Τρίτη 6 Φεβρουαρίου 2018
Recent Progress of Nano-drug Delivery System for Liver Cancer Treatment
Liver cancer is one of serious diseases which threaten human life and health. Studies on the treatment of liver cancer have attracted widespread attention. Application of nano-drug delivery system (NDDS) can not only improve selective drug delivery to liver tissue and improve the bioavailability of drug, but also can reduce the side effects of drugs when it is specially modified in the respects of structure modification or specific target molecules decoration. This review will address the latest development of liver-targeted drug delivery system.
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Tetrazole Derivatives as Promising Anticancer Agents
Tetrazole cycle is a promising pharmacophore fragment frequently used in the development of novel drugs. This moiety is a stable, practically non-metabolized bioisosteric analog of carboxylic, cis-amide, and other functional groups. Over recent 10–15 years, various isomeric forms of tetrazole (NH-unsubstituted, 1H-1- substituted, and 2H-2-substituted tetrazoles) have been successfully used in the design of promising anticancer drugs. Coordination compounds of transition metals containing tetrazoles as ligands, semisynthetic tetrazolyl derivatives of natural compounds (biogenic acids, peptides, steroids, combretastatin, etc.), 5-oxo and 5- thiotetrazoles, and some other related compounds have been recognized as promising antineoplastic agents. This review presents a comprehensive analysis of modern approaches to synthesis of these tetrazole derivatives as well as their biological (anticancer) properties. The most promising structure types of tetrazoles to be used as anticancer agents have been picked out.
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1,3,4-Oxadiazoles as Telomerase Inhibitor: Potential Anticancer Agents
Cancer is a rapidly growing disease of current era which poses a major life threaten situation to human beings. Continuous research is going on in the direction to develop effective molecules for the treatment of the cancer. These efforts include searching of more active heterocyclic compounds possessing potential anticancer activity. The 1,3,4-Oxadiazole scaffold is a five member heterocyclic ring having versatile activities and created interest for synthetic organic and medicinal chemists for the designing of novel compounds having anticancer activity. The important mechanism behind tumor suppression by 1,3,4-Oxadiazole is related with the inhibition of different growth factors, enzymes and kinases etc. The current literature surveys revealed that 1,3,4-Oxadiazole is a promising lead for anti-cancer agents by the inhibition of telomerase activity. In cancerous cells telomerase enzyme is activated which maintains and restores the telomere which leads to cell proliferation. The telomerase inhibitors with enhanced specificity and improved pharmacokinetics have been considered for design and development of novel anti-cancer agents. This review focuses primarily on telomerase enzyme its function and mechanism of action. It also describes the interaction of telomerase enzyme with 1,3,4-Oxadiazole inhibitors including their structure activity relationships (SARs). With the knowledge of this molecular target, structural insights and SARs, this review may be helpful for (medicinal) chemists to design more potent, safe, selective and cost effective anti-cancer agents.
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Synthesis of New Antibacterial Cubane-based Nanocomposite and its Application in Combination Cancer Therapy
Background: The need for therapeutically effective anticancer drug delivery systems constantly persuades researchers to explore novel strategies.
Objective: In this study a novel cubane based antibacterial nanocomposite was tailored as dual chemotherapy drug delivery vesicle in order to increase the therapeutic outcome in cancer therapy.
Method: The physico-chemical characterization of engineered nanocarrier was assessed by Fourier transforms infrared spectroscopy (FTIR), Hydrogen nuclear magnetic resonance spectroscopy (1H NMR), Thermogravimetric analysis (TGA), and Field emission scanning electron microscopy-energy dispersive using X-ray (FESEMEDX). The antibacterial activity of novel developed nanocomposite was tested by determining minimum inhibitory concentration (MIC) values against Pseudomonas aeruginosa, Escherichia Coli and Candida albicans.
Results: In order to investigate the efficacy of novel engineered nanocomposite (with average particle size of 50 nm) as dual anticancer drug delivery, DOX and MTX were bind to nanocarrier with encapsulation efficiency and loading content of around 97.3 ± 2.7% and 20.8 ± 1.6 %, respectively. Dual drugs released simultaneously with distinct tumor targeted, pH responsive sustained release manner. Moreover, the probable antitumoral activity of this engineered nanocomposite system against MCF7 cell lines was evaluated by MTT assay and cell cycle studies. The outcomes showed that novel engineered nanocomposite had no cytotoxic effects, while DOX@MTX-loaded nanocomposite possessed higher growth inhibition property and higher S-phase arrest as compared to cells treated with DOX@MTX alone.
Conclusion: It was concluded that this novel cubane based drug delivery vehicle could process antibacterial and anticancer therapeutics spontaneously, representing promising tumor targeted system in nanomedicine.
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Excitons and Trions in One-Photon- and Two-Photon-Excited MoS2: A Study in Dispersions
Abstract
Herein, various dispersions of MoS2 obtained by means of liquid phase exfoliation are spectroscopically, (spectro-) electrochemically, and microscopically characterized. At the core of these studies are transient absorption assays. Importantly, small-angle X-ray scattering measurements are employed to corroborate the exfoliated character of the MoS2 flakes in dispersion, on the one hand, and to correlate the results with TEM, AFM, and Raman characterization in the solid state, on the other. It is, then, demonstrated that transient absorption spectroscopy responds sensitively not only to changes in the sample preparation but also to instrumental and environmental parameters. It is documented that the spectroscopic features and their underlying lifetimes are tuneable on the femto-, pico-, and nanosecond scales by changing, for example, the centrifugation speed, the pump fluence, or the temperature. In other words, transient absorption spectroscopy provides an in situ method to quantitatively characterize liquid dispersions of MoS2 without facing the problems of reaggregated samples due to their drying for microscopic assays. The most far reaching results stem from resonantly and nonresonantly changing the pump fluence to characterize either single- or multiple-excited-state species such as excitons, trions, and bi-/multiexcitons and to follow their formation and deactivation pattern.
Pump–probe spectroscopic assays with liquid-exfoliated MoS2 dispersions reveal spectroscopic and kinetic features, which are tuneable on the femto-, pico-, and nanosecond scales by changing, for example, the centrifugation speed, the pump fluence, or the temperature. In addition, resonantly or nonresonantly changing the pump fluence enables characterization of either single- or multiple-excited-state species in MoS2.
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Stable and Efficient Organo-Metal Halide Hybrid Perovskite Solar Cells via π-Conjugated Lewis Base Polymer Induced Trap Passivation and Charge Extraction
Abstract
High-quality pinhole-free perovskite film with optimal crystalline morphology is critical for achieving high-efficiency and high-stability perovskite solar cells (PSCs). In this study, a p-type π-conjugated polymer poly[(2,6-(4,8-bis(5-(2-ethylhexyl) thiophen-2-yl)-benzo[1,2-b:4,5-b′] dithiophene))-alt-(5,5-(1′,3′-di-2-thienyl-5′,7′-bis(2-ethylhexyl) benzo[1′,2′-c:4′,5′-c′] dithiophene-4,8-dione))] (PBDB-T) is introduced into chlorobenzene to form a facile and effective template-agent during the anti-solvent process of perovskite film formation. The π-conjugated polymer PBDB-T is found to trigger a heterogeneous nucleation over the perovskite precursor film and passivate the trap states of the mixed perovskite film through the formation of Lewis adducts between lead and oxygen atom in PBDB-T. The p-type semiconducting and hydrophobic PBDB-T polymer fills in the perovskite grain boundaries to improve charge transfer for better conductivity and prevent moisture invasion into the perovskite active layers. Consequently, the PSCs with PBDB-T modified anti-solvent processing leads to a high-efficiency close to 20%, and the devices show excellent stability, retaining about 90% of the initial power conversion efficiency after 150 d storage in dry air.
p-Type π-conjugated polymer is introduced during the anti-solvent process to form high-quality pinhole-free perovskite films. Traps are passivated through Lewis adducts between the lead and oxygen atoms in the polymer. The hydrophobic polymer protects the perovskite grain boundaries against moisture invasion. The perovskite solar cells show efficiency reaching 20%, and high stability under storage, thermal stress (85 °C), and white-light illumination.
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Laser Irradiation of Metal Oxide Films and Nanostructures: Applications and Advances
Abstract
Recent technological advances in developing a diverse range of lasers have opened new avenues in material processing. Laser processing of materials involves their exposure to rapid and localized energy, which creates conditions of electronic and thermodynamic nonequilibrium. The laser-induced heat can be localized in space and time, enabling excellent control over the manipulation of materials. Metal oxides are of significant interest for applications ranging from microelectronics to medicine. Numerous studies have investigated the synthesis, manipulation, and patterning of metal oxide films and nanostructures. Besides providing a brief overview on the principles governing the laser–material interactions, here, the ongoing efforts in laser irradiation of metal oxide films and nanostructures for a variety of applications are reviewed. Latest advances in laser-assisted processing of metal oxides are summarized.
Laser irradiation has emerged as an effective and reliable fabrication approach for the synthesis, manipulation, and patterning of metal oxides. A comprehensive overview is provided regarding the laser-assisted tailoring of the functionality of metal oxide films and nanostructures for a wide range of applications. In addition, current progress and latest advances in the laser processing of metal oxides are summarized.
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Progress toward Catalytic Micro- and Nanomotors for Biomedical and Environmental Applications
Abstract
Synthetic micro- and nanomotors (MNMs) are tiny objects that can autonomously move under the influence of an appropriate source of energy, such as a chemical fuel, magnetic field, ultrasound, or light. Chemically driven MNMs are composed of or contain certain reactive material(s) that convert chemical energy of a fuel into kinetic energy (motion) of the particles. Several different materials have been explored over the last decade for the preparation of a wide variety of MNMs. Here, the discovery of materials and approaches to enhance the efficiency of chemically driven MNMs are reviewed. Several prominent applications of the MNMs, especially in the fields of biomedicine and environmental science, are also discussed, as well as the limitations of existing materials and future research directions.
Catalytic micro- and nanomotors are tiny devices that can autonomously propel in the presence of a chemical fuel. An overview is presented of the achievements toward the discovery of new materials and approaches to achieve efficient motion in different chemical fuels. The motion can be utilized to perform various tasks for biomedical and environmental applications.
http://ift.tt/2GUTi95
Near-Infrared Excitation/Emission and Multiphoton-Induced Fluorescence of Carbon Dots
Abstract
Carbon dots (CDs) have significant potential for use in various fields including biomedicine, bioimaging, and optoelectronics. However, inefficient excitation and emission of CDs in both near-infrared (NIR-I and NIR-II) windows remains an issue. Solving this problem would yield significant improvement in the tissue-penetration depth for in vivo bioimaging with CDs. Here, an NIR absorption band and enhanced NIR fluorescence are both realized through the surface engineering of CDs, exploiting electron-acceptor groups, namely molecules or polymers rich in sulfoxide/carbonyl groups. These groups, which are bound to the outer layers and the edges of the CDs, influence the optical bandgap and promote electron transitions under NIR excitation. NIR-imaging information encryption and in vivo NIR fluorescence imaging of the stomach of a living mouse using CDs modified with poly(vinylpyrrolidone) in aqueous solution are demonstrated. In addition, excitation by a 1400 nm femtosecond laser yields simultaneous two-photon-induced NIR emission and three-photon-induced red emission of CDs in dimethyl sulfoxide. This study represents the realization of both NIR-I excitation and emission as well as two-photon- and three-photon-induced fluorescence of CDs excited in an NIR-II window, and provides a rational design approach for construction and clinical applications of CD-based NIR imaging agents.
Both near-infrared (NIR) absorption band and enhanced NIR photoluminescence under NIR excitation are simultaneously realized for carbon dots through surface engineering of molecules or polymers rich in sulfoxide/carbonyl groups. Two-photon-induced NIR emission and three-photon-induced red emission are simultaneously observed for carbon dots in dimethyl sulfoxide under excitation of a 1400 nm femtosecond pulse laser in an NIR-II window.
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Anchoring and Upgrading Ultrafine NiPd on Room-Temperature-Synthesized Bifunctional NH2-N-rGO toward Low-Cost and Highly Efficient Catalysts for Selective Formic Acid Dehydrogenation
Abstract
Hydrogen is widely considered to be a sustainable and clean energy alternative to the use of fossil fuels in the future. Its high hydrogen content, nontoxicity, and liquid state at room temperature make formic acid a promising hydrogen carrier. Designing highly efficient and low-cost heterogeneous catalysts is a major challenge for realizing the practical application of formic acid in the fuel-cell-based hydrogen economy. Herein, a simple but effective and rapid strategy is proposed, which demonstrates the synthesis of NiPd bimetallic ultrafine particles (UPs) supported on NH2-functionalized and N-doped reduced graphene oxide (NH2-N-rGO) at room temperature. The introduction of the ![[BOND]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_uUzr4wPTm0ratMmlvgHDUucj7I5ykaWIvUDz5VI0hej_E1fs2GRedgyW9e1YtWZ5u4DA4eeKDBKE3woc5QOS_uc5SFVOMLATXe9ShEo9nbNxMEURYdX0d3ktwpi0osT4TiORw690b-gOg1gg=s0-d)
Ultrafine NiPd nanoparticles supported on a NH2-functionalized and N-doped reduced graphene oxide (NH2-N-rGO) substrate are successfully prepared through a facile one-step strategy. The as-prepared NiPd/NH2-N-rGO catalyst shows prominent catalytic performance (turnover frequency value up to 954.3 h−1), 100% H2 selectivity, and 100% conversion for formic acid dehydrogenation at 298 K without any additive.
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Discontinuities and disruptions in drug dosage guidelines for the paediatric population
Summary
Aims
This study investigates paediatric drug dosage guidelines with the aim of investigating their agreement with body surface area (BSA) scaling principles.
Methods
454 drug dosage guidelines listed in the AMH-CDC 2015 were examined. Data extracted included the administration, frequency and dose per age bracket from 0-18 years. Drug treatments were categorized as follows: 1) The same dose recommendation in milligrams per kilogram (mg/kg) for all age/weights; 2) Change in the mg/kg dosing according to age/weight; 3) Change in dose in mg according to age/weight; 4) Change from mg/kg dosing to a dose in mg according to age/weight; 5)
The same recommendation for all age/weight groups in mg or 6) BSA dosing. Example drugs were selected to illustrate dose progression across ages.
Results
Most drug treatments (63%) have the same mg/kg dose for all age/weight groups, 14% are dosed in mg/kg across all ages with dose changes according to age/weight, 13% were dosed in mg across all ages with dose changes, 10% switched from mg/kg to a set dose in mg, 4.2% have the same dose in mg for all age and weight groups and 2.2% are dosed according to BSA.
Conclusions
Paediatric dosage guidelines are based on weight-based formulas, available dosing formulations, and prior patterns of use. Substantial variation from doses predicted by BSA scaling are common, as are large shifts in recommended doses at age thresholds. Further research is required to determine if better outcomes could be achieved by adopting biologically based scaling of paediatric doses.
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Emergency department utilisation for inflammatory bowel disease in the United States from 2006 to 2014
Summary
Background
Despite advances in treatment, patients with inflammatory bowel disease (IBD) frequently require emergency department (ED) visits and hospitalisations.
Aims
To analyse trends in ED visits and subsequent hospitalisations for IBD in the United States (US).
Methods
Data were analysed from the Nationwide Emergency Department Sample (NEDS) years 2006-2014. The NEDS is the largest all-payer ED database in the US, weighted to represent 135 million visits/year. IBD was identified using ICD-9 codes for Crohn's disease (CD) or ulcerative colitis (UC). Surgeries were identified using procedure codes.
Results
The frequency of IBD-ED visits increased 51.8%, from 90 846 visits in 2006 to 137 946 in 2014, which was statistically significant in linear regression. For comparison, all-case ED use between 2006 and 2014 increased 14.8%. In-patient hospitalisations from the ED decreased 12.1% for IBD (from 64.7% rate of hospitalisation from the ED in 2006 to 52.6% in 2014), with a UC:CD ratio of 1.2:1 in 2006 and 1.3:1 in 2014. Chi-square analysis revealed that this was a significant decrease. Surgery rates also showed a statistically significant decrease. The mean ED charge per patient rose 102.5% and the aggregate national cost of IBD-ED visits increased 207.5%. CD accounted for over twice as many visits as UC in both years. UC, age, male gender, highest income quartile, private insurance, Medicaid/Medicare, and tobacco use were associated with in-patient admissions.
Conclusions
The number of ED visits due to IBD and associated charges have continued to rise, while the rates of in-patient hospitalisations referred from the ED and surgeries have decreased.
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Review article: the evidence that vancomycin is a therapeutic option for primary sclerosing cholangitis
Summary
Background and Aims
PSC is an autoimmune biliary inflammatory disorder that is often associated with inflammatory bowel disease (IBD), with 50%-75% of patients with PSC having coexisting IBD, most commonly ulcerative colitis. Currently, no medical therapies have been shown to improve the disease course or slow its progression. However, ongoing research has resulted in a growing interest in the use of antibiotics for treatment of PSC, of which vancomycin is the most studied. In this review, we summarise the current evidence on the use of vancomycin in PSC and comment on future research areas of interest.
Methods
A comprehensive PUBMED and EMBASE literature search for articles on vancomycin, PSC, therapeutic options and microbiome was performed.
Results
Two randomised clinical trials, three case series and two case reports were included in the study. These include uncontrolled data from at least 98 patients that include promising improvements in biochemistry and imaging. Optimal dosing regimens are unclear.
Conclusion
Vancomycin is one of the most studied antibiotics used in the treatment of PSC with promising results. There is not currently sufficient evidence to support treatment recommendations. Further research is needed to establish if vancomycin is a PSC treatment.
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Letter to the editor concerning “Risk factors for implant failure after fixation of proximal femoral fractures with fracture of the lateral femoral wall”
Publication date: Available online 6 February 2018
Source:Injury
Author(s): Ahmet Imerci, Nevres Hurriyet Aydogan, Mustafa Cem Özkan
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Factors Influencing Survival following Hip Fracture Among Octogenarians and Nonagenarians in the United States
Publication date: Available online 6 February 2018
Source:Injury
Author(s): Steven L. Bokshan, Stephen E. Marcaccio, Travis D. Blood, Roman A. Hayda
IntroductionHip fractures account for a significant disease burden in the Unites States. With an aging population, this disease burden is expected to increase in the upcoming decades.Materials and methodsThis represents a retrospective cohort study to assess mortality following hip fracture in the octogenarian and nonagenarian populations. Odds ratios for postoperative mortality were constructed using normalized patients from United States Social Security death tables. Kaplan Meier analysis and binary logistic regression were used to assess the impact of surgical delay and medical comorbidity (measured by the Carlson Comorbidity Index (CCI)) on postoperative mortality.Results189 octogenarians and 95 nonagenarians were included. One-year mortality was nearly three times higher for both the octogenarians (OR: 3.1) and nonagenarians (OR: 3.14), and returned to that of the normal population 4 years post-op for octogenarians and 5 years post-op for nonagenarians. Higher preoperative medical comorbidity (CCI) was associated with higher post-op mortality for both octogenarians (log rank = 0.026) and nonagenarians (log rank = 0.034). A 48-hour surgical delay resulted in significantly increased postoperative mortality among healthy patients (CCI of 0 or 1, OR: 18.1), but was protective for patients with significant medical comorbidity (CCI ≥ 3). Age, preoperative CCI, and 48-hour surgical delay were all independent predictors of 1-year post-op mortality.ConclusionsFollowing hip fracture, there is a 3-fold increase in mortality for octogenarians and nonagenarians at 1 year post-op. A 48-hour surgical delay significantly increased mortality for healthier patients but was protective against mortality for sicker patients.
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International survey among orthopaedic trauma surgeons: Lack of a definition of fracture-related infection
Publication date: Available online 6 February 2018
Source:Injury
Author(s): M. Morgenstern, T.F. Moriarty, R. Kuehl, R.G. Richards, M. McNally, M.H.J. Verhofstad, O. Borens, C. Zalavras, M. Raschke, S.L. Kates, W.J. Metsemakers
IntroductionFracture-related infection (FRI) is one of the most challenging musculoskeletal complications in orthopaedic-trauma surgery. Although the orthopaedic community has developed and adopted a consensus definition of prosthetic joint infections (PJI), it still remains unclear how the trauma surgery community defines FRI in daily clinical practice or in performing clinical research studies.The central aim of this study was to survey the opinions of a global network of trauma surgeons on the definitions and criteria they routinely use, and their opinion on the need for a unified definition of FRI. The secondary aims were to survey their opinion on the utility of currently used definitions that may be at least partially applicable for FRI, and finally their opinion on the important clinical parameters that should be considered as diagnostic criteria for FRI.MethodsAn 11-item questionnaire was developed to cover the above-mentioned aims. The questionnaire was administered by SurveyMonkey and was sent via blast email to all registered users of AO Trauma (Davos, Switzerland).ResultsOut of the 26'563 recipients who opened the email, 2'327 (8.8%) completed the questionnaire. Nearly 90% of respondents agreed that a consensus-derived definition for FRI is required and 66% of the surgeons also agreed that PJI and FRI are not equal with respect to diagnosis, treatment and outcome. Furthermore, "positive cultures from microbiology testing", "elevation of CRP", "purulent drainage" and "local clinical signs of infection" were voted the most important diagnostic parameters for FRI.ConclusionThis international survey infers the need for a consensus definition of FRI and provides insight into the clinical parameters seen by an international community of trauma surgeons as being critical for defining FRI.
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Risk of pharmacokinetic interactions between antiepileptic and other drugs in older persons and factors associated with risk
Summary
Objective
To determine the frequency of older Americans with epilepsy receiving concomitant prescriptions for antiepileptic drugs (AEDs) and non-epilepsy drugs (NEDs) which could result in significant pharmacokinetic (PK) interaction, and to assess the contributions of racial/ethnic, socioeconomic, and demographic factors.
Methods
Retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries ≥67 years old in 2009 augmented for minority representation. Prevalent cases had ≥1 ICD-9 345.x or ≥2 ICD-9 780.3x, and ≥1 AED. Among them, incident cases had no seizure/epilepsy claim codes nor AEDs in preceding 365 days. Drug claims for AEDs, and for the 50 most common NEDs within +/− 60 days of the index epilepsy date were tabulated. Interacting pairs of AEDs/NEDs were identified by literature review. Logistic regression models were used to examine factors affecting the likelihood of interaction risk.
Results
Interacting drug pairs affecting NED efficacy were found in 24.5% of incident, 39% of prevalent cases. Combinations affecting AED efficacy were found in 20.4% of incident, 29.3% of prevalent cases. Factors predicting higher interaction risk included having ≥ 1 comorbidity, being eligible for Part D low Income Subsidy, and not living in the northeastern US. Protective factors were Asian race/ethnicity, and treatment by a neurologist.
Significance
A substantial portion of older epilepsy patients received NED-AED combinations that could cause important PK interactions. The lower frequency among incident vs. prevalent cases may reflect changes in prescribing practices. Avoidance of interacting AEDs is feasible for most persons because of the availability of newer drugs.
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Fibrosis in ulcerative colitis is directly linked to severity and chronicity of mucosal inflammation
Summary
Background
Fibrosis in ulcerative colitis has remained largely unexplored despite its clinical implications.
Aims
This cross-sectional study was aimed at characterising the presence, anatomical location and degree of ulcerative colitis-associated fibrosis and its possible link to clinical parameters.
Methods
Seven hundred and six individual tissue cross-sections derived every 10 cm along the length of 89 consecutive Ulcerative colitis colectomy specimens were examined and compared to Crohn's disease colitis, diverticular disease and uninvolved areas from colorectal cancer patients. Degree of inflammation, fibrosis and morphometric measurements of all layers of the intestinal wall were evaluated. Three gastrointestinal pathologists independently assessed colon sections stained with haematoxylin and eosin, Masson trichrome and Sirius red. Clinical data were collected prospectively.
Results
Submucosal fibrosis was detected in 100% of ulcerative colitis colectomy specimens, but only in areas affected by inflammation. Submucosal fibrosis was associated with the severity of intestinal inflammation (Spearman correlations rho (95% confidence interval): 0.58 (P < 0.001) and histopathological changes of chronic mucosal injury, but not active inflammation. Colectomy for refractory disease rather than presence of dysplasia was associated with increased fibrosis and a thicker muscularis mucosae, whereas a thinner muscularis mucosae was associated with anti-tumour necrosis factor therapy. No feature on endoscopic mucosal biopsies could predict the underlying amount of fibrosis or the thickness of the muscularis mucosae.
Conclusions
A significant degree of fibrosis and muscularis mucosae thickening should be considered as common complications of chronic progressive ulcerative colitis. These features may have clinical consequences such as motility abnormalities and increased wall stiffness.
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Effect of ultrahigh temperature treatment on qualities of watermelon juice
Abstract
The watermelon juice was pasteurized by the ultrahigh temperature (UHT) treatment, and the qualities of the pasteurized juice were compared to screen the optimal UHT. The UHT of 120 and 135°C inactivated the microbial colonies and maintained the original color of the watermelon juice. The temperature of 120 and 135°C was also maintained the phenolic content by reducing the polyphenoloxidase activity. Moreover, the C9 aldehydes, especially the (E,Z)-2,6-nonadienal, presented the main aroma of the watermelon juice. The C9 aldehydes were formed as the results of the heat reduction and enzymatic metabolism. The temperature of 120 and 135°C reduced the alcohol dehydrogenase activity and well maintained the C9 aldehyde content of the watermelon juice. Hence, the temperature of 120°C of the UHT treatment was the optimal temperature for the production of the watermelon juice.
The temperature of 120°C of the UHT treatment was the optimal temperature for the production of the watermelon juice.
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Moisture sorption isotherm and changes in physico-mechanical properties of films produced from waste flour and their application on preservation quality of fresh strawberry
Abstract
Waste flour from the noodle industry was used to produce films, which were plasticized with 40% w/w glycerol:sorbitol at 2:1, 3:1, and 4:1 w/w and formulated with 200 ppm potassium sorbate. Henderson's equation was found to be the best estimator for moisture sorption isotherm of the films stored at 5, 25, and 45°C, and then, equilibrated at 0.11, 0.23, 0.32, 0.43, 0.58, 0.64, 0.76, 0.84, and 0.93 water activity. Developed flour films (plasticized with 2:1 w/w glycerol:sorbitol/formulated with 20% w/w potassium sorbate), with the best mechanical properties (tensile strength of 1.05 MPa; elongation at break of 73.01%), were used to cover fresh strawberries on a polystyrene foam tray. It was found that higher average phenolic contents, antioxidant activity, and firmness were found in strawberries wrapped in plasticized/formulated films, when compared against both films without potassium sorbate and without film (control). Furthermore, a lower average total microorganism count was found for fresh strawberries wrapped in the plasticized/formulated films, when compared with films without potassium sorbate.
Waste flour from noodle production could be used to produce flour-based films. The moisture sorption isotherms of the films showed the correlation between the equilibrium moisture content and the water activities was well fitted by Henderson's equation. The flour film with plasticizers (glycerol and sorbitol) and potassium sorbate could be a promising alternative natural packaging material to reduce the use of nonbiodegradable synthetic polymer films in food applications.
http://ift.tt/2E6pqsB
Potential kidney toxicity from the antiviral drug tenofovir: new indications, new formulations, and a new prodrug
Purpose of review The antiviral agent tenofovir is highly effective for the treatment of HIV and hepatitis B virus infections, and the older prodrug tenofovir disoproxil fumarate (TDF) is also a component of daily preexposure prophylaxis (PrEP) to reduce the risk of HIV infection in high-risk populations. Although TDF is well tolerated, the potential for kidney and bone toxicity has important implications for public health given the large number of individuals exposed to TDF worldwide. This review summarizes the recent literature on kidney and bone health in individuals treated with TDF and the newer prodrug tenofovir alafenamide (TAF). Recent findings Risk factors for TDF toxicity appear to be similar in patients treated for HIV or hepatitis B virus and in HIV-uninfected PrEP users, although drug–drug interactions are a more important concern in HIV-positive individuals. The risk of toxicity appears to be lower with TAF, but further studies are needed to confirm the safety of long-term use and to evaluate the efficacy of TAF-based PrEP. Summary Nephrologists should be aware of the potential kidney and bone toxicity of TDF, as well as unique situations in which the newer prodrug TAF may contribute to kidney injury.http://ift.tt/2C0fF9y
The regulation of aldosterone secretion by leptin: implications in obesity-related cardiovascular disease
Purpose of review Although it has been known for some time that increases in body mass enhance aldosterone secretion, particularly in women, the origin of this elevation in aldosterone production is not well defined. Adipocyte-derived factors have emerged as potential candidates to increase aldosterone production in obesity. Recent findings Emerging evidence suggests the presence of a mechanistic link in which the adipocyte-derived hormone leptin stimulates aldosterone production in obesity, thereby creating a positive feedback loop for obesity-associated cardiovascular disease. In addition, recent reports give credence to the concept that this leptin–aldosterone stimulation pathway in obesity is an underlying mechanism for sex-discrepancies in obesity-associated cardiovascular disease. Summary Leptin appears as a new direct regulator of adrenal aldosterone production and leptin-mediated aldosterone production is a novel candidate mechanism underlying obesity-associated hypertension, particularly in females.http://ift.tt/2E8sTHr
Renal effects of cytokines in hypertension
Purpose of review Inflammatory cytokines contribute to the pathogenesis of hypertension through effects on renal blood flow and sodium handling. This review will update recent advances that explore the renal actions of immune cells and cytokines in the pathogenesis of hypertension. Recent findings Populations of cells from both the innate and adaptive immune systems contribute to hypertension by modulating functions of the vasculature and epithelial cells in the kidney. Macrophages and T lymphocytes can directly regulate the hypertensive response and consequent target organ damage. Dendritic cells and B lymphocytes can alter blood pressure (BP) indirectly by facilitating T-cell activation. Proinflammatory cytokines, including tumor necrosis factor-α, interleukin 17, interleukin 1, and interferon-γ augment BP and/or renal injury when produced by T helper 1 cells, T helper 17 cells, and macrophages. In contrast, interleukin 10 improves vascular and renal functions in preclinical hypertension studies. The effects of transforming growth factor-β are complex because of its profibrotic and immunosuppressive functions that also depend on the localization and concentration of this pleiotropic cytokine. Summary Preclinical studies point to a key role for cytokines in hypertension via their actions in the kidney. Consistent with this notion, anti-inflammatory therapies can attenuate BP elevation in human patients with rheumatologic disease. Conversely, impaired natriuresis may further polarize both T lymphocytes and macrophages toward a proinflammatory state, in a pathogenic, feed-forward loop of immune activation and BP elevation. Understanding the precise renal actions of cytokines in hypertension will be necessary to inhibit cytokine-dependent hypertensive responses while preserving systemic immunity and tumor surveillance.http://ift.tt/2E9P5AA
Maximum allowable contrast dose and prevention of acute kidney injury following cardiovascular procedures
Purpose of review Contrast-induced acute kidney injury (CI-AKI) is a serious complication. Although nonmodifiable and modifiable risk factors have been thoroughly characterized, the utility of the maximal allowable contrast dose (MACD) has not received adequate attention. The focus of this review is to provide a critical appraisal of this modifiable risk factor. Recent findings Several retrospective and prospective cohort studies have demonstrated that the incidence of CI-AKI among patients receiving contrast media in volumes exceeding the MACD is consistently higher compared with those who do not exceed the MACD (an average of 24 vs. 6%). Furthermore, the MACD is independent predictor of CI-AKI and other adverse events. A two-step algorithm incorporating the determination of the MACD and the contrast volume to eGFR ratio prior to a planned cardiovascular procedure is a sound approach to minimize contrast volume and prevent CI-AKI. Summary Prevention of CI-AKI must remain a clinical priority. Intraprocedural preventive measures should include a priori calculation of the MACD and contrast volume to eGFR ratio to limit contrast volume. Other measures may include the adoption of the transradial approach, the use of automated contrast injectors and small catheters to limit contrast volume, the use of low-osmolar contrast agents, and if necessary the use of staged procedures. We call for the system-wide implementation of evidence-based care bundles to prevent CI-AKI.http://ift.tt/2BZvxJv
Enzymatic sources and physio-pathological functions of soluble (pro)renin receptor
Purpose of review (Pro)renin receptor (PRR) belongs to type I transmembrane receptor family and binds both prorenin and renin, representing a potential regulator of the activity of the renin–angiotensin system. Soluble form of PRR (sPRR) is generated by intracellular protease-mediated cleavage of full-length PRR. The purpose of this review is to highlight recent advances in understanding the mechanisms of action and production of sPRR. Recent findings It has recently been demonstrated that site-1-protease (S1P) plays a dominant role in the generation of sPRR. New evidence is also emerging to support a biological function of sPRR in the physiological regulation of fluid homeostasis as well as pathogenesis of chronic kidney disease. Summary sPRR is a 28 kDa product of PRR cleavage via S1P-mediated protease activity. Not only does sPRR regulate renal tubular water transport, but it also mediates pathogenic responses to renal cellular injury. sPRR is likely involved in a wide range of physio-pathological processes.http://ift.tt/2E64TnZ
Retarding progression of chronic kidney disease: use of modalities that counter acid retention
Purpose of review Acid retention because of chronic kidney disease (CKD) increases tissue acidity and accelerates progression of CKD, whereas reduction in acid retention slows progression of CKD. Herein, we describe the mechanisms through which increased tissue acidity worsens CKD, modalities for countering acid retention and their impact on progression of CKD, and current recommendations for therapy. Recent findings Studies in animals and humans show that increased tissue acidity raises the renal levels of endothelin, angiotensin II, aldosterone, and ammoniagenesis, thereby worsening renal fibrosis and causing progression of CKD. Measures that counter acid retention, such as providing alkali or modifying the quantity or type of dietary protein, reduce the levels of endothelin, angiotensin II, aldosterone, and ammoniagenesis, slowing progression of CKD. Alkali can be provided as NaHCO3, sodium citrate, or base in fruits and vegetables. A serum [HCO3−] of 24–26 mEq/l is targeted, because higher values can be associated with adverse consequences. Summary Insights into the mechanisms through which increased tissue acidity mediates progression of CKD and the beneficial impact of ameliorating positive acid balance underlie our recommendation for modalities that counter acid retention in CKD.http://ift.tt/2C1C71T
The pivotal role of renal vasodysfunction in salt sensitivity and the initiation of salt-induced hypertension
Purpose of review For decades, it has been widely accepted that initiation of salt-induced hypertension involves a type of kidney dysfunction (natriuretic handicap), which causes salt-sensitive subjects to initially excrete less of a sodium load than normal subjects and undergo abnormal increases in cardiac output, and therefore blood pressure. Here we discuss emerging views that renal vasodysfunction, not natriuretic dysfunction (subnormal sodium excretion), is usually a critical factor initiating salt-induced hypertension. Recent findings Serious logical issues have been raised with arguments supporting historical views that natriuretic dysfunction initiates hypertension in response to increased salt intake. Most salt-sensitive humans do not have a 'natriuretic handicap' causing them to excrete a sodium load more slowly and retain more of it than salt-resistant normal subjects. Mounting evidence indicates that in most salt-sensitive subjects, renal vasodysfunction, defined as impaired renal vasodilation and abnormally increased renal vascular resistance in response to increased salt intake, in the absence of greater sodium retention than in salt-loaded normal subjects, is involved in initiation of salt-induced hypertension. Summary To advance discovery, prevention, and treatment of primary abnormalities causing salt-induced hypertension, greater research emphasis should be placed on identifying mechanisms mediating subnormal renal vasodilation and abnormally increased renal vascular resistance in response to high-salt diets.http://ift.tt/2E9P4ww
Chronic kidney disease and acquired mitochondrial myopathy
Purpose of review Sarcopenia and muscle weakness contribute to fragility and limit exercise tolerance among patients with CKD. This review focuses on the role of reduction in mitochondrial mass and function in the myopathy associated with CKD, causes for these muscle mitochondrial abnormalities, and potential therapeutic interventions that may improve mitochondrial biogenesis and function as well as skeletal muscle function and performance in patients with CKD. Recent findings Multiple abnormalities of mitochondrial structure, function, and composition have been shown in both experimental models and patients with CKD. A significant reduction in mitochondrial respiratory function and an increase in mitochondrial complex 1 enzyme activity has been demonstrated in the muscle tissue of male Sprague–Dawley rats following 5/6 nephrectomy. These changes were associated with a substantial reduction in skeletal muscle mitochondrial mass. In patients with CKD, in-vivo magnetic resonance and optical spectroscopy show significantly elevated resting skeletal muscle oxygen consumption and lower mean mitochondrial coupling ratio indicating disrupted muscle mitochondrial metabolism and uncoupling of oxidative phosphorylation. Skeletal muscle biopsies from patients with advanced CKD show lower mitochondrial volume density and mitochondrial DNA (mtDNA) copy number than controls. Summary Advanced CKD is associated with decreased exercise capacity, skeletal muscle weakness, and muscle atrophy. Impaired mitochondrial respiratory function, reduced muscle mitochondrial mass, and decreased energy production in skeletal muscle play a critical role in this 'acquired mitochondrial myopathy' of CKD. It is reasonable, therefore, to develop therapeutic interventions that enhance mitochondrial biogenesis and function as well as skeletal muscle function and performance in patients with CKD.http://ift.tt/2C0aWVu
Quality measures in acute kidney injury
Purpose of review Quality measure assessment and reporting is evolving in end-stage renal disease care and is inchoate in ambulatory nephrology clinic care. Acute kidney injury (AKI) quality measures have not received sufficient attention, yet deserve consideration in view of the substantial proportion of effort nephrology providers devote to AKI care. Recent findings Accumulating literature permits consideration of timing of nephrology consultation, follow-up after AKI hospitalization, early detection, medication dosing, hospital readmissions and length of stay, cost, and mortality as potential AKI quality measures. Summary We review candidate AKI quality measures and assess the strength of evidence supporting the use of each measure as a standard for AKI care.http://ift.tt/2BZHsXQ
Postactivation Potentiation Following Acute Bouts of Plyometric versus Heavy-Resistance Exercise in Collegiate Soccer Players
Postactivation potentiation is referred to as an acute and temporary enhancement of muscle performance resulting from previous muscle contraction. The purpose of this study was to compare the acute effect of plyometric exercise (PLY) and heavy-resistance exercise (RES) on the blood lactate level (BLa) and physical performance. Fourteen male collegiate soccer players were randomized to perform either RES or PLY first and then crossed over to perform the opposite intervention. PLY consisted of 40 jumps, whereas RES comprised ten single repetitions at 90% of one repetition maximum. BLa and physical performance (countermovement jump height and 20-m sprint) were measured before and at 1 and 10 min following the exercise. No significant difference was observed in the BLa for both exercises (PLY and RES). Relative to baseline, countermovement jump (CMJ) height was significantly better for the PLY group after 1 min and after 10 min compared to that of the RES group. The 20-m sprint time was significantly better for PLY at 10 min compared to that of RES. The present study concluded that, compared to RES, PLY causes greater potentiation, which leads to improved physical performance. This trial is registered with NCT03150277.
http://ift.tt/2nHmFUy
A comparative study of the antioxidant and intestinal protective effects of extracts from different parts of Java tea (Orthosiphon stamineus)
Abstract
The aim of this study was to compare the free radical scavenging ability and intestinal epithelial cell protective effects of Java tea (Orthosiphon stamineus) root extracts (ORE), stem extracts (OSE), and leaf extracts (OLE) to determine the potential of Java tea by-products. The Java tea extracts were prepared using a standard water–ethanol method. The antioxidant activity and intestinal protective effects were tested by H2O2-induced cell model and high-fat diet-induced mice model, respectively. The results showed that the total phenolic acid and flavonoid content and relative content were different in the ORE, OSE, and OLE. ORE had the highest total polyphenol and flavonoid content, the highest free radical scavenging rate, and the highest intracellular free radical scavenging rate. However, the yeast content in the ORE was lower than that in the OSE and OLE. All the Java tea extracts protected mouse intestine from high-fat diet-induced oxidative injury. This study indicates the potential of Java tea extracts as food or feed additives to protect the intestine from oxidative stress.
JAVA tea leaf, stem, and root showed high antioxidants and intestinal epithelial cell protective effect; Java tea by-products have potential as a food or feed additive for protecting the intestine from oxidative stress.
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Pediatric Oncology Provider Perceptions of a Pediatric Palliative Care Service: The Influence of Emotional Esteem and Emotional Labor
Pediatric palliative care consults for children with cancer often occur late in the course of disease and close to death, when earlier involvement would reduce suffering. The perceptions that pediatric oncology providers hold about the pediatric palliative care service (PPCS) may shape referral patterns.
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Family meetings in in-patient specialist palliative care: A mechanism to convey empathy
Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in in-patient settings.
http://ift.tt/2EKR5MV
Validation of the Diagnostic Tool for Complexity in Palliative Care—Pilot Study (S727)
The Diagnostic Tool for Complexity in Palliative Care (Pal-Cx) is designed to determine which patients benefit from a referral to a specialized palliative care (PC) team, is based on the degree of complexity, and has been validated in Spain. This work describes the first steps of the Spanish tool's validation process into the English language and cultural context.
http://ift.tt/2FUYNDD
Rapid Response Team-Driven Palliative Care Consults: A Case Series (QI836)
Rapid response events, often critical moments for seriously ill patients, present as clear opportunities for symptom management, for clarification of goals, and for complex shared decision making. Nevertheless, optimal processes to involve specialty palliative care (PC) in this setting have not been described. At our institution, RRT and PC leaders initiated a quality improvement (QI) project to increase appropriate referrals to PC arising from rapid response events.
http://ift.tt/2EI9DNH
Impact of Goals of Care upon End-Of-Life Care Planning (S750)
Knowledge of patients' goals of care can help guide treatment decisions. Our objective is to examine whether there are differences in advance care plans and resource use at end of life (EOL) between those who identify goals of care focused heavily upon survival versus quality of life (QOL).
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First Responders: Educating Interdisciplinary Champions to Provide Primary Palliative Care (QI802)
We implemented an interprofessional palliative care education project to train clinicians in primary palliative care skills in an urban academic medical center through a Fan Fox and Leslie R. Samuel's Foundation Grant.
http://ift.tt/2EMH7L9
Improving the Validity of MOLST (MA Medical Orders for Life-Sustaining Treatment) Documentation for Patients Discharged from Solid Oncology and Palliative Care Teams with Physician Assistants (FR419C)
Patient records that are accurate and transferable between different care environments are an essential part of quality patient care. Inaccurate and incomplete advance care planning documentation breaks down communication during care transitions.
http://ift.tt/2FTOAHg
What Is The Goal of Care for This Patient? Documenting and Communicating Patient Goals of Care across Teams in ICU (QI820)
Providing goal concordant care in ICU settings can be challenging. Clinical status of patients fluctuates daily, often hourly, thus treatment options and goals of care could change accordingly. Complex conditions require involvement of multiple specialists and teams, and understanding of the patient's goals of care may be inconsistent among them. Nurses in an ICU experienced difficulty tracking multiple providers discussing with their patient and/or families and resulting goals of care decisions.
http://ift.tt/2EMklmi
Effectiveness of Subacute Rehab as a Bridge to Cancer Treatment (S766)
Patients with advanced cancer inevitably experience functional decline. Discharge to subacute rehabilitation (SAR) with the goal of gaining strength for future cancer treatment is common. However, patients may forgo hospice, and it is not known how many patients make it to oncology follow-up or receive cancer treatment after discharge to SAR.
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Hospital-Wide Impact of Early Palliative Care Interventions on Direct Costs and Length of Stay (S734)
Earlier palliative care consultations have been shown to reduce length of stay (LOS) and overall costs, while improving the quality of medical care afforded, in most, but not all studies.
http://ift.tt/2ELnnYf
Palliative Care: Bringing It Home (FR432)
Come visit New Mexico, a state that has piloted effective new models of care based on the healthcare funding limitations we will face in the future. Presbyterian Healthcare at Home's innovative team-based community palliative program includes a clinic- and home-based program housed in a home agency and a house calls program, as well as an advanced illness management program. Together, they have demonstrated significant impact on patient lives and on the total cost of care. The key is developing and fully utilizing primary palliative care skills, as much as tertiary palliative skills, and building a team where all team members work to the full scope of practice, including a robust social work practice and a local group of community paramedics that offer urgent as well as follow-up care in the home.
http://ift.tt/2FRCSNs
Advance Care Planning: With Whom and When? (QI828)
In cancer patients, goals of care discussions tend to occur in the last few months of life. A systematic method that identifies seriously ill patients early in their admission may encourage consistent advanced care planning (ACP) and improve access to palliative care.
http://ift.tt/2EMKYrs
Quality Improvement and The Veterans Health Administration’s Palliative Care National Clinical Template (QI812)
Process measures provide evidence of care delivered at the bedside. The Veterans Health Administration's (VHA) Palliative Care National Clinical Template (PC-NCT), writes process-level data from palliative care (PC) consultations to the Electronic Health Record (EHR) that are aggregated and used for quality improvement (QI).
http://ift.tt/2FREvL6
Is Nonhospice Palliative Care ‘Colorblind’? Evaluating Racial Differences in Inpatient Nonhospice Palliative Care (S774)
Minorities are less likely than whites to utilize hospice services and more likely to receive medically ineffective treatments at end of life. Barriers towards hospice utilization among African Americans (AA) are well-documented, however less is known about disparities in non-hospice inpatient palliative care (PC).
http://ift.tt/2EJXxDK
Attributes of Primary Care Physicians Associated with Engaging Patients in Advance Care Planning: Analysis of US Physicians Responses from International Survey (S758)
Sparse data exist concerning frequency of advance care planning conversations (ACPC) by primary care providers (PCP) and practice attributes facilitating ACPC.
http://ift.tt/2FPl6uj
Family Participation in Withholding and Withdrawing Life-Sustaining Therapy Decisions: “I Just Had to Have Myself Prepared for this Day” (S742)
Little is known about the experiences families face when participating in decisions to continue or limit life-sustaining treatments in the intensive care unit (ICU) setting. Understanding what families experience is important so that nurses, physicians, and other members of the interdisciplinary team can best help families.
http://ift.tt/2ENI0Tm
Substance Use Disorders 101 for the Palliative Care Specialist (FR417)
Experts in neuroscience and medicine recognize substance use disorders as a brain disease. Current definitions describe substance use disorders as "a primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations." Manifestations include behaviors such as: impaired control over drug use, compulsive use, continued use despite harm, and craving. Unaddressed substance use disorders perpetuate patient suffering and can devastate caregivers and families.
http://ift.tt/2FSXXax
Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety (FR420C)
Documenting patients' advance care planning (ACP) wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about ACP documentation practices in the electronic health record (EHR).
http://ift.tt/2EMkh62
Scoping the scope: endoscopic evaluation of endoscope working channels with a new high-resolution inspection endoscope (with video)
Outbreaks of transmission of infection related to endoscopy despite reported adherence to reprocessing guidelines, warrant scrutiny of all potential contributing factors. Recent reports from ambulatory surgery centers indicated widespread significant occult damage within endoscope working channels, raising concerns regarding the potential detrimental impact of this damage on the adequacy of endoscope reprocessing.
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ERCP performed through previously placed duodenal stents: a multicenter retrospective study of outcomes and adverse events
ERCP (endoscopic retrograde cholangiopancreatography) performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature, and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction (GOO).
http://ift.tt/2EKxGf0
Timing of Radiation Therapy in Pediatric Wilms Tumor – A Report from the National Cancer Database
Many patients with Wilms tumor (WT) will require adjuvant radiotherapy in addition to surgery and chemotherapy. National Wilms Tumor Studies (NWTS) 1 and 2 found delayed radiation correlated with relapse; however, subsequent analyses have not confirmed this finding. We used the National Cancer Database (NCDB) to determine the impact of the surgery-to-radiotherapy interval (SRI) on survival in contemporary patients with WT.
http://ift.tt/2E5MBzh
Deep Learning Algorithm for Auto-Delineation of High-Risk Oropharyngeal Clinical Target Volumes with Built-in Dice Similarity Coefficient Parameter Optimization Function
Automating and standardizing the contouring of clinical target volumes (CTVs) can reduce inter-physician variability which is one of the largest sources of uncertainty in head and neck radiotherapy. Besides using uniform margin expansions to auto-delineate high-risk CTVs, very little work has been done to provide patient and disease specific high-risk CTVs. The aim of this study is to develop a deep neural network for the auto-delineation of high-risk CTVs.
http://ift.tt/2E6UVin
Risk of Pancreatic Cancer in Patients with Pancreatic Cysts and Family History of Pancreatic Cancer
A diagnosis of pancreatic cancer in a first-degree relative increases an individuals' risk of this cancer. However, it is not clear whether this cancer risk increases in individuals with pancreatic cystic lesions who have a first-degree relative with pancreatic cancer. The Fukuoka criteria are used to estimate risk of pancreatic cancer for patients with pancreatic cystic lesions: individuals with cysts with high risk or worrisome features (Fukuoka positive) have a higher risk of pancreatic cancer than individuals without these features (Fukuoka negative).
http://ift.tt/2FT8Qce
Single Fluid-Filled Intragastric Balloon Safe and Effective for Inducing Weight Loss in a Real-world Population
The Orbera Intragastric Balloon (OIB) is a single fluid-filled intra-gastric balloon approved for induction of weight loss and treatment of obesity. However, little is known about the effectiveness and safety of outside clinical trials, and since approval, the Food and Drug Administration has issued warnings to healthcare providers about risk of balloon hyper-inflation requiring early removal, pancreatitis, and death. We analyzed data on patients who have received the OIB since its approval determine its safety, effectiveness, and tolerance in real-world clinical settings.
http://ift.tt/2EoeWEd
Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
Nosocomial infections are a major setback in the healthcare delivery system especially in developing countries due to the limited resources. The roles played by medical care equipment and work surfaces in the ...
http://ift.tt/2FTan20
Laboratory parameters in lean NAFLD: comparison of subjects with lean NAFLD with obese subjects without hepatic steatosis
Search for meaningful laboratory and anthropometric parameters in lean non-alcoholic fatty liver disease (lean NAFLD) in the general population. Out of 2445 subjects in a random population sample, we compared ...
http://ift.tt/2nEAPpt
Comparative genomics reveals a widespread distribution of an exopolysaccharide biosynthesis gene cluster among Vibrionaceae
The eps locus in Vibrio diabolicus is involved in the production of the biotechnologically valuable HE800 EPS. In this study, the distribution and diversity of similar eps gene clusters across Vibrionaceae and it...
http://ift.tt/2nOe3e4
Bacterial and parasitic contaminants of salad vegetables sold in markets in Fako Division, Cameroon and evaluation of hygiene and handling practices of vendors
Increase in awareness of the health benefits of vegetables has resulted in an increase in consumption. Many vegetables are consumed raw to retain the natural taste and heat labile nutrients. The safety of raw ...
http://ift.tt/2nKKPNV
Variation in Adolescent Idiopathic Scoliosis Surgery: Implications for Improving Healthcare Value
To investigate the variation in care and cost of spinal fusion for adolescent idiopathic scoliosis (AIS), and to identify opportunities for improving healthcare value.
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Infantile Tremor Syndrome: Response to B12 Therapy
A 1-year-old boy, firstborn to nonconsanguineous parents, presented with loss of acquired developmental milestones and abnormal tremulous movements of his limbs for the past 20 days. The onset followed a period of normal development and was precipitated by an upper respiratory tract infection. On examination, he was underweight (weight: 6.2 kg, <–3 z score); had microcephaly (42 cm, <–3 z score); a plump appearance; a dull, expressionless face; thin, sparse, lightly pigmented hairs (Figure, A); and peripheral hyperpigmentation predominantly over knuckle, elbow, and knee.
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In Vivo Imaging of Muscle-tendon Morphogenesis in Drosophila Pupae
http://ift.tt/2FSf9N9
Variations on Negative Stain Electron Microscopy Methods: Tools for Tackling Challenging Systems
Negative stain EM is a powerful technique for visualizing macromolecular structure, but different staining techniques can produce varying results in a sample dependent manner. Here several negative staining approaches are described in detail to provide an initial workflow for tackling the visualization of challenging systems.
http://ift.tt/2Er0DPg
Two-photon Intravital Imaging of Leukocytes During the Immune Response in Lipopolysaccharide-treated Mouse Liver
http://ift.tt/2FSFuLf
Amputee Locomotion: Joint Moment Adaptations to Running Speed using Running-Specific Prostheses after Unilateral Transtibial Amputation
AbstractObjectiveThe objective of this study was to investigate 3D lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses.Design8 individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/s). A 2x2x3 (group x leg x speed) repeated-measures ANOVA with Bonferroni adjustments determined statistical significance.ResultsThe prosthetic limb generated significantly greater peak ankle plantarflexion moments and smaller peak ankle varus, knee stance extension, knee swing flexion, knee internal rotation, hip stance flexion, hip swing flexion, hip swing extension, hip valgus, and hip external rotation moments than the intact limb. The intact limb had greater peak hip external rotation moments than control limbs, but all other peak moments were similar between these limbs. Increases in peak hip stance and knee swing flexion moments associated with speed were greater in the intact limb than the prosthetic limb.ConclusionIndividuals with amputation relied on the intact limb more than the prosthetic limb to run at a particular speed when wearing running-specific prostheses, but the intact joints were not overloaded relative to the control limbs. Objective The objective of this study was to investigate 3D lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses. Design 8 individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/s). A 2x2x3 (group x leg x speed) repeated-measures ANOVA with Bonferroni adjustments determined statistical significance. Results The prosthetic limb generated significantly greater peak ankle plantarflexion moments and smaller peak ankle varus, knee stance extension, knee swing flexion, knee internal rotation, hip stance flexion, hip swing flexion, hip swing extension, hip valgus, and hip external rotation moments than the intact limb. The intact limb had greater peak hip external rotation moments than control limbs, but all other peak moments were similar between these limbs. Increases in peak hip stance and knee swing flexion moments associated with speed were greater in the intact limb than the prosthetic limb. Conclusion Individuals with amputation relied on the intact limb more than the prosthetic limb to run at a particular speed when wearing running-specific prostheses, but the intact joints were not overloaded relative to the control limbs. Corresponding Author: Jae Kun Shim, PhD, Department of Kinesiology, University of Maryland, College Park, 0110F School of Public Health (Bldg #225), 2242 Valley Drive, College Park, MD 20742, E-mail address: jkshim@umd.edu Disclosures: The authors have no conflicts of interest. This work was funded by the National Institute of Arthritis and Musculoskeletal and Skin Disease (NIAMS) R03 Award #1R03AR062321 and the University of Maryland Department of Kinesiology Graduate Research Initiative Fund. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Quantifying Effect of Onabotulinum Toxin A on Passive Muscle Stiffness in Children with Cerebral Palsy Using Ultrasound Shear Wave Elastography
ABSTRACTObjectiveA pilot study to longitudinally quantify effect of onabotulinum toxin A (BoNT-A) on passive muscle properties in children with cerebral palsy (CP) using ultrasound shear wave elastography (SWE).DesignProspective longitudinal cohort studyResultsBetween 1 and 3 months post-BoNT-A, a significant improvement in the shear modulus of the lateral gastrocnemius was found at 10° plantar flexion (PF) (-7.57 [-10.98, -5.07], p=0.02) and 0° PF (-14.74 [-18.21, -9.38], p=0.03). There was a notable, but non-significant difference in shear modulus at 20° PF, 10° PF, 0° PF between pre-BoNT-A and 1 month post-BoNT-A. Pre-BoNT-A shear modulus was not significantly different than 3 months post-BoNT-A at all foot positions. No significant differences in ankle passive range of motion or spasticity were found.ConclusionDespite no significant change in ankle range of motion or spasticity, SWE was able to detect a difference in lateral gastrocnemius passive muscle properties in children with CP following BoNT-A injections. The difference in passive muscle properties resolved by 3 months post-BoNT-A. Objective A pilot study to longitudinally quantify effect of onabotulinum toxin A (BoNT-A) on passive muscle properties in children with cerebral palsy (CP) using ultrasound shear wave elastography (SWE). Design Prospective longitudinal cohort study Results Between 1 and 3 months post-BoNT-A, a significant improvement in the shear modulus of the lateral gastrocnemius was found at 10° plantar flexion (PF) (-7.57 [-10.98, -5.07], p=0.02) and 0° PF (-14.74 [-18.21, -9.38], p=0.03). There was a notable, but non-significant difference in shear modulus at 20° PF, 10° PF, 0° PF between pre-BoNT-A and 1 month post-BoNT-A. Pre-BoNT-A shear modulus was not significantly different than 3 months post-BoNT-A at all foot positions. No significant differences in ankle passive range of motion or spasticity were found. Conclusion Despite no significant change in ankle range of motion or spasticity, SWE was able to detect a difference in lateral gastrocnemius passive muscle properties in children with CP following BoNT-A injections. The difference in passive muscle properties resolved by 3 months post-BoNT-A. Corresponding Author: Joline E. Brandenburg, MD, Department of Physical Medicine and Rehabilitation, Mayo Clinic – 200 First Street SW, Rochester, MN 55905 Author Disclosures: We would like to disclose that National Institutes of Health (NIH) (grants KL2TR000136, K12HD00109, F30 AG044075) and the Mayo Clinic Department of Physical Medicine and Rehabilitation for supported this research. In addition, this publication was made possible by CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). We would also like to disclose that there may be a perceived conflict of interest for author Pengfei Song, PhD, due to patents and licensing in the field of ultrasound elastography. A portion of this work was presented at the Association of Academic Physiatrists Annual Meeting in Sacramento, California on February 20th, 2016 as part of the Rehabilitation Medicine Scientist Training Program Presentations. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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http://ift.tt/2nJxSDS
Impaired cognitive performance in endothelial nitric oxide synthase knock-out mice after ischemic stroke, a pilot study
ABSTRACTObjectivesCognitive dysfunction and dementia are common following ischemic stroke. Endothelial nitric oxide synthase (eNOS) has been found to play an important role in neurological function and cognition. The purpose of the present study was to assess the specific role of eNOS in cognitive performance after stroke.DesignMale wildtype (WT) and mice lacking eNOS (eNOS-/-) underwent middle cerebral artery occlusion (MCAO) or sham-surgery. Primary outcomes were repeated measures of neurological score, limb asymmetry, sensory/motor function and spatial memory/learning assessed at intervals up to 28-days post-surgery. Group differences in brain microglia activation and infiltration, and levels of interferon-gamma (IFN-γ) were examined.ResultsThere was no genotype x surgery interaction effect on the pattern of change in neurological score, limb asymmetry, or sensory motor function across the 28-days post-surgery. In the Morris Water Maze, eNOS-/- MCAO mice displayed learning and memory deficits not evident in WT MCAO mice. Poorer spatial memory and learning in eNOS-/- MCAO mice was associated with a reduction in the number of activated microglia in the striatum on the lesion side and decreased brain tissue levels of IFN-γ.ConclusionsOur data support a role for eNOS in cognitive performance after stroke. This finding may lead to the development of novel interventions to treat post-stroke cognitive deficits. Objectives Cognitive dysfunction and dementia are common following ischemic stroke. Endothelial nitric oxide synthase (eNOS) has been found to play an important role in neurological function and cognition. The purpose of the present study was to assess the specific role of eNOS in cognitive performance after stroke. Design Male wildtype (WT) and mice lacking eNOS (eNOS-/-) underwent middle cerebral artery occlusion (MCAO) or sham-surgery. Primary outcomes were repeated measures of neurological score, limb asymmetry, sensory/motor function and spatial memory/learning assessed at intervals up to 28-days post-surgery. Group differences in brain microglia activation and infiltration, and levels of interferon-gamma (IFN-γ) were examined. Results There was no genotype x surgery interaction effect on the pattern of change in neurological score, limb asymmetry, or sensory motor function across the 28-days post-surgery. In the Morris Water Maze, eNOS-/- MCAO mice displayed learning and memory deficits not evident in WT MCAO mice. Poorer spatial memory and learning in eNOS-/- MCAO mice was associated with a reduction in the number of activated microglia in the striatum on the lesion side and decreased brain tissue levels of IFN-γ. Conclusions Our data support a role for eNOS in cognitive performance after stroke. This finding may lead to the development of novel interventions to treat post-stroke cognitive deficits. S Li and Y Wang contributed equally. The study was performed at Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA 02129 Co-coresponding author and eighth author: Lisa J. Wood, PhD, RN, FAAN, School of Nursing, Fatigue Research Laboratory, MGH Institute of Health Professions, 96 13th street, Charlestown, MA 02129, USA Phone: 617-724-3454, Email: ljwood@mghihp.edu Corresponding author and Last author: Qing Mei Wang, MD, PhD, Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The teaching affiliate of Harvard Medical School, 96 13th street, Charlestown, MA 02129, USA. Email: wang.qingmei@mgh.harvard.edu Disclosures: This work was funded by the National Institutes of Health [grant number HD074668, 2013-2016). The funding organization was not involved in study design, in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. An abstract was presented at the annual meeting of American Association of Physiatrists in February 2016. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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http://ift.tt/2C0w2mv
Relationship of Spinal Cord Injury Level and Duration to Peak Aerobic Capacity with Arms-Only and Hybrid FES-Rowing
ABSTRACTObjectiveTo assess the relationship of spinal cord injury level and duration to peak aerobic capacities during arms-only (AO) rowing compared to hybrid Functional Electrical Stimulation (FES) rowing.DesignComparison of peak aerobic capacity (VO2peak), peak ventilation (VEpeak), peak respiratory exchange ratio (RERpeak), and peak heart rate (HRpeak) were measured during AO-rowing and FES-rowing obtained from graded exercise tests.ResultsPeak aerobic values were strongly related to injury level and injury duration for both AO-rowing (r=0.67, p
http://ift.tt/2C0vOf9
http://ift.tt/2C0vOf9
Generation of Discriminative Human Monoclonal Antibodies from Rare Antigen-specific B Cells Circulating in Blood
We describe a method for the production of human antibodies specific for an antigen of interest, starting from rare B cells circulating in human blood. Generation of these natural antibodies is efficient and rapid, and the antibodies obtained can discriminate between highly related antigens.
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Extraction of Ramie Fiber in Alkali Hydrogen Peroxide System Supported by Controlled-release Alkali Source
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Reporting of Sepsis Cases for Performance Measurement Versus for Reimbursement in New York State
http://ift.tt/2E74Y70
Outcomes and Costs of Patients Admitted to the ICU Due to Spontaneous Intracranial Hemorrhage
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Equilibration Time Required for Respiratory System Compliance and Oxygenation Response Following Changes in Positive End-Expiratory Pressure in Mechanically Ventilated Children
Objectives: Increases in positive end-expiratory pressure are implemented to improve oxygenation through the recruitment and stabilization of collapsed alveoli. However, the time it takes for a positive end-expiratory pressure change to have maximum effect upon oxygenation and pulmonary compliance has not been adequately described in children. Therefore, we sought to quantify the time required for oxygenation and pulmonary system compliance changes in children requiring mechanical ventilation. Design: Retrospective analysis of continuous data. Settings: Multidisciplinary ICU of a pediatric university hospital. Patients: Mechanically ventilated pediatric subjects. Interventions: A case was eligible for analysis if during a 90-minute window following an increase in positive end-expiratory pressure, no other changes to the ventilator were made, ventilator and physiologic data were continuously available and a positive oxygenation response was observed. Time to 90% (T90) of the maximum change in oxygenation and compliance was computed. Differences between oxygenation and compliance T90 were compared using a paired t test. The effect of severity of illness (by oxygen saturation index) upon oxygenation and compliance was analyzed. Measurements and Main Results: A total of 200 subjects were enrolled and 1,150 positive end-expiratory pressure change cases were analyzed. Of these, 54 subjects with 171 positive end-expiratory pressure change case were included in the analysis (67% were responders). Changes in dynamic compliance (T90 = 38 min) preceded changes in oxygenation (T90 = 71 min; p
http://ift.tt/2E6vkpN
http://ift.tt/2E6vkpN
Activator Protein-1 Decoy Oligodeoxynucleotide Transfection Is Beneficial in Reducing Organ Injury and Mortality in Septic Mice
Objectives: Inflammation and apoptosis are decisive mechanisms for the development of end-organ injury in sepsis. Activator protein-1 may play a key role in regulating expression of harmful genes responsible for the pathophysiology of septic end-organ injury along with the major transcription factor nuclear factor-κB. We investigated whether in vivo introduction of circular dumbbell activator protein-1 decoy oligodeoxynucleotides can provide benefits for reducing septic end-organ injury. Design: Laboratory and animal/cell research. Settings: University research laboratory. Subjects: Male BALB/c mice (8–10 wk old). Interventions: Activator protein-1 decoy oligodeoxynucleotides were effectively delivered into tissues of septic mice in vivo by preparing into a complex with atelocollagen given 1 hour after surgery. Materials and Main Results: Polymicrobial sepsis was induced by cecal ligation and puncture in mice. Activator protein-1 decoy oligodeoxynucleotide transfection inhibited abnormal production of proinflammatory and chemotactic cytokines after cecal ligation and puncture. Histopathologic changes in lung, liver, and kidney tissues after cecal ligation and puncture were improved by activator protein-1 decoy oligodeoxynucleotide administration. When activator protein-1 decoy oligodeoxynucleotides were given, apoptosis induction was strikingly suppressed in lungs, livers, kidneys, and spleens of cecal ligation and puncture mice. These beneficial effects of activator protein-1 decoy oligodeoxynucleotides led to a significant survival advantage in mice after cecal ligation and puncture. Apoptotic gene profiling indicated that activator protein-1 activation was involved in the up-regulation of many of proapoptotic and antiapoptotic genes in cecal ligation and puncture-induced sepsis. Conclusions: Our results indicate a detrimental role of activator protein-1 in the sepsis pathophysiology and the potential usefulness of activator protein-1 decoy oligodeoxynucleotides for the prevention and treatment of septic end-organ failure. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://ift.tt/29S62lw). Supported, in part, by Grant-in-Aids for Scientific Research (20590250, 26460336) and for Challenging Exploratory Research (15K15661) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan. The authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: nmatsuda@med.nagoya-u.ac.jp; yhattori@med.u-toyama.ac.jp Copyright © by 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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http://ift.tt/2GQI7hT
Is Heparin-Binding Protein Inhibition a Mechanism of Albumin’s Efficacy in Human Septic Shock?
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Amazon and Health Care: Next Moves
Amazon announced a major health-care partnership deal with Berkshire Hathaway and JP Morgan Chase on January 30, 2018. It's no secret that Amazon CEO Jeff Bezos has been thinking about health care since the 1990s, when he took a very hands-on role at Drugstore.com. Apparently, it is still top of mind, and he has enlisted Warren Buffet and Jamie Dimon to focus their attention on employer-sponsored health care.
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A Seminiferous Tubule Squash Technique for the Cytological Analysis of Spermatogenesis Using the Mouse Model
The goal of this tubule squash technique is to rapidly assess cytological features of developing mouse spermatocytes while preserving cellular integrity. This method allows for the study of all stages of spermatogenesis, and can be easily implemented alongside other biochemical and molecular biological approaches for the study of mouse meiosis.
http://ift.tt/2BbmnwK
In Vivo Electrophysiological Measurement of the Rat Ulnar Nerve with Axonal Excitability Testing
Axonal excitability techniques provide a powerful tool to examine pathophysiology and biophysical changes that precede irreversible degenerative events. This manuscript demonstrates the use of these techniques on the ulnar nerve of anesthetized rats.
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Association of Blood Glucose and Clinical Outcome after Mechanical Thrombectomy for Acute Ischemic Stroke
Intervent Neurol 2018;7:182–188
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447 Consecutive Cases of Pipeline Flex Flow Diversion Utilizing a Novel Large-Bore Intracranial Intermediate Catheter: Nuances and Institutional Experience with the Syphontrak
Intervent Neurol 2018;7:153–163
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Treatment and survival vary by race/ethnicity in patients with anaplastic thyroid cancer
BACKGROUND
Anaplastic thyroid cancer (ATC) is the rarest type of thyroid cancer and has the lowest overall survival. To the authors' knowledge, the impact of socioeconomic status and race/ethnicity has not yet been described.
METHODS
Data regarding 719 patients diagnosed with their first primary malignant ATC from January 1, 1998 to December 31, 2011 in the Surveillance, Epidemiology, and End Results program registries were examined. Differences in receipt of thyroidectomy, radiotherapy, and lymph node examination were examined by race/ethnicity. Survival also was examined by race/ethnicity.
RESULTS
Nearly 70% of patients were non-Hispanic white, and 55.4% of patients received treatment. Tumor size (P = .13), lymph node involvement (P = .60), and residence in high poverty neighborhoods (P = .08) did not vary by race/ethnicity. Nonwhite patients were more likely to receive no treatment (adjusted odds ratio, 0.29; 95% confidence interval [95% CI], 0.16-0.54). When receipt of radiotherapy was adjusted for, nonwhite patients had a higher risk of overall death (adjusted hazards ratio [aHR], 1.24; 95% CI, 1.01-1.54), although not disease-specific death (aHR, 1.14; 95% CI, 0.92-1.42). Patients living in areas of high poverty had lower overall survival (aHR, 1.54; 95% CI, 1.09-2.18) and disease-specific survival (aHR, 1.68; 95% CI, 1.19-2.36).
CONCLUSIONS
In this population-based study of patients with ATC, nonwhite patients were found to be less likely to receive treatment. Furthermore, nonwhite patients had poorer overall survival, and patients living in areas of high poverty had both worse overall and disease-specific survival. Racial/ethnic and socioeconomic disparities appear to exist in the treatment and survival of patients with ATC. Cancer 2018. © 2018 American Cancer Society.
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Current developments in immunotherapy in the treatment of multiple myeloma
Multiple myeloma (MM) is the second most common hematologic malignancy and represents approximately 10% of all hematological neoplasms. Standard therapy consists of induction therapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) or, if ASCT cannot be performed, standard doublet, triplet, or quadruplet, novel agent–containing induction treatment until progression. Although MM is still regarded as mostly incurable by current standards, the development of several novel compounds, combination therapies, and immunotherapy approaches has raised great hopes about transforming MM into an indolent, chronic disease and possibly achieving a cure for individual patients. Several new inhibitory and immunological agents have been approved or are under intensive investigation and may lead to new therapeutic options for patients with relapsed/refractory MM, for patients ineligible for ASCT, and for patients after ASCT. Especially in the field of immunotherapy, including monoclonal antibodies, checkpoint inhibition, and chimeric antigen receptor T cells, current advances are rapid and highly promising. This review aims to summarize the newest and most promising immunotherapeutic agents for MM, their clinical efficacy, their adverse event (AE) profiles, and the ways in which these AEs can best be overcome or avoided. Cancer 2018. © 2018 American Cancer Society.
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Αλέξανδρος Γ. Σφακιανάκης Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,0030693260717...
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heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
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