A Silk Cranial Fixation System for Neurosurgery

Abstract

Cranial fixation should be safe, reliable, ideally degradable, and produce no hazardous residues and no artifacts on neuroimaging. Protein-based fixation devices offer an exciting opportunity for this application. Here, the preclinical development and in vivo efficacy verification of a silk cranial fixation system in functional models are reported by addressing key challenges toward clinical use. A comprehensive study on this fixation system in rodent and canine animal models for up to 12 months is carried out. The silk fixation system shows a superb performance on the long-term stability of the internal structural support for cranial flap fixation and bone reconnection and has good magnetic resonance imaging compatibility, and tolerability to high dose radiotherapy, underscoring the favorable clinical application of this system for neurosurgery compared to the current gold standard.

A silk cranial fixation system for neurosurgery in long-term animal models is reported by addressing key challenges toward clinical use, including manufacturing large-size defect-free silk parts, insight on structure–strength relations in bulk silk, tunable mechanical strengths and degradation rates, incorporating therapeutic agents, and compatibility with magnetic resonance imaging, X-ray radiation, and Gamma sterilization.

http://ift.tt/2BuFnD1

Antigen-Free Radionuclide-Embedded Gold Nanoparticles for Dendritic Cell Maturation, Tracking, and Strong Antitumor Immunity

Abstract

Dendritic cell (DC)-based cancer immunotherapy requires efficient maturation of DCs and sensitive monitoring of DCs localized in the lymph nodes that activate T cells. This paper reports a robust and simple surface chemistry for highly sensitive and stable radionuclide-embedded gold nanoparticles (Poly-Y-RIe-AuNPs) prepared with oligotyrosine-modified AuNPs with additional Au shell formation as a promising positron emission tomography/computed tomography imaging agent. The multiple oligotyrosine binding sites modified on AuNPs provide excellent stability for conjugated radioisotopes by forming an Au shell. They can be heavily conjugated with radioisotope iodine, which enables sensitive tracking of DCs in the lymphatic system. More importantly, it is found that the maturation of DCs is possible solely with Poly-Y-RIe-AuNPs without any additional stimulus for DC maturation. DCs matured by Poly-Y-RIe-AuNPs induce antitumor immunity to cervical cancer comparable to that produced from DCs pulsated with tumor lysates. These results demonstrate that the peptide-based surface chemistry of Poly-Y-RIe-AuNPs is a simple and straightforward method to produce a highly sensitive and stable nuclear medicine imaging agent that also improves the efficiency of current antitumor immunotherapies.

Polytyrosine peptide-based surface chemistry on gold nanoparticles and additional Au shell formation is a simple and straightforward method to produce a highly sensitive and stable nuclear imaging agent (positron emission tomography/single photon emission computed tomography). The nanoparticle strongly induces the maturation of dendritic cells and it allows to sensitively track the migration of dendritic cells into the lymph node.

http://ift.tt/2ndEMRC

Ultrasound-Guided Shoulder Injection or Ultrasound Guides the Shoulder Injection?: Standard vs State-of-the-Art

No abstract available

http://ift.tt/2DGZCmZ

Effect of Polydeoxyribonucleotide Injection in a Patient with Carpal Tunnel Syndrome: A Case Report

Ultrasound-guided corticosteroid injection into the carpal tunnel is widely performed for the management of carpal tunnel syndrome (CTS). However, this injection may worsen the condition in patients with type 2 diabetes mellitus (DM). Polydeoxyribonucleotide (PDRN) was recently recognized as a substitute for corticosteroid due to its anti-inflammatory effects. A 41-year-old woman with type 2 DM was admitted to our rehabilitation clinic with a 1-month history of numbness and tingling in her right hand and first 3 fingers tips. She declined corticosteroid treatment because of a previous episode of uncontrolled blood glucose levels following corticosteroid injection. Therefore, ultrasound-guided PDRN injections into the carpal tunnel were carried out. At the 6-month follow-up, the patient demonstrated an improvement in the CTS symptoms without any complications. Thus, PDRN injections into the carpal tunnel can be an alternative to corticosteroid injections for CTS if there are limitations due to side effects of the latter. Disclosure : This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT and Future Planning (NRF- 2017R1D1A1B03033127) No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. **Address corresponding author: Donghwi Park, M.D. Department of Rehabilitation Medicine, Department of Rehabilitation Medicine, Daegu Fatima Hospital, Ayangro 99, Dong gu, Daegu 41199, Republic of Korea (e-mail: bdome@hanmail.net), Tel : 82-53-940-7821, Fax : 82-53-954-7417 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2nhyYpJ

Response to the Letter to the Editor on“Point-of-Care Ultrasonography Findings and Care use Among Patients Undergoing Ultrasound-Guided Shoulder Injections”

No abstract available

http://ift.tt/2DE7jKh

Symptom-associated probability does not reliably distinguish functional heartburn from reflux hypersensitivity

Summary

Background

Symptom association probability (SAP) is thought to distinguish reflux hypersensitivity from functional disorders. A diagnosis of hypersensitive oesophagus (SAP-positive) indicates that gastro-oesophageal reflux disease (GERD) is the cause of continued symptoms.

Aim

To conduct an analysis of pH and symptom criteria that lead to a diagnosis of SAP-positivity

Methods

We calculated SAP for 205 patients with GERD symptoms refractory to proton pump inhibitor (PPI) therapy who underwent endoscopy with wireless pH monitoring from 2007 to 2014. Patients were divided into three groups: pH-negative with no oesophagitis (n = 45), pH-positive with no oesophagitis (n = 130), and patients with oesophagitis (n = 30). We constructed a 2 × 2 table of symptom and reflux event association and quantified the number of 2-minute intervals for each of the 2 × 2 variables that distinguished SAP-positive from SAP-negative. In a separate cohort of 58 patients who had undergone anti-reflux surgery, we evaluated the effects of pre-surgery SAP.

Results

The difference in symptom association parameters that led to a diagnosis of an SAP-positive was small (2.98% in oesophagitis-positive; 1.56% in oesophagitis-negative/pH-positive; 0.48% in oesophagitis-negative/pH-negative). In the pH-negative/oesophagitis-negative group, a difference of 0.48% led to a diagnosis of hypersensitivity. There was significant variability in SAP values between day 1 and day 2 of pH testing in all groups, with the greatest in the oesophagitis-positive group, despite objective evidence for reflux (27% in oesophagitis-positive, 19% pH-positive/oesophagitis-negative, and 7% in pH-negative/oesophagitis-negative). Pre-surgery SAP was not associated with response to anti-reflux surgery.

Conclusion

In PPI-refractory GERD, SAP cannot accurately distinguish reflux hypersensitivity from functional oesophageal symptoms.

http://ift.tt/2DHqH9l

Zero-Depth Interfacial Nanopore Capillaries

Abstract

High-fidelity analysis of translocating biomolecules through nanopores demands shortening the nanocapillary length to a minimal value. Existing nanopores and capillaries, however, inherit a finite length from the parent membranes. Here, nanocapillaries of zero depth are formed by dissolving two superimposed and crossing metallic nanorods, molded in polymeric slabs. In an electrolyte, the interface shared by the crossing fluidic channels is mathematically of zero thickness and defines the narrowest constriction in the stream of ions through the nanopore device. This novel architecture provides the possibility to design nanopore fluidic channels, particularly with a robust 3D architecture maintaining the ultimate zero thickness geometry independently of the thickness of the fluidic channels. With orders of magnitude reduced biomolecule translocation speed, and lowered electronic and ionic noise compared to nanopores in 2D materials, the findings establish interfacial nanopores as a scalable platform for realizing nanofluidic systems, capable of single-molecule detection.

A novel architecture for nanopore devices, which combines zero physical nanopore length with ultimate stability, is introduced and characterized. With biomolecule translocation speed reduced by orders of magnitude, and lowered electronic and ionic noise compared to nanopores in 2D materials, interfacial nanopores are established as a scalable platform for realizing nanofluidic systems, capable of single-molecule detection.

http://ift.tt/2DyF0Jj

Review article: the physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome and other functional disorders

Summary

Background

Peppermint oil has been used for centuries as a treatment for gastrointestinal ailments. It has been shown to have several effects on gastrointestinal physiology relevant to clinical care and management.

Aim

To review the literature on peppermint oil regarding its metabolism, effects on gastrointestinal physiology, clinical use and efficacy, and safety.

Methods

We performed a PubMed literature search using the following terms individually or in combination: peppermint, peppermint oil, pharmacokinetics, menthol, oesophagus, stomach, small intestine, gallbladder, colon, transit, dyspepsia, nausea, abdominal pain, and irritable bowel syndrome. Full manuscripts evaluating peppermint oil that were published through 15 July 2017 were reviewed. When evaluating therapeutic indications, only randomised clinical trials were included. References from selected manuscripts were used if relevant.

Results

It appears that peppermint oil may have several mechanisms of action including: smooth muscle relaxation (via calcium channel blockade or direct enteric nervous system effects); visceral sensitivity modulation (via transient receptor potential cation channels); anti-microbial effects; anti-inflammatory activity; modulation of psychosocial distress. Peppermint oil has been found to affect oesophageal, gastric, small bowel, gall-bladder, and colonic physiology. It has been used to facilitate completion of colonoscopy and endoscopic retrograde cholangiopancreatography. Placebo controlled studies support its use in irritable bowel syndrome, functional dyspepsia, childhood functional abdominal pain, and post-operative nausea. Few adverse effects have been reported in peppermint oil trials.

Conclusion

Peppermint oil is a natural product which affects physiology throughout the gastrointestinal tract, has been used successfully for several clinical disorders, and appears to have a good safety profile.

http://ift.tt/2nc35zj

Cost-effectiveness of increasing vaccination in high-risk adults aged 18–64 Years: a model-based decision analysis

Adults aged 18–64 years with comorbid conditions are at high risk for complications of certain vaccine-preventable diseases, including influenza and pneumococcal disease. The 4 Pillars™ Practice Transformation...

http://ift.tt/2DDPevT

A complex scenario of tuberculosis transmission is revealed through genetic and epidemiological surveys in Porto

Tuberculosis (TB) incidence is decreasing worldwide and eradication is becoming plausible. In low-incidence countries, intervention on migrant populations is considered one of the most important strategies for...

http://ift.tt/2ncb3Yu

Place of death for people with HIV: a population-level comparison of eleven countries across three continents using death certificate data

With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This ...

http://ift.tt/2DDPdrP

Characterization of Staphylococcus aureus isolated from patients with burns in a regional burn center, Southeastern China

S.aureus is a predominant pathogen that causes infection in critically ill patients, but little information exists regarding the characterization of S. aureus from different sources in burn patients in southeaste...

http://ift.tt/2neV5wH

Case report: mechanisms of HIV elite control in two African women

The majority of people living with HIV require antiretroviral therapy (ART) for controlling viral replication, however there are rare HIV controllers who spontaneously and durably control HIV in the absence of...

http://ift.tt/2DDP3kd

Immune gene expression and response to chemotherapy in advanced breast cancer

Immune gene expression and response to chemotherapy in advanced breast cancer

Immune gene expression and response to chemotherapy in advanced breast cancer, Published online: 25 January 2018; doi:10.1038/bjc.2017.446

Immune gene expression and response to chemotherapy in advanced breast cancer

http://ift.tt/2rH4J0v

Anti-proliferative and cytotoxic activities of Allium autumnale P. H. Davis (Amaryllidaceae) on human breast cancer cell lines MCF-7 and MDA-MB-231

Natural products obtained from plants can be potent sources for developing a variety of pharmaceutical products. Allium species have been widely studied for their anti-cancer effects and presented promising resul...

http://ift.tt/2rGtY37

Dual function of active constituents from bark of Ficus racemosa L in wound healing

Different parts including the latex of Ficus racemosa L. has been used as a medicine for wound healing in the Ayurveda and in the indigenous system of medicine in Sri Lanka. This plant has been evaluated for its ...

http://ift.tt/2Gjh5iE

Association between socioeconomic status and post-stroke functional outcome in deprived rural southern China: a population-based study

Data on the association between socioeconomic status and post-stroke functional outcome in developing countries is lacking. We aimed to evaluate the association in stroke survivors in deprived rural Southern C...

http://ift.tt/2DF1tZi

Are all Xq26.2 duplications overlapping GPC3 on array-CGH a cause of Simpson-Golabi-Behmel syndrome? When do we need transcript analysis?

http://ift.tt/2BsuPEq

Tylosis associated with squamous cell carcinoma of the oesophagus (TOC): Report of an African family with a novel RHBDF2 variant

http://ift.tt/2nbSDIb

Facilitators and barriers to pregnant women’s participation in research: A systematic review

Publication date: Available online 17 January 2018
Source:Women and Birth
Author(s): Indira S.E. van der Zande, Rieke van der Graaf, Lotty Hooft, Johannes J.M. van Delden
BackgroundAlthough there is consensus among many that exclusion of pregnant women from clinical research should be justified, there is uncertainty as to whether and why pregnant women themselves would be willing to participate even if they were found to be eligible. The objective was to identify the reasons why pregnant women participate in clinical research and thereby to distinguish between facilitators and barriers.MethodsWe conducted a systematic review of articles regarding pregnant women's reasons for participation in clinical research. We used the PubMed/MEDLINE, EMBASE, PsycINFO and CINAHL databases and retrieved additional articles through manually searching the reference lists. We included all articles that reported on pregnant women's reasons for participation in clinical research. We accumulated all reasons that were mentioned in the total of articles and collated them to themes, classifying these themes as a facilitator or a barrier.ResultsThe search identified thirty articles that met the inclusion criteria. Themes classified as facilitators: aspirational benefits, collateral benefits, direct benefits, third party influence and lack of inconvenience. Themes classified as barriers: inconveniences, risks, randomisation, lack of trust in research enterprise, medical reasons and third party influence.ConclusionsPregnant women report mostly altruistic and personal reasons for their willingness to participate in clinical research, while barriers primarily relate to inconveniences. It appears that pregnant women's described reasoning is similar to the described reasoning of non-pregnant research subjects. Enhancing the facilitators and overcoming the barriers is the next step to increase the evidence-base underlying maternal and foetal health.



http://ift.tt/2DExsZB

Longitudinal evaluation of a training program to promote routine antenatal enquiry for domestic violence by midwives

Publication date: Available online 17 January 2018
Source:Women and Birth
Author(s): Kathleen Baird, Debra K. Creedy, Amornrat S. Saito, Jennifer Eustace
BackgroundRoutine enquiry about domestic violence during pregnancy is accepted best practice. Training is essential to improve knowledge and practice. Few studies have undertaken a comprehensive evaluation of training impact over time.AimTo evaluate the longitudinal impact of a domestic violence training and support program to promote midwives' routine antenatal enquiry for domestic violence using a mixed methods design.MethodData sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives' knowledge, preparation for routine enquiry, knowledge of domestic violence and perceptions of impact of the training and support for practice change.FindingsForty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z=4.88, p<.001); and knowledge scores increased from a mean of 21.15 to 24.65 (Z=4.9, p<.001). Most participants (>90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates revealed that of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral.ConclusionsTraining, support processes, and referral pathways, contributed to midwives' sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence.



http://ift.tt/2nggl5w

A longitudinal study of perinatal depression among Chinese high-risk pregnant women

Publication date: Available online 17 January 2018
Source:Women and Birth
Author(s): Ying Zhao, Michelle L. Munro-Kramer, Shenxun Shi, Jing Wang, Xinli Zhu
BackgroundInformation is needed on the prevalence of depression in Chinese women with medically defined complications across the perinatal period, as well as key risk factors to develop appropriate perinatal mental health services and ensure the services target those most in need.AimThe goal of this study was to examine whether women's perinatal depression scores change across the perinatal period and evaluate risk factors associated with postnatal depression at 6-weeks after delivery.MethodsA sample of 167 Chinese pregnant women with medically defined complications and an Edinburgh Postnatal Depression Scale≥9 and/or a Postpartum Depression Screening Scale≥60 were followed throughout early pregnancy (<28 weeks), late pregnancy (>28 weeks), 3-days and 6-weeks after delivery.FindingsRepeated measures analysis of variance showed that there were significant differences on the Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale scores at each time point between high-risk depressed and low-risk depressed groups. Binary logistic regression indicated a significant association between postnatal depression at 6-weeks after delivery and depression in late pregnancy and 3-days after delivery, postnatal stress events, postnatal complications, and concerns about the fetus.ConclusionsPostnatal depression is a common condition with limited research among Chinese pregnant women with medically defined complications. Additional research is warranted to develop strategies to identify high-risk depressed pregnant women as well as effective treatment options during the perinatal period.



http://ift.tt/2DExsJ5

Ice pack induced perineal analgesia after spontaneous vaginal birth: Randomized controlled trial

Publication date: Available online 12 January 2018
Source:Women and Birth
Author(s): Adriana Amorim Francisco, Sonia Maria Junqueira Vasconcellos De Oliveira, Mary Steen, Moacyr Roberto Cuce Nobre, Eder Viana De Souza
BackgroundIce-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy.AimsTo evaluate if a 10min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2h.MethodsA randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6–24h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10min or standard care. The primary and secondary outcomes were a reduction ≥30% in perineal pain intensity, immediately after the application and the maintenance of the analgesic effect for up to 2h, respectively.FindingsImmediately post-intervention, the proportion of women whose perineal pain decreased ≥30% was significantly higher in the experimental group. Within 2h, there was no significant difference in the pain levels in both groups. Within 2h, for 61.9% and 89.3% of women in the experimental and control group, respectively, the perineal pain levels remained unchanged. For the remaining participants, perineal pain was increasing after an average time of 1h 45min and 1h 56min for the experimental and control groups, respectively.ConclusionBy applying an ice-pack for 10min to the perineum, effective pain relief is achieved, that is maintained for between 1h 45min and 2h.



http://ift.tt/2nfVgrw

Postnatal post-traumatic stress: An integrative review

Publication date: Available online 11 January 2018
Source:Women and Birth
Author(s): Madeleine Simpson, Virginia Schmied, Cathy Dickson, Hannah Grace Dahlen
ProblemPost-traumatic stress disorder and post-traumatic stress symptoms following birth occur amongst a small proportion of women but can lead to poor maternal mental health, impairment in mother-infant bonding and relationship stress. This integrative review aims to examine the associated risk factors and women's own experiences of postnatal post-traumatic stress in order to better understand this phenomenon.MethodFifty three articles were included and critically reviewed using the relevant Critical Appraisal Skills Program checklists or Strengthening the Reporting of Observational studies in Epidemiology assessment tool.FindingsRisk factors for postnatal post-traumatic stress symptoms and disorder include factors arising before pregnancy, during the antenatal period, in labour and birth and in the postnatal period. Potential protective factors against postnatal post-traumatic stress have been identified in a few studies. The development of postnatal post-traumatic stress can lead to negative outcomes for women, infants and families.DiscussionRisk factors for post-traumatic stress symptoms and disorder are potentially identifiable pre-pregnancy and during the antenatal, intrapartum and postnatal periods. Potential protective factors have been identified however they are presently under researched. Predictive models for postnatal post-traumatic stress disorder development have been proposed, however further investigation is required to test such models in a variety of settings.ConclusionsPostnatal post-traumatic stress symptoms and disorder have been shown to negatively impact the lives of childbearing women. Further investigation into methods and models for identifying women at risk of developing postnatal post-traumatic stress following childbirth is required in order to improve outcomes for this population of women.



http://ift.tt/2DF9P3f

Building capacity and wellbeing in vulnerable/marginalised mothers: A qualitative study

Publication date: Available online 19 January 2018
Source:Women and Birth
Author(s): Marie-Clare Balaam, Gill Thomson
ProblemThe persistence of health inequalities in pregnancy and infancy amongst vulnerable/marginalised groups in the UK.BackgroundDuring pregnancy and early motherhood some women experience severe and multiple psychosocial and economic disadvantages that negatively affect their wellbeing and make them at increased risk of poor maternal and infant health outcomes.AimTo explore vulnerable/marginalised women's views and experiences of receiving targeted support from a specialist midwifery service and/or a charity.MethodsA mixed-methods study was undertaken that involved analysis of routinely collected birth-related/outcome data and interviews with a sample of vulnerable/marginalised women who had/had not received targeted support from a specialist midwifery service and/or a charity. In this paper we present in-depth insights from the 11 women who had received targeted support.FindingsFour key themes were identified; 'enabling needs-led care and support', 'empowering through knowledge, trust and acceptance', 'the value of a supportive presence' and 'developing capabilities, motivation and confidence'.DiscussionSupport provided by a specialist midwifery service and/or charity improved the maternity and parenting experiences of vulnerable/marginalised women. This was primarily achieved by developing a provider–woman relationship built on mutual trust and understanding and through which needs-led care and support was provided — leading to improved confidence, skills and capacities for positive parenting and health.ConclusionThe collaborative, multiagency, targeted intervention provides a useful model for further research and development. It offers a creative, salutogenic and health promoting approach to provide support for the most vulnerable/marginalised women as they make the journey into parenthood.



http://ift.tt/2ngg5U6

Colonoscopy procedure simulation: virtual reality training based on a real time computational approach

Colonoscopy plays an important role in the clinical screening and management of colorectal cancer. The traditional 'see one, do one, teach one' training style for such invasive procedure is resource intensive ...

http://ift.tt/2nfGMcn

Hybrid blade and locking plate fixation for proximal humerus fractures: a comparative biomechanical analysis

Open reduction and internal fixation of proximal humerus fractures can be difficult to achieve adequate, complication free results due to osteopenia of the proximal humerus and unstable fracture patterns. This...

http://ift.tt/2BstihE

STINGing Antitumor Immunity into Action [News in Depth]

Efforts to modulate STING signaling for therapeutic purposes are rapidly gaining steam.

http://ift.tt/2rHmRY7

The Potential of Stem Cells in Treatment of Traumatic Brain Injury

Abstract

Purpose of Review

Traumatic brain injury (TBI) is a global public health concern, with limited treatment options available. Despite improving survival rate after TBI, treatment is lacking for brain functional recovery and structural repair in clinic. Recent studies have suggested that the mature brain harbors neural stem cells which have regenerative capacity following brain insults. Much progress has been made in preclinical TBI model studies in understanding the behaviors, functions, and regulatory mechanisms of neural stem cells in the injured brain. Different strategies targeting these cell population have been assessed in TBI models. In parallel, cell transplantation strategy using a wide range of stem cells has been explored for TBI treatment in pre-clinical studies and some in clinical trials. This review summarized strategies which have been explored to enhance endogenous neural stem cell-mediated regeneration and recent development in cell transplantation studies for post-TBI brain repair.

Recent Findings

Thus far, neural regeneration through neural stem cells either by modulating endogenous neural stem cells or by stem cell transplantation has attracted much attention. It is highly speculated that targeting neural stem cells could be a potential strategy to repair and regenerate the injured brain.

Summary

Neuroprotection and neuroregeneration are major aspects for TBI therapeutic development. With technique advancement, it is hoped that stem cell-based therapy targeting neuroregeneration will be able to translate to clinic in not so far future.

http://ift.tt/2DH29xd

Immune gene expression and response to chemotherapy in advanced breast cancer

http://ift.tt/2nbxTzu

Editorial: The Roy Porter Prize

The Editors are delighted to include in this issue articles by two previous winners of the Roy Porter Prize, Julie Hipperson (2013) and Erica Storm (2014). The Prize, offered by the Society for the Social History of Medicine, and named in honour of the late Professor Roy Porter, recognises outstanding work by undergraduate or postgraduate students in the social history of medicine, broadly defined. Prizewinners are offered the opportunity to submit their work to be peer-reviewed for Social History of Medicine, and for many authors this has been the first step in a successful career in the field. A full list of winners can be found on the Society's website at https://sshm.org/the-roy-porter-prize-articles/ and are freely accessible on the journal's platform at https://academic.oup.com/shm/pages/porter_prize

http://ift.tt/2Bt8xlT

Thuy Linh Nguyen, Childbirth, Maternity and Medical Pluralism in French Colonial Vietnam, 1880–1945

NguyenThuy Linh, Childbirth, Maternity and Medical Pluralism in French Colonial Vietnam, 1880–1945, Rochester, NY: University of Rochester Press, 2016. Pp. 254. £80. ISBN 978 1 5804 6568 7.

http://ift.tt/2ndclDv

Jonathan Lamb, Scurvy: The Disease of Discovery

LambJonathan, Scurvy: The Disease of Discovery, Princeton, NJ: Princeton University Press, 2016. Pp. 328. £27.95. ISBN 978 0 691 14782 6.

http://ift.tt/2BtirDV

Sharrona Pearl, Face/On: Face Transplants and the Ethics of the Other

PearlSharrona, Face/On: Face Transplants and the Ethics of the Other, Chicago: University of Chicago Press, 2017. Pp. 272. $35. ISBN 978 0 2264 6136 6.

http://ift.tt/2nfsR67

J. C. McKeown, A Cabinet of Ancient Medical Curiosities: Strange Tales and Surprising Facts from the Healing Arts of Greece and Rome

McKeownJ. C., A Cabinet of Ancient Medical Curiosities: Strange Tales and Surprising Facts from the Healing Arts of Greece and Rome, New York: Oxford University Press, 2017. Pp. 288. £12.99. ISBN 978 0 1906 1043 2.

http://ift.tt/2Bsefoa

Josep L. Barona, The Rockefeller Foundation, Public Health and International Diplomacy, 1920–1945

BaronaJosep L., The Rockefeller Foundation, Public Health and International Diplomacy, 1920–1945, London, Pickering & Chatto, 2015. Pp. xviii + 200. £95. ISBN 978 1 8489 3567 9.

http://ift.tt/2ncM9ss

Sarah Lamb (ed), Successful Aging as a Contemporary Obsession. Global Perspectives

LambSarah (ed), Successful Aging as a Contemporary Obsession. Global Perspectives, New Brunswick: Rutgers University Press, 2017. Pp. 266. $34.95. ISBN 978 0 8135 8533 8.

http://ift.tt/2BvrEf8

Stephen Brogan, The Royal Touch in Early Modern England: Politics, Medicine, and Sin

BroganStephen, The Royal Touch in Early Modern England: Politics, Medicine, and Sin. Woodbridge, Suffolk: Royal Historical Society, 2015. Pp. 265. £50. ISBN 978 0 8619 3337 2.

http://ift.tt/2ncM9bW

Ornella Moscucci, Gender and Cancer in England, 1860–1948

MoscucciOrnella, Gender and Cancer in England, 1860–1948, London: Palgrave Macmillan, 2016. Pp. xi + 342. $99.99. ISBN: 978 0 230 55423 8.

http://ift.tt/2BtNake

Jeanne Kisacky, Rise of the Modern Hospital. An Architectural History of Health and Healing, 1870–1940

KisackyJeanne, Rise of the Modern Hospital. An Architectural History of Health and Healing, 1870–1940, Pittsburgh: University of Pittsburgh Press, 2017. Pp. 465. $65. ISBN 978 0 8229 4461 4.

http://ift.tt/2naW5TA

Andrew J. Hogan, Life Histories of Genetic Disease: Patterns and Prevention in Postwar Medical Genetics

HoganAndrew J., Life Histories of Genetic Disease: Patterns and Prevention in Postwar Medical Genetics, Baltimore: Johns Hopkins University Press, 2016. Pp. 280. $40. ISBN 978 1 4214 2074 5.

http://ift.tt/2BtMQ58

Baltic Drugs Traffic, 1650–1850. Sound Toll Registers Online as a Source for the Import of Exotic Medicines in the Baltic Sea Area

Summary

The analysis of the shipping of five key Asian, African and American drugs through the Danish Sound in the period 1650–1850 suggests that the Baltic Sea area absorbed exotic medicinal drugs in significant quantities only from the second half of the eighteenth century—at least about a century later than northwest Europe. This may be an indication that the area differed significantly from northwest Europe in the development of medical services. We have analysed the shipping of five medicinal drugs: china root, sarsaparilla, rhubarb, senna and benjamin. The main source for this analysis is the Danish Sound Toll Registers (STRs), accessed via Sound Toll Registers Online, the STRs electronic database at www.soundtoll.nl.

http://ift.tt/2naK2p0

Magaly Tornay, Zugriffe auf das Ich: Psychoaktive Stoffe und Personenkonzepte in der Schweiz, 1945 bis 1980

TornayMagaly, Zugriffe auf das Ich: Psychoaktive Stoffe und Personenkonzepte in der Schweiz, 1945 bis 1980, Tübingen: Mohr Siebeck, 2016. pp. 288. €49. ISBN 978–3–16–154279–4.

http://ift.tt/2BtMPOC

Bruce M. Z. Cohen, Psychiatric Hegemony: A Marxist Theory of Mental Illness

CohenBruce M. Z., Psychiatric Hegemony: A Marxist Theory of Mental Illness, London: Palgrave Macmillan, 2016, Pp. 241. $87. ISBN 978 1 137 46050 9.

http://ift.tt/2naJUWy

Anthony Ryan Hatch, Blood Sugar: Racial Pharmacology and Food Justice in Black America

HatchAnthony Ryan, Blood Sugar: Racial Pharmacology and Food Justice in Black America, Minneapolis, MN: University of Minnesota Press, 2016. Pp. 184. $25. ISBN 978 0 8166 9618 5.

http://ift.tt/2BuMawb

Joel Peter Eigen, Mad-Doctors in the Dock. Defending the Diagnosis, 1760–1913

EigenJoel Peter, Mad-Doctors in the Dock. Defending the Diagnosis, 1760–1913, Baltimore: Johns Hopkins University Press, 2016. Pp. 224. $40. ISBN: 978 1 4214 2048 6.

http://ift.tt/2nb0aqz

Daniel E. Dawes, 150 Years of ObamaCare

DawesDaniel E., 150 Years of ObamaCare, Baltimore: Johns Hopkins University Press, 2016. Pp. 213. $26.95. ISBN 978 1 4214 1963 3.

http://ift.tt/2BtFpuJ

Sarah Chaney, Psyche on the Skin: A History of Self-Harm

ChaneySarah, Psyche on the Skin: A History of Self-Harm, London: Reaktion Books, 2017. Pp. 320. £20. ISBN: 978 1 7802 3750 3.

http://ift.tt/2naJm2W

Roy Porter Student Prize Essay, Professional Entrepreneurs: Women Veterinary Surgeons as Small Business Owners in Interwar Britain

Summary

Although a recent resurgence in interest in female entrepreneurship has focused attention on working 'on their own account', the artificial distinction made between professional women and women in business has had the effect of segregating rather than integrating research findings. This article focuses on the first cohort of women to qualify as veterinary surgeons in interwar Britain to challenge the assumption that moving beyond the experience of professional women is the only way to bring new insights into women in business. It examines the construction and contestation of the image and role of the female veterinary surgeon in the two decades after they were first able to qualify in 1919, and the experience of women running their own veterinary businesses. It concludes that in a profession with high levels of self-employment, women's identities were defined to a greater degree by their business activities than their professional status.

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Michael Zeheter, Epidemics, Empire and Environments: Cholera in Madras and Quebec City, 1818–1910

ZeheterMichael, Epidemics, Empire and Environments: Cholera in Madras and Quebec City, 1818–1910, Pittsburgh, PA: University of Pittsburgh Press, 2015. Pp. 336. $45. ISBN 978 0 8229 4446 1.

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Tri-Tech Forensics Announces Acquisition of Rescue Essentials

LELAND, N.C. and SALIDA, Colo. — Tri-Tech Forensics, Inc., a leader in the crime scene supplies, digital forensics, and evidence collection kit markets, announced today the acquisition of Rescue Essentials, a leading manufacturer and marketer of Individual First Aid Kits, tactical EMS supplies, and first responder trauma gear and equipment. Rescue Essentials' products are sold to medical ...

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The impact of parallel regulatory-HTA scientific advice on clinical development. Assessing the uptake of regulatory and HTA recommendations.

Abstract

Background

The "Parallel regulatory-HTA SA" (PSA) procedure allows manufacturers to receive simultaneous feedback from both EU regulators and HTA bodies on development plans for new medicines.

Objectives

Primary objective of the present study is to investigate whether PSA is integrated in the clinical development programmes for which advice was sought.

Methods

Contents of PSA provided by regulators and HTA bodies for each procedure between 2010 and 2015 were analysed. The development of all clinical studies for which PSA had been sought was tracked using three different databases. The rate of uptake of the advice provided by regulators and HTA bodies was assessed on two key variables: comparator/s and primary endpoint. .

Results

In terms of uptake of comparator recommendations at the time of PSA in the actual development, our analysis showed that manufacturers implemented comparators to address both the needs of regulators and of at least one HTA body in 12 of 21 studies. For primary endpoints, in all included studies manufacturers addressed both the needs of the regulators and at least one HTA body.

Discussion

One of the key findings of this analysis is that manufacturers tend to implement changes to the development programme based on both regulatory and HTA advice with regards to the choice of primary endpoint and comparator. It also confirms the challenging choice of the study comparator, for which manufacturers seem to be more inclined to satisfy the regulatory advice. Continuous research efforts in this area are of paramount importance from a public health perspective.

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TGF-β requires the activation of canonical and non-canonical signalling pathways to induce skeletal muscle atrophy

Journal Name: Biological Chemistry
Issue: Ahead of print


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Metformin-induced anticancer activities: recent insights

Journal Name: Biological Chemistry
Issue: Ahead of print


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Biomechanistic insights into the roles of oxidative stress in generating complex neurological disorders

Journal Name: Biological Chemistry
Issue: Ahead of print


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Changes of the peripheral blood mononuclear cells membrane fluidity from type 1 Gaucher disease patients: an electron paramagnetic resonance study

Journal Name: Biological Chemistry
Issue: Ahead of print


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A Simple Method for Isolation of Soybean Protoplasts and Application to Transient Gene Expression Analyses

We developed a simple and efficient protocol for the preparation of large quantities of soybean protoplasts to study complex regulatory and signaling mechanisms in live cells.

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A Method for the Measurement of Salivary Gland Function in Mice

Salivary gland hypofunction is a frequent consequence of autoimmune disease and radiation therapy. Reproducible evaluation of salivary gland function in mouse models of these diseases is a technical challenge. Here, a simple method for accurate and reproducible measurement of saliva production in mice is described.

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Music from and for Your Ears

Jacob Kirkegaard, sonic artist extraordinaire, hailed for his work inspired by natural phenomena and scientific explorations is making music out of the sounds your ears make. Originally trained at the Academy of Media Arts in Cologne, Germany, the Denmark-born artist has numerous critically acclaimed exhibitions and permanent installations under his belt.

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Stridor as the First Presentation of Metastatic Breast Cancer that Was Managed with Chemotherapy: a Case Report

Abstract

Supraclavicular nodal metastases of breast cancer are rare and occur in about 8% of newly diagnosed cases. It is rarely discussed in the literature that breast cancer was metastasizing to higher levels of the cervical nodes. We report a case of metastatic breast cancer to the deep cervical lymph nodes that caused stridor due to compression of the recurrent laryngeal nerve which was diagnosed by indirect laryngoscopy. After full investigations, urgent chemotherapy was started and it showed a dramatic response with disappearance of the lymph node after two cycles with resolution of the stridor. This report also highlights the association of other metastatic sites with this higher level of neck nodal metastases of breast cancer.

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Fertility preservation options in pediatric and adolescent patients with cancer

Abstract

The incidence of childhood cancer has steadily increased since the 1950s, with approximately 16,000 children diagnosed each year. However, with the advent of more effective multimodal therapies, childhood cancer survival rates have continued to improve over the past 40 years, with >80% of patients now surviving into adulthood. Fertility preservation (FP) has become an important quality-of-life issue for many survivors of childhood cancer. As a result, the therapeutic options have become less gonadotoxic over time and more patients are being offered FP options. This review examines the indications for consultation, male and female FP options both in the prepubertal patient and adolescent patient, and the unique ethical issues surrounding FP in this vulnerable population. Cancer 2018. © 2018 American Cancer Society.

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Dasatinib dose management for the treatment of chronic myeloid leukemia

Chronic myeloid leukemia (CML) has evolved into a chronic disease that is managed with tyrosine kinase inhibitor therapy. Now that long-term survival has been achieved in patients with CML, the focus of treatment has shifted to dose optimization, with the goal of maintaining response while improving quality of life. In this review, the authors discuss optimizing the dose of the second-generation tyrosine kinase inhibitor dasatinib. Once-daily dosing regimens for dasatinib in the first and later lines of treatment were established through long-term (5-year and 7-year) trials. Recently published data have indicated that further dose optimization may maintain efficacy while minimizing adverse events. Results obtained from dose optimization and discontinuation trials currently in progress will help practitioners determine the best dose and duration of dasatinib for patients with CML, because treatment decisions will be made through continued discussions between physicians and patients. Cancer 2018. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

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Temporal trends in the risk of second primary cancers among survivors of adult-onset cancers, 1980 through 2013: An Australian population-based study

BACKGROUND

The authors' systematic review indicated an increasing trend in the risk of second primary cancers (SPCs) from the 1980s to 2000 when considering studies from the United States and Australia. It is uncertain whether this trend has continued to increase since 2000.

METHODS

The current study was a population-based study of 51,802 individuals with adult-onset cancers identified in the Tasmanian Cancer Registry. Patients with a first cancer diagnosis made between 1980 and 2009 were followed up to December 2013. SPC risks were quantified using standardized incidence ratios (SIRs) and absolute excess risks (AERs). Trends in SPC risk were assessed using multivariable Poisson models.

RESULTS

With a median follow-up of 4.8 years (mean, 6.9 years), a total of 5339 SPCs were observed. The SIRs for any SPC increased from 0.98 (95% confidence interval, 0.90-1.07) after a first cancer diagnosis in 1980 through 1984 to 1.12 (95% confidence interval, 1.05-1.20) in 2005 through 2009. In multivariable Poisson models accounting for patient sex, age at the time of the first cancer diagnosis, follow-up interval, and first cancer type, the trend in SIRs increased significantly from 1980 through 2009 for all SPCs (P for trend <.001) and for specific SPCs of the head and neck, lung, digestive tract, and prostate (all P for trend <.05). From 2000 onward, the AER for specific SPCs after specific first cancers was highest for prostate cancer after first cancers of the urinary tract (AER, 54.3 per 10,000 person-years).

CONCLUSIONS

In Tasmania, the risk of SPCs among survivors of adult-onset cancers has increased with periods of first cancer diagnosis from 1980 through 2009. Increased cancer screening and improved medical imaging may have contributed to the greater risk in recent years. Cancer 2018. © 2018 American Cancer Society.

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Imaging-based biomarkers: Changes in the tumor interface of pancreatic ductal adenocarcinoma on computed tomography scans indicate response to cytotoxic therapy

BACKGROUND

The assessment of pancreatic ductal adenocarcinoma (PDAC) response to therapy remains challenging. The objective of this study was to investigate whether changes in the tumor/parenchyma interface are associated with response.

METHODS

Computed tomography (CT) scans before and after therapy were reviewed in 4 cohorts: cohort 1 (99 patients with stage I/II PDAC who received neoadjuvant chemoradiation and surgery); cohort 2 (86 patients with stage IV PDAC who received chemotherapy), cohort 3 (94 patients with stage I/II PDAC who received protocol-based neoadjuvant gemcitabine chemoradiation), and cohort 4 (47 patients with stage I/II PDAC who received neoadjuvant chemoradiation and were prospectively followed in a registry). The tumor/parenchyma interface was visually classified as either a type I response (the interface remained or became well defined) or a type II response (the interface became poorly defined) after therapy. Consensus (cohorts 1-3) and individual (cohort 4) visual scoring was performed. Changes in enhancement at the interface were quantified using a proprietary platform.

RESULTS

In cohort 1, type I responders had a greater probability of achieving a complete or near-complete pathologic response (21% vs 0%; P = .01). For cohorts 1, 2, and 3, type I responders had significantly longer disease-free and overall survival, independent of traditional covariates of outcomes and of baseline and normalized cancer antigen 19-9 levels. In cohort 4, 2 senior radiologists achieved a κ value of 0.8, and the interface score was associated with overall survival. The quantitative method revealed high specificity and sensitivity in classifying patients as type I or type II responders (with an area under the receiver operating curve of 0.92 in cohort 1, 0.96 in cohort 2, and 0.89 in cohort 3).

CONCLUSIONS

Changes at the PDAC/parenchyma interface may serve as an early predictor of response to therapy. Cancer 2018. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Racial disparities in prostate cancer survival in a screened population: Reality versus artifact

BACKGROUND

Racial disparities in prostate cancer survival (PCS) narrowed during the prostate-specific antigen (PSA) era, suggesting that screening may induce more equitable outcomes. However, the effects of lead time and overdiagnosis can inflate survival even without real screening benefit.

METHODS

A simulation model of PCS in the early PSA era (1991-2000) was created. The modeled survival started with baseline survival in the pre-PSA era (1975-1990) and added lead times and overdiagnosis using estimates from published studies. The authors quantified 1) discrepancies between modeled and observed PCS in the PSA era and 2) residual period effects on PCS given specified values for screening benefit.

RESULTS

Lead time and overdiagnosis explained more of the improvement in PCS for older ages at diagnosis (46% [95% confidence interval (CI), 44%-50%] for blacks and 51% [95% CI, 50%-52%] for all races ages 50-54 years vs 98% [95% CI, 97%-99%] for blacks and 100% for all races ages 75-79 years). They also explained more of the narrowing in PCS disparities for older ages (33% [95% CI, 31%-43%] for men ages 50-54 years vs 74% [95% CI, 71%-81%] for men ages 75-79 years). The period effects amounted to reductions of 27% to 40% among blacks and 26% to 38% among all races in the risk of prostate cancer death, depending on the screening benefit.

CONCLUSIONS

Real improvements in survival disparities in the PSA era are smaller than those observed and reflect similar reductions in the risk of prostate cancer death among blacks and all races. Understanding screening artifacts is necessary for valid interpretation of observed survival trends. Cancer 2018. © 2018 American Cancer Society.

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Survival by Hispanic ethnicity among patients with cancer participating in SWOG clinical trials

BACKGROUND

Racial disparities in cancer outcomes have been described. To the authors' knowledge, it remains unclear whether patients of Hispanic ethnicity have better or worse survival outcomes. In the current study, the authors evaluated whether Hispanic participants in SWOG clinical trials had different survival outcomes compared with non-Hispanics.

METHODS

Adult patients registered in SWOG phase 2/3 clinical trials between 1986 and 2012 were analyzed. Studies of similar histology and stage of disease were combined. Within each analysis, Kaplan-Meier survival curves were generated to examine differences in outcome by ethnicity. Multivariate Cox regression was used to estimate the association between ethnicity and survival outcomes, controlling for major disease-specific prognostic factors and demographic variables plus area-level income and education to account for socioeconomic status.

RESULTS

A total of 29,338 patients registered to 38 trials were included; 5% of these patients were Hispanic. Hispanic patients were more likely to be younger and from areas of lower income and education (all P<.05). No differences in survival were observed across tumor types except in the patients with advanced stage prostate cancer, in whom the authors observed an association between Hispanic ethnicity and worse overall survival (hazard ratio [HR], 1.40; P = .006), progression-free survival (HR, 1.36; P = .007), and cancer-specific survival (HR, 1.42; P = .013). After adjusting for multiple comparisons, no differences in outcomes were noted.

CONCLUSIONS

Hispanic patients participating in SWOG trials who received uniform treatment and follow-up were found to have similar survival outcomes compared with non-Hispanic patients, with the single exception of those patients with advanced stage prostate cancer. The results of the current study demonstrate that Hispanic patients receiving uniform treatment and follow-up have similar outcomes compared with non-Hispanics. Cancer 2018. © 2018 American Cancer Society.

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Assessment of Social Transmission of Food Preferences Behaviors

This paper presents a protocol for the investigation of social transmission of food preference in mice. The advantages and possible applications for this procedure, for instance, in detecting early changes in AD mouse models, are highlighted. To conclude, interpretation of the results in light of critical details are discussed.

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Preparation of Hollow Polystyrene Particles and Microcapsules by Radical Polymerization of Janus Droplets Consisting of Hydrocarbon and Fluorocarbon Oils

A protocol for the fabrication of hollow polymer particles and microcapsules by radical polymerization using emulsions consisting of styrene, perfluoro-n-octane, and aqueous SDS (sodium dodecylsulfate) solution is presented.

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Application of Chronic Stimulation to Study Contractile Activity-induced Rat Skeletal Muscle Phenotypic Adaptations

This protocol describes the use of the chronic contractile activity model of exercise to observe stimulation-induced skeletal muscle adaptations in the rat hindlimb.

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SEOM clinical guidelines for the treatment of head and neck cancer (2017)

Abstract

Head and neck cancer (HNC) is defined as malignant tumours located in the upper aerodigestive tract and represents 5% of oncologic cases in adults in Spain. More than 90% of these tumours have squamous histology. In an effort to incorporate evidence obtained since 2013 publication, Spanish Society of Medical Oncology (SEOM) presents an update of HNC diagnosis and treatment guideline. The eighth edition of TNM classification, published in January 2017, introduces important changes for p16-positive oropharyngeal tumours, for lip and oral cavity cancer and for N3 category. In addition, there are new data about induction chemotherapy and the role of immunotherapy in HNC.

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Quantitative Measurement of γ-Secretase-mediated Amyloid Precursor Protein and Notch Cleavage in Cell-based Luciferase Reporter Assay Platforms

We have successfully generated two substrate-specific γ-secretase assays. Both cell-based assays presented here are designed to quantify γ-secretase enzymatic activities via the output of firefly luciferase reporters.

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Protective potential of Tetrapleura tetraptera against trona ( kaun )-induced hepatic injury in rat models

Abstract

The antioxidant protective effect of the fruits and peels of Tetrapleura tetraptera were investigated in trona (kaun)-induced oxidative injuries in male albino rats. The peels and fruits of T. tetraptera were air-dried and extracted with ethanol. The concentrated extracts were subjected to FTIR spectroscopy analysis to identify their chemical functional groups. Five groups of six rats each were pretreated with trona (500 mg/kg bw) for 7 days, while a sixth group was administered water only which served as normal control. Four of the pretreated groups were subjected to posttreatment with T. tetraptera extracts, while the fifth served as negative control. At the end of the experiment, their hepatic, kidney, and intestinal tissues were assessed for catalase activity and malondialdehyde (MDA) level. Aspartate transaminase (AST) and alanine transaminase (ALT) levels were analyzed in blood serum. While histopathology was carried out on hepatic tissues. FTIR spectroscopy of the extracts revealed amines, alcohols, carboxylic acids, esters, ethers, aromatics, alkanes, aldehydes, ketones, phenols, and amides as the functional groups. Ingestion of trona caused significant (p < 0.05) increase in all studied biological parameters in all tissues. These were significantly (p < 0.05) reversed to near normal after treatment with both extracts. Histopathology revealed reduction in trona-induced lesions and alterations in hepatic tissue after treatment with the extracts. These results indicate the antioxidant protective effect of T. tetraptera against trona-induced oxidative injury, which can be attributed to the identified functional groups.

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The clinicopathological features and prognosis of tumor MSI in East Asian colorectal cancer patients using NCI panel

Future Oncology, Ahead of Print.


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A novel mutation in the TM6 domain of GABBR2 leads to a Rett-like phenotype

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Gamma-glutamyl transferase predicts future stroke: a Korean nationwide study

ABSTRACT

Objective: Although gamma-glutamyl transferase (GGT) is generally regarded as an alternative biomarker for alcohol consumption, its independent role in vascular diseases emerged recently. However, its role in stroke remains unknown. The aim of this study is to clarify the impact of GGT on stroke in a large-sized, national, standardized population cohort in Korea.

Methods: In Korea, the National Health Insurance Service (NHIS) provides full-coverage health insurance service for all citizens. Using data from the NHIS, the NHIS-National Sample Cohort (NHIS-NSC) was designed by randomly selecting 2% of Koreans, carefully considering demographic characteristics. We analyzed eligible individuals from this standardized cohort. The Cox proportional hazards model was used for the longitudinal study investigating the relationship between GGT and stroke.

Results: Among the 456,100 eligible participants, 7,459 patients (1.64%) developed stroke as follows: 5,789 ischemic strokes, 1,046 intracerebral hemorrhages (ICHs), and 624 subarachnoid hemorrhages. GGT was independently correlated with increased risk of stroke after adjustment for alcohol consumption and stroke risk factors (hazard ratio (HR), 1.39; 95% confidence interval (CI), 1.29–1.51). The risks of both ischemic stroke (HR, 1.45; 95% CI, 1.32–1.58) and ICH (HR, 1.46; 95% CI, 1.18–1.80) were significantly elevated with increasing GGT. Despite some effect modifications by sex, age and alcohol, the risk of total stroke and ischemic stroke in association with GGT remained significant in all subgroups.

Interpretation: In a standard Korean population, GGT was a novel biomarker predicting stroke risk, independently from alcohol consumption and other risk factors. This article is protected by copyright. All rights reserved.

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Pallidal deep brain stimulation modulates cortical excitability and plasticity

Abstract

Objective: Internal globus pallidus (GPi) deep brain stimulation (DBS) relieves symptoms in dystonia patients. However, the physiological effects produced by GPi DBS are not fully understood. In particular, how a single-pulse GPi DBS changes cortical circuits has never been investigated. We studied the modulation of motor cortical excitability and plasticity with single-pulse GPi DBS in dystonia patients with bilateral implantation of GPi DBS.

Methods: The cortical evoked potentials from DBS were recorded with electroencephalography. Transcranial magnetic stimulation with a conditioning-test paired-pulse paradigm was used to investigate the effect of GPi DBS on the primary motor cortex. How GPi DBS might modulate the motor cortical plasticity was tested using a paired associative stimulation paradigm with repetitive pairs of GPi DBS and motor cortical stimulation at specific time intervals.

Results: GPi stimulation produced two peaks of cortical evoked potentials with latencies of ∼10 and ∼25 ms in the motor cortical area. Cortical facilitation was observed at ∼10 ms after single-pulse GPi DBS and cortical inhibition was observed at ∼25 ms interval. Repetitive pairs of GPi stimulation with cortical stimulation at these two time intervals produced long term potentiation-like effects in the motor cortex.

Interpretation: Single-pulse DBS modulates cortical excitability and plasticity at specific time intervals. These effects may be related to the mechanism of action of DBS. Combination of DBS with cortical stimulation at appropriate timing has therapeutic potential and could be explored in the future as a method to enhance the effects of neuromodulation for neurological and psychiatric diseases. This article is protected by copyright. All rights reserved.

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Parkinson's disease and the risk of epileptic seizures

ABSTRACT

Objective

To assess the association between incident Parkinson's disease (PD) and subsequent incident epileptic seizures.

Methods

We conducted a retrospective cohort study with a nested case-control analysis using data from the UK Clinical Practice Research Datalink. We identified patients aged ≥40 years with an incident diagnosis of PD between 1995 and 2016 and a matched comparison group of PD-free individuals. We calculated crude incidence rates (IRs) with 95% confidence intervals (CIs) of epileptic seizures in PD patients and the PD-free comparison group, and corresponding crude incidence rate ratios (IRRs). In the nested case-control analysis, we calculated adjusted odds ratios (adj. ORs) of incident PD among cases with incident epileptic seizures and seizure-free controls overall and stratified by various, seizure-provoking comorbidities.

Results

Among 23,086 incident PD patients and 92,343 PD-free individuals, we identified 898 patients with incident epileptic seizures. The crude IR of epileptic seizures in PD patients was 266.7/100,000 person years (95% CI 235.6-297.7), and in PD-free individuals 112.4/100,000 person years (95% CI 103.5-121.3) [IRR: 2.37, 95% CI 2.06-2.37]. The adj. OR of epileptic seizures was 1.68 [95% CI 1.43-1.98]) in PD patients compared with PD-free individuals. PD patients with comorbid brain disorders (adj. OR 12.36 [95% CI 8.74-17.48]) or with >1 seizure-provoking comorbidity (adj. OR 13.24 [95% CI 10.15-17.25]) were at the highest risk of epileptic seizures compared with PD-free individuals with no seizure-provoking comorbidities.

Interpretation

This study suggests that incident PD is associated with an increased risk of incident epileptic seizures. This article is protected by copyright. All rights reserved.

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Neutrophil hyperactivation correlates with Alzheimer's disease progression

Abstract

Objective: Recent studies have underlined the effect of systemic inflammation on the pathophysiology of Alzheimer's disease. Neutrophils are key components of early innate immunity and contribute to uncontrolled systemic inflammation if not tightly regulated. The aim of our study was to fully characterize human circulating neutrophils at different disease stages in Alzheimer's disease.

Methods: We analyzed neutrophil phenotypes and functions in forty-two patients with Alzheimer's disease (sixteen with mild cognitive impairment and twenty-six with dementia), and compared them with twenty-two age-matched healthy subjects. This study was performed directly in whole blood to avoid issues with data interpretation related to cell isolation procedures.

Results: Blood samples from Alzheimer's diseases patients with dementia revealed neutrophil hyperactivation associated with increased reactive oxygen species production and increased levels of intravascular neutrophil extravascular traps. The homeostasis of circulating neutrophils in these patients also changed: the ratio between the harmful hyperreactive CXCR4^high/CD62L^low senescent and the CD16^bright/CD62L^dim immunosuppressive neutrophil subsets rose in the later stage of the disease. These abnormalities were greater in fast-decliner than in slow-decliner patients.

Interpretation: Our results indicate that the inflammatory properties of circulating neutrophils shift as the percentage of aged neutrophils expands in patients with Alzheimer's disease — changes that may play an instrumental role in establishing systemic chronic inflammation. Most important, our data strongly suggest that the neutrophil phenotype may be associated with the rate of cognitive decline and may thus constitute an innovative and prognostic blood biomarker in patients with Alzheimer's disease. This article is protected by copyright. All rights reserved.

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Metallothioneins are Neuroprotective Agents in Lysosomal Storage Disorders

ABSTRACT

Objective: Lysosomal Storage Disorders (LSDs) are a broad class of inherited metabolic diseases caused by the defective activity of lysosomal enzymes. Central nervous system (CNS) manifestations are present in roughly 50% of LSD patients and represent an unmet medical need for them. We explored the therapeutic potential of Metallothioneins (MTs), a newly identified family of proteins with reported neuroprotective roles, in the murine models of two LSDs with CNS involvement.

Methods: MT-1 over-expressing transgenic mice (MTtg) were crossed with the murine models of Batten and Krabbe diseases. Changes in the survival and in the manifestations of the disease in the MTtg setting were assessed. In addition, we analyzed the therapeutic effects of MT-1 CNS gene delivery in one of these LSD models.

Results: Constitutive expression of MT-1 exerted favorable phenotypic effects in both LSD models. MT-LSD mice showed a 5-10% increase in survival and slower disease progression as compared to not-transgenic LSD mice. Rescue of Purkinje cells from degeneration and apoptosis was also observed in the MT- LSD models. This phenotypic amelioration was accompanied by a modulation of the disease-associated activated inflammatory microglia phenotype, and by a reduction of oxidative stress. Importantly for the clinical translation of our findings, the very same effects were obtained when MTs were delivered to the brains by systemic AAV gene transfer.

Interpretation: MTs can be considered novel therapeutic agents (and targets) in LSDs and potentiate the effects of approaches aiming at correction of the disease-causing enzyme deficiency in the CNS. This article is protected by copyright. All rights reserved.

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Expression profiling suggests microglial impairment in HIV neuropathogenesis

ABSTRACT

Objective: CD16⁺/CD163⁺ macrophages (MΦ)s and microglia accumulate in the brains of patients with HIV encephalitis (HIVE), a neuropathological correlate of the most severe form of HIV-associated neurocognitive disorders (HAND), HIV-associated dementia (HIV-D). Recently, we found that some parenchymal microglia in brain of HIV⁺ subjects without encephalitis (HIV/noE) but with varying degrees of neurocognitive impairment express CD16 and CD163, even in the absence of detectable virus production. To further our understanding of microglial activation in HIV, we investigated expression of specific genes by profiling parenchymal microglia from archival brain tissue of patients with HIVE, HIV/noE, and HIV^- controls.

Methods: Single-population microarray analyses were performed on ∼2,500 laser capture microdissected CD163⁺, CD16⁺ or CD68⁺ MΦs/microglia per case, using terminal continuation (TC) RNA amplification and a custom-designed array platform.

Results: Several classes of microglial transcripts in HIVE and HIV/noE, were altered, relative to HIV^- subjects, including factors related to cell stress, immune activation, and apoptosis. Additionally, several neurotrophic factors are reduced in HIV infection, suggesting an additional mechanism of neuropathogenesis. The majority of transcripts altered in HIVE displayed intermediate changes in HIV/noE.

Interpretation: Our results support the notion that microglia contribute to the maintenance of brain homeostasis and their potential loss of function in the context of chronic inflammation contributes to neuropathogenesis. Furthermore, they indicate the utility of profiling MΦs/microglia to increase our understanding of microglia function, as well as ascertain alterations in specific pathways, genes, and, ostensibly, encoded proteins that may be amenable to targeted treatment modalities in diseases affecting the brain. This article is protected by copyright. All rights reserved.

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Superimposed signaling inspired channel estimation in full-duplex systems

Residual self-interference (SI) cancellation in the digital baseband is an important problem in full-duplex (FD) communication systems. In this paper, we propose a new technique for estimating the SI and commu...

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Khat chewing increases the risk for developing chronic liver disease: A hospital-based case-control study

ABSTRACT

The chewing of the leaves of Catha edulis (khat) has been implicated in the development of liver disease, but no controlled observations have been undertaken. The objective of the present study was to determine whether khat chewing is associated with development of chronic liver disease (CLD). A case-control study was conducted at two public hospitals in Harar, Ethiopia, between April 2015 and April 2016. A consecutive sample of 150 adult hospital attendees with CLD were included as cases, and 300 adult hospital attendees without clinical or laboratory evidence of CLD were included as controls. Khat consumption was quantified in khat years; one khat year was defined as daily use of 200 grams of fresh khat for one year. A logistic regression model was used to control for confounders. There was a significant association between chewing khat and the risk for developing CLD (crude odds ratio [OR] 2.64; 95% CI 1.56-4.58). In men, this risk, following adjustment for age, alcohol use, and chronic hepatitis B/C infection, increased with increasing khat exposure; thus, compared to never users the adjusted OR for low khat exposure was 3.58 (95% CI 1.05-12.21), moderate khat exposure 5.90 (95% CI 1.79-19.44), and high khat exposure 13.03 (95% CI 3.61-47.02). The findings were robust in a post-hoc sensitivity analysis in which individuals with identifiable risk factors for CLD were excluded. Conclusion: A significant association was observed between chewing khat and the risk for developing CLD. In men, the association was strong and dose-dependent, suggesting a causal relationship. As the prevalence of khat chewing is increasing worldwide, these findings have major public health implications. This article is protected by copyright. All rights reserved.

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iPhone to get 911 location feature in update

Apple said they are adopting Advanced Mobile Location, a precise way for the phone to report the location of the caller to dispatchers

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7 Benefits of Implementing an Online Time Clock Into Your Time and Attendance Process

EMS agencies nationwide have started implementing biometric clocks into their time and attendance scheduling process based on the numerous benefits that come with the system. Biometric technology offers one of the most cost effective, convenient, and secure forms of employee and staff identification available in the world today; combining this tool with a strong EMS scheduling suite enables each agency ...

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Thin Is In? Think Again: The Rising Importance of Muscularity in the Thin Ideal Female Body

Abstract

Research has documented an increased emphasis on fitness in media targeting women. However, it is unclear whether this emphasis has resulted in increased muscularity in the perceived ideal female body shape. We sought to evaluate whether the ideal female figure has incorporated increased muscularity into the existing ideal body type that already emphasizes thinness. In Study 1, 78 female undergraduates evaluated images of U.S. beauty pageant winners over the past 15 years on dimensions of thinness, muscularity, and attractiveness. Results indicated that muscularity and thinness ratings of pageant winners significantly increased over time. In Study 2, 64 female undergraduates evaluated two different versions of the same image of a model: a Thin Muscular image and a Thin Only image in which the appearance of muscularity was removed through digital editing. When images were presented in pairs, results indicated that participants found the Thin Muscular image more attractive than the Thin Only image. These results suggest that the current perceived ideal female figure includes both extreme thinness and muscularity and that women prefer this muscular thin figure to a solely thin figure. These findings have implications for clinical treatments related to body image, compulsive exercise, and media literacy.

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What Rights Are Human Rights and Who Gets to Choose?

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Concurrent renal cell carcinoma and urothelial carcinoma: long-term follow-up study of 27 cases

Abstract

Background

To investigate the clinical manifestation, diagnosis, treatment, and outcome of simultaneous occurrence of renal cell carcinoma (RCC) and urothelial carcinoma.

Methods

Twenty-seven consecutive patients with synchronous renal cell carcinoma and urothelial carcinoma treated in two tertiary medical centers from March 2005 to December 2015 were retrospectively reviewed. Their clinical, pathological, and prognostic features were evaluated. Kaplan-Meier curves were used to estimate overall survival.

Results

The median age was 69 years (range, 37–79 years). Seventeen patients presented with macroscopic hematuria, and 10 patients were asymptomatic. B-ultrasound, computed tomography (CT), and cystoscopy initially indicated RCC concurrent with ipsilateral upper tract urothelial carcinoma (UTUC) in 5 cases, RCC concurrent with contralateral UTUC in 1 case, RCC concurrent with bladder tumor in 17 cases, RCC concurrent with both ipsilateral UTUC and bladder tumor in 1 case, RCC in 2 cases and ureter carcinoma in 1 case. Different treatments were performed. The median follow-up time after surgery was 23 months. For patients with synchronous RCC and bladder tumor, there was no significant survival difference between patients treated with partial nephrectomy and radical nephrectomy. During follow up, four patients died of RCC, three patients died of non-oncological disease, one patient died of ureter carcinoma. The 3-year overall survival rate was 80.8%.

Conclusions

Concurrence of RCC and urothelial carcinoma is clinically rare. Treatments should be individualized. The prognosis for a patient with synchronous RCC and urothelial carcinoma is possibly associated with the more aggressive one.

http://ift.tt/2DDsSuD

Management and Point-of-Care for Tobacco Dependence (PROMPT): a feasibility mixed methods community-based participatory action research project in Ottawa, Canada

Objective

To determine the feasibility of a Community-Based Participatory Tobacco Dependence Strategy (PROMPT) in the inner city population of Ottawa (Canada).

Design

A feasibility mixed methods prospective cohort study following principles of community-based participatory action research.

Intervention

Recruited 80 people whouse drugs, followed them for 6 months while providing access to counselling, nicotine replacement therapy and peer-support in a community setting.

Setting

Community research office in downtown Ottawa, adjacent to low-income housing, shelter services and street-based drug consumption.

Primary outcome

Retention rate at 6-month follow-up.

Secondary outcome

Biochemically validated 7-day point prevalence smoking abstinence at 26 weeks, self-reported abstinence in the past 7 days with exhaled carbon monoxide ≤10 ppm.

Results

The average age of participants was 43.8 years. The 6-month follow-up rate was 42.5%. The mean number of smoking years reported was 27.3 years. The participants were 70% male, 33.7% reported less than a high-school education, 21% identified as indigenous and 43.8% reported an income between US$1000 and US$1999 per month. The baseline mean daily cigarette use was 20.5 and 9.3 cigarettes at study end, with mean reduction of 11.2 cigarettes at 6 months (P=0.0001). There was a considerable reduction in self-reported illicit substance use (18.8%), including a reduction in the opioids heroin (6.3%), fentanyl (2.6%) and Oxycontin (3.8%). The study findings also reveal psycho-socioeconomic benefits such as improved health, return to work and greater community engagement.

Conclusions

The PROMPT project describes socioeconomic variables associated with tobacco and polysubstance use. A programme focused on tobacco dependence, easily accessible in the community and led by community peers with lived experience is feasible to implement and has the potential to support positive life changes. PROMPT's patient engagement model is an effective harm-reduction strategy for the growing opioid use crisis and can improve the health outcomes of marginalised at-risk populations worldwide.

http://ift.tt/2n9KEL5

Motives for sickness presence among students at secondary school: a cross-sectional study in five European countries

Objectives

This article investigates various motives for sickness presence (SP) among students in secondary school.

Design

Cross-sectional study.

Setting

25 secondary schools in Belgium, Estonia, Finland, Italy and Latvia.

Participants

5002 students between 16 and 19 years of age, 49% female.

Results

Almost half of the students reported two or more incidents of SP. The study indicated that the practice of SP was mainly extrinsically motivated. The most often reported motives for SP were that absence could affect grades negatively, that important curriculum material was explained at the school and attendance requirements. Some students practising SP expressed intrinsic motivation, such as maintaining their social network and interest in what was learnt at school.

Conclusion

The study investigated various motives for SP in secondary schools in five European countries. Extrinsic motivation for SP was more often reported than intrinsic motivation for SP. Multivariate analyses indicated that boys, students in vocational education, immigrants and students with low-educated parents more often reported intrinsic motivation for SP, while girls and students with high absence more often reported extrinsic motivation. There were also notable cross-country differences regarding reported motives for SP.

http://ift.tt/2DBDoT2

Women, their Offspring and iMproving lifestyle for Better cardiovascular health of both (WOMB project): a protocol of the follow-up of a multicentre randomised controlled trial

Introduction

Women, their Offspring and iMproving lifestyle for Better cardiovascular health of both (WOMB) project is the follow-up of the LIFEstyle study, a randomised controlled trial in obese infertile women, and investigates the effects of a preconception lifestyle intervention on later health of women (WOMB women) and their children (WOMB kids).

Methods and analysis

Obese infertile women, aged between 18 and 39 years, were recruited in 23 Dutch fertility clinics between June 2009 and June 2012. The 284 women allocated to the intervention group received a 6-month structured lifestyle programme. The 280 women in the control group received infertility care as usual. 4 to 7 years after inclusion in the trial, all women (n=564) and children conceived during the trial (24 months after randomisation) (n=305 singletons and age 3–5 years) will be approached to participate in this follow-up study (starting in 2015). The main focus of outcome will be cardiovascular health, but the dataset comprises a wide range of physical and mental health measures, diet and physical activity measures, child growth and development measures, biological samples and genetic and epigenetic information. The follow-up assessment consists of three stages that take place between 2016 and 2018, and includes (online) questionnaires, accelerometry and physical and behavioural measurements in a mobile research vehicle. A subsample of 100 women and 100 children are planned for cardiac ultrasound measurements.

Ethics and dissemination

The protocol of this follow-up study is approved by the local medical ethics committee (University Medical Centre Groningen). Study findings of the WOMB project will be widely disseminated to the scientific community, healthcare professionals, policy makers, future parents and general public.

Trial registration number

The original LIFEstyle study is registered at The Netherlands Trial Registry (number 1530).

http://ift.tt/2n9KkMn

Association between low bone mineral density and hearing impairment in postmenopausal women: the Korean National Health and Nutrition Examination Survey

Objective

To investigate the relationship between bone mineral density (BMD) and hearing impairment using a nationally demonstrative sample of Korean female adults.

Study design

Cross-sectional study of a national health survey.

Methods

Data from the 2009–2010 Korean National Health and Nutrition Examination Surveys (KNHANES) with 19 491 participants were analysed, and 8773 of these participants were enrolled in this study. BMD was measured using dual-energy X-ray absorptiometry. Auditory functioning was evaluated by pure-tone audiometric testing according to established KNHANES protocols. We deliberated auditory impairment as pure-tone averages at frequencies of 0.5, 1.0, 2.0 and 3.0 kHz at a threshold of ≥40 decibels hearing level in the auricle with better hearing status.

Results

Among women aged 19 years and older, prevalences of bilateral hearing impairment in premenopausal and postmenopausal women were 0.1%±0.1% and 11.5%±1.1% (mean±SE), respectively. Hearing impairment was meaningfully associated with low BMD in postmenopausal women. Logistic regression models indicated that lower BMDs of the total femur (OR=0.779; 95% CI 0.641 to 0.946, P=0.0118) and femur neck (OR=0.746; 95% CI 0.576 to 0.966, P=0.0265) were significantly associated with hearing impairment among postmenopausal women.

Conclusions

Postmenopausal Korean women with low BMD of the total femur and femoral neck showed an increased risk for developing hearing impairment. Further epidemiological and investigational studies are needed to elucidate this association.

http://ift.tt/2DClRtV

Tulsa 1000: a naturalistic study protocol for multilevel assessment and outcome prediction in a large psychiatric sample

Introduction

Although neuroscience has made tremendous progress towards understanding the basic neural circuitry underlying important processes such as attention, memory and emotion, little progress has been made in applying these insights to psychiatric populations to make clinically meaningful treatment predictions. The overall aim of the Tulsa 1000 (T-1000) study is to use the NIMH Research Domain Criteria framework in order to establish a robust and reliable dimensional set of variables that quantifies the positive and negative valence, cognition and arousal domains, including interoception, to generate clinically useful treatment predictions.

Methods and analysis

The T-1000 is a naturalistic study that will recruit, assess and longitudinally follow 1000 participants, including healthy controls and treatment-seeking individuals with mood, anxiety, substance use and eating disorders. Each participant will undergo interview, behavioural, biomarker and neuroimaging assessments over the course of 1 year. The study goal is to determine how disorders of affect, substance use and eating behaviour organise across different levels of analysis (molecules, genes, cells, neural circuits, physiology, behaviour and self-report) to predict symptom severity, treatment outcome and long-term prognosis. The data will be used to generate computational models based on Bayesian statistics. The final end point of this multilevel latent variable analysis will be standardised assessments that can be developed into clinical tools to help clinicians predict outcomes and select the best intervention for each individual, thereby reducing the burden of mental disorders, and taking psychiatry a step closer towards personalised medicine.

Ethics and dissemination

Ethical approval was obtained from Western Institutional Review Board screening protocol #20101611. The dissemination plan includes informing health professionals of results for clinical practice, submitting results to journals for peer-reviewed publication, presenting results at national and international conferences and making the dataset available to researchers and mental health professionals.

Trial registration number

NCT02450240; Pre-results.

http://ift.tt/2nevLaq

Best practices for community-engaged participatory research with Pacific Islander communities in the USA and USAPI: protocol for a scoping review

Introduction

Community-based participatory research is a partnership approach to research that seeks to equally involve community members, organisational representatives and academic partners throughout the research process in a coequal and mutually beneficial partnership. To date, no published article has synthesised the best practices for community-based participatory research practices with Pacific Islanders.

Methods and analysis

The reviewers will examine studies' titles, abstracts and full text, comparing eligibility to address discrepancies. For each eligible study, data extraction will be executed by two reviewers and one confirmation coder, comparing extracted data to address any discrepancies. Eligible data will be synthesised and reported in a narrative review assessing coverage and gaps in existing literature related to community-based participatory research with Pacific Islanders.

Discussion and dissemination

The purpose of this review is to identify best practices used when conducting community-based participatory research with Pacific Islanders; it will also extrapolate where the gaps are in the existing literature. This will be the first scoping review on community-based participatory research with Pacific Islanders. To facilitate dissemination, the results of this scoping review will be submitted for publication to a peer-reviewed journal, presented at conferences and shared with community-based participatory research stakeholders.

http://ift.tt/2DDKVkp

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial

Objective

To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes.

Design

Cluster randomised controlled trial.

Setting

Thirty long-term care homes across the Netherlands.

Participants

Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses.

Intervention

Nurse-supported self-management programme.

Measurements

Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses' job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics.

Results

Self-management did not affect all four domains of social participation; however. the domain 'instrumental activities of daily living' had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate.

Conclusions

A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain 'instrumental activities of daily living', but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons.

Trial registration number

NCT01217502; Results.

http://ift.tt/2nbNUWh

Electroacupuncture as an adjunctive therapy for motor dysfunction in acute stroke survivors: a systematic review and meta-analyses

Objectives

To assess the effectiveness and safety of electroacupuncture (EA) combined with rehabilitation therapy (RT) and/or conventional drugs (CD) for improving poststroke motor dysfunction (PSMD).

Design

Systematic review and meta-analysis.

Methods

The China National Knowledge Infrastructure, Chinese Biological Medicine Database, Chinese Scientific Journal Database, Cochrane Library, Medline and Embase were electronically searched from inception to December 2016. The methodological quality of the included trials was assessed using the Cochrane risk of bias assessment tool. Statistical analyses were performed by RevMan V.5.3 and Stata SE V.11.0.

Results

Nineteen trials with 1434 participants were included for qualitative synthesis and meta-analysis. The methodological quality of the included trials was generally poor. The meta-analysis indicated that the EA group might be benefiting more than the non-EA group in terms of the changes in the Fugl-Meyer Assessment Scale (FMA) (weighted mean difference (WMD): 10.79, 95% CI 6.39 to 15.20, P<0.001), FMA for lower extremity (WMD: 5.16, 95% CI 3.78 to 6.54, P<0.001) and activities of daily living (standardised mean difference: 1.37, 95% CI 0.79 to 1.96, P<0.001). However, there was no difference between EA and non-EA groups in terms of the effective rate (relative risk: 1.13, 95% CI 1.00 to 1.27, P=0.050). Moreover, there were not any reports of side effects due to EA combined with RT and/or CD in the included trials.

Conclusions

This review provides new evidence for the effectiveness and safety of EA combined with RT and/or CD for PSMD. However, the results should be interpreted cautiously because of methodological weakness and publication bias. Further clinical trials with a rigorous design and large sample sizes are warranted.

PROSPERO registration number

CRD42016037597.

http://ift.tt/2DDdEpx

Correction: Do urology journals enforce trial registration? A cross-sectional study of published trials

Kunath F, Grobe HR, Keck B, et al. Do urology journals enforce trial registration? A cross-sectional study of published trials. BMJ Open 2011;1:e000430. doi: 10.1136/bmjopen-2011-000430

In relation to an issue raised by a reader regarding some minor overlap between this paper published in BMJ Open (10.1136/bmjopen-2011-000430) and one published in Urologia Internationalis (Do journals publishing in the field of urology endorse reporting guidelines? A survey of author instructions. Kunath F, Grobe HR, Rücker G, Engehausen D, Antes G, Wullich B, Meerpohl JJ. Urol Int 2012;88:54–9. doi:10.1159/000332742. Epub 19 Nov 2011) we would like to clarify:

Both publications are based on the same set of journal author's instructions. However, they were evaluated separately and one after the other for the individual research questions several weeks apart. Obviously, both projects address different issues. Due to the same data sources, both publications include a minor section of text that is similar. Citation...

http://ift.tt/2ncDxl0

Longitudinal designs to study neighbourhood effects on the development of obesity: a scoping review protocol

Introduction

The prevalence of obesity has increased significantly in the last three decades and became an important public health concern. Evidence of weight status variability at the neighbourhood level has led researchers to look more precisely at the characteristics of local geographic areas that might influence energy balance related behaviours, giving rise to the field of the 'neighbourhood effect' in public health research. Among an abundant literature about neighbourhood effects and obesity, we propose a protocol for a scoping review that will aim at determining how temporal measurements of residential neighbourhood exposure, individual covariates and weight outcome are integrated in longitudinal designs.

Methods and analysis

A list of relevant citations will be obtained through a comprehensive systematic database search in Pubmed, Web of Science and Embase. The search strategy will be designed using a broad definition of neighbourhood to take into account the heterogeneity of this concept in research. Two investigators will screen titles, abstracts and entire publications using predetermined eligibility criteria yielding a list of selected publications. Data from the publications included in the scoping review will be charted according to bibliographic information, study population, exposure, outcomes and results.

Discussion and conclusion

To our knowledge, our protocol will yield the first scoping review regarding longitudinal designs of neighbourhood effect on obesity. Describing how longitudinal designs include temporal measurements of exposure, covariates and outcome is a necessary step in the quest to determine if or which contextual characteristics are likely to be involved in the development of obesity. Such information would bring new knowledge to complement current aetiological investigations and would contribute to enhancing resource allocation strategies for stakeholders in developing relevant interventions to prevent obesity and its negative impacts.

http://ift.tt/2DEB1iz

Are risk factors for preterm and early-term live singleton birth the same? A population-based study in France

Objectives

To investigate whether risk factors for preterm (<37 weeks gestation) and early-term birth (37 and 38 weeks gestation) are similar.

Design

Nationally representative cross-sectional study of births.

Setting

France in 2010.

Participants

Live singleton births (n=14 326).

Primary and secondary outcome measures

Preterm and early-term birth rates overall and by mode of delivery (spontaneous and indicated). Risk factors were maternal sociodemographic characteristics, previous preterm birth, height, prepregnancy body mass index (BMI) and smoking, assessed using multinomial regression models with full-term births 39 weeks and over as the reference group.

Results

There were 5.5% preterm and 22.5% early-term births. Common risk factors were: a previous preterm delivery (adjusted relative risk ratio (aRRR) 8.2 (95% CI 6.2 to 10.7) and aRRR 2.4 (95% CI 2.0 to 3.0), respectively), short stature, underweight (overall and in spontaneous deliveries), obesity (in indicated deliveries only), a low educational level and Sub-Saharan African origin. In contrast, primiparity was a risk factor only for preterm birth, aRRR 1.8 (95% CI 1.5 to 2.2), while higher parity was associated with greater risk of early-term birth.

Conclusions

Most population-level risk factors were common to both preterm and early-term birth with the exception of primiparity, and BMI which differed by mode of onset of delivery. Our results suggest that preterm and early-term birth share similar aetiologies and thus potentially common strategies for prevention.

http://ift.tt/2nbLdno

Association between body mass index and obesity-related cancer risk in men and women with type 2 diabetes in primary care in the Netherlands: a cohort study (ZODIAC-56)

Objective

To investigate the relationship between body mass index (BMI) and obesity-related cancers in men and women with type 2 diabetes (T2D).

Design

Observational cohort study.

Setting

Primary care.

Participants

A total of 52 044 patients with T2D who participated in the ZODIAC (Zwolle Outpatient Diabetes project Integrating Available Care) study between 1998 and 2012 was included (49% women). A dataset of these patients was linked to available information of the Netherlands Cancer Registry to obtain data on cancer incidents.

Primary outcome measures

Analyses were performed for the total group of obesity-related cancers and for non-sex-specific and sex-specific obesity-related cancers (in men: advanced prostate cancer, in women: ovarian, endometrial and postmenopausal breast cancer).

Results

The median follow-up period in all analyses was 3.1 (1.7–5.0) years in men and 3.1 (1.7–5.1) in women. During follow-up, 689 men and 914 women were diagnosed with an obesity-related cancer. In men, BMI was associated with a higher risk of the total group of obesity-related cancers and non-sex-specific obesity-related cancers (HR (per 5 kg/m² increase) 1.12 (95% CI 1.02 to 1.23) and HR 1.18 (95% CI 1.06 to 1.31)). No association was found with prostate cancer. In women, an association between BMI and all obesity-related cancers combined and sex-specific obesity-related cancers was present (HR 1.15 (95% CI 1.08 to 1.22) and HR 1.22 (95% CI 1.14 to 1.32)). No association with non-sex-specific cancers was found in women.

Conclusions

BMI is associated with obesity-related cancers in men with T2D, except with advanced prostate cancer. The results of this study provide reason to reconsider the classification of advanced prostate cancer as an obesity-related cancer, at least in T2D. In women, BMI is associated with the total group of obesity-related cancers and with sex-specific obesity-related cancers.

http://ift.tt/2ncf3bz

Diagnostic markers of acute infections in infants aged 1 week to 3 months: a retrospective cohort study

Objective

History and physical examination do not reliably exclude serious bacterial infections (SBIs) in infants. We examined potential markers of SBI in young febrile infants.

Design

We reviewed white cell count (WBC), absolute neutrophil count (ANC), neutrophil to lymphocyte count ratio (NLR) and C reactive protein (CRP) in infants aged 1 week to 90 days, admitted for fever to one medical centre during 2012–2014.

Results

SBI was detected in 111 (10.6%) of 1039 infants. Median values of all investigated diagnostic markers were significantly higher in infants with than without SBI: WBC (14.4 vs 11.4 K/µL, P<0.001), ANC (5.8 vs 3.7 K/µL, P<0.001), CRP (19 vs 5 mg/L, P <0.001) and NLR (1.2 vs 0.7, P<0.001). Areas under the receiver operating characteristic curve (AUC) for discriminating SBI were: 0.65 (95% CI 0.59 to 0.71), 0.69 (95% CI 0.63 to 0.74), 0.71 (95% CI 0.65 to 0.76) and 0.66 (95% CI 0.60 to 0.71) for WBC, ANC, CRP and NLR, respectively. Logistic regression showed the best discriminative ability for the combination of CRP and ANC, with AUC: 0.73 (95% CI 0.67 to 0.78). For invasive bacterial infection, AUCs were 0.70 (95% CI 0.56 to 0.85), 0.80 (95% CI 0.67 to 0.92), 0.78 (95% CI 0.68 to 0.89) and 0.78 (95% CI 0.66 to 0.90), respectively. CRP combined with NLR or ANC were the best discriminators of infection, AUCs: 0.82 (95% CI 0.70 to 0.95) and 0.82 (95% CI 0.68 to 0.95), respectively.

Conclusions

Among young febrile infants, CRP was the best single discriminatory marker of SBI, and ANC was the best for invasive bacterial infection. ANC and NLR can contribute to evaluating this population.

http://ift.tt/2DENhQc