Finite Element Model and Validation of Nasal Tip Deformation

Abstract

Nasal tip mechanical stability is important for functional and cosmetic nasal airway surgery. Palpation of the nasal tip provides information on tip strength to the surgeon, though it is a purely subjective assessment. Providing a means to simulate nasal tip deformation with a validated model can offer a more objective approach in understanding the mechanics and nuances of the nasal tip support and eventual nasal mechanics as a whole. Herein we present validation of a finite element (FE) model of the nose using physical measurements recorded using an ABS plastic-silicone nasal phantom. Three-dimensional photogrammetry was used to capture the geometry of the phantom at rest and while under steady state load. The silicone used to make the phantom was mechanically tested and characterized using a linear elastic constitutive model. Surface point clouds of the silicone and FE model were compared for both the loaded and unloaded state. The average Hausdorff distance between actual measurements and FE simulations across the nose were 0.39 ± 1.04 mm and deviated up to 2 mm at the outermost boundaries of the model. FE simulation and measurements were in near complete agreement in the immediate vicinity of the nasal tip with millimeter accuracy. We have demonstrated validation of a two-component nasal FE model, which could be used to model more complex modes of deformation where direct measurement may be challenging. This is the first step in developing a nasal model to simulate nasal mechanics and ultimately the interaction between geometry and airflow.

http://ift.tt/2cuGFUW

Overuse of colorectal cancer screening services in the United States and its implications

Abstract

As a standard way for prevention and early detection of colorectal cancer (CRC), colonoscopy has been used for CRC screening in the United States for more than one decade. An article entitled "Assessing Colorectal Cancer Screening Adherence of Medicare Fee-For-Service Beneficiaries Age 76 to 95 Years" recently published at the Journal of Oncology Practice reports the trends in overuse of CRC screening services among average-risk elderly populations at the age of 76–95 years. Several reasons for overusing colonoscopy have been postulated, and some strategies for reducing overuse of CRC screening services have also been proposed.

http://ift.tt/2chMHsk

Expression pattern of subA in different tissues and blood-feeding status in Haemaphysalis flava

Abstract

Tick-borne-diseases (TBD) pose a huge threat to the health of both humans and animals worldwide. Tick vaccines constitute an attractive alternative for tick control, due to their cost-efficiency and environmental-friendliness. Subolesin, a protective antigen against ticks, is reported to be a promising candidate for the development of broad-spectrum vaccines. However, the entire length of its gene, subA, and its gene expression pattern in different tissues and blood-feeding status (or different levels of engorgement) have not been studied extensively. In our study, the full-length of subA in Haemaphysalis flava, Rhipicephalus haemaphysaloides, Rhipicephalus microplus, and Dermacentor sinicus was cloned by RACE–PCR. The subA expression pattern was analyzed further in H. flava in different tissues and blood-feeding status by RT-PCR. We found that the full-length of subA in H. flava, R. haemaphysaloides, R. microplus, and D. sinicus was 1318, 1498, 1316, and 1769 bp, respectively, with encoded proteins at 180, 162, 162, and 166 aa in length, respectively. The primary structure of subolesin in H. flava included three conserved regions and two hypervariable regions, with no signal peptide. SubA expression in female H. flava of different blood-feeding status was in the order of the fasted < the 1/4-engorged < the half-engorged < the fully-engorged (p < 0.01). Tissue expression of subA was in the order of salivary gland > midgut > integument (p < 0.01), but its expression in salivary glands was not statistically different from that in ovaries. We concluded that subolesin was a conserved antigen and that subA was expressed differentially in H. flava in different tissues and blood-feeding status. Those features made subolesin feasible as a potential target antigen for development of a universal vaccine for the control of tick infestations and a reduction in TBD.

http://ift.tt/2cqPw7J

Optimising electrogenerated chemiluminescence of quantum dots via co-reactant selection

Abstract

We demonstrate that for quantum dot (QD) based electrochemiluminescence (ECL), the commonly used co-reactant does not perform as effectively as potassium persulfate. By exploiting this small change in co-reactant, ECL intensity can be enhanced dramatically in a cathodic-based ECL system. However, TPA remains the preferential co-reactant-based system for anodic ECL. This phenomenon can be rationalised through the relative energy-level profiles of the QD to the co-reactant in conjunction with the applied potential range. This work highlights the importance of understanding the co-reactant pathway for optimising the application of ECL to bioanalytical analysis, in particular for near-infrared (NIR) QDs which can be utilised for analysis in blood.

Graphical Abstract

Optimising ECL Production Through Careful Selection of Co-Reactions Based on Energetics Involved

http://ift.tt/2cJ90b3

Functionalization of indium tin oxide electrode with both of dendrimer-encapsulated Pt nanoparticles and chemically converted graphenes for enhanced electrochemiluminescence of luminol/H 2 O 2

Abstract

Here, we report highly enhanced electrochemiluminescence (ECL) of luminol in the presence of H₂O₂ on indium tin oxides (ITOs) modified with both of dendrimer-encapsulated Pt nanoparticles (Pt DENs) and chemically converted graphenes (CCGs). The ITO electrodes were electrochemically modified with size-monodisperse Pt DENs via electrooxidative grafting of the terminal amines of the dendrimers encapsulating Pt nanoparticles. The Pt DEN-modified ITOs were then decorated with CCG sheets via electrostatic attachments of graphene oxides (GOs) and subsequent chemical reduction of the GOs to the CCGs. The resulting CCG-Pt DEN/ITO electrodes exhibited highly catalyzed electrochemical oxidation of luminol/H₂O₂, leading to significantly enhanced ECL of the luminol/H₂O₂ system, i.e., ∼15-fold enhancement, compared to ECL emission from bare ITOs even at lower applied potentials, which allowed sensitive ECL-based analysis of H₂O₂ using the CCG-Pt DEN/ITOs.

Graphical abstract

We report the highly enhanced electrochemiluminescence of the luminol/H₂O₂ system on the indium tin oxide electrodes modified with both of Pt nanoparticles and chemically converted graphenes using amine-terminated dendrimers

http://ift.tt/2cJ8M40

Investigation of perfluorooctanoic acid induced DNA damage using electrogenerated chemiluminescence associated with charge transfer in DNA

Abstract

An electrogenerated chemiluminescence (ECL)-DNA sensor was designed and fabricated for the investigation of DNA damage by a potential environmental pollutant, perfluorooctanoic acid (PFOA). The ECL-DNA sensor consisted of a Au electrode that had a self-assembled monolayer of 15 base-pair double-stranded (ds) DNA oligonucleotides with covalently attached semiconductor CdSe quantum dots (QDs) at the distal end of the DNA. Characterization of the ECL-DNA sensor was conducted with X-ray photoelectron spectroscopy (XPS), electrochemical impedance spectroscopy (EIS), ECL, and cyclic voltammetry before and after the exposure of the sensor to PFOA. Consistent data revealed that the dsDNA on Au was severely damaged upon the incubation of the electrode in PFOA, causing significant increase in charge (or electron) transfer (CT) resistance within DNA strands. Consequently, the cathodic coreactant ECL responses of the Au/dsDNA-QDs electrode in the presence of K₂S₂O₈ were markedly decreased. The strong interaction between DNA and PFOA via the hydrophobic interaction, especially the formation of F···H hydrogen bonds by insertion of the difluoro-methylene group of PFOA into the DNA base pairs, was believed to be responsible for the dissociation or loosening of dsDNA structure, which inhibited the CT through DNA. A linear relationship between the ECL signal of the sensor and the logarithmical concentration of PFOA displayed a dynamic range of 1.00 × 10⁻¹⁴–1.00 × 10⁻⁴ M, with a limit of detection of 1.00 × 10⁻¹⁵ M at a signal-to-noise ratio of 3.

Graphical Abstract

Illustration of ECL detection of PFOA on a Au/dsDNA-QDs ECL-DNA sensor

http://ift.tt/2cJ8mKT

Analytical electrochemiluminescence

http://ift.tt/2cJ8s5h

A novel solid-state electrochemiluminescence sensor for detection of cytochrome c based on ceria nanoparticles decorated with reduced graphene oxide nanocomposite

Abstract

A novel ultrasensitive sensing system for the rapid detection of cytochrome c (Cyt C) was developed on the basis of an electrochemiluminescence (ECL) method. A nanocomposite biosensor was made of reduced graphene oxide decorated with cerium oxide/tris(2,2-bipyridyl)ruthenium(II)/chitosan (CeO₂NPs-RGO/ Ru(bpy)₃²⁺/CHIT) and used for this purpose. The ECL signal was produced by an electrochemical interaction between Ru(bpy)₃²⁺ and tripropyl amine (TPA) on the surface of the electrode. Addition of Cyt C to the solution decreases the ECL signal due to its affinity for TPA and inhibition of its reaction with Ru(bpy)₃²⁺. The effects of the amount of CeO₂NPs-RGO, Ru(bpy)₃²⁺, TPA concentration as a co-reactant, and the pH of the electrolyte solution on the ECL signal intensity were studied and optimized. The results showed that the method was fast, reproducible, sensitive, and stable for the detection of Cyt C. The method has a linear range from 2.5 nM to 2 μM (R ² = 0.995) with a detection limit of 0.7 nM. Finally, the proposed biosensor was used for the determination of Cyt C in human serum samples with RSDs of 1.8–3.6 %. The results demonstrate that this solid-state ECL quenching biosensor has high sensitivity, selectivity, and good stability.

Graphical Abstract

A novel solid-state electrochemiluminescence sensor for detection of cytochrome C based on Ceria Nanoparticles Decorated Reduced Graphene Oxide Nanocomposite

http://ift.tt/2cRSa7p

Determination of silver ions based on the electrogenerated chemiluminescence of silver ions/peroxydisulfate

Abstract

In this work, a simple, sensitive, and selective method for the determination of silver ions (Ag⁺) was proposed on the basis of the enhancement of Ag⁺ on the electrogenerated chemiluminescence (ECL) of peroxydisulfate (S₂O₈²⁻), which can be attributed to the obvious electrocatalytic reduction of S₂O₈²⁻ by Ag⁺, giving rise to more abundant sulfate radical anion (SO₄^•−). Under optimal conditions, a linear range from 4 to 500 nM (R = 0.997) with a detection limit of 2.5 nM (S/N = 3) was achieved for the detection of Ag⁺. The Ag⁺/S₂O₈²⁻ ECL system could not only provide an assay protocol for the determination of Ag⁺ but also offer an effective way to enhance the ECL of S₂O₈²⁻, which may act as a promising platform for the detection of other species such as 4-chlorophenol.

Graphical abstract

ECL-potential curves of 0.1 M PBS (pH 8.5) containing (a) 500 nM AgNO₃, (b) 50 mM K₂S₂O₈, (c) 500 nM AgNO₃ and 50 mM K₂S₂O₈

http://ift.tt/2cRQxq2

Multiwalled carbon nanotubes/gold nanocomposites-based electrochemiluminescent sensor for sensitive determination of bisphenol A

Abstract

An electrochemiluminescence (ECL) sensor for bisphenol A was proposed by using l-cysteine-functionalized multiwalled carbon nanotubes/gold nanocomposites-modified glassy carbon electrode (MWCNTs-Au/GCE) based on ECL of peroxydisulfate solution. The ECL behaviors of peroxydisulfate solution had been investigated at the chitosan/MWCNTs-Au/GCE, and bisphenol A was found to have quenching effects on the ECL of peroxydisulfate solution. Both Au nanoparticles (AuNPs) and multiwalled CNTs could promote the electron transfer and synergetically amplify the ECL signal of peroxydisulfate solution. Under the optimized conditions, the ECL signal intensity was linear with the concentration of bisphenol A in the concentration range between 0.25 and 100 μM (R = 0.9931) with a detection limit (S/N = 3) of 0.083 μM. The constructed ECL sensor has the advantages of simplicity, sensitivity, good selectivity, and reproducibility, exhibiting a great potential application in the determination of bisphenol A.

http://ift.tt/2cRRoHl

Electrochemiluminescence behavior of meso -tetra(4-sulfonatophenyl)porphyrin in aqueous medium: its application for highly selective sensing of nanomolar Cu 2+

Abstract

The cathodic electrochemiluminescence (ECL) behavior of meso-tetra(4-sulfonatophenyl)porphyrin (TSPP) with potassium peroxydisulfate (K₂S₂O₈) as the coreactant in aqueous solution with strong and stable emission was exploited to determine Cu²⁺ down to nanomolar concentration. Two possible reaction mechanisms have been proposed to understand the generation of ECL by the TSPP/K₂S₂O₈ system. The effects of the concentration of TSPP and K₂S₂O₈, pH of the medium, and scan rate on the ECL intensity were studied in detail. The ECL intensity was efficiently quenched by trace amounts of Cu²⁺. This phenomenon was used to develop a new method, which can offer rapid, reliable, and selective detection of Cu²⁺. Under the optimum conditions, plots of the ECL of the TSPP/K₂S₂O₈ system versus the concentration of Cu²⁺ are linear in the range of 5 to 160 nM with a detection limit of 1.56 nM (S/N = 3). The proposed ECL sensor was successfully applied for analysis of tap and river water samples. It is anticipated that TSPP could be a new class of promising luminescent agent for ECL sensors.

Graphical Abstract

A two-step cathodic elelctrochemiluminescence (ECL) behavior of TSPP/K₂S₂O₈ system in the aqueous solution and Cu²⁺ determination using the same

http://ift.tt/2cJ8DNQ

Electrochemiluminescence of graphitic carbon nitride and its application in ultrasensitive detection of lead(II) ions

Abstract

Graphitic carbon nitride (g-C₃N₄) materials with a layered structure have unusual physicochemical properties. Herein it was shown that g-C₃N₄ quantum dots (QDs) obtained through a thermal-chemical etching route exhibited attractive upconversion and electrochemiluminescence (ECL) properties. After modification on nanoporous gold (NPG) with a sponge-like porous structure, g-C₃N₄ QDs were employed to fabricate an ECL sensor for the determination of Pb²⁺ using target - dependent DNAzyme as the recognition unit. Moreover, magnetic reduced graphene oxide nanosheets (rGO) attached with Fe₃O₄ nanoparticles (rGO-Fe₃O₄) were obtained via a one-pot in situ reduction approach, and used as carriers of DNAzyme. To make full use of the unique magnetic property the prepared rGO-Fe₃O₄, a flow injection ECL detecting cell was designed using indium tin oxide (ITO) glass as working electrode. Due to the unique separation and enrichment properties of magnetic Fe₃O₄-rGO materials as well as wire-like conductivity of NPG, high sensitivity and selectivity for the determination of Pb²⁺ in real water samples were achieved. This indicates that g-C₃N₄ has excellent anodic ECL performance in the presence of triethanolamine, and could be applied in real environmental samples analyses.

Graphical Abstract

Graphitic carbon nitride based electrochemiluminescence sensor for the sensitive monitor of lead(II) ions in real samples was constructed.

http://ift.tt/2cJ8Qkk

New insights into liquid chromatography for more eco-friendly analysis of pharmaceuticals

Abstract

Greening the analytical methods used for analysis of pharmaceuticals has been receiving great interest aimed at eliminating or minimizing the amount of organic solvents consumed daily worldwide without loss in chromatographic performance. Traditional analytical LC techniques employed in pharmaceutical analysis consume tremendous amounts of hazardous solvents and consequently generate large amounts of waste. The monetary and ecological impact of using large amounts of solvents and waste disposal motivated the analytical community to search for alternatives to replace polluting analytical methodologies with clean ones. In this context, implementing the principles of green analytical chemistry (GAC) in analytical laboratories is highly desired. This review gives a comprehensive overview on different green LC pathways for implementing GAC principles in analytical laboratories and focuses on evaluating the greenness of LC analytical procedures. This review presents green LC approaches for eco-friendly analysis of pharmaceuticals in industrial, biological, and environmental matrices.

Graphical Abstract

Green pathways of liquid chromatography for more eco-friendly analysis of pharmaceuticals

http://ift.tt/2cJ7Rk7

Label-free electrochemiluminescence biosensor for ultrasensitive detection of telomerase activity in HeLa cells based on extension reaction and intercalation of Ru(phen) 3 2+

Abstract

Telomerase is one of the most common markers of human malignant tumors, such as uterine, stomach, esophageal, breast, colorectal, laryngeal squamous cell, thyroid, bladder, and so on. It is necessary to develop some sensitive but convenient detection methods for telomerase activity determination. In this study, a label-free and ultrasensitive electrochemiluminescence (ECL) biosensor has been fabricated to detect the activity of telomerase extracted from HeLa cells. Thiolated telomerase substrate (TS) primer was immobilized on the gold electrode surface through gold-sulfur (Au-S) interaction and then elongated by telomerase specifically. Then, it was hybridized with complementary DNA to form double-stranded DNA (dsDNA) fragments on the electrode surface, and Ru(phen)₃²⁺ has been intercalated into the dsDNA grooves to act as the ECL probe. The enhanced ECL intensity has a linear relationship with the number of HeLa cells in the range of 5∼5000 and with a detection limit of 2 HeLa cells. The proposed ECL biosensor has high specificity to telomerase in the presence of common interferents. The relative standard deviations (RSDs) were <5 % at 100 HeLa cells. The proposed method provides a convenient approach for telomerase-related cancer screening or diagnosis.

http://ift.tt/2d3HeGS

Electrochemiluminescent (ECL) [Ru(bpy) 3 ] 2+ /PAMAM dendrimer reactions: coreactant effect and 5-fluorouracil/dendrimer complex formation

Abstract

Electrogenerated chemiluminescence (ECL) reactions between tris(2,2′-bipyridine)ruthenium(II) and PAMAM dendrimers of the full (G1.0) and half (G1.5) generations were carried out in an aqueous medium at pH 6.1 and 10.0. In the absence of 5-fluoro-1H,3H-pyrimidine-2,4-dione (5-fluorouracil, 5-Fu) (coreactant effect study), the ECL efficiency trends as a function of [G1.0] and [G1.5] at pH 6.1 and 10.0 revealed that PAMAM dendrimers are about 100 (G1.5, pH 6.1), 60 (G1.5, pH 10.0), 26 (G1.0, pH 10.0) and 13 (G1.0, pH 6.1) times more efficient as ECL coreactants than oxalate anion is. Moreover, ECL reactions were done in the presence of several solutions of 5-Fu at a fixed concentration of the G1.0 and G1.5 dendrimers at pH 6.1 and 10.0 (binding study). The ECL efficiency trends as a function of [5-Fu] highlighted a dendrimer/5-Fu binding. Therefore, one of the most remarkable and novel findings of this work is the potential of PAMAM dendrimers to be used as both sensors and biosensors in an aqueous medium in the presence of a suitable sensitizer. Redox potentials of the [Ru(bpy)₃]^3+/2+ couple were also determined in the absence and presence of 5-Fu at both pHs. In the absence of 5-Fu the positive or negative shift of redox potentials showed the influence of the repulsive or attractive electrostatic long-range and short-range interactions between the charged dendrimer surface and the oxidized and reduced forms of the couple. In the presence of 5-Fu the trends of redox potentials highlighted the existence of a charged dendrimer/5-Fu species.

Graphical Abstract

ECL emission for the [Ru(bpy)₃]²⁺/ G1.0 dendrimer reaction in the presence of the 5-Fu at pH 6.1

http://ift.tt/2cJ9cXV

Pharmakologische Epilepsietherapie bei Kinderwunsch und in der Schwangerschaft

Zusammenfassung

Bei einer frühzeitigen präkonzeptionellen Beratung und einer engmaschigen Begleitung in der Schwangerschaft verläuft die überwiegende Mehrheit der Schwangerschaften bei Frauen mit Epilepsie komplikationslos. Anzustreben ist eine bestmögliche Anfallskontrolle ohne Auftreten von Grand-mal-Anfällen unter Einsatz eines Antiepileptikums mit möglichst niedrigem Fehlbildungsrisiko. Aufgrund des dosisabhängig erhöhten Fehlbildungsrisikos und weiterer Risiken, vor allem hinsichtlich der kognitiven Entwicklung der Kinder, wurden die Warnungen zur Verordnung von Valproinsäure bei Frauen im reproduktiven Alter verschärft. Die Pharmakokinetik der antiepileptischen Medikation (AED) in der Schwangerschaft macht regelmäßige Serumspiegelkontrollen und eine frühzeitige Dosisanpassung erforderlich. Frauen können auch bei Einnahme eines Antiepileptikums zum Stillen ermutigt werden, sofern der Säugling gut hinsichtlich einer möglichen Sedierung oder Trinkschwäche beobachtet wird.

http://ift.tt/2cbqMPV

Caffeine Blocks HIV-1 Tat-Induced Amyloid Beta Production and Tau Phosphorylation

Abstract

The increased life expectancy of people living with HIV-1 who are taking effective anti-retroviral therapeutics is now accompanied by increased Alzheimer's disease (AD)-like neurocognitive problems and neuropathological features such as increased levels of amyloid beta (Aβ) and phosphorylated tau proteins. Others and we have shown that HIV-1 Tat promotes the development of AD-like pathology. Indeed, HIV-1 Tat once endocytosed into neurons can alter morphological features and functions of endolysosomes as well as increase Aβ generation. Caffeine has been shown to have protective actions against AD and based on our recent findings that caffeine can inhibit endocytosis in neurons and can prevent neuronal Aβ generation, we tested the hypothesis that caffeine blocks HIV-1 Tat-induced Aβ generation and tau phosphorylation. In SH-SY5Y cells over-expressing wild-type amyloid beta precursor protein (AβPP), we demonstrated that HIV-1 Tat significantly increased secreted levels and intracellular levels of Aβ as well as cellular protein levels of phosphorylated tau. Caffeine significantly decreased levels of secreted and cellular levels of Aβ, and significantly blocked HIV-1 Tat-induced increases in secreted and cellular levels of Aβ. Caffeine also blocked HIV-1 Tat-induced increases in cellular levels of phosphorylated tau. Furthermore, caffeine blocked HIV-1 Tat-induced endolysosome dysfunction as indicated by decreased protein levels of vacuolar-ATPase and increased protein levels of cathepsin D. These results further implicate endolysosome dysfunction in the pathogenesis of AD and HAND, and by virtue of its ability to prevent and/or block neuropathological features associated with AD and HAND caffeine might find use as an effective adjunctive therapeutic agent.

http://ift.tt/2cqLZXj

Design and Analysis of a Four-Pendulum Omnidirectional Spherical Robot

Abstract

This paper presents the design, analysis, and comparison of a novel four-pendulum spherical robot. The proposed mechanism rolls omnidirectionally via four tetrahedrally-located pendulums that shift the robot's center of mass to create rolling torque. The nine dynamic equations of motion are derived via the Lagrangian and nonholonomic constraint equations, and then simulated numerically; results show successful propulsion with expected behaviors. The mechanism is then compared to existing center-of-mass designs in terms of directionality, drive torque arm, and inertia eccentricity. In these regards, the four-pendulum design is a balance of existing designs: it is omnidirectional with eccentricity and torque capability that are in the middle of the range exhibited by existing designs. In addition, the new four-pendulum mechanism has been built and tested as a successful proof-of-concept prototype.

http://ift.tt/2cYJ0KO

Regarding Dettloff et al. “Mammary Analog Secretory Carcinoma (MASC) Involving the Thyroid Gland: A Report of the First Three Cases”

http://ift.tt/2cusXBd

Letter to the Editor concerning “Virtually bloodless posterior midline exposure of the lumbar spine using the ‘paramidline’ fatty plane” by Moghimi MH, Leonard DA, Cho CH, et al. (Eur Spine J (2016) 25;956–962)

http://ift.tt/2cIPKuh

Benefits of a national network of drug information centres: RELIS

http://ift.tt/2cut3Jl

Medication errors reported to the National Medication Error Reporting System in Malaysia: a 4-year retrospective review (2009 to 2012)

Abstract

Purpose

Reporting and analysing the data on medication errors (MEs) is important and contributes to a better understanding of the error-prone environment. This study aims to examine the characteristics of errors submitted to the National Medication Error Reporting System (MERS) in Malaysia.

Methods

A retrospective review of reports received from 1 January 2009 to 31 December 2012 was undertaken. Descriptive statistics method was applied.

Results

A total of 17,357 MEs reported were reviewed. The majority of errors were from public-funded hospitals. Near misses were classified in 86.3 % of the errors. The majority of errors (98.1 %) had no harmful effects on the patients. Prescribing contributed to more than three-quarters of the overall errors (76.1 %). Pharmacists detected and reported the majority of errors (92.1 %). Cases of erroneous dosage or strength of medicine (30.75 %) were the leading type of error, whilst cardiovascular (25.4 %) was the most common category of drug found.

Conclusions

MERS provides rich information on the characteristics of reported MEs. Low contribution to reporting from healthcare facilities other than government hospitals and non-pharmacists requires further investigation. Thus, a feasible approach to promote MERS among healthcare providers in both public and private sectors needs to be formulated and strengthened. Preventive measures to minimise MEs should be directed to improve prescribing competency among the fallible prescribers identified.

http://ift.tt/2crmESh

R&D on glass fiber reinforced epoxy resin composites for superconducting Tokamak

The glass fiber reinforced epoxy resin composites play an important role in superconducting Tokamak, which are used to insulate the metal components, such as superconducting winding, cooling pipes, metal elect...

http://ift.tt/2cMA4EU

Gain enhancement for wideband end-fire antenna design with artificial material

Gain enhancement wideband end-fire antenna is proposed in this paper. The proposed antenna can achieve gain enhancement by loading novel artificial materials structures (Split-ring Resonators) in the end-fire ...

http://ift.tt/2d3przI

The effect of long-term amiodarone administration on myocardial fibrosis and evolution of left ventricular remodeling in a porcine model of ischemic cardiomyopathy

Amiodarone is effective in suppressing arrhythmias in heart failure patients. We investigated the effect of long-term amiodarone administration on myocardial fibrosis and left ventricular (LV) remodeling in a ...

http://ift.tt/2cMByiC

Distance-based topological polynomials and indices of friendship graphs

Drugs and chemical compounds are often modeled as graphs in which the each vertex of the graph expresses an atom of molecule and covalent bounds between atoms are represented by the edges between their corresp...

http://ift.tt/2d3pVFV

The use of vanishing spray reduces the extent of rule violations in soccer

More and more sport associations introduce innovative devices to support referees and umpires respectively, affecting a strong need for the evaluation of these devices. This study evaluates the use of the new ...

http://ift.tt/2cMzQxB

Biosimilar Monoclonal Antibodies for Inflammatory Bowel Disease: Current Comfort and Future Prospects

Abstract

Biosimilars are biologic medicines that enter the market after a patent for an original reference product expires. The European Medicines Agency (EMA) developed a stringent legislation process for biosimilar monoclonal antibodies, whereby similarity to the reference medicinal product in terms of quality characteristics, biological activity, clinical safety and efficacy must be demonstrated. Biosimilar infliximab CT-P13 was the first biosimilar monoclonal antibody to receive EMA marketing authorization, and further biosimilar molecules are being developed. The phase I and III clinical trials were conducted in ankylosing spondylitis and rheumatoid arthritis, and the use of CT-P13 in inflammatory bowel disease (IBD) was extrapolated on the results of these trials. Medical professionals were initially concerned about the reversed engineering process, the novel legal framework and the lack of clinical data in IBD. Emerging real-world data have confirmed the similarities between CT-P13 and the reference product in terms of efficacy, safety and immunogenicity in IBD. The cost reduction represented by biosimilars promotes industry competition and improves treatment access with sustained quality of care. This article reviews the existing and emerging clinical data for CT-P13 and a future perspective on biosimilar use in IBD.

http://ift.tt/2cqqdTp

Different predictive values of interim 18 F-FDG PET/CT in germinal center like and non-germinal center like diffuse large B-cell lymphoma

Abstract

Purpose

Diffuse large B-cell lymphoma (DLBCL) is a pathologically heterogeneous disease with different prognoses according to its molecular profiles. Despite the broad usage of ¹⁸F-fluoro-2-dexoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT), previous studies that have investigated the value of interim ¹⁸F-FDG PET/CT in DLBCL have given the controversial results. The purpose of this study was to evaluate the prognostic value of interim ¹⁸F-FDG PET/CT in DLBCL according to germinal center B cell-like (GCB) and non-GCB molecular profiling.

Methods

We enrolled 118 newly diagnosed DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). Interim ¹⁸F-FDG PET/CT scans performed after 2 or 3 cycles of R-CHOP treatment were evaluated based on the Lugano response criteria. Patients were grouped as GCB or non-GCB molecular subtypes according to immunohistochemistry results of CD10, BCL6, and MUM1, based on Hans' algorithm.

Results

In total 118 DLBCL patients, 35 % were classified as GCB, and 65 % were classified as non-GCB. Interim PET/CT was negative in 70 %, and positive in 30 %. During the median follow-up period of 23 months, the positive interim ¹⁸F-FDG PET/CT group showed significantly inferior progression free survival (PFS) compared to the negative interim ¹⁸F-FDG PET/CT group (P = 0.0004) in entire patients. A subgroup analysis according to molecular profiling demonstrated significant difference of PFS between the positive and negative interim ¹⁸F-FDG PET groups in GCB subtype of DLBCL (P = 0.0001), but there was no significant difference of PFS between the positive and negative interim ¹⁸F-FDG PET groups in non-GCB subtype of DLBCL.

Conclusions

Interim ¹⁸F-FDG PET/CT scanning had a significant predictive value for disease progression in patients with the GCB subtype of DLBCL treated with R-CHOP, but not in those with the non-GCB subtype. Therefore, molecular profiles of DLBCL should be considered for interim ¹⁸F-FDG PET/CT practice.

http://ift.tt/2cB6WOR

Efficiency of Modified Phosphatic Fertilizer in Transplanted Rice ( Oryza sativa L.) Under Partially Reclaimed Salt Affected Soil of Uttar Pradesh

Abstract

The present investigations was conducted at the instructional farm of the Narendra Deva University of Agriculture and Technology, Kumarganj, Faizabad to evaluate the response of single super phosphate (SSP) modified with different organic and inorganic materials to rice. The application of modified and split doses of phosphatic fertilizer increased the yield, yield attributes, and nutrient uptake over the control. The maximum yield of rice was obtained in gypsum coated SSP (49.50 q ha⁻¹) than 50 % Basal + 50 % Top dressing in two split 25 % tillering stage + 25 % PI stage (44.70 q ha⁻¹) and Cow dung coated SSP (1:5) (38.80 q ha⁻¹) treatment. The SSP with gypsum coated recorded higher N, P, and K uptake response by 65.64, 168.23 and 89.06 % respectively as compared to other treatment. The maximum net income and cost benefit ratio was obtained with gypsum coated SSP followed by 50 % Basal + 50 % Top dressing in two split 25 % tillering stage + 25 % PI stage.

http://ift.tt/2ch9pkd

The expression of miRNA-221 and miRNA-222 in gliomas patients and their prognosis

Abstract

The aim of this study is to explore the expression of microRNA (miRNA)-221 and miRNA-222 in human glioma cells and tissues. The expression of miRNA-221 and miRNA-222 in human glioma cell line U87, U251, A172, LN229 and surgery resected glioma tissues were measured. The survival rate of X-ray (2 Gy) irradiated glioma cells were calculated. 165 cases of glioma patients were recruited successfully; the expression of miRNA-221 and miRNA-222 in their resected tissues were measured. The expression of miRNA-221 and miRNA-222 in cancer tissues were obviously higher than control tissues (normal brain tissue) and control cell (gastric mucosal epithelial cell, GES) (p < 0.05). The highly malignant glioma tissues expressed significantly higher miRNA-221 and miRNA-222 than low malignant glioma tissues. Patients with highly expressed miRNA-221 and miRNA-222 have shorter survival time. Survival rate of glioma cells was significantly higher than GES cell after irradiation (p < 0.05); miRNA-221 in glioma cells. The expressions of miRNA-221 and miRNA-222 in irritated glioma cells were positively correlated with the survival rate of glioma cells (r = 0.629, 0.712, both p < 0.01). For the 165 glioma patients, the expressions of miRNA-221 and miRNA-222 increased with the increasing of pathological grades (χ ² = 42.85, p < 0.01); and their survival time decreased when miRNA-221 expression elevated (χ ² = 57.12, p < 0.01). MiRNA-221 and miRNA-222 express highly in human glioma cells and tissues. Expression of miRNA-221 and miRNA-222 are closely related to pathological grading and prognosis of glioma; they could be used as independent prognostic factor for glioma.

http://ift.tt/2czOtFH

Gadolinium Deposition and Toxicity: A Global Concern

Abstract

Purpose of Review

Gadolinium-based contrast agents (GBCAs) have been used since 1988 for magnetic resonance imaging. These agents were considered very safe and, excluding nephrogenic systemic fibrosis in patients with renal failure, no clinical entities were associated with its administration. Our purpose is to summarize gadolinium induced toxicity by reviewing the most recent literature in this subject.

Recent Findings

It was believed that GBCAs distribute rapidly in the extracellular volume after intravenous administration and eliminate rapidly, almost completely, via renal excretion. Currently, we know that this is not entirely true. Some GBCAs may be retained, undergo dechelation and induce gadolinium deposition in different tissues such as liver, bone or brain in patients with normal renal function. The retained gadolinium, whether dechelated and associated with different compounds or in its original formulation, may trigger gadolinium-related toxic effects. This potential toxicity became a global concern.

Summary

This review summarizes the most recent published data regarding gadolinium deposition, possible clinical significance of gadolinium tissue retention and accumulation, strategies to limit gadolinium body burden and some future trends in this area.

http://ift.tt/2cqI5Tz

Radiologist Incomes: A Global Perspective

Abstract

Purpose of Review

To present a global perspective on wages in Radiology.

Recent Findings

The level of income of radiologists in the great majority of countries reflects a combination of economic supply and demand, the wealth of the country, and political efforts. Incomes in Radiology may be extremely variable not only in different countries but also in the same country or even in the same department. There are several variables and factors that influence the expected differences in radiologist incomes, including country's Gross Domestic Product, location (metropolitan or rural), type of institution (public or private), financial perks and incentives, part time versus full time, subspecialization, age, degree, and gender.

Summary

In this paper, we review some of the critical factors involved in these existing disparities regarding radiologist's income. Discussion of related subjects of radiologist work is also made.

http://ift.tt/2cu37gQ

Ten year maturation period in a level-I trauma center, a cohort comparison study

Abstract

Purpose

Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation.

Methods

A cohort comparison, between June 2004–July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome.

Results

From June 2004 to July 2005 219, patients were admitted, and for the year 2014, this was 282 patients. The 2014 cohort was significantly older (mean age of 53.6 ± 23.8 vs 45.6 ± 22.7 years). The mean RTS did not differ. P-HEMS assists increased to 116 (13.5 %). The number of CT scans, blood transfusion, and acute trauma surgical interventions decreased. Mean LOS, ICU admission, and ICU LOS did not differ. The mortality rate, however, decreased by 7.0 %, observed and predicted survival was significantly different in favour of the 2014 cohort, with a Z-score of 4.25.

Conclusion

An increase in age is seen, though trauma scores remain comparable. The number of blood products transfused and acute trauma surgical interventions performed declines. Mortality significantly decreased and a significant difference in observed and predicted survival is seen. Showing improved trauma care in our hospital, in favour of the second period.

http://ift.tt/2d0X0iZ

Novel six-week protocol for generating functional human connective tissue-type (MC TC ) mast cells from buffy coats

Abstract

Objective

The aim of this study was to develop a novel protocol for generating large populations of fully mature and functional human mast cells (HMC) from CD34⁺ hematopoietic stem cells which require less culturing time than previously reported methods.

Methods

CD34⁺ cells isolated from fresh human buffy coats were sequentially cultured with different combinations of SCF, IL-6, IL-3, IL-9 and IL-4 under selected culturing conditions and time periods. Cells were then harvested for immunohistochemical characterization of morphological phenotypes and were functionally characterized by assessing their responses to IgE-dependent and -independent stimuli by measuring the release of inflammatory mediators and cytokines. Moreover, the pharmacological profiles of several classes of anti-inflammatory drugs in inhibiting the activation of these HMC were also characterized.

Results

We have developed a novel protocol that can generate large homogenous populations of mature and functional HMC in 6 weeks. These cells expressed both tryptase and chymase and were activated by anti-IgE, cationic peptides and calcium ionophores. Moreover, IgE-dependent activation of these cells was significantly inhibited by anti-inflammatory drugs. The morphological and functional characteristics of these mast cells resembled those of MC_TC type or connective tissue-type HMC.

Discussion

Our protocol represents a novel time-saving and economical approach for generating large numbers of primary HMC for functional studies of mast cell biology and for profiling novel anti-inflammatory therapeutic agents with mast cell-inhibitory properties in humans.

http://ift.tt/2czJDIu

Post-relapse survival in patients with the early and late distant recurrence in estrogen receptor-positive HER2-negative breast cancer

Abstract

Background

Few studies have been performed on post-relapse survival in patients with the early and late distant recurrence in estrogen receptor (ER)-positive, HER2-negative breast cancer.

Methods

A total of 205 patients with the early distant recurrence and 134 patients with the late distant recurrence of ER-positive, HER2-negative breast cancer who had undergone breast surgery or neoadjuvant chemotherapy between January 2000 and December 2004 were registered from nine institutions. Prognostic factors for post-relapse survival in patients with the early and late recurrence were analyzed.

Results

Post-relapse survival was significantly longer in patients with the late recurrence than in patients with the early recurrence. Predictive factors for post-relapse survival in patients with the early recurrence were lack of adjuvant chemotherapy, a long disease-free interval, and long durations of endocrine therapies and chemotherapies after relapse. In patients with the late recurrence, post-relapse survival was significantly improved for those individuals with one metastatic organ at relapse and individuals who were treated with the first-line and subsequent endocrine therapies for prolonged periods. Moreover, ER expression in primary breast tumors of late recurrence patients was significantly higher with a duration of the first-line endocrine therapy >6 months than in those with a duration ≤6 months.

Conclusion

Predictors for prognosis after relapse differed between patients with the early and late distant recurrence. Endocrine responsiveness after relapse is a key factor for improved post-relapse survival, and it is thus important to establish whether metastatic tumors are endocrine-resistant in ER-positive, HER2-negative recurrent breast cancer.

http://ift.tt/2d0VOfm

A new model for the artificial aorta blood vessels using double-sided radial functionally graded biomaterials

Abstract

Based on radial functionally graded biomaterials and inspired by the geometry of a real aorta blood vessel, a new model was proposed to fabricate the artificial blood vessels. A finite element analyzer is employed to reach the optimal and proper material properties while earlier, it was validated by two famous theories, i.e., the first shear deformation and the plane elasticity. First, the geometry of a real ascending aorta part was simulated and then solved under the axially varying blood pressure and other real and actual conditions. Since the construction of artificial blood vessels just similar to the natural one is impossible, it was tried to find the best substitutes for other materials. Due to the significant properties of functionally graded biomaterials in the reduction in sudden changes of stress and deformation, these types of materials were selected and studied. Two types of conventional single-sided and an efficient double-sided radial functionally graded vessel were proposed and simulated. The elastic behaviors of proposed vessels were obtained and compared to ones previously attained from the real vessel. The results show that all the desired behaviors cannot be achieved by using a conventional single-sided radial FG vessel. Instead and as a conjecture, a smart double-sided radial FG biomaterial is suggested. Fortunately, the proposed material can meet all the desired goals and satisfy all of the indices simultaneously.

http://ift.tt/2czJrc3

An interval prototype classifier based on a parameterized distance applied to breast thermographic images

Abstract

Breast cancer is one of the leading causes of death in women. Because of this, thermographic images have received a refocus for diagnosing this cancer type. This work proposes an innovative approach to classify breast abnormalities (malignant, benignant and cyst), employing interval temperature data in order to detect breast cancer. The learning step takes into account the internal variation of the intervals when describing breast abnormalities and uses a way to map these intervals into a space where they can be more easily separated. The method builds class prototypes, and the allocation step is based on a parameterized Mahalanobis distance for interval-valued data. The proposed classifier is applied to a breast thermography dataset from Brazil with 50 patients. We investigate two different scenarios for parameter configuration. The first scenario focuses on the overall misclassification rate and achieves 16 % misclassification rate and 93 % sensitivity to the malignant class. The second scenario maximizes the sensitivity to the malignant class, achieving 100 % sensitivity to this specific class, along with 20 % overall misclassification rate. We compare the performances of our approach and of many methods taken from the literature of interval data classification for the breast thermography task. Results show that our method outperforms competing algorithms.

http://ift.tt/2d0TC7W

Cerebral and non-cerebral coenurosis: on the genotypic and phenotypic diversity of Taenia multiceps

Abstract

We characterised the causative agents of cerebral and non-cerebral coenurosis in livestock by determining the mitochondrial genotypes and morphological phenotypes of 52 Taenia multiceps isolates from a wide geographical range in Europe, Africa, and western Asia. Three studies were conducted: (1) a morphological comparison of the rostellar hooks of cerebral and non-cerebral cysts of sheep and goats, (2) a morphological comparison of adult worms experimentally produced in dogs, and (3) a molecular analysis of three partial mitochondrial genes (nad1, cox1, and 12S rRNA) of the same isolates. No significant morphological or genetic differences were associated with the species of the intermediate host. Adult parasites originating from cerebral and non-cerebral cysts differed morphologically, e.g. the shape of the small hooks and the distribution of the testes in the mature proglottids. The phylogenetic analysis of the mitochondrial haplotypes produced three distinct clusters: one cluster including both cerebral isolates from Greece and non-cerebral isolates from tropical and subtropical countries, and two clusters including cerebral isolates from Greece. The majority of the non-cerebral specimens clustered together but did not form a monophyletic group. No monophyletic groups were observed based on geography, although specimens from the same region tended to cluster. The clustering indicates high intraspecific diversity. The phylogenetic analysis suggests that all variants of T. multiceps can cause cerebral coenurosis in sheep (which may be the ancestral phenotype), and some variants, predominantly from one genetic cluster, acquired the additional capacity to produce non-cerebral forms in goats and more rarely in sheep.

http://ift.tt/2cfTTF8

Artemisia absinthium -borne compounds as novel larvicides: effectiveness against six mosquito vectors and acute toxicity on non-target aquatic organisms

Abstract

The eco-friendly control of mosquito vectors is a crucial challenge of public health importance. Here we evaluated the larvicidal potential of Artemisia absinthium essential oil (EO) and its three major chemical constituents against six mosquito vectors: Anopheles stephensi, Anopheles subpictus, Aedes aegypti, Aedes albopictus, Culex quinquefasciatus, and Culex tritaeniorhynchus. The EO was obtained by leaf hydro-distillation. Its chemical composition was analyzed using gas chromatography-mass spectrometry. Major components were (E)-β-farnesene (31.6 %), (Z)-en-yn-dicycloether (11.12 %), and (Z)-β-ocimene (27.8 %). The EO was toxic effect against larval populations of An. stephensi, An. subpictus, Ae. aegypti, Ae. albopictus, Cx. quinquefasciatus, and Cx. tritaeniorhynchus, with LC₅₀ values of 41.85, 52.02, 46.33, 57.57, 50.57, and 62.16 μg/ml. (E)-β-farnesene, (Z)-en-yn-dicycloether, and (Z)-β-ocimene were highly effective on An. stephensi (LC₅₀ = 8.13, 16.24 and 25.84 μg/ml) followed by An. subpictus (LC₅₀ = 10.18, 20.99, and 30.86 μg/ml), Ae. aegypti (LC₅₀ = 8.83,17.66, and 28.35 μg/ml), Ae. albopictus (LC₅₀ = 11.38,23.47, and 33.72 μg/ml), Cx. quinquefasciatus (LC₅₀ = 9.66, 19.76, and 31.52 μg/ml), and Cx. tritaeniorhynchus (LC₅₀ = 12.51,25.88, and 37.13 μg/ml). Notably, the EO and its major compounds were safer to the non-target organisms Chironomous circumdatus, Anisops bouvieri and Gambusia affinis, with LC₅₀ values ranging from 207.22 to 4385 μg/ml. Overall, our results highlight that (E)-β-farnesene, (Z)-en-yn-dicycloether, and (Z)-β-ocimene from the A. absinthium EO represent promising eco-friendly larvicides against six key mosquito vectors with moderate toxicity against non-target organisms.

http://ift.tt/2cz0HLr

Control of parasitic infection with ivermectin long-acting injection (IVOMEC® GOLD) and production benefit in first-season grazing cattle facing a high-level larval challenge in Germany

Abstract

Gastrointestinal and pulmonary nematode infections are affecting the health and productivity of grazing cattle worldwide. To evaluate the effects of a single treatment with ivermectin long-acting injection (IVM LAI; IVOMEC® GOLD, Merial; 3.15 % ivermectin w/v) in first-grazing season cattle, two studies were conducted under continued stocking conditions for 84 or 100 days in Bavaria, Germany. Each study involved 68 naturally infected, approximately 4- to 6-month-old Brown Swiss bull calves. Animals were blocked based on pretreatment body weights. Within each block of four animals, animals were randomly assigned to treatments: one to saline (control) and three to IVM LAI. Treatments were injected at 1 mL/50 kg body weight subcutaneously in front of the shoulder. Animals in both studies were managed as one herd each grazing together. Cattle were weighed and fecal samples were collected pretreatment and at intervals thereafter for determination of weight gain and treatment efficacy, respectively. Fecal examination including composite fecal culture indicated the presence of nematodes of the genera Cooperia (dominating), Haemonchus, Nematodirus, Ostertagia, Strongyloides, Trichostrongylus, Trichuris, and Dictyocaulus, and Moniezia cestodes in the cattle. Following treatment, IVM LAI-treated cattle did not shed any Dictyocaulus larvae for 84 days while controls continued to pass larvae. Compared to the controls, IVM LAI-treated cattle had significantly (p < 0.01) lower strongylid egg counts at each occasion. Percentage reductions were ≥94 % up to 70 days after treatment and were ≥83.9 and 58.9 % at 84 and 100 days. Over the 84- or 100-day study periods, IVM LAI-treated cattle gained significantly more weight than the controls: 22.7 and 12.4 kg, respectively. The two studies demonstrated a high efficacy of IVM LAI against gastrointestinal and pulmonary nematode infections under field conditions in Germany which was associated with significant benefit as to weight gain.

http://ift.tt/2cz0RT8

Can hemozoin alone cause host anaemia?

Abstract

Both schistosomes and malaria parasites produce hemozoin and cause host anaemia. However, the relationship between anaemia and hemozoin is unclear. Although some studies have proposed that hemozoin is related to anaemia in malaria patients, whether hemozoin alone can cause anaemia in patients infected by malaria parasites or schistosomes is uncertain. To investigate the effect of hemozoin on hosts, β-haematin was injected intravenously to normal mice. Then, liver and spleen tissues were observed. Mouse blood was examined. Red blood cells (RBCs), white blood cells (WBCs) and haemoglobin were analysed. Macrophage changes in the spleens and marrow cells were compared using immunofluorescence and H&E or Giemsa stain, respectively. We found that after 15 injections of β-haematin, a large amount of β-haematin was observed to deposit in the livers and spleens. Splenomegaly and bone marrow mild hyperplasia were detected. The average number of RBCs, average number of WBCs and average concentration of haemoglobin decreased significantly from 9.36 × 10¹² cells/L to 8.7 × 10¹² cells/L, 3.8 × 10⁹ cells/L to 1.7 × 10⁹ cells/L and 142.8 g/L to 131.8 g/L, respectively. In specific, the number of macrophages in the spleens greatly increased after β-haematin infection. The results showed that injections of β-haematin alone can cause anaemia possibly through hypersplenism.

http://ift.tt/2cLm8xM

Assessment of a multiple biomarker panel for diagnosis of amyotrophic lateral sclerosis

Abstract

Background

The aim of the study was to assess a panel of promising biomarkers for their ability to improve diagnosis of sporadic amyotrophic lateral sclerosis (ALS).

Methods

Forty patients with sporadic ALS and 40 controls with other neurological diseases were evaluated. Levels of phosphorylated neurofilament heavy chain (pNfH), S100-β, cystatin C, and chitotriosidase (CHIT) in cerebrospinal fluid were assayed using two-site solid-phase sandwich ELISA.

Results

Patients with sporadic ALS showed higher levels of pNfH and CHIT than controls, but lower levels of cystatin C. Multivariate logistic regression that adjusted for patient age and sex identified significant associations between sporadic ALS and levels of pNfH, CHIT and cystatin C. Levels of pNfH correlated positively with rate of progression and decline based on the Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised. Based on receiver operating curve analysis, a pNfH cut-off of 437 ng/L discriminated patients from controls with a sensitivity of 97.3 % and specificity of 83.8 %. A CHIT cut-off of 1593.779 ng/L discriminated patients from controls with a sensitivity of 83.8 % and specificity of 81.1 %. Combining the two biomarkers gave a sensitivity of 83.8 % and specificity of 91.9 %.

Conclusions

Levels of pNfH in cerebrospinal fluid may be a reliable biomarker for diagnosing ALS, and combining this biomarker with levels of CHIT may improve diagnostic accuracy.

http://ift.tt/2ch1JOZ

Perioperative application of somatostatin analogs for pancreatic surgery—current status in Germany

Abstract

Background

The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs.

Methods

A questionnaire evaluating the perioperative management–especially the use of somatostatin analogs—and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center). Statistical analysis was carried out using SPSS 21.

Results

The final response rate was 77 % (160/209), 14.5 % of hospitals never, 37 % always, and 45 % occasionally apply somatostatin analogs after pancreatic surgery. A (standard) drug of choice was defined in 64 % of hospitals. When standard and occasional usage was analyzed, it appeared that hospitals favored somatostatin (69 %) > sandostatin (50 %) > pasireotide (5 %). A relation between the usage of the different somatostatin analogs and morbidity (POPF) or mortality (84 and 16 % of hospitals reported <5 and 5–10 %, respectively) was not seen. Eighty-seven percent of hospitals were interested in participating in future studies analyzing somatostatin use.

Conclusion

This is the first national survey in Germany evaluating the perioperative application of somatostatin analogs for pancreatic surgery. Despite controversial results in the literature, the majority of German pancreas surgeons apply somatostatin analogs perioperatively. The ideal drug to reduce POPF is still unclear. This uncertainty has aroused significant interest and prompted surgeons to participate in future studies in order to elucidate this issue.

http://ift.tt/2ch1nb0

Dissonant response of M0/M2 and M1 bone-marrow-derived macrophages to RhoA pathway interference

Abstract

Macrophages have a multitude of functions in innate and adaptive immune response and organ and tissue homeostasis. Many experimental studies are performed on bone-marrow-derived macrophages differentiated in vitro into M1 (inflammatory) and M2 (anti-inflammatory) subtypes that express different molecular markers pertaining to their prospective functions. Macrophage phenotype, polarity and functions depend on the actin cytoskeleton, which is regulated by small GTPase RhoA, its downstream effector ROCK, and non-apoptotic Caspase-3. We generated transgenic mice with the macrophage-specific deletion of RhoA and compared the effect of Rho pathway interference (RhoA deletion and ROCK and Caspase-3 inhibition) on the phenotype, polarity and expression of subtype-specific molecular markers of bone-marrow-derived M0, M1 and M2 macrophages. We show that M0 and M2 macrophages have a radically different phenotype and polarity from M1 macrophages, and that this is mirrored in dissonant response to RhoA pathway interference. The RhoA pathway interference induces extreme elongation (hummingbird phenotype) of M0 and M2 but not M1 macrophages and inhibits the expression of M2-specific but not M1-specific molecular markers. These dramatic differences in the response of M0/M2 versus M1 macrophages to the same molecular cues ought to be important considerations in the interpretation of experimental data and therapeutic use of bone-marrow-derived macrophages.

http://ift.tt/2cXO3ef

Deficiency of the DSPP-cleaving enzymes meprin α and meprin β does not result in dentin malformation in mice

Abstract

Formation of dentin requires the maturation of procollagen I and the proteolytic processing of the dentin sialophosphoprotein (DSPP). These cleavage events can be facilitated by the metalloproteinases meprin α and meprin β as well as by bone morphogenetic protein 1 (BMP-1). All three enzymes have been shown to play important roles during collagen I maturation in vivo and their potential in cleaving DSPP was demonstrated in vitro. Hence, it has been discussed whether meprin α, meprin β, BMP-1 or all three are crucial factors in the onset and progression of dentin-related diseases and this issue is addressed here. In this study, we compare the incisors and molars of meprin α (Mep1a ^-/-)- and meprin β (Mep1b ^-/-)-deficient mice with wild-type (WT) controls on the macroscopic and microscopic level. The dentin was evaluated towards the bone mineral density, dentin volume, calcification and collagen matrix integrity. Using immunohistochemistry, we could identify meprin β, BMP-1 and DSPP/DSP in the pre-dentin of WT mice. Nevertheless, no significant dentin malformation was observed in Mep1b ^-/- or Mep1a ^-/- deficient mice.

http://ift.tt/2cpOIQz

Patient and physician perspectives of hand function in a cohort of rheumatoid arthritis patients: the impact of disease activity

Abstract

Background

In 2004, we initiated an inception cohort of patients with recent-onset rheumatoid arthritis (RA). Hand function was incorporated into evaluations from 2014 onward. The objectives were to examine hand function in our cohort, compare hand function with function in healthy controls and determine the factors associated with impaired function.

Methods

From February 2014 to June 2015, 139 patients (97.2 % of the cohort) had disease activity scored (28 joints, [DAS28]); the Michigan Hand Outcome Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) were completed, and the tip-, key- and palmar-pinch and grip strengths were measured. Sixty-nine healthy controls underwent the same evaluations. Ninety-nine patients underwent a second evaluation one year after their baseline. Descriptive statistics and linear regression models were used. Patients and controls signed informed consent.

Results

Patients were primarily middle-aged females with a median disease duration of 7 years; 91 patients had DAS28-remission, and 16, 23, and 9 patients had low, moderate and high disease activity, respectively. Controls scored better than did patients with (any) disease activity level; remission patients had similar DASH and key pinch function as did controls with poorer MHQ and both tip and palmar pinch and grip strength. DAS28 was consistently associated with impaired hand function. Among the patients with a one-year re-assessment, changes in DAS28 correlated (rho = 0.34 to 0.63) with changes in hand function (p ≤ 0.01 for all comparisons), but there was no correlation with palmar pinch strength.

Conclusions

Disease activity was associated with hand function impairment in RA patients with variable follow-up. MHQ discriminated poorer hand function in remission patients who otherwise had similar DASH scores as the controls did.

http://ift.tt/2cgU3MF

Swedish Sonographers’ perceptions of ergonomic problems at work and their suggestions for improvement

Abstract

Background

Sonographers' perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers' perceptions of ergonomic problems at work, and their suggestions for improvement strategies.

Methods

Twenty-two female sonographers were individually interviewed regarding different aspects of their physical working environment. Content analysis was applied.

Results

The sonographers perceived different ergonomic problems in their working environment, but to offer patient comfort and to obtain the best possible images were often prioritized over working posture. Echocardiography was considered demanding as the examination is performed with little variation in posture. Ergonomic improvements included reducing the manual handling of the transducer, optimizing the adjustability of equipment, and taking the patient's physique and health into account. As some examinations were perceived to be more ergonomically demanding, variation between examinations was suggested, however, this requires broader skills.

Conclusion

Sonography, especially echocardiography is ergonomically demanding but the improvement strategies suggested were perceived useful and applicable.

http://ift.tt/2cAAWKR

Secretin-stimulated MR cholangiopancreatography: spectrum of findings in pancreatic diseases

Abstract

MR cholangiopancreatography (MRCP) is an imaging technique that has evolved over the past 2 decades and that continues to have a fundamental role in the non-invasive detection of morphologic features of the pancreatic ducts. In several studies, MRCP has shown a good correlation with endoscopic retrograde cholangiopancreatography in the evaluation of diseases and anatomic variants of the pancreatic ductal system. However, in physiologic conditions the pancreatic ducts are not always easily recognisable. More recently, secretin-enhanced MRCP protocols have been developed for a more complete assessment of pancreatic ducts and glandular function, including monitoring of pancreatic flow dynamics and duodenal filling after pancreatic hormonal stimulation with secretin. The injection of this hormone causes temporary dilation of the pancreatic ducts, principally by increasing pancreatic exocrine secretions, and thus improving MRCP detection of the ducts and characterisation of pancreatic disorders and allowing the assessment of the exocrine pancreatic reserve. The purpose of this pictorial review is to summarise the technical aspects of secretin-stimulated MRCP, to report the secretin-stimulated MRCP findings of pancreatic duct abnormalities and to review the diagnostic capabilities of secretin-stimulated MRCP in various pancreatic ductal system conditions.

Main Messages

• MRCP has a fundamental role in the non-invasive detection of pancreatic ducts.

• In physiologic conditions pancreatic ducts are not always well detected on MRCP.

• Secretin injection causes temporary dilation of pancreatic ducts and thus improves MRCP detection.

• Secretin-stimulated MRCP may allow the assessment of the exocrine pancreatic reserve.

• Secretin increases the diagnostic capabilities of MRCP for evaluating pancreatic disorders.

http://ift.tt/2d2Dqpx

IL-9-producing Th9 cells may participate in pathogenesis of Takayasu’s arteritis

Abstract

Takayasu's arteritis (TAK) is a type of large vessel vasculitis which involves the aorta and its major branches. Interleukin (IL)-9 or IL-9-producing Th9 cells were found to be involved in pathogenesis of autoimmune arteritis such as giant cell arteritis, but IL-9 or Th9 cells in TAK were not well known. Here, this study aims to analyze the levels of serum IL-9 and their major source Th9 cells in TAK. With the help of cytometric bead array (CBA), a total of 21 patients with TAK were examined for serum levels of cytokines IL-4, IL-6, IL-8, IL-17, IL-10, TNF-α, IFN-γ, and IL-9. Flow cytometry techniques were used to examine the frequencies of Th9 cells from peripheral blood mononuclear cells (PBMCs) for 11 patients with active TAK and 10 healthy controls. Higher serum levels of serum IL-6 (P < 0.05), TNF-α (P < 0.05), and IL-9 level (P < 0.05) were observed in TAK patients compared to those of healthy controls. Higher frequencies of CD4⁺ IL-9⁺ T cells and CD4⁺ PU.1⁺ T cells in PBMCs and IL-9⁺ PU.1⁺ T cells in CD4⁺ T cells were observed in active TAK patients than those in healthy controls (all P < 0.01). The levels of IL-9 had a positive correlation with ESR (r = 0.975, P = 0.015) in these cases. Our data suggested that Th9 cells and IL-9 could possibly be involved in the pathogenesis of TAK.

http://ift.tt/2cgOaih