Temporal variability in the thermal requirements for vegetation phenology on the Tibetan plateau and its implications for carbon dynamics

Abstract

Static thermal requirements (T _req ) are widely used to model the timing of phenology, yet may significantly bias phenological projections under future warming conditions, since recent studies argue that climate warming will increase T _req for triggering vegetation phenology. This study investigates the temporal trend and inter-annual variation of T _req derived from satellite-based spring and autumn phenology for the alpine and temperate vegetation on the Tibetan Plateau from 1982 to 2011. While we detected persistent warming in both spring and autumn across this time period, we did not find a corresponding long-term increase in T _req for most of the study area. Instead, we found a substantial interannual variability of T _req that could be largely explained by interannual variations in other climatic factors. Specifically, the number of chilling days and fall temperature were robust variables for predicting the dynamics of T _req for spring onset and autumn senescence, respectively. Phenology models incorporating a dynamic T _req algorithm performed slightly better than those with static T _req values in reproducing phenology derived from SPOT-VGT NDVI data. To assess the degree to which T _req variation affects large-scale phenology and carbon cycling projections, we compared the output from versions of the Terrestrial Ecosystem Model that incorporated static and dynamic T _req values in their phenology algorithms. Under two contrasting future climate scenarios, the dynamic T _req setting reduced the projected growing season length by up to 1–3 weeks by the late twenty-first century, leading to a maximum reduction of 8.9 % in annual net primary production and ~15 % in cumulative net ecosystem production for this region. Our study reveals that temporal dynamics of T _req meaningfully affect the carbon dynamics on the Tibetan Plateau, and should thus be considered in future ecosystem carbon modeling.

http://ift.tt/2cpHwoJ

Health sector preparedness for adaptation planning in India

Abstract

Developing countries face substantial vulnerabilities to the current and projected health risks of climate change. The paper explores some key elements for health care system preparedness and adaptation planning for heatwaves, flooding and cyclones, illustrating the constraints faced in the Indian context, by analyzing data from a field study. The barriers are not insurmountable and many opportunities exist in building climate resilient infrastructure, improving intersectoral organization, resource planning, and framing health policies and programmes that mainstream climate risks. This is the first comprehensive attempt to collect and analyse data on morbidity, mortality, and extreme events, supported by intensive primary survey based data on the preparedness of the health care system to manage risks in India. Recognizing the importance of specific climatic events such as heatwaves, systematic documentation and assessment of risks with associated morbidity and mortality, and collaboration across relevant departments are instrumental in framing an appropriate adaptation plan.

http://ift.tt/2cDF9lU

Mind the gap – the case for medium level emission scenarios

Abstract

In this essay I argue that the research on emission scenarios over the past few years has focused on low emission scenarios while producing few medium level emission scenarios. As a consequence, there is a gap in the literature on emission scenarios which prohibits answering several basic questions. This relative lack of medium emission scenarios is problematic for three reasons. First, scientific integrity, as the research community should produce scenarios along the full range of future options. Second, there is currently a very limited number of scenarios that describe real-world conditions of imperfect climate policy combined with technology restrictions. Finally, I observe a growing mismatch between the mitigation research focus on low emission scenarios and research to impacts and adaptation on medium and high emission scenarios. If this trend continues, it will be difficult to draw overarching conclusions from mitigation and impacts research in IPCCs 6th Assessment Report. Therefore, this essay ends with several recommendations for the mitigation research community to stimulate production and publication of medium level emission scenarios.

http://ift.tt/29KfeoO

Particulate air pollution from wildfires in the Western US under climate change

Abstract

Wildfire can impose a direct impact on human health under climate change. While the potential impacts of climate change on wildfires and resulting air pollution have been studied, it is not known who will be most affected by the growing threat of wildfires. Identifying communities that will be most affected will inform development of fire management strategies and disaster preparedness programs. We estimate levels of fine particulate matter (PM_2.5) directly attributable to wildfires in 561 western US counties during fire seasons for the present-day (2004–2009) and future (2046–2051), using a fire prediction model and GEOS-Chem, a 3-D global chemical transport model. Future estimates are obtained under a scenario of moderately increasing greenhouse gases by mid-century. We create a new term "Smoke Wave," defined as ≥2 consecutive days with high wildfire-specific PM_2.5, to describe episodes of high air pollution from wildfires. We develop an interactive map to demonstrate the counties likely to suffer from future high wildfire pollution events. For 2004–2009, on days exceeding regulatory PM_2.5 standards, wildfires contributed an average of 71.3 % of total PM_2.5. Under future climate change, we estimate that more than 82 million individuals will experience a 57 % and 31 % increase in the frequency and intensity, respectively, of Smoke Waves. Northern California, Western Oregon and the Great Plains are likely to suffer the highest exposure to widlfire smoke in the future. Results point to the potential health impacts of increasing wildfire activity on large numbers of people in a warming climate and the need to establish or modify US wildfire management and evacuation programs in high-risk regions. The study also adds to the growing literature arguing that extreme events in a changing climate could have significant consequences for human health.

http://ift.tt/2cDE6SQ

Outcomes of hospitalizations for common illnesses associated with a comorbid heat-related illness in the United States, 2001–2010

Abstract

This research examines whether inpatients with common illnesses and comorbid heat-related illness (HRI) suffer worse health outcomes and use more hospital resources than similar patients without a diagnosed HRI. We used the Nationwide Inpatient Sample, 2001–2010 to compare outcomes, including inpatient length of stay, number of procedures, total charges, discharge status and death, for hospitalization of common illnesses with and without HRI. We used bivariate and multivariable regressions to identify risk factors for health outcomes among inpatients with common illnesses and comorbid HRI. Stratified analyses examined outcomes according to sociodemographics and hospital characteristics to further identify specific risk factors. Among inpatients with respiratory illnesses, negative outcomes were more frequent when a comorbid HRI was present. Additionally, inpatients with cardiac diseases showed increased mortality when a comorbid HRI was present. Overall, comorbid HRI was not associated with worse outcomes among the other common illnesses analyzed. While heat may precipitate hospital admissions for renal and diabetic conditions, these conditions have similar outcomes whether or not a HRI is present. However, comorbid HRI is associated with worse outcomes for respiratory illness hospitalizations and higher risk of death among cardiac disease hospitalizations.

http://ift.tt/2cpG4mf

Carbon balance effects of U.S. biofuel production and use

Abstract

The use of liquid biofuels has expanded over the past decade in response to policies such as the U.S. Renewable Fuel Standard (RFS) that promote their use for transportation. One rationale is the belief that biofuels are inherently carbon neutral, meaning that only production-related greenhouse gas (GHG) emissions need to be tallied when comparing them to fossil fuels. This assumption is embedded in the lifecycle analysis (LCA) modeling used to justify and administer such policies. LCA studies have often found that crop-based biofuels such as corn ethanol and biodiesel offer at least modest net GHG reductions relative to petroleum fuels. Data over the period of RFS expansion enable empirical assessment of net CO₂ emission effects. This analysis evaluates the direct carbon exchanges (both emissions and uptake) between the atmosphere and the U.S. vehicle-fuel system (motor vehicles and the physical supply chain for motor fuels) over 2005–2013. While U.S. biofuel use rose from 0.37 to 1.34 EJ/yr over this period, additional carbon uptake on cropland was enough to offset only 37 % of the biofuel-related biogenic CO₂ emissions. This result falsifies the assumption of a full offset made by LCA and other GHG accounting methods that assume biofuel carbon neutrality. Once estimates from the literature for process emissions and displacement effects including land-use change are considered, the conclusion is that U.S. biofuel use to date is associated with a net increase rather than a net decrease in CO₂ emissions.

http://ift.tt/2cDETDb

Effects of climate change on the distribution of indigenous species in oceanic islands (Azores)

Abstract

Oceanic islands host a high proportion of the world's endemic species. Many such species are at risk of extinction owing to habitat degradation and loss, biological invasions and other threats, but little is known about the effects of climate change on island native biodiversity. The Azorean archipelago provides a unique opportunity to study species-climate-change relationships. We used ensemble forecasting to evaluate the current and future distribution of well-studied endemic and native bryophytes (19 species), endemic vascular plants (59 species) and endemic arthropods (128 species), for two of the largest Azorean Islands, Terceira and São Miguel. Using a Regional Climate Model (CIELO), and assuming the extreme scenario RCP8.5, we examined changes in the potential distributions of the species and possible loss of climate space for them. Models projected that 23 species (11 %) could lose all adequate climate on either one or both islands. Five additional species were projected to lose ≥90 % of climate space. In total, 90 % of the species were projected to lose climate space: 79 % of bryophytes, 93 % of vascular plants and 91 % of arthropods. We also found for vascular plants and arthropods a tendency for upward shift in altitude in their suitable climate space, while for bryophytes the shift was towards the coastal areas. Our results have profound implications for future conservation priorities on islands, such as for the redrawing of conservation borders of current protected areas.

http://ift.tt/2cpFO77

Climate change discourse among Iranian farmers

Abstract

Climate change poses a severe threat to agriculture and rural populations around the world, with the potential to devastate lives and livelihoods. Farmers need to adapt their farming methods and land management decisions to reduce the negative consequences associated with climate change. Understanding farmers' beliefs and perceptions regarding climate change is a good starting point for addressing current and future policy. As there is no one-size-fits-all strategy to promote adaptation, local adaptation-support strategies must be tailored to the particular needs and constraints of specific groups of farmers. To determine the policy implications of such strategies, a prudent and cost-effective approach is to categorize farmers into homogenous groupings using Q methodology to establish their perceptual frameworks with respect to climate change. Forty six farmers completed the Q sort procedure in this study. Data analysis identified that there are three different types of farmers' attitudes to climate change: fatalism, support seekers, and technocrats. These findings are critical for decision makers to help them develop more appropriate adaptation strategies for the agricultural sector.

http://ift.tt/2cDEKzJ

The effect of climate change on rural land cover patterns in the Central United States

Abstract

This study projects land cover probabilities under climate change for corn (maize), soybeans, spring and winter wheat, winter wheat-soybean double cropping, cotton, grassland and forest across 16 central U.S. states at a high spatial resolution (see http://ift.tt/2cDEHE3), while also taking into account the influence of soil characteristics and topography. The scenarios span three coupled climate models, three Representative Concentration Pathways (RCPs), and three time periods (2040, 2070, 2100). As climate change intensifies, the suitable area for all six crops display large northward shifts. Total suitable area within the study area for spring wheat, followed by corn and soybeans, diminish. Suitable area for winter wheat and for winter wheat-soybean double-cropping expand northward, while cotton suitability migrates to new, more northerly, locations. Grassland intensifies in the western Great Plains as crop suitability diminishes; suitability for forest intensifies in the south while yielding to crops in the north. To maintain current broad geographic patterns of land use, large changes in the thermal response of crops such as corn would be required. A transition from corn-soybean rotations to winter wheat-soybean doubling cropping is an alternative adaptation.

http://ift.tt/2cpGoBQ

Place-based inter-generational communication on local climate improves adolescents’ perceptions and willingness to mitigate climate change

Abstract

With the Paris Agreement, countries have pledged to promote strategies and policies to substantially reduce their carbon emissions. To align public sentiment with potentially expensive climate mitigation policy, climate change education is considered an essential tool in tackling climate change, particularly for the young generation. However, a general lack of engagement is driven by the perception that climate change is irrelevant at local and individual scales. Based on a modified version of the Theory of Planned Behaviour, we implemented a new climate change educational programme, in 12 rural areas of China, where adolescents communicated with local seniors (aged ≥ 60 years) in focus groups to discuss local climate over the past decades. Seniors' memories of extreme climatic events generally were in concordance with meteorological data. The adolescents' uncertainty about climate change exhibited significant change after the programme, followed by concern, risk perception, and perceived behavioural control. Based on mediation analysis, the shift in adolescent concern and perceived behavioural control translated into greater willingness to support climate change mitigation. Thus, we suggest that climate change education should emphasize place-based strategies that highlight the relevance of global climate change through local impacts and individual experiences vis-a-vis inter-generational communication to promote greater engagement with climate change.

http://ift.tt/2cpFFAm

Assessing climate change vulnerability in urban America: stakeholder-driven approaches

Abstract

Localized vulnerability assessments are critical to effective climate adaptation. However, the differences between how local decision-makers and experts see vulnerability have not yet been fully explored, especially in the United States. Seeing possible distinctions between these approaches is critical since it is necessary to ensure a comprehensive, accountable approach. This research explores the distinct approach of local stakeholders to conceptualizing climate vulnerability in six American cities. Sixty-five interviews of cross-sectoral local stakeholders were conducted in: Boston (MA), Los Angeles (CA), Portland (OR), Raleigh (NC), and Tampa (FL). Findings demonstrate that conceptualizations of vulnerability are affected by intellectual frameworks that tend to orient around infrastructure and human health; that retrospective and prospective thinking are inter-related and affect one another; and that institutionalized forms and biases are critical. These factors shape the way that vulnerability is conceived differently than traditional expert frameworks.

http://ift.tt/2cDDzjE

A case of undifferentiated-type mucosal gastric cancer with multiple lymph node metastases fulfilling the curative criteria for endoscopic resection according to routine pathological analysis

Abstract

Background

Endoscopic resection is accepted as the standard treatment for early mucosal gastric cancer, and its indications have recently been expanded while its long-term outcomes are still unclear. Herein, we present a didactic case of undifferentiated-type mucosal gastric cancer fulfilling the expanded indication and curative criteria for endoscopic submucosal dissection (ESD), having synchronous multiple lymph node metastases.

Case presentation

A 40-year-old woman was found to have a Helicobacter pylori infection at a standard health check with no abdominal symptoms. She received an upper gastrointestinal endoscopy and found to have an undifferentiated-type mucosal gastric cancer with the size of 15 mm in diameter without ulceration, which fulfilled the expanded indication for ESD. According to patient's preference, we performed laparoscopy-assisted distal gastrectomy with D1+ lymph node dissection, and routine pathological analysis revealed a predominantly signet ring cell carcinoma limited to the mucosa without ulceration or any vessel involvement; on the other hand, 15 lymph node metastases were detected. Then, we added deep sectioning of the whole tumoral area at a thickness of 20 μm and immunohistochemical analyses. As the result, an isolated lymphatic capillary involvement of the extremely superficial submucosa was identified in a single histological section, and pathological diagnosis was corrected to ly1. She received postoperative adjuvant chemotherapy with an S-1 oral agent and had no recurrence under strict surveillance for 1 year postoperatively.

Conclusions

When we perform ESD for undifferentiated-type gastric cancer, deep sectioning of the whole tumoral area into thin slices and immunohistochemical staining using D2-40 should be practically considered.

http://ift.tt/2cp7olo

Microsurgical management of primary jugular foramen meningiomas: a series of 22 cases and review of the literature

Abstract

This study summarized clinical manifestations, surgical management, histological grading, and long-term outcome of jugular foramen meningiomas (JFMs). Retrospective study was performed in 22 consecutive patients with primary JFMs from January 2004 to October 2010, enrolling 10 men and 12 women with average age of 39.4 (14–57 years). The most common initial symptom is hearing disorder, followed by lower cranial nerve dysfunctions. The tumor was classified into type I (intracranial) in 1, type II (intracranial) in 15, type IV (intracranial-extracranial) in 6, and none type III (extracranial). Surgical approaches mainly included retrosigmoid in 7, far lateral in 10, and juxtacondylar in 5, with some variations. The gross total resection was achieved in 15 cases and subtotal resection in 7. Fourteen patients (63.6 %) developed new or worse neurological deficits immediately after operation, of whom 11 (78.6 %) got alleviation. Postoperatively, keeping airway patency and prevention from aspiration pneumonia is very important. Nasotracheal intubation is much more tolerated than orotracheal intubation for postoperative patient management. WHO grade 2 was found in four cases (18.2 %) and grade 3 in one. During the average time of follow-up in 83.2 months, only one (grade 3) died of tumor regrowth 20 months after surgery and radiosurgery. Five of 17 patients of grade 1 developed tumor regrowth. Radiosurgery provides a good tumor control for tumor regrowth in grade 1, or postoperative grade 2 tumor. In conclusion, JFMs has a favorable long-term overall survival; however, neurological preservation is still challenging, especially low cranial nerves.

http://ift.tt/2ccDSzE

Extracranial-intracranial bypass for internal carotid/middle cerebral atherosclerotic steno-occlusive diseases in conjunction with carotid endarterectomy for contralateral cervical carotid stenosis: clinical results and cognitive performance

Abstract

Clinical results as well as cognitive performances after extracranial to intracranial (EC-IC) bypass in conjunction with contralateral carotid endarterectomy (CEA) are poorly understood. Data from 14 patients who underwent unilateral EC-IC bypass for atherosclerotic internal carotid artery (ICA)/middle cerebral artery (MCA) steno-occlusive disease in conjunction with CEA for contralateral cervical carotid stenosis were retrospectively reviewed. Postoperative results were evaluated by MRI imagings. Nine patients also underwent neuropsychological examinations (NPEs), including assessment by the Wechsler Adult Intelligence Scale-Third Edition and the Wechsler Memory Scale-Revised (WMS-R) before and about 6 months after bilateral surgeries. Postoperative MRI follow-up (median, 8 months; interquartile range, 7–8 months) confirmed successful bypass in all patients, with no additional ischemic lesions on T2WI when compared with preoperative imaging. Further, MRA showed patent bypass and contralateral smooth patency at CEA portion in all patients. In the group rate analysis, all five postoperative NPE scores (Verbal IQ, Performance IQ, WMS-memory, WMS-attention, and Average scores of all those four scores) were improved relative to preoperative NPE scores. Performance IQ and Average score improvements were statistically significant. Clinical results after EC-IC bypass in conjunction with contralateral CEA were feasible. Based on the group rate analysis, we conclude that successful unilateral EC-IC bypass and contralateral carotid endarterectomy does not adversely affect postoperative cognitive function.

http://ift.tt/2ctWjx8

Chondroprotective effect of high-molecular-weight hyaluronic acid on osteoarthritic chondrocytes in a co-cultivation inflammation model with M1 macrophages

Abstract

Background

Osteoarthritis (OA) is described by an imbalance between anabolic and catabolic processes in the affected joint. This dysregulation of metabolism affects not only chondrocytes within cartilage tissue but also the cells of the synovial membrane across the border of the joint. An important factor in OA is the low viscosity of the synovial fluid. High-molecular-weight hyaluronic acid (HA) can be used to increase the viscosity and also reduce inflammatory processes. The purpose was to establish an in vitro inflammation model and to evaluate the effects of high-molecular-weight HA in a co-cultivation inflammation model of osteoarthritic chondrocytes and M1 macrophages.

Methods

For the establishment of the inflammation model THP-1 cells were, at first, differentiated to M0 macrophages and then activated to the M1 subtype after 5 days of resting period. Surface markers, cytokine release, and gene expression, were analyzed to examine the successful differentiation. In the inflammation model, the defined M1 macrophages were co-cultivated with osteoarthritic chondrocytes for 2 days, with and without the addition of 10 % HA and further analyzed for chondrogenic gene expression markers and the release of cytokines in the supernatant.

Results

The differentiation and activation process was successful as M1 macrophages expressed higher levels of pro-inflammatory cytokines and specific genes. Similarly, the surface marker CD14 was significantly decreased compared to M0 macrophages. For the co-culture system, the analysis of gene expression showed that HA increased the expression of cartilage-specific genes while catabolic-encoding genes exhibited lower expression levels than the control group. This positive effect of HA was also demonstrated by the measurement of pro-inflammatory cytokines, as their level decreased.

Conclusion

Our study implies that high-molecular-weight HA has a chondroprotective effect in the present co-cultivation inflammation model, as it decreases pro-inflammatory cytokines and increases anabolic factors.

http://ift.tt/2c6Hccu

In vitro cultures of ectodermal monolayers from the model sea anemone Nematostella vectensis

Abstract

We report here a novel approach for the extraction, isolation and culturing of intact ectodermal tissue layers from a model marine invertebrate, the sea anemone Nematostella vectensis. A methodology is described in which a brief exposure of the animal to the mucolytic agent N-acetyl-L-cysteine (NAC) solution triggers the dislodging of the ectodermis from its underlying basement membrane and mesoglea. These extracted fragments of cell sheets adherent to culture-dish substrates, initially form 2D monolayers that are transformed within 24 h post-isolation into 3D structures. These ectodermal tissues were sustained in vitro for several months, retaining their 3D structure while continuously releasing cells into the surrounding media. Cultures were then used for cell type characterizations and, additionally, the underlying organization of actin filaments in the 3D structures are demonstrated. Incorporation of BrdU and immunohistochemical labeling using p-histone H3 primary antibody were performed to compare mitotic activities of ectodermal cells originating from intact and from in vivo regenerating animals. Results revealed no change in mitotic activities at 2 h after bisection and a 1.67-, 1.71- and 3.74-fold increase over 24, 48 and 72 h of regeneration, respectively, depicting a significant correlation coefficient (p < 0.05; R ² = 0.74). A significant difference was found only between the control and 3-day regenerations (p = 0.016). Cell proliferation was demonstrated in the 3D ectodermis after 6 culturing days. Moreover, monolayers that were subjected to Ca++/Mg++ free medium for the first 2 h after isolation and then replaced by standard medium, showed, at 6 days of culturing, profuse appearance of positive p-histone H3-labeled nuclei in the 3D tissues. Cytochalasin administered throughout the culturing period abolished all p-histone H3 labeling. This study thus depicts novel in vitro tissue culturing of ectodermal layers from a model marine invertebrate, demonstrating the ease with which experiments can be performed and cellular and molecular pathways can be revealed, thus opening studies on 2D tissue organizations and morphogenesis as well as the roles of cellular components in the formation of tissues in this organism.

http://ift.tt/2cpta89

A novel culture platform for fast proliferation of human annulus fibrosus cells

Abstract

Tissue engineering provides a promising approach to treat degenerative disc disease, which usually requires a large quantity of seed cells. A simple and reliable in vitro culture system to expand seed cells in a timely fashion is necessary to implement the application clinically. Here, we sought to establish a cost-effective culture system for expanding human annulus fibrosus cells using extracellular matrix (ECM) proteins as culture substrates. Cells were cultured onto a plastic surface coated with various types of ECMs, including fibronectin, vitronectin, collagen type I, gelatin and cell-free matrix deposited by human nucleus pulposus cells. AF cell morphology, growth, adhesion and phenotype (anabolic and catabolic markers) were assessed by microscopy, real-time RT-PCR, western blotting, zymography, immunofluorescence staining and biochemical assays. Fibronectin, collagen and gelatin promoted cell proliferation and adhesion in a dose-dependent manner. Fibronectin elevated mRNA expression of proteoglycan and enhanced glycosaminoglycan production. Both collagen and gelatin increased protein expression of type II collagen. Consistent with increased cell adhesion, collagen and fibronectin promoted formation of focal adhesion complexes in the cell-matrix junction, suggesting enhanced binding of the actin network with both ECM substrates. On the other hand, fibronectin, collagen and gelatin decreased expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 in media. Finally, a mixture of fibronectin (1.7 μg/mL) and collagen (1.3 μg/mL) was identified as the most promising in vitro culture substrate system in promoting proliferation and maintaining anabolic-catabolic balance. Our method provides a simple and cost-effective platform for tissue engineering applications in intervertebral disc research.

http://ift.tt/2cDsf7o

Functiogenesis of the embryonic central nervous system revealed by optical recording with a voltage-sensitive dye

Abstract

Clarification of the functiogenesis of the embryonic central nervous system (CNS) has long been problematic, because conventional electrophysiological techniques have several limitations. First, early embryonic neurons are small and fragile, and the application of microelectrodes is challenging. Second, the simultaneous monitoring of electrical activity from multiple sites is limited, and as a consequence, spatiotemporal response patterns of neural networks cannot be assessed. We have applied multiple-site optical recording with a voltage-sensitive dye to the embryonic CNS and paved a new way to analyze the functiogenesis of the CNS. In this review, we discuss key points of optical recording in the embryonic CNS and introduce recent progress in optical investigations on the embryonic CNS with special emphasis on the development of the chick olfactory system. The studies clearly demonstrate the usefulness of voltage-sensitive dye recording as a powerful tool for elucidating the functional organization of the vertebrate embryonic CNS.

http://ift.tt/2ctOiID

Efficient implementation of superquadric particles in Discrete Element Method within an open-source framework

Abstract

Particle shape representation is a fundamental problem in the Discrete Element Method (DEM). Spherical particles with well known contact force models remain popular in DEM due to their relative simplicity in terms of ease of implementation and low computational cost. However, in real applications particles are mostly non-spherical, and more sophisticated particle shape models, like superquadric shape, must be introduced in DEM. The superquadric shape can be considered as an extension of spherical or ellipsoidal particles and can be used for modeling of spheres, ellipsoids, cylinder-like and box(dice)-like particles just varying five shape parameters. In this study we present an efficient C++ implementation of superquadric particles within the open-source and parallel DEM package LIGGGHTS. To reduce computational time several ideas are employed. In the particle–particle contact detection routine we use the minimum bounding spheres and the oriented bounding boxes to reduce the number of potential contact pairs. For the particle–wall contact an accurate analytical solution was found. We present all necessary mathematics for the contact detection and contact force calculation. The superquadric DEM code implementation was verified on test cases such as angle of repose and hopper/silo discharge. The simulation results are in good agreement with experimental data and are presented in this paper. We show adequacy of the superquadric shape model and robustness of the implemented superquadric DEM code.

http://ift.tt/2cBPVaP

Continuum modeling of rate-dependent granular flows in SPH

Abstract

We discuss a constitutive law for modeling rate-dependent granular flows that has been implemented in smoothed particle hydrodynamics (SPH). We model granular materials using a viscoplastic constitutive law that produces a Drucker–Prager-like yield condition in the limit of vanishing flow. A friction law for non-steady flows, incorporating rate-dependence and dilation, is derived and implemented within the constitutive law. We compare our SPH simulations with experimental data, demonstrating that they can capture both steady and non-steady dynamic flow behavior, notably including transient column collapse profiles. This technique may therefore be attractive for modeling the time-dependent evolution of natural and industrial flows.

http://ift.tt/2cKzAOe

Large-scale numerical simulations of polydisperse particle flow in a silo

Abstract

Very recently, we have examined experimentally and numerically the micro-mechanical details of monodisperse particle flows through an orifice placed at the bottom of a silo (Rubio-Largo et al. in Phys Rev Lett 114:238002, 2015). Our findings disentangled the paradoxical ideas associated to the free-fall arch concept, which has historically served to justify the dependence of the flow rate on the outlet size. In this work, we generalize those findings examining large-scale polydisperse particle flows in silos. In the range of studied apertures, both velocity and density profiles at the aperture are self-similar, and the obtained scaling functions confirm that the relevant scale of the problem is the size of the aperture. Moreover, we find that the contact stress monotonically decreases when the particles approach the exit and vanish at the outlet. The behavior of this magnitude is practically independent of the size of the orifice. However, the total and partial kinetic stress profiles suggest that the outlet size controls the propagation of the velocity fluctuations inside the silo. Examining this magnitude, we conclusively argue that indeed there is a well-defined transition region where the particle flow changes its nature. The general trend of the partial kinetic pressure profiles and the location of the transition region results the same for all particle types. We find that the partial kinetic stress is larger for bigger particles. However, the small particles carry a higher fraction of kinetic stress respect to their concentration, which suggest that the small particles have larger velocity fluctuations than the large ones and showing lower strength of correlation with the global flow. Our outcomes explain why the free-fall arch picture has served to describe the polydisperse flow rate in the discharge of silos.

http://ift.tt/2cBPMUW

The Effects of Molecular Hydrogen and Suberoylanilide Hydroxamic Acid on Paraquat-Induced Production of Reactive Oxygen Species and TNF-α in Macrophages

Abstract

The aim of this study is to investigate the effects of molecular hydrogen (H₂) and suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor, on paraquat (PQ)-stimulated production of reactive oxygen species (ROS) and tumor necrosis factor alpha (TNF-α) in macrophages. First, the PQ optimal concentration was determined in RAW264.7 macrophage by treating serum-starved cells with PQ at 0, 0.001, 0.01, 0.1, 1, and 10 mM. We evaluated at 1, 2 and 8 h (1) cell viability (by means of trypan blue exclusion method), (2) intracellular ROS levels (with a fluorescent DCFH-DA probe), and (3) TNF-α level in the culture media (determined by enzyme-linked immunosorbent assay, ELISA). Subsequently, mouse RAW267.4 macrophages were treated with PQ in combination with SAHA and/or H₂ for 8 h. PQ exerted a significant stimulatory but nontoxic effect on RAW267.4 macrophages at 0.1 mM. This PQ concentration was used in the subsequent experiments. H₂ and H₂ combined with SAHA evoked a greater reduction in PQ-induced ROS production than SAHA alone, especially at 2 and 8 h. At 1 and 2 h, treatments involving H₂ caused a greater decrease in PQ-induced production of TNF-α than the corresponding treatments without H₂. However, at 8 h, treatment with SAHA evoked more pronounced effects on TNF-α than treatment without SAHA. H₂ decreases PQ-induced ROS production and attenuates early PQ-induced TNF-α production whereas SAHA reduces the late phase of the PQ-induced TNF-α production in macrophages. The effects are enhanced by the combination of H₂ and SAHA.

http://ift.tt/2c8o1nm

Thallium Toxicity in Mediterranean Horticultural Crops ( Fragaria vesca L., Mentha pulegium L., Ocimum basilicum L.)

Abstract

Thallium is a non-essential, toxic element that concerns mining areas and their acid drainage effluents. Minerals containing thallium can be eroded, and Tl can be leached into soil, thus being spread into the environment and adsorbed by plants and living organisms, entering the food chain, and inducing serious toxicity problems. In this study, the Tl cycle was observed and analyzed on basil, mint, and strawberry cultivated in a greenhouse and irrigated with Tl-contaminated water. The Tl content in both bulk and rhizosphere soils as well as thallium present in different plant organs were analyzed during the experiment, with the aim of revealing both physiological symptoms and metabolic disorders linked to the Tl toxicity. The mechanism of plants to exclude, uptake, translocate, and tolerate Tl varied among the different species, and both the bioconcentration factor (BCF) and the translocation index (TI) were calculated to highlight a different response to Tl toxicity of strawberry, mint, and basil. Basil is the less tolerant species, while mint and strawberry showed different self-defense mechanism against Tl adsorption and translocation.

http://ift.tt/2cKD8Qx

Introduction of a new electronic medical record system has mixed effects on first surgical case efficiency metrics

Abstract

To evaluate the effect of deploying a new electronic medical record (EMR) system on first case starts in the operating room. Data on first case start times were collected after implementation of a new EMR (Epic) from June 2015 to May 2016, which replaced a legacy system of both paper and electronic records. These were compared to data from the same months in the three proceeding years. First patient in room (FPIR) on time was true if the patient was in operating room before 7:35 AM (or 9:35 AM on Wednesdays) and first case on time start (FCOTS) was true if completion of anesthetic induction was less than 20 min after the patient entered the operating room (or 35 min for cardiac and neurosurgery). Times beyond these cutoffs were quantified as FPIR and FCOTS delays in minutes. Average delays were compared by month with two-sample t tests and 95 % confidence intervals. There was a significant increase in FPIR delays in the first month (11.07 vs. 3.47 min, p < 0.0001), which abated by the fifth month. Post-implementation FCOTS delays improved by the third month (4.53 vs. 7.10 min, p < 0.0001). Both results persisted throughout the study. First month FPIR delays were not limited to any one specialty. EMRs have the potential to improve hospital workflows, but are not without learning curves. FPIR and FCOTS delays return to baseline after a few months, and in the case of FCOTS, can improve beyond baseline.

http://ift.tt/2cKAcDt

Editorial: Peculiarities of unruptured internal carotid artery bifurcation aneurysms

http://ift.tt/2cctUyv

Treatment with high-dose recombinant human hyaluronidase-facilitated subcutaneous immune globulins in patients with juvenile dermatomyositis who are intolerant to intravenous immune globulins: a report of 5 cases

Abstract

Background

High-dose intravenous immune globulins (IVIg) are frequently used in refractory juvenile dermatomyositis (JDM) but are often poorly tolerated. High-dose recombinant human hyaluronidase-facilitated subcutaneous immune globulins (fSCIg) allow the administration of much higher doses of immune globulins than conventional subcutaneous immune globulin therapy and may be an alternative to IVIg. The safety and efficacy of fSCIg therapy in JDM is unknown.

Case Presentation

In this retrospective case series, five patients with steroid-refractory severe JDM were treated with high-dose fSCIg due to IVIg adverse effects (severe headaches, nausea, vomiting, difficult venous access). Peak serum IgG levels, muscle enzymes, the childhood myositis assessment scale and adverse effects were retrieved for at least 6 months following intiation of fSCIg. Data were analyzed by descriptive statistics.

Patients initially received fSCIg 1 g/kg every 14 days, resulting in median IgG peak levels of 1901 mg/dl (1606–2719 mg/dl), compared to median IgG peak and trough levels while previously receiving IVIg of 2741 mg/dl (2429–2849 mg/dl) and 1351 mg/dl (1156–1710 mg/dl). Additional antirheumatic therapies consisted of low-dose glucocorticoid therapy, methotrexate, mycophenolate mofetil and/or rituximab. Two patients maintained clinically inactive disease and three patients had only a partial treatment response. In the three patients with partial treatment response, fSCIg 1 g/kg was then given on days 1 and 6 of every 28-day cycle resulting in IgG peak levels of between 2300–2846 mg/dl (previously 1606–1901 mg/dl on the biweekly regimen), resulting in clinically inactive disease in two of the three patients. There were no relevant adverse effects that limited continuation of fSCIg treatment.

Conclusions

High-dose fSCIg is well-tolerated in patients with JDM and high peak serum IgG levels can be achieved which may be important for treatment success. High-dose fSCIg may therefore be an alternative to high-dose IVIg and deserves further study.

Trial registration

This is a case series and data were retrospectively registered.

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Breast cancer and thyroid diseases: analysis of 867 consecutive cases

Abstract

Introduction

The aim of this study was to evaluate the association of breast cancer with thyroid diseases. Many authors have already studied the possible relationship between these two diseases, but the results are nowadays conflicting.

Materials and methods

Our study examining 867 patients with breast cancer (862 women and 5 men, average age = 61 years old) of whom 141 also had thyroid disease evaluated the recurrence of thyroid diseases and their association with different types of breast cancer. Statistical analyses were performed using SPSS software for Windows; we used nonparametric tests (Chi-square and Mann–Whitney), and the level of significance was set at p < 0.05.

Results

We found a significant association between breast cancer diagnosed after menopause and thyroid disease (p < 0.003). Moreover, we analyzed the role of thyroid autoimmunity identifying an association between chronic autoimmune thyroiditis and breast cancer diagnosed before menopause (p < 0.05). Regarding receptor profile of breast carcinoma, we have found an increased expression of estrogen receptors in patients with autoimmune thyroiditis compared to patients with any other thyroid diseases (p < 0.03). Contrariwise, we do not have found any difference between the group with every thyroid disease and the group without thyroid disease (p < 1.00). We did not find other statistically significant associations with breast cancer's parameters like family history, tumor size, lymph node metastasis, distant metastasis, cancer clinical and pathological stage, differentiation grade and expression of Ki67, p53 and Her2 in the two main groups with or without thyroid disease. Likewise, we did not found other statistically significant association between hypothyroidism or hyperthyroidism and breast cancer.

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A likely case of goiter in the Madonna col Bambino dormiente (1465/1470) by Andrea Mantegna (1431–1506)

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Lanreotide Depot: An Antineoplastic Treatment of Carcinoid or Neuroendocrine Tumors

Abstract

Purpose

Peptide drugs for antineoplastic therapies usually have low oral bioavailability and short in vivo half-lives, requiring less preferred delivery methods. Lanreotide depot is a sustained-release somatostatin analog (SSA) formulation produced via an innovative peptide self-assembly method. Lanreotide is approved in the USA and Europe to improve progression-free survival (PFS) in patients with unresectable gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and also approved in Europe for symptom control in carcinoid syndrome associated with GEP-NETs. This review discusses how the distinct molecule and formulation of lanreotide depot provide advantages to patients and health care providers, as well as the most recent clinical evidence demonstrating the safety and efficacy of lanreotide depot in inhibiting tumor growth and controlling hormonal symptoms in GEP-NETs.

Methodology and Results

The lanreotide depot formulation confers a remarkable pharmacokinetic profile with no excipients, comprised only of lanreotide acetate and water. Of note, lanreotide depot constitutes an example for peptide self-assembly based formulations, providing insights that could help future development of sustained-release formulations of other antineoplastic peptides. Most patients with GEP-NETs will present with inoperable or incurable disease; thus, medical management for symptoms and tumor control plays a crucial role. Recent long-term clinical studies have demonstrated that lanreotide depot is well tolerated, prolongs PFS in GEP-NET patients, and significantly reduces symptoms related to carcinoid syndrome.

Conclusions

The unique depot formulation and delivery method of lanreotide confer advantages in the treatment of metastatic GEP-NETs, contributing to improvements in NET-related symptoms and PFS without reducing quality of life in this patient population.

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Announcements October 2016

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Comparison of the superelasticity of different nickel–titanium orthodontic archwires and the loss of their properties by heat treatment

Abstract

The aim of this work is to describe and compare mechanical properties of eight widely used nickel–titanium orthodontic wires under uniform testing conditions and to determine the influence of the heat treatments on the loss of the superelasticity. Ten archwires from two batches from eight different manufacturers were evaluated. A three-point bending test was performed, in accordance with ISO 15841:2006, on 80 round nickel–titanium archwire segments of 0.016 inch. To obtain a load-deflection curve, the centre of each segment was deflected to 3.1 mm and then unloaded until force became zero. On the unloading curve, deflection at the end of the plateau and forces delivered at that point, and at 3, 2, 1 and 0.5 mm of deflection, were recorded. Plateau slopes were calculated from 3 and from 2 mm of deflection. Data obtained were statistically analysed to determine inter-brand, intra-brand and inter-batch differences (P < 0.05). The results show that at 2 mm of deflection, maximum differential force exerted among brands [Nitinol SuperElastic (1.999N)—Sentalloy M (1.001 N)] was 0.998 N (102 gf). The Nitinol SuperElastic plateau slope (0.353 N/mm) was the only one that was statistically different from 2 mm of deflection, as compared with the other brand values (0.129–0.155 N/mm). Damon Optimal Force described the gentlest slope from 3 mm of deflection (0.230 N/mm) and one of the longest plateaus. Titanol and Orthonol showed the most notable intra-brand differences, whereas inter-batch variability was significant for Nitinol (Henry Schein), Euro Ni–Ti and Orthonol. Superelasticity degree and exerted forces differed significantly among brands. Superelasticity of Nitinol SuperElastic was not observed, while Damon Optimal Force and Proclinic Ni–Ti Superelástico (G&H) showed the most superelastic curves. Intra-brand and inter-batch differences were observed in some brands. In all cases, the heat treatment at 600 °C produces precipitation in the matrix. The precipitates are rich in titanium and this fact produce changes in the chemical composition of the matrix and the loss of the superelasticity. At 400 °C these precipitates are not produced and the forces delivered by the wires are very similar with wires untreated.

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P2Y 1 , P2Y 2 , and TRPV1 Receptors Are Increased in Diarrhea-Predominant Irritable Bowel Syndrome and P2Y 2 Correlates with Abdominal Pain

Abstract

Background

Previous studies indicated that P2Y₁ and P2Y₂ receptors, which are widely distributed in the enteric nervous system, are related to pain, while TRPV1 may contribute to visceral pain and hypersensitivity states in irritable bowel syndrome (IBS). Other studies showed that ATP activates the capsaicin-sensitive TRPV1 channel via P2Y receptors.

Aim

To detect the expression of P2Y₁, P2Y₂, and TRPV1 receptors in diarrhea-predominant IBS (IBS-D) patients and analyze any correlations with abdominal pain and to investigate interactions between P2Y receptors and the TRPV1 receptor in IBS-D patients.

Methods

Rectosigmoid biopsies were collected from patients with IBS-D (n = 36) and healthy controls (n = 15). Abdominal pain was scored using a 10-cm visual analogue scale. Expression levels of P2Y₁, P2Y₂, and TRPV1 receptors in rectosigmoid biopsies were determined by real-time PCR and double-labeling immunofluorescence with specific antibodies.

Results

Both mRNA and protein expression levels of P2Y₁, P2Y₂, and TRPV1 receptors were increased in IBS-D compared with controls. Of these receptors, P2Y₂ expression correlated with the maximum pain scores (p = 0.02, r = 0.63, Spearman correlation) in IBS-D patients. However, no relationships were detected between P2Y receptors and the TRPV1 receptor.

Conclusion

In the present study, we identified an increased expression of P2Y₁ and P2Y₂ receptors in the rectosigmoid mucosa of IBS-D patients, and P2Y₂ correlated with abdominal pain. Furthermore, we identified an increase in TRPV1 expression; however, there were no correlations found between P2Y receptors and the TRPV1 receptor.

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Severe Lactic Acidosis in a Parenteral Nutrition-Dependent Teenager with Ulcerative Colitis

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Good Clinical Outcomes in Budd–Chiari Syndrome with Hepatic Vein Occlusion

Abstract

Background

Budd–Chiari syndrome (BCS) with hepatic vein (HV) occlusion is manifested by severe liver damage in acute cases and esophageal variceal bleeding or refractory ascites in chronic cases, which is difficult to differentiate from cirrhotic portal hypertension.

Aims

To evaluate the clinical efficacy and safety of HV angioplasty and transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of BCS with HV occlusion.

Methods

Between May 1995 and December 2014, 60 patients with HV occlusive BCS underwent HV angioplasty or TIPS. BCS was subacute or chronic in 55 patients and acute in 5 patients. HV angioplasty was performed in 18 patients with HV occlusion, combined HV and IVC angioplasty in 9 patients with HV and IVC occlusion, TIPS in 12 patients with HV occlusion, and modified TIPS in 21 patients with extensive HV occlusion.

Results

The interventional procedure was successfully performed in all 60 patients. The portal pressure decreased from 41.23 ± 10.46 cmH₂O preoperatively to 26.68 ± 6.46 cmH₂O postoperatively, while the portal flow velocity increased from 14.31 ± 10.43 to 52.16 ± 13.68 cm/s in patients undergoing TIPS or modified TIPS. During hospitalization, two patients died from hepatic failure, and acute shunt occlusion occurred in two other patients during subsequent treatment with repeated intervention. During 82.25 ± 46.16 months of follow-up, three patients underwent re-intervention with a stenotic shunt, and other three with repeated dilation of the stenotic HV.

Conclusion

HV angioplasty and TIPS yield excellent long-term outcomes in patients with HV occlusive BCS.

http://ift.tt/2cT9yx1

Lymphocytic Esophagitis: An Emerging Clinicopathologic Disease Associated with Dysphagia

Abstract

Background

Lymphocytic esophagitis (LyE) is a recently described clinicopathological condition, but little is known about its features and clinical associations.

Aim

The aim of this study was to characterize patients with LyE, compare them to non-LyE controls, and identify risk factors.

Methods

We conducted a retrospective study of all patients ≥18 years old who underwent upper endoscopy with esophageal biopsy between January 1, 2000, and June 1, 2012. Archived pathology slides were re-reviewed, and LyE was diagnosed if there was lymphocyte-predominant esophageal inflammation with no eosinophils or granulocytes. Three non-LyE controls groups were also defined: reflux, eosinophilic esophagitis (EoE), and normal. Clinical data were extracted from electronic medical records, and LyE cases were compared to non-LyE controls.

Results

Twenty-seven adults were diagnosed with LyE, and the majority were female (63 %). The most common symptom was dysphagia (70 %). Fifty-two percentage had a prior or current diagnosis of reflux. Endoscopic findings included strictures (37 %), erosive esophagitis (33 %), rings (26 %), and hiatal hernia (26 %); 33 % of patients required dilation. After histology re-review, 78 % of LyE patients were found to have more than 20 lymphs/hpf. In comparison with the normal, reflux and EoE controls, patients with LyE tended to be nonwhite (p < 0.01), were more commonly tobacco users (p = 0.02) and less likely to have seasonal allergies (p = 0.02).

Conclusion

LyE commonly presents with dysphagia due to esophageal strictures which require dilation. Smoking was associated with LyE, whereas atopy was not. LyE should be considered as a diagnostic possibility in patients with these characteristics undergoing upper endoscopy.

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Many Inflammatory Bowel Disease Patients Are Not Immune to Measles or Pertussis

Abstract

Background

Current guidelines emphasize vaccination for influenza and pneumococcus for IBD patients and the avoidance of live virus vaccines for those who are on immunosuppressive (ISS) therapy. Given the recent resurgence of measles and pertussis infections, we assessed the immune status of our IBD population in order to advise about these risks.

Methods

We prospectively collected measles and pertussis titers in our IBD patients from February 1–May 1, 2015. Immune status based on standard threshold values was determined: measles antibodies ≤0.8 antibody index (AI) = negative immunity, 0.9–1.1 AI = equivocal immunity and titers ≥1.2 AI = positive immunity. For pertussis immunity, anti-pertussis antibodies ≤5 IU/mL were considered negative immunity. Univariate analysis was performed to examine predictive factors including age, disease duration, and current medical therapies.

Results

A total of 122 patients' titers were assessed (77 Crohn's disease, 1 indeterminate colitis, and 45 ulcerative colitis). Sixteen (13.1 %) patients lacked detectable immunity to measles, and four (3 %) had equivocal immunity. Twelve (75 %) of the measles non-immune patients were on ISS therapy versus 65 (64 %) of 102 immune patients (OR 1.7, 95 % CI 0.5–5.9, p = 0.34). Out of 96 patients, 58 (60 %) were not immune to pertussis. Disease duration ≥10 years and age ≥50 were associated with significant lower measles titers.

Conclusions

A significant number of our IBD patients lack immunity to measles, and a majority of our IBD patients do not have detectable immunity to pertussis. Importantly, the majority of the measles non-immune patients are on ISS therapy and therefore unable to receive a booster.

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The 2010–2015 Prevalence of Eosinophilic Esophagitis in the USA: A Population-Based Study

Abstract

Background and Aims

Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder with increasing prevalence. However, epidemiologic data have mostly been acquired from small studies. We sought to describe the epidemiology of EoE in the USA, utilizing a large database.

Methods

We queried a commercial database (Explorys Inc, Cleveland, OH, USA), an aggregate of electronic health record data from 26 major integrated US healthcare systems from 1999 to July 2015. We identified an aggregated patient cohort of eligible patients with EoE and a history of proton-pump inhibitor use between July 2010 and July 2015, based on Systematized Nomenclature of Medicine—Clinical Terms. We calculated the prevalence of EoE among different patient groups.

Results

Of the 30,301,440 individuals in the database, we identified 7840 patients with EoE with an overall prevalence of 25.9/100,000 persons. Prevalence was higher in males than females [odds ratio (OR) 2.00; 95 % CI 1.92–2.10, p < 0.0001], Caucasians versus African-Americans and Asians (OR 2.00; 95 % CI 1.86–2.14, p < 0.0001), and adults (18–65 years) versus elderly (>65 years) and children (<18 years) (OR 1.63; 95 % CI 1.54–1.71, p < 0.0001). Compared with controls (individuals in database without EoE), individuals with EoE were more likely to have other gastrointestinal diagnoses such as dysphagia and at least one allergic condition.

Conclusions

In this large study, we found that the estimated prevalence of EoE in the USA is 25.9/100,000, which is at the lower end of prevalence rates reported in the USA and other industrial countries. We confirmed that EoE has a strong association with allergic and gastrointestinal diagnoses.

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Long-Term Fenofibrate Treatment in Primary Biliary Cholangitis Improves Biochemistry but Not the UK-PBC Risk Score

Abstract

Background

Fenofibrate (FF) has been suggested as a second-line agent in primary biliary cholangitis (PBC) patients who do not achieve adequate biochemical response to ursodeoxycholic acid (UDCA) monotherapy. Limited data exist on FF use beyond 12 months, and its long-term effects are unclear.

Aim

To study the biochemical outcome of long-term (>12 months) FF treatment in combination with UDCA (FF + UDCA) in PBC patients and to determine the effect on predicted prognosis using the UK-PBC Risk Score.

Methods

This was a retrospective cohort study of all PBC patients treated in a specialist center with FF + UDCA therapy after failure to achieve biochemical response. Liver and renal biochemical indices and the UK-PBC Risk Score at baseline and at 12, 24, 36, 48, and 60 months of FF + UDCA treatment were compared. Biochemical response was assessed using the POISE trial criteria at the end of FF + UDCA treatment.

Results

Data from 23 patients treated with FF + UDCA combination were analyzed. The median dose of fenofibrate was 200 mg/day, and median treatment duration was 21 months (range 1–123 months). Six (26 %) patients discontinued FF within 1 year. In patients who completed 12 months (n = 17) and long-term therapy, significant decrease in ALP was seen at 12 (p = 0.0002), 24 (p = 0.002), and 36 (p = 0.03) months. More than 75 % patients met the POISE criteria of ALP response at all study time points. There was no significant improvement in the 5-, 10-, and 15-year UK-PBC Risk Scores after FF + UDCA treatment. No significant renal impairment or adverse events were reported.

Conclusion

The long-term treatment of PBC patients with fenofibrate as an adjunct to UDCA is safe and effective in improving ALP, but the treatment did not significantly reduce the estimated probability of liver-related death or need for liver transplantation.

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Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection in the Elderly: Long-Term Outcomes and Microbiota Changes

Abstract

Background and Aims

Fecal microbiota transplantation (FMT) has become the cornerstone in management of recurrent Clostridium difficile infection (RCDI) in adults. However, data on efficacy, safety, long-term outcomes, and microbiota alterations are limited in elderly patients (>65 years).

Methods

Twenty-nine consecutive elderly patients with RCDI underwent FMT with combined jejunal and colonic method and monitored for long-term outcomes. Fecal samples from five elderly RCDI patients (G65) were subjected to genomic analysis before and after FMT, and microbiota changes were compared with matched RCDI patients below 65 years (L65).

Results

FMT resulted in marked improvement in all clinical parameters, including abdominal pain, bloating, and diarrhea in all elderly RCDI patients. Fecal C. difficile toxin was positive in all 29 patients and turned negative in all 27 patients, who agreed to undergo this test after FMT. Statistically significant improvement in leukocytosis was noted (p < 0.05). Only adverse events reported were transient mild fever (2/29) and bloating (3/29). Long-term follow-up over 25.4 ± 12.8 months did not reveal any additional adverse events or RCDI recurrence. Genomic analysis suggested that overall microbiota diversity increased post-FMT in elderly RCDI patients. However, this response was less robust than the younger group. While Firmicutes did not change markedly, Proteobacteria decreased significantly in post-FMT samples in elderly RCDI patients.

Conclusions

These observations suggest that FMT in elderly patients with RCDI appears to be highly efficacious with no recurrence of infection over long-term follow-up. Alterations in microbiota in this group of patients are characterized by less robust increase in microbial diversity and marked reduction in phylum Proteobacteria.

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Prevention of the Paracentesis-Induced Circulatory Dysfunction (PICD) in Cirrhosis: Is the SPA Treatment Worthwhile?

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Another New Esophagitis: The Lymphocyte Gets Its Turn

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Pancreaticobiliary Maljunctions in European Patients with Bile Duct Cysts: Results of the Multicenter Study of the French Surgical Association (AFC)

Abstract

Background

Pancreaticobiliary maljunctions (PBMs) are congenital anomalies of the junction between pancreatic and bile ducts, frequently associated with bile duct cyst (BDC). BDC is congenital biliary tree diseases that are characterized by distinctive dilatation types of the extra- and/or intrahepatic bile ducts. Todani's types I and IVa, in which dilatation involves principally the main bile duct, are the most frequent. PBM induces pancreatic juice reflux into the biliary tract that is supposed to be one of the main factors of biliary cancer degeneration, although the diagnostic criteria of PBM that can be either morphological and/or functional are not well defined especially in Western series.

Objective

The aim of this study was to assess the relative prevalence of PBM in BDC in a large European multicenter study, to analyze the characteristics of PBM and try to propose diagnostic criteria of PBMs based on morphological and/or functional criteria and define the positive, negative predictive values, sensibility and specificity of either criteria.

Results

From 1975 to 2012, 263 patients with BDC were analyzed. Among them, 190 (72.2 %) were considered to present PBM. Types I and IVa had a similar rate of PBM association. According to the "AFC classification," 57.2 % had a C–P type, 34.5 % a P–C type and 8.3 % a complex type ("anse-de-seau"). The median length of the common channel in patients with PBM was 15.8 ± 6.8 mm (range 5–40 mm). The median intrabiliary amylase and lipase levels were 65,249 and 172,104 UI/L, respectively. For the diagnostic of PBM, a common channel length of more than 8 mm and an intrabiliary amylase level superior to 8000 UI/L were associated with a predictive positive value and a specificity of more than 90 %. Synchronous biliary cancer had an incidence of 8.7 % in all patients with BDC and PBM 11.1 % in adults. Compared to type IV, the type I BDC was associated with statistically more cancer patients in the presence of PBM.

Conclusions

Characteristics of PBM associated with BDC in Western population are quite close to reported Eastern series. The results suggest considering both the intrabiliary value of amylase >8000 UI/L and a length of a common channel >8 mm as appropriate values for positive diagnosis of PBM.

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Activation of NQO1 in NQO1*2 polymorphic human leukemic HL-60 cells by diet-derived sulforaphane

Abstract

Background

The NAD(P)H: quinone oxidoreductase (NQO1) confers protection against semiquinones and also elicits oxidative stress. The C609T polymorphism of the NQO1 gene, designated NQO1*2, significantly reduces its enzymatic activity due to rapid degradation of protein. Since down regulation of NQO1 mRNA expression correlates with increased susceptibility for developing different types of cancers, we investigated the link between leukemia and the NQO1*2 genotype by mining a web-based microarray dataset, ONCOMINE. Phytochemicals prevent DNA damage through activation of phase II detoxification enzymes including NQO1. Whether NQO1 expression/activity in leukemia cells that carry the labile NQO1*2 genotype can be induced by broccoli-derived phytochemical sulforaphane (SFN) is currently unknown.

Methods and Results

The ONCOMINE query showed that: (1) acute lymphoblastic leukemia and chronic myelogenous leukemia are associated with reduced NQO1 levels, and (2) under-expressed NQO1 was found in human HL-60 leukemia cell line containing the heterozygous NQO1*2 polymorphism. We examined induction of NQO1 activity/expression by SFN in HL-60 cells. A dose-dependent increase in NQO1 level/activity is accompanied by upregulation of the transcription factor, Nrf2, following 1–10 μM SFN treatment. Treatment with 25 µM SFN drastically reduced NQO1 levels, inhibited cell proliferation, caused sub-G₁ cell arrest, and induced apoptosis, and a decrease in the levels of the transcription factor, nuclear factor-κB (NFκB).

Conclusions

Up to 10 μM of SFN increases NQO1 expression and suppresses HL-60 cell proliferation whereas ≥ 25 μM of SFN induces apoptosis in HL-60 cells. Further, SFN treatment restores NQO1 activity/levels in HL-60 cells expressing the NQO1*2 genotype.

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The direct and indirect effect of climate change on citrus production in Tunisia: a macro and micro spatial analysis

Abstract

In this study, we tried to show the direct and indirect effect of precipitation and temperature on the production of citrus in Tunisia of a governorate i and the neighboring governorates. To do this, we used a new original analysis of spatial econometrics to take into account in an efficient and finely manner the spatial effects, individual and temporal effects of the spatial autocorrelation. This analysis was done on the basis of global spatial autocorrelation test and the spatial autoregressive model (SAR) as well as the spatial Durbin model (SDM). It appears from our results that the available water in the groundwater table of the governorate i can be an effective solution for the farmer who resides there provided that the means are implemented so that he can benefit. Our robustness results based on the cointegration dynamic panel data, also shows the effect of temperature via the hydric resources of the governorate i and that the neighboring governorates represent a negative spillover effect.

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Improvement of vibrodamping properties of polyvinyl acetate–graphite composites by electron beam processing of the filler

The effect of electron beam processing (energy 900 keV, absorbed dose in the range from 25 to 600 kGy) of graphite upon the efficiency of its use as a filler in polyvinyl acetate (PVA) based vibrodamping compo...

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Enhanced bioethanol production from wheat straw hemicellulose by mutant strains of pentose fermenting organisms Pichia stipitis and Candida shehatae

The main aim of the present study was to mutate yeast strains, Pichia stipitis NCIM 3498 and Candida shehatae NCIM 3501 and assess the mutant's ability to utilize, ferment wheat straw hemicellulose with enhanced ...

http://ift.tt/2c6dB2U

Determination of collective behavior of the financial market

In this paper, we adopt the network synchronization to measure the collective behavior in the financial market, and then analyze the factors that affect the collective behavior. Based on the data from the Chin...

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Predictive factors for cosmetic surgery: a hospital-based investigation

Cosmetic surgery is becoming increasingly popular in China. However, reports on the predictive factors for cosmetic surgery in Chinese individuals are scarce in the literature.

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Identification and tissue expression profiling of odorant binding protein genes in the red palm weevil, Rhynchophorus ferrugineus

The red palm weevil, Rhynchophorus ferrugineus, is a lethal pest of the palms. The identification of odorant binding protein (OBP) genes will be helpful for clarifing the mechanism of odorant detection of this pe...

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Basic MR sequence parameters systematically bias automated brain volume estimation

Abstract

Introduction

Automated brain MRI morphometry, including hippocampal volumetry for Alzheimer disease, is increasingly recognized as a biomarker. Consequently, a rapidly increasing number of software tools have become available. We tested whether modifications of simple MR protocol parameters typically used in clinical routine systematically bias automated brain MRI segmentation results.

Methods

The study was approved by the local ethical committee and included 20 consecutive patients (13 females, mean age 75.8 ± 13.8 years) undergoing clinical brain MRI at 1.5 T for workup of cognitive decline. We compared three 3D T1 magnetization prepared rapid gradient echo (MPRAGE) sequences with the following parameter settings: ADNI-2 1.2 mm iso-voxel, no image filtering, LOCAL− 1.0 mm iso-voxel no image filtering, LOCAL+ 1.0 mm iso-voxel with image edge enhancement. Brain segmentation was performed by two different and established analysis tools, FreeSurfer and MorphoBox, using standard parameters.

Results

Spatial resolution (1.0 versus 1.2 mm iso-voxel) and modification in contrast resulted in relative estimated volume difference of up to 4.28 % (p < 0.001) in cortical gray matter and 4.16 % (p < 0.01) in hippocampus. Image data filtering resulted in estimated volume difference of up to 5.48 % (p < 0.05) in cortical gray matter.

Conclusion

A simple change of MR parameters, notably spatial resolution, contrast, and filtering, may systematically bias results of automated brain MRI morphometry of up to 4–5 %. This is in the same range as early disease-related brain volume alterations, for example, in Alzheimer disease. Automated brain segmentation software packages should therefore require strict MR parameter selection or include compensatory algorithms to avoid MR parameter-related bias of brain morphometry results.

http://ift.tt/2cG1CM5