of high spinal block in parturients undergoing cesarean delivery: a retrospective cohort study
Abstract
Purpose
To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients.
Methods
This is a retrospective study at an academic center. We searched the perioperative database for women who underwent cesarean delivery under spinal or combined spinal epidural anesthesia with hyperbaric bupivacaine ≥10.5 mg. A body mass index (BMI) ≥30 kg/m2 was defined as obese. We categorized obesity into: obesity class I (BMI = 30–34.9 kg/m2), obesity class II (BMI = 35–39.9 kg/m2), obesity class III (BMI = 40–49.9 kg/m2), and super obese (BMI ≥50 kg/m2). The primary outcome was high spinal block defined as need to convert to general anesthesia within 20 min of spinal placement as a result of altered mental status, weakness, or respiratory distress resulting from the high block, or a recorded block height ≥T1.
Results
The analysis included 5015 women. High spinal blocks occurred in 29 patients (0.6%). The risk of high spinal was significantly different according to BMI (p = 0.025). In a multivariate model, BMI (p = 0.008) and cesarean delivery priority (p = 0.009) were associated with high blocks. BMI ≥50 kg/m2 was associated with greater odds of high block compared to BMI <30 kg/m2 [odds ratio (95% confidence interval): 6.3 (2.2, 18.5)]. Scheduled cesarean delivery was also associated with greater odds of high block compared with unscheduled delivery.
Conclusions
At standard spinal doses of hyperbaric bupivacaine used in our practice (≥10.5 mg), there were greater odds of high block in those with BMI ≥50 kg/m2.
http://ift.tt/2pwaz2K
Comparison of the coracoid and retroclavicular approaches for ultrasound-guided infraclavicular brachial plexus block
Abstract
Purpose
This prospective randomized study compared the coracoid and retroclavicular approaches to ultrasound-guided infraclavicular brachial plexus block (IBPB) in terms of needle tip and shaft visibility and quality of block. We hypothesized that the retroclavicular approach would increase needle tip and shaft visibility and decrease the number of needle passes compared to the coracoid approach.
Methods
A total of 100 adult patients who received IBPB block for upper limb surgery were randomized into two groups: a coracoid approach group (group C) and a retroclavicular approach group (group R). In group C, the needle was inserted 2 cm medial and 2 cm inferior to the coracoid process and directed from ventral to dorsal. In group R, the needle insertion point was posterior to the clavicle and the needle was advanced from cephalad to caudal. All ultrasound images were digitally stored for analysis. The primary aim of the present study was to compare needle tip and shaft visibility between the coracoid approach and retroclavicular approach in patients undergoing upper limb surgery. The secondary aim was to investigate differences between the two groups in the number of needle passes, sensory and motor block success rates, surgical success rate, block performance time, block performance-related pain, patient satisfaction, use of supplemental local anesthetic and analgesic, and complications.
Results
Needle tip visibility and needle shaft visibility were significantly better in group R (p = 0.040, p = 0.032, respectively). Block performance time and anesthesia-related time were significantly shorter in group R (p = 0.022, p = 0.038, respectively). Number of needle passes was significantly lower in group R (p = 0.044). Paresthesia during block performance was significantly higher in group C (p = 0.045). There were no statistically significant differences between the two groups in terms of sensory or motor block success, surgical success, block-related pain, and patient satisfaction.
Conclusion
The retroclavicular approach is associated with better needle tip and shaft visibility, reduced performance time and anesthesia-related time, less paresthesia during block performance, and fewer needle passes than the coracoid approach.
Trıal registry number
Clinicaltrials.gov (no. NCT02673086).
http://ift.tt/2pOUamr
Genome Mining and Predictive Functional Profiling of Acidophilic Rhizobacterium Pseudomonas fluorescens Pt14
Abstract
Pseudomonas fluorescens Pt14 is a non-pathogenic and acidophilic bacterium isolated from acidic soil (pH 4.65). Genome sequencing of strain Pt14 was performed using Single Molecule Real Time (SMRT) sequencing to get insights into unique existence of this strain in acidic environment. Complete genome sequence of this strain revealed a chromosome of 5,841,722 bp having 5354 CDSs and 88 RNAs. Phylogenomic reconstruction based on 16S rRNA gene, Average Nucleotide Identity (ANI) values and marker proteins revealed that strain Pt14 shared a common clade with P. fluorescens strain A506 and strain SS101. ANI value of strain Pt14 in relation to strain A506 was found 99.23% demonstrating a very close sub-species association at genome level. Further, orthology determination among these three phylogenetic neighbors revealed 4726 core proteins. Functional analysis elucidated significantly higher abundance of sulphur metabolism (>1×) which could be one of the reasons for the survival of strain Pt14 under acidic conditions (pH 4.65). Acidophilic bacteria have capability to oxidize sulphur into sulphuric acid which in turn can make the soil acidic and genome-wide analysis of P. fluorescens Pt14 demonstrated that this strain contributes towards making the soil acidic.
http://ift.tt/2pdHJEt
Synthesis and bio-applications of targeted magnetic-fluorescent composite nanoparticles
Abstract
Magnetic-fluorescent nanoparticles have a tremendous potential in biology. As the benefits of these materials gained recognition, increasing attention has been given to the conjugation of magnetic-fluorescent nanoparticles with targeting ligands. The magnetic and fluorescent properties of nanoparticles offer several functionalities, including imaging, separation, and visualization, while the presence of a targeting ligand allows for selective cell and tissue targeting. In this review, methods for the synthesis of targeted magnetic-fluorescent nanoparticles are explored, and recent applications of these nanocomposites to the detection and separation of biomolecules, fluorescent and magnetic resonance imaging, and cancer diagnosis and treatment will be summarized. As these materials are further optimized, targeted magnetic-fluorescent nanoparticles hold great promise for the diagnosis and treatment of some diseases.
http://ift.tt/2ojQ59m
Palladium nanoparticles as catalysts for reduction of Cr(VI) and Suzuki coupling reaction
Abstract
Herein, six kinds of PdNPs (including icosahedron, sphere, spindle, cube, rod, and wire) were synthesized via simple methods. The catalytic activities were investigated by the reduction reaction of Cr(VI) and Suzuki coupling reaction. Chemically synthesized morphologies of the six catalysis were characterized by transmission electron microscopy, field emission scanning electron microscopy, and X-ray diffraction, etc. Pd icosahedron shows a better catalytic property than other PdNPs with a rate constants 0.42 min−1 for the reduction of Cr(VI). Moreover, the electrocatalyst shows that Pd icosahedron possesses a bigger surface area of 8.56 m2/g than other nanoparticles, which is attributed to the better catalyst. The Pd icosahedron possesses a better catalytic property, attributing to the abundant exposed {111} facets with high activity on Pd icosahedron. The catalytic activities are closely related to the surface area with the following order: icosahedrons ≥ sphere > rod > spindle > cube > wire. The Pd icosahedron catalyst represents a strong activity for Suzuki coupling reaction as well, outweighting is 80%. The results reveal that Pd icosahedron acts as an efficient catalyst compared to other PdNPs (wire, rod, sphere, spindle, and cube).
http://ift.tt/2oRhoLB
Obstructive sleep apnea increases the risk of cardiac events after percutaneous coronary intervention: a meta-analysis of prospective cohort studies
Abstract
Purpose
Recent studies have shown an association between obstructive sleep apnea (OSA) and coronary artery disease; however, the association between OSA and cardiac outcomes in patients after percutaneous coronary intervention (PCI) remains undetermined.
Methods
PubMed, EMBASE, and CENTRAL were searched from inception to July 2016 for cohort studies that followed up with patients after PCI, and evaluated their overnight sleep patterns within 1 month for major adverse cardiac events (MACEs) as primary outcomes including cardiac death, non-fatal myocardial infarction (MI), and coronary revascularization and secondary outcomes including re-admission for heart failure and stroke. Outcomes data were pooled using fixed-effect meta-analysis, and heterogeneity was assessed with the I 2 statistics. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale checklist, and publication bias was evaluated by a visual investigation of funnel plots.
Results
We identified seven pertinent studies including 2465 patients from 178 related articles. OSA was associated with MACEs (odds ratio [OR], 1.52, 95% confidence interval [CI], 1.20–1.93, I 2 = 29%), which included cardiac death (OR 2.05, 95% CI, 1.15–3.65, I 2 = 0%), non-fatal MI (OR 1.59, 95% CI, 1.14–2.23, I 2 = 15%), and coronary revascularization (OR 1.69, 95% CI, 1.28–2.23, I 2 = 0%). However, OSA was not associated with re-admission for heart failure (OR 1.71, 95% CI, 0.99–2.96, I 2 = 0%) and/or stroke (OR 1.68, 95% CI, 0.91–3.11, I 2 = 0%) according to the pooled results.
Conclusions
In patients after PCI, OSA appears to increase the risk of cardiac death, non-fatal MI, and coronary revascularization.
http://ift.tt/2pNWWIt
Tropendermatologisch relevante Erkrankungen der Kopfhaut
Zusammenfassung
Menschen, deren genetische Wurzeln tropischen oder tropennahen Regionen entstammen, weisen unter anderem auch an Kopfhaut und Kopfhaar spezifische strukturelle Merkmale auf, die sie einerseits für diese Klimazonen schützend ausrüsten, andererseits jedoch für bestimmte dermatologische Krankheitsbilder besonders empfänglich machen. Auf eine Auswahl dieser Erkrankungen autoimmuner, chronisch entzündlicher, infektiöser und mechanischer Genese wird im Folgenden vertiefend eingegangen.
http://ift.tt/2pxxms6
Do Modic changes affect cervical sagittal alignment and motion in symptomatic patients?
Abstract
Purpose
The cervical segmental instability often occurs simultaneously with Modic changes (MCs). However, it is unknown whether there is a relation between the two diseases. The aim of this study was to evaluate the relationship between MCs and cervical segmental instability, cervical curvature and range of motion (ROM) in the cervical spine.
Methods
A total of 464 patients with neck pain or cervical neurologic symptoms who underwent imaging examination were analyzed retrospectively. Based on MRI imaging cervical MCs were diagnosed, and patients were divided into with or without MCs groups. The cervical curvature and range of motion were measured. We compared the incidence of cervical instability, cervical curvature and ROM between the two group patients and their relationships with MCs were studied. Logistic regression was used to study the risk factors associated with MCs.
Results
MCs were observed in 94 of 464 patients and 122 of total 2320 cervical segments and were most frequent at C5–6 segment. The incidence of the cervical instability was significantly higher in patients with MCs than those without MCs at cervical level C3–7. In addition, cervical curvature and ROM in patients with MCs were less than those without MCs. Logistic regression analysis showed that the occurrence of cervical spine instability, less cervical curvature and ROM were risk factors for MCs.
Conclusions
Patients with MCs were prone to have cervical instability at the same cervical level and may have a higher possibility of less cervical curvature and ROM.
http://ift.tt/2nZC1Ww
Long-term deterioration of perceived health and functioning in adults with cerebral palsy
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Joyce L. Benner, Sander R. Hilberink, Thessa Veenis, Henk J. Stam, Wilma M.A. van der Slot, Marij E. Roebroeck
ObjectiveTo describe longitudinal change in perceived health, presence of health issues and functional level in adults with cerebral palsy (CP).DesignProspective cohort study.SettingParticipants who completed baseline assessments in 1996 or 2000 were invited for a long-term follow-up in 2010.ParticipantsForty-nine Dutch adults with CP (age 35-45 years, 55% male, 75% spastic) formerly known in pediatric rehabilitation care.InterventionsNot applicable.Main Outcome MeasuresPostal questionnaires were completed by the adults or their proxies (n=9). Health outcomes included perceived health (adapted from SF-36), presence of health issues such as pain, severe fatigue (dichotomized), and functional level (Barthel Index; walking performance).ResultsOver a 10-year period, the percentage of adults with CP worrying about their health increased (29 to 54%, p=0.008) and those indicating that health problems limit their activities increased (19 to 45%, p=0.002). In the same period the majority continued to report good general health (93 to 86%, p=0.148). Presence of some health issues increased over time, such as pain; severe fatigue was a common health issue at follow-up (32%). Over a 14-year period, mobility and self-care deteriorated (Barthel Index 17.1 (SD 4.8) to 16.3 (SD 5.6), p=0.007). Walking performance, specifically indoors declined (83 to 71%, p=0.010).ConclusionsAdults with CP experienced deterioration in health outcomes in the long-term. Most notably, perceived health and functional level decreased. Pain and severe fatigue were the most common health issues in adult CP. More research is required to explore the mechanisms at work in the process of aging among persons with CP. Systematic follow-up of adults with CP appears necessary to timely detect and intervene on health problems and functional decline.
http://ift.tt/2pvQSYL
Objective versus subjective measures of executive functions; predictors of participation and quality of life in Parkinson’s disease?
Publication date: Available online 17 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Thialda T. Vlagsma, Janneke Koerts, Oliver Tucha, Hilde T. Dijkstra, Annelien A. Duits, Teus van Laar, Jacoba M. Spikman
ObjectiveTo determine whether objective (neuropsychological tests) and subjective measures (questionnaires) of executive functions (EF) are associated in patients with Parkinson's disease (PD) and to determine to what extent level of participation and QoL of PD patients can be predicted by these measures of EF.DesignCorrelational research design (case-control and prediction design).SettingAssessment took place at departments of Neuropsychology of three medical centers in The Netherlands.Participants42 PD patients and relatives. 94 healthy controls.InterventionsNot applicable.Main Outcome MeasuresA test battery measuring EF. In addition, patients, their relatives and controls completed the DEX, BAFQ and BDEFS-tm questionnaires measuring complaints about EF. Participation and QoL were measured with the IPA and the PDQ-39, respectively.ResultsPD patients showed impairments in EF on objective tests and reported significantly more complaints in EF than healthy controls. No associations were found between patients' performances on objective and subjective measures of EF. However, both objective and subjective measures predicted patients' level of participation. In addition, subjective measures of EF predicted QoL in PD patients.ConclusionsThese findings show that objective and subjective measures of EF are not interchangeable and that both approaches predict level of participation and QoL of PD patients. However, within this context, gender needs to be taken into account.
http://ift.tt/2pxMJRg
Effects of home-based supportive care on improvements in physical function and depressive symptoms in stroke patients: a meta-analysis
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Hui-Chuan Huang, Yi-Chieh Huang, Mei-Feng Lin, Wen-Hsuan Hou, Meei-Ling Shyu, Hsiao-Yean Chiu, Hsiu-Ju Chang
ObjectiveTo examine the effects of home-based supportive care on improvements in physical function and depressive symptoms in home-dwelling patients after a stroke.Data sourcesSeven electronic databases (e.g., Medline, PubMed, CINAL, EMBASE, the Cochrane Central Register of Controlled Trials, ProQuest, and Google Scholar) and four Chinese database (e.g.,Wanfang med online, Chinese Electronic Periodical Services, China Integrated Knowledge Resources Database, and National Central Library) were fully searched for all relevant articles up to June 25, 2016.Study selectionRandomized controlled trials that examining the effects of home-based supportive care on physical function and depression in home-dwelling patients after a stroke were included. Finally, 16 articles in Chinese (n=4) and English (n=12) met inclusion criteria.Data extractionData related to patient characteristics, study characteristics, intervention details, and outcome were extracted. Two reviewers independently extracted data and assessed methodological quality using the Cochrane Risk of Bias tool.Data synthesisHome-based supportive care had a small size effect on physical function (g = 0.17, 95% confidence interval [CI] 0.09∼0.26) and a moderate size effect on depressive symptoms (g = -0.44, 95% CI -0.83 to -0.05) in home-dwelling patients after a stroke. The moderator analysis revealed that some components of study participants and intervention programs improved the effects on physical function and depressive symptoms; however, no significant moderators were further identified to have superiorly improved physical function and depressive symptoms.ConclusionsRegular performance of home-based supportive care should be considered for inclusion as routine care for managing and improving physical function and depressive symptoms in home-dwelling patients after a stroke. The current findings provide further evidence with which to design appropriate supportive interventions for home-dwelling stroke survivors.
http://ift.tt/2pvVZYZ
Chemical and biological properties of a supramolecular complex of tuftsin and cucurbit[7]uril
Publication date: June 2017
Source:International Immunopharmacology, Volume 47
Author(s): Ekaterina A. Kovalenko, Ekaterina A. Pashkina, Lyubov Y. Kanazhevskaya, Alexey N. Masliy, Vladimir A. Kozlov
Cucurbit[7]uril (CB7) is an uncharged and water-soluble macrocyclic host. CB7 binds to doubly protonated tuftsin, which is the tetrapeptide Thr-Lys-Pro-Arg, with moderate affinity (Ka=2.1×103M−1). In this study, the host–guest complexation was confirmed by fluorescence titration. This affinity would allow for easy release of the peptide under physiological conditions. According to density functional theory calculations, the structural binding motif involves hydrogen bonding. The most energetically stable form had the Arg side chain inside the CB7 cavity. The effects of the tuftsin–CB7 complex on the proliferation and cytokine activity of immune cells were studied. The complex had broader spectrum immunomodulation than free peptides, and caused statistically significant (p<0,05) changes in cytokine production (tumor necrosis factor-α, interleukin-2, interferon-γ, and interleukin-10) by mononuclear cells. By contrast, the free peptide only activated tumor necrosis factor-α production.
http://ift.tt/2okhLuK
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