An image-processing method to detect sub-optical features based on understanding noise in intensity measurements

Abstract

Accurate quantitative analysis of image data requires that we distinguish between fluorescence intensity (true signal) and the noise inherent to its measurements to the extent possible. We image multilamellar membrane tubes and beads that grow from defects in the fluid lamellar phase of the lipid 1,2-dioleoyl-sn-glycero-3-phosphocholine dissolved in water and water-glycerol mixtures by using fluorescence confocal polarizing microscope. We quantify image noise and determine the noise statistics. Understanding the nature of image noise also helps in optimizing image processing to detect sub-optical features, which would otherwise remain hidden. We use an image-processing technique "optimum smoothening" to improve the signal-to-noise ratio of features of interest without smearing their structural details. A high SNR renders desired positional accuracy with which it is possible to resolve features of interest with width below optical resolution. Using optimum smoothening, the smallest and the largest core diameter detected is of width \(88 \pm 23\) and \(6860 \pm 50\) nm, respectively, discussed in this paper. The image-processing and analysis techniques and the noise modeling discussed in this paper can be used for detailed morphological analysis of features down to sub-optical length scales that are obtained by any kind of fluorescence intensity imaging in the raster mode.

http://ift.tt/2Eshi2y

Determinants of Increased Aortic Diameters in Young Normotensive Patients With Turner Syndrome Without Structural Heart Disease

Abstract

Factors associated with aortic dilation and dissection in patients with Turner syndrome (TS) remain unclear. We assessed magnetic resonance imaging-based aortic diameters at nine predefined anatomic positions and examined associations of increased aortic diameters with B-type natriuretic peptide (BNP), A-type NP (ANP), growth hormone treatment, insulin-like growth factor 1 (IGF1), and estrogen status. Forty-seven patients with TS aged 7.3–21 years and 34 healthy peers were enrolled in this study. Aortic diameters were higher in patients with TS at three positions than in controls (p < 0.05). History of GH treatment, pubertal status, and serum estradiol levels were not associated with increased aortic diameters. Patients with TS had higher plasma BNP and ANP levels than controls. BNP and IGF1 were independently associated with the increase in aortic diameters in TS at three positions of the ascending aorta (R² = 0.361–0.458, p < 0.05 for all). At two positions of the descending aorta, only BNP emerged as an independent variable (R² = 0.130–0.139, p < 0.05). We conclude that young, normotensive patients with TS had greater aortic diameters at several positions than healthy controls. BNP and IGF1 were independently associated with increased aortic diameters in TS.

http://ift.tt/2DPXC7S

Necrotizing Enterocolitis in Infants with Hypoplastic Left Heart Syndrome Following Stage 1 Palliation or Heart Transplant

Abstract

Previous studies of necrotizing enterocolitis (NEC) among infants with hypoplastic left heart syndrome (HLHS) were conducted in single centers or had small sample sizes. This study aimed to determine the mortality rate and the risk factors for NEC among infants with HLHS who were discharged over a 10-year period (2004–2013) from 41 Pediatric Health Information System affiliated children's hospitals. Either stage 1 palliation and/or heart transplant were completed prior to patient's death or hospital discharge. We compared the characteristics of infants with HLHS who did not develop NEC and those who developed medical or surgical NEC and of patients who had medical vs. surgical NEC. The primary outcome was mortality over time and by birth weight category (low birth weight [LBW], birth weight < 2500 vs. ≥ 2500 g). Multivariable analyses were performed to identify the risk factors for developing NEC and for mortality among infants with HLHS. The study evaluated 5720 infants with HLHS including 349 patients (6.1%) with medical or surgical NEC. Fifty-two patients (0.9%) required laparotomy or percutaneous abdominal drainage. On univariable analysis, the overall mortality rate for infants who developed NEC was significantly higher than infants who did not develop NEC (23.5 vs. 13.9%, P < 0.001). On multivariable analysis, neither medical nor surgical NEC was a significant predictor of mortality in the study population. LBW infants were at higher risk for mortality in both the univariable and the multivariable models. Nevertheless, LBW did not significantly predispose infants with HLHS to develop NEC. Our results provide a national benchmark incidence of NEC, its risk factors, and outcomes among a large cohort of infants with HLHS and establish that NEC is not a significant risk factor for mortality in this population.

http://ift.tt/2Et2DnV

Scale and benefit of global carbon markets under the 2 °C goal: integrated modeling and an effort-sharing platform

Abstract

Global climate change mitigation needs all countries' efforts under the United Nations Framework Convention on Climate Change's guideline of equity and common but differentiated responsibilities and respective capabilities. The medium-to-long term regional emissions pathways simulated by integrated assessment models with global mitigation costs minimized to achieve the 2 °C goal might be very different from the regional emissions allowances allocated based on effort-sharing principles. Global carbon trading is a cost-effective mechanism to bridge the gap. Insight of previous papers has mainly focused on the impact of a single effort-sharing scheme on global carbon market, while this study attempts to explore the scale and benefit of global carbon market under different effort-sharing principles to achieve the 2 °C goal, with the application of a consistent modeling framework, consisting of an integrated assessment model and an effort-sharing platform. The results indicate that scale of global carbon market would be highly related with the effort-sharing principles. The global trading volumes would change from 1.8 Gigatons (Gt) carbon dioxide (CO₂) to over 12 GtCO₂ per year and largely peak between 2030 and 2040 under different kinds of effort-sharing principles. Correspondingly, annual global finance flows in the carbon market would increase gradually and reach the scale of hundreds of billions United States (US) dollars since 2020. Global carbon market would lower the abatement costs of developed countries, and the overall global abatement costs would drop by 0.4–2.6% during 2011–2050. The developing countries would not only acquire revenues from global carbon trading but also be provided with an opportunity to accelerate their domestic low-carbon energy transformation, local environmental improvement, job creation, and economic development. Linking national and regional carbon markets to develop global carbon market will be critical to maximize the utility of the market mechanism.

http://ift.tt/2nq96bI

Enhancement of UV-aging resistance of UV-curable polyurethane acrylate coatings via incorporation of hindered amine light stabilizers-functionalized TiO 2 -SiO 2 nanoparticles

Abstract

In this study, polymeric hindered amine light stabilizers (HALS)-functionalized silica coated rutile titanium dioxide (TiO₂-SiO₂) nanoparticles were prepared by encapsulating commercially available TiO₂-SiO₂ nanoparticles with methyl methacrylate (MMA) and 1,2,2,6,6-pentamethyl-4-piperidyl methacrylate (PMPM) copolymers via miniemulsion polymerization. The obtained functional (TiO₂-SiO₂/P(MMA-co-PMPM)) fillers have been added to polyurethane acrylate (PUA) oligomers to get UV-curable nanocomposite coatings. The functionalization of the TiO₂-SiO₂ nanoparticles with polymeric HALS has been confirmed by infrared spectra (IR), thermogravimetric (TG), and X-ray photoelectron spectroscopy (XPS) analyses. The scanning electron microscope (SEM) micrographs indicated that homogeneous dispersion of TiO₂-SiO₂/P(MMA-co-PMPM) composite nanoparticles resulted in improved transparency and mechanical properties of the UV-curable PUA coatings. Rhodamine B (Rh.B) photodegradation measurement confirmed the excellent UV-shielding performance of PUA nanocomposite coatings containing TiO₂-SiO₂/P(MMA-co-PMPM). The addition of TiO₂-SiO₂/P(MMA-co-PMPM) composite nanoparticles reduced the UV-curable PUA coatings degradation rate dramatically. The UV-aging resistance of PUA coatings was improved significantly. Over all, the combination of TiO₂-SiO₂ nanoparticles and polymeric HALS offers an attractive way to fabricate the multi-functional fillers, which can be used to improve the mechanical properties and UV-aging resistance of PUA coatings simultaneously.

http://ift.tt/2FwNhy8

The Ratio Fallacy, with Special Reference to the Cardiac Index

Abstract

When comparing cardiac outputs in children of different sizes, or deciding on the normality of these outputs, we often convert the absolute output to the output per m² body surface area—the cardiac index. For small infants, this leads to potentially large errors. The best way to evaluate these outputs is to determine their z values.

http://ift.tt/2E73a15

4-Hydroxybenzaldehyde sensitizes Acinetobacter baumannii to amphenicols

Abstract

Bacterial metabolism modulated by environmental chemicals could alter antibiotic susceptibility. 4-Hydroxybenzaldehyde (4-HBA), which cannot support the growth of Acinetobacter baumannii, exhibited synergism only with amphenicol antibiotics including chloramphenicol (CAM) and thiamphenicol. Interestingly, this synergistic effect was not observed with other growth-supporting, structurally similar compounds such as 4-hydroxybenzoate. Transcriptomic analysis demonstrated that genes involved in protocatechuate metabolism (pca genes) and osmotic stress (bet genes) were significantly upregulated by 4-HBA and CAM treatment. The ¹⁴C-labeled CAM influx was lower in a pcaK1 (encoding a transporter of protocatechuate) deletion mutant and was higher in the pcaK1 overexpressing cells relative to that in the wild type upon 4-HBA treatment. Our kinetic data using ¹⁴C-labeled CAM clearly showed that CAM uptake is possibly through facilitated diffusion. Deletion of pcaK1 did not result in the elimination of CAM influx, indicating that CAM does not enter only through PcaK1. The amount of 4-HBA in the culture supernatant was, however, unaffected during the test conditions, validating that it was not metabolized by the bacteria. CAM resistant A. baumannii cells derived by serial passages through CAM-amended media exhibited lower level of pcaK1 gene expression. These results led us to conclude that the activation of PcaK1 transporter is probably linked to cellular CAM susceptibility. This is the first report showing a relationship between CAM influx and aromatic compound metabolism in A. baumannii.

http://ift.tt/2DSjkw5

Role of Biochar and Fungi on PAH Sorption to Soil Rich in Organic Matter

Abstract

The use of biochar (BC) has been suggested for remediation of contaminated soils. This study aims to investigate the role of microorganisms in sorption of PAH to BC-amended soils. Fungi, especially the wood and litter-degrading fungi, have shown the ability for humification and to degrade recalcitrant molecules, and are thus suitable model organisms. Haplic Arenosol with high organic matter content was chosen to highlight the importance of soil organic matter (SOM) in PAH sorption, possibly to form non-extractable residue. Basidiomycetous fungi Agrocybe praecox and Phanerochaete velutina grown on pine bark were inoculated in organic matter (OM)-rich Haplic Arenosol and OM-poor sandy loam with either BC or chemically activated BC (ABC) and ¹⁴C-labelled pyrene for 60 days. Fungi did not mineralize pyrene, but increased sorption up to 47–56% in BC-amended Haplic Arenosol in comparison with controls (13–25%) without a fungus irrespective of the presence of an adsorbent. In OM-poor sandy loam, only 9–12% of pyrene was sorbed to amended soil in the presence of fungus and adsorbent. The results suggest that BC and fungal amendment increased sorption of pyrene, especially to Haplic Arenosol more than by either BC or fungi alone.

http://ift.tt/2ns0HF3

National-scale analysis of low flow frequency: historical trends and potential future changes

Abstract

The potential impact of climate change on hydrological extremes is of increasing concern across the globe. Here, a national-scale grid-based hydrological model is used to investigate historical trends and potential future changes in low flow frequency across Great Britain. The historical analyses use both observational data (1891–2015) and ensemble data from a regional climate model (1900–2006). The results show relatively few significant trends in historical low flows (2- or 20-year return period), whether based on 7- or 30-day annual minima. Significant negative trends seen in some limited parts of the country when using observational data are generally not seen when using climate model data. The future analyses use climate model ensemble data for both near future and far future time periods (2020–2049 and 2070–2099 respectively), which are compared to a baseline sub-period from the historical ensemble (1975–2004). The results show future reductions in low flows, which are generally larger in the south of the country, at the higher (20-year) return period, and for the later time period. Reductions are more limited if the estimates of future potential evaporation include the effect of increased carbon dioxide concentrations on stomatal resistance. Such reductions in river flow could have significant impacts on the aquatic environment and on agriculture, and present a challenge for water managers, especially as reductions in water supply are likely to occur alongside increases in demand.

http://ift.tt/2FyNWPF

Long-term disease and patient-reported outcomes of a continuous treat-to-target approach in patients with early rheumatoid arthritis in daily clinical practice

Abstract

Patients in real life may differ from those in clinical trials. The aim of this study is to report 5-year outcomes of a continuous treat-to-target (T2T) approach in patients with rheumatoid arthritis (RA) in daily clinical practice. In the Dutch RhEumatoid Arthritis Monitoring cohort, all patients with a clinical diagnosis of RA were treated according to a protocolled T2T strategy, aimed at 28-joint Disease Activity Score (DAS28) < 2.6. Outcomes were percentages of patients in distinct levels of disease activity, mean course of DAS28 and prevalence of sustained (drug-free) remission. Also, data on functional disability (Health Assessment Questionnaire) and health-related quality of life (Short-Form 36) were examined. Mean DAS28 improved from 4.93 (95% CI 4.81–5.05) at baseline to 2.49 (95% CI 2.35–2.63) after 12 months and remained stable thereafter. Percentages of patients at 12 months with DAS28 < 2.6 (remission), DAS28 ≥ 2.6 and ≤ 3.2 (low disease activity), DAS28 > 3.2 and ≤ 5.1 (moderate disease activity) and DAS28 > 5.1 (high disease activity) were 63, 16, 18 and 3%, respectively. Sustained remission (DAS28 < 2.6 during ≥ 6 months) was observed at least once in 84% of the patients and drug-free remission (DAS28 < 2.6 during ≥ 6 months after withdrawal of all disease-modifying anti-rheumatic drugs) in 36% of the patients. Functional disability and health-related quality of life significantly improved during the first 24 weeks. Continuous application of T2T in real-life RA patients leads to favourable disease- and patient-related outcomes.

http://ift.tt/2EsPxXL

Effects of an oral bisphosphonate and three intravenous bisphosphonates on several cell types in vitro

Abstract

Objective

To analyze the influence of an oral bisphosphonate and compare the potency to intravenous bisphosphonates on various cell types as regards the rarity of bisphosphonate-associated osteonecrosis of the jaw (BP-ONJ) caused by oral bisphosphonate.

Materials and methods

A viability assay (MTT), a migration assay (Boyden chamber), and an apoptosis assay (Caspase-Glo® 3/7) were performed to analyze the effect of bisphosphonates on human fibroblasts, umbilical vein endothelial cells (HUVEC), and osteoblasts.

Results

Alendronate and intravenous bisphosphonates suppressed cell viability and migration, and induced apoptosis in all tested cell types. Alendronate had a greater impact than ibandronate on the characteristics in fibroblasts and osteoblasts but not as strong as zoledronate.

Conclusions

The incidence of BP-ONJ in oral bisphosphonate treatment is reported to be much lower than that in intravenous bisphosphonates. However, the influences of alendronate on human cells were at least as strong as ibandronate, although it was lower than zoledronate.

Clinical relevance

Alendronate showed strong enough effects to suppress human somatic cells and was comparable to certain intravenous bisphosphonates in potency. This study suggests that the lower incidence of BP-ONJ in alendronate treatment is not originated by its potency, but might be due to the low bioavailability of alendronate, lower dosing on a daily basis, and having no additional therapies.

http://ift.tt/2DQuKAp

Assessment of condylar morphology and position using MSCT in an Asian population

Abstract

Objectives

The purpose of the present study was to investigate the volume, surface, morphometric index (MI), and position of the condyle in a normal population by applying Mimics 17.0 software. Then, the difference between left and right sides, sex, and age can be explored, which will contribute to establish the reference value of condylar morphology and position in normal individuals, and help us to study characteristics of condylar morphology and position in abnormal individuals.

Materials and methods

Three-hundred subjects were enrolled in our study from the radiology department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. They were divided into three groups according to the age: group 1 (18–24 years old), group 2 (25–34 years old), and group 3 (35–44 years old). Each group included 100 subjects (with 50 males and 50 females). They were examined using multislice computed tomography (MSCT) after that. All images of condyle were reconstructed by Mimics 17.0 software, so as to measure the volume, surface, and MI of condyle, and to analyze the position of condyle in the articular fossa by means of joint spaces.

Results

The differences of condylar volume, surface, and MI between left and right sides were not obvious (P > 0.05). The condylar volume and surface were greater in males than females (P < 0.05), while their condylar MI existed no difference (P > 0.05). No statistical differences were found in volume and surface among three age groups. However, the MI of group 1 was statistically lower than that of group 3 (P < 0.05). On the other hand, no significant differences were found between left and right condylar position (P > 0.05). Nevertheless, there were significant differences of condylar position regarding the gender and age (P < 0.05).

Conclusions

This study showed no significant differences in condylar morphology and position between left and right sides, but factors of gender and age were proven to have a certain influence on the morphology and position of the condyle. This information can be clinically useful in establishing the diagnostic criteria for condylar morphology and position in the normal Asian population.

Clinical relevance

Examination of condylar morphology and position is important for evaluating the abnormalities and bony changes that affect the temporomandibular joint (TMJ). So, this will be conducive to the diagnosis and the evaluation of therapeutic effect of temporomandibular joint diseases. Also, it is important to evaluate these indexes prior to commencing orthodontic treatment, because TMJ abnormalities play a critical role in orthodontic treatment planning.

http://ift.tt/2nwU2Zd

Hydrothermal preparation of blue molybdenum bronze nanoribbons: structural changes in mother crystals, related to solid-state conversion and crystallite splitting to nanomorphology

Abstract

Hydrothermal syntheses of alkali-metal blue molybdenum bronze nanoribbons, which are expected to exhibit unique properties induced by a combined effect of extrinsic and intrinsic low-dimensionalities, from hydrated-alkali-metal molybdenum bronzes were investigated. Nanoribbons grown along the quasi-one-dimensional (1D) conductive direction of Cs_0.3MoO₃, which is difficult to prepare by the conventional methods, were first synthesized. The nanomorphology formation is achieved by a solid-state conversion (or crystallite splitting) and subsequent crystallite growth, and the structural changes of the starting material related to the conversion were first observed by powder X-ray diffraction and scanning transmission electron microscopy as a result of finely tuned reaction system and preparation conditions. The structural changes were analyzed by model simulations and were attributed to the structural modulations that were concerned with the intralayer packing disorder and with two-dimensional long-range ordered structure, formed in MoO₃ sheets of the hydrated molybdenum bronze. Moreover, the modulations were related to displacement defects of the Mo-O framework units generated along the [100] direction in the hydrated molybdenum bronze. Then, it was suggested that the solid-state conversion into blue molybdenum bronze and the crystallite splitting to nanomorphology were initiated by the breaking of the Mo-O-Mo bonds at the defects.

Graphical Abstract

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http://ift.tt/2Er5Kwx

Electrochemical mechanism of silver nanoprisms transformation in aqueous solutions containing the halide ions

Abstract

The transformation process of 20–50 nm silver nanoprisms in the presence of Cl-, Br-, and I- ions was studied. The threshold concentrations of halide ions that initiate the transformation do not depend on the size of nanoprisms. It was shown that the structure change is caused by the formation of poorly soluble silver complexes on nanoprisms and occurs by an electrochemical mechanism. The induction period preceding the onset of shape transformation is related to the formation of silver halide nanoelectrodes. The electrochemical reactions involving silver and silver halide nanoelectrodes induce restructuring of silver particles the efficiency of which is determined by electrode potentials.

Graphical abstract

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http://ift.tt/2DPBt9y

Properties and phase structure of melt-processed PLA/PMMA blends

Abstract

This study examines the rheological, mechanical and thermal behavior of Poly(lactic acid)/Poly(methyl methacrylate) (PLA/PMMA) blends and takes a look at the phase structure evolution during their melt processing. Semi-crystalline or amorphous PLA grades were combined with PMMA of different molecular weight to prepare the blends. The rheological properties and phase structure was first assessed using small-amplitude oscillatory shear experiments. The blends were injection molded into bars and characterized in terms of their tensile properties and of their dynamic mechanical behavior. Differential scanning calorimetry was also used to study the miscibility and crystallization behavior of prepared blends. Tensile properties of the blends nearly followed a linear mixing rule with no detrimental effect that could have been associated with an uncompatibilized interface. However, dynamic mechanical analysis and calorimetric experiments showed that some phase separation was present in the molded parts. Nevertheless, a single T_g was found if sufficient time was given in quiescent conditions to achieve miscibility. The Gordon-Taylor equation was used to assess the polymer interactions, suggesting that miscibility is the thermodynamically stable state. The ability of PLA to crystallize was strongly restricted by the presence of PMMA and little or no crystallinity development was possible in the blends with more than 30% of PMMA. Results showed an interesting potential of these blends from an application point of view, whether they are phase separated or not.

http://ift.tt/2BHQ45f

Breastfeeding, Parenting, and Infant Attachment Behaviors

Abstract

Objectives Infants and toddlers need secure attachments in order to develop the social competence required to successfully navigate later peer and adult relationships. Breastfeeding is a parenting factor that has been associated with child emotional development—specifically the attachment between children and their mothers. Yet, this link may simply be the result of other parenting behaviors that are associated with breastfeeding. Thus, our objective is to examine whether the link between infant attachment behaviors and breastfeeding endures when accounting for a broad array of in-depth measures of parenting. Methods We use the Early Childhood Longitudinal Study of children from 9 months to 2 years of age collected by the National Center for Education Statistics. Using Ordinary Least Squares regression, data analyses examine the association between the Toddler Attachment Sort-45 (TAS-45) measures of toddler-parent attachment (infant attachment security and temperamental dependency) and breastfeeding practices. We also examine individual items of the TAS-45 to isolate specific attachment behaviors that have the strongest associations with breastfeeding. Results We find an enduring link between children who are predominantly breastfed for six or more months and infant attachment security. However, we find no evidence that breastfeeding is linked to a child's temperamental dependency. Of the nine items used to examine infant attachment behaviors, we find that breastfed children are rated as having slightly higher scores on two measures ("warm and cuddly," "cooperative") and lower scores on one measure ("demanding/angry"). Conclusions for Practice Breastfeeding has an important link to the child's use of their caregiver as a secure base for exploration and a place of comfort when distressed (infant attachment security). Yet, breastfeeding does not appear to reduce a child's temperamental dependency or level of clinginess as measured by how demanding, fussy or distressed the child becomes when separated.

http://ift.tt/2GCyTpq

Correlation of FANCM expression with clinical factors in luminal B breast cancer

Abstract

Background

The genotype of Fanconi Anemia complementation group M (FANCM) was previously found to be associated with breast cancer risk in several populations. Here, we studied the expression of FANCM and its correlation with clinical characteristics in Chinese patients with breast cancer.

Methods

We performed an immunohistochemical study of FANCM protein in clinical breast cancer tissues from 310 patients along with 44 adjacent tissues.

Results

FANCM protein level is lower in triple-negative breast cancer tissues than in other subtypes (P = 0.008). In addition, high FANCM expression correlated with pathology type IDC (P = 0.040), estrogen receptor positive (P < 0.001), progesterone receptor positive (P = 0.001), and low Ki-67 status (P = 0.003). Multivariate analysis revealed that FANCM status was an independent prognostic factor for overall survival (P = 0.017) in luminal B breast cancer.

Conclusions

FANCM levels are significantly associated with different subtypes of human breast cancer. Specifically, FANCM could play a role in the progression of luminal B breast cancer.

http://ift.tt/2DRhgUX

Surface Induced Dissociation Coupled with High Resolution Mass Spectrometry Unveils Heterogeneity of a 211 kDa Multicopper Oxidase Protein Complex

Abstract

Manganese oxidation is an important biogeochemical process that is largely regulated by bacteria through enzymatic reactions. However, the detailed mechanism is poorly understood due to challenges in isolating and characterizing these unknown enzymes. A manganese oxidase, Mnx, from Bacillus sp. PL-12 has been successfully overexpressed in active form as a protein complex with a molecular mass of 211 kDa. We have recently used surface induced dissociation (SID) and ion mobility-mass spectrometry (IM-MS) to release and detect folded subcomplexes for determining subunit connectivity and quaternary structure. The data from the native mass spectrometry experiments led to a plausible structural model of this multicopper oxidase, which has been difficult to study by conventional structural biology methods. It was also revealed that each Mnx subunit binds a variable number of copper ions. Becasue of the heterogeneity of the protein and limited mass resolution, ambiguities in assigning some of the observed peaks remained as a barrier to fully understanding the role of metals and potential unknown ligands in Mnx. In this study, we performed SID in a modified Fourier transform-ion cyclotron resonance (FTICR) mass spectrometer. The high mass accuracy and resolution offered by FTICR unveiled unexpected artificial modifications on the protein that had been previously thought to be iron bound species based on lower resolution spectra. Additionally, isotopically resolved spectra of the released subcomplexes revealed the metal binding stoichiometry at different structural levels. This method holds great potential for in-depth characterization of metalloproteins and protein–ligand complexes.

Graphical Abstract

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http://ift.tt/2rXRiJI

An Anonymity, Availability and Security-Ensured Authentication Model of the IoT Control System for Reliable and Anonymous eHealth Services

Abstract

eHealth is supported by electronic processes and communication. The Internet of Things (IoT) is utilized to realize smart healthcare, backup terminal devices are required for reliable eHealth services, and the IoT control system is essential for the security of IoT applications. In 2013, Yang et al. first added backup terminal devices, a status monitor device and an alarm module to the IoT control system and proposed an authentication mechanism for availability and security. In 2016, Chang et al. found that Yang et al.'s authentication model suffers from some drawbacks. In this paper, we adjust the operation and requirements of the IoT control system and take user anonymity into consideration to propose an authentication model for the IoT control system for reliable and anonymous eHealth services. To ensure anonymity of the user and the accessed service, the real identifiers will not be transmitted for untraceability. The proposed authentication model complies with six essential requirements. Via the proposed authentication model, the IoT control system can ensure reliable and anonymous eHealth services with anonymity, availability and security.

http://ift.tt/2DQ3Kkj

Expert’s comment concerning Grand Rounds case entitled “Posterolateral cervical transpedicular corpectomy for the surgical management of metastatic tumor” by M.H. Pham et al. (Eur Spine J; 2018: DOI 10.1007/s00586-018-5466-7)

http://ift.tt/2npLrIz

An investigation on the preparation of nanocrystalline hydrous zirconia from zirconium tungstate

Abstract

Hydrous nanocrystalline zirconia was prepared from an unusual precursor—the bimetallic oxide zirconium tungstate (ZrW₂O₈)—in alkaline medium. Different experimental conditions (NaOH concentration, time and temperature) were used to investigate the effects on crystallographic, morphological, chemical and thermal characteristics of the products. The resulting materials are composed of particles with a crystal structure similar to that of cubic ZrO₂ (or a mixture of tetragonal and cubic phases, depending on the synthesis conditions), with particle size around 5 nm and crystallites around 3 nm in diameter. These particles form high surface area agglomerates, exhibiting mesoporosity and capacity for adsorption of water and carbon dioxide. The synthesis mechanism appears to be constituted, first, by a chemical substitution reaction between the WO₄ tetrahedra and hydroxyl ions, with subsequent solubilization of the structure. Indeed, excess hydroxyls in the medium form colloidal zirconium ions which polymerize/condense, generating crystalline nuclei in a process facilitated by heterogeneous nucleation and supersaturation. The presence of residual tungsten in all samples appears to be a key element for stabilizing the size and crystalline structure of the materials produced.

http://ift.tt/2rSVJWd

Minmax-concave total variation denoising

Abstract

Total variation (TV) denoising is a commonly used method for recovering 1-D signal or 2-D image from additive white Gaussian noise observation. In this paper, we define the Moreau enhanced function of \(L_1\) norm as \({\varPhi }_\alpha (x)\) and introduce the minmax-concave TV (MCTV) in the form of \({\varPhi }_\alpha (Dx)\) , where D is the finite difference operator. We present that MCTV approaches \(\Vert Dx\Vert _0\) if the non-convexity parameter \(\alpha \) is chosen properly and apply it to denoising problem. MCTV can strongly induce the signal sparsity in gradient domain, and moreover, its form allows us to develop corresponding fast optimization algorithms. We also prove that although this regularization term is non-convex, the cost function can maintain convexity by specifying \(\alpha \) in a proper range. Experimental results demonstrate the effectiveness of MCTV for both 1-D signal and 2-D image denoising.

http://ift.tt/2rXtaH8

Relationship of aspiration pneumonia to cognitive impairment and oral condition: a cross-sectional study

Abstract

Objectives

The objective of this study was to investigate the relationship of the incidence of aspiration pneumonia to cognitive impairment and the oral condition.

Materials and methods

A total of 1174 elderly patients were analyzed in a cross-sectional study. Cognitive function was evaluated by the Clinical Dementia Rating scale and the oral condition was evaluated by inspection and palpation. Swallowing was examined in 196 patients by video-endoscopic evaluation. The Mann-Whitney U test or chi-square test was used for statistical analysis. Conditional logistic regression analysis was performed to compute the odds ratio (OR) and 95% confidence interval (CI).

Results

Loss of posterior occlusion, impaired tongue movements, and impaired cognition were factors significantly related to aspiration pneumonia. The incidence of aspiration pneumonia was higher in patients with both cognitive impairment and loss of posterior occlusion compared with those having either factor alone (OR: 5.16). There was no statistical association between impaired swallowing and the incidence of aspiration pneumonia in elderly patients with normal cognitive function (cognitive impairment, OR: 3.45; normal function, OR: 0.94).

Conclusion

Co-existence of cognitive impairment and oral frailty significantly enhances the risk of aspiration pneumonia.

Clinical relevance

Early and simple evaluation of the oral condition and cognitive function can predict the risk of aspiration pneumonia.

http://ift.tt/2GAf6GO

18 F-FPYBF-2, a new F-18-labelled amyloid imaging PET tracer: first experience in 61 volunteers and 55 patients with dementia

Abstract

Objective

Recently, we developed a benzofuran derivative for the imaging of β-amyloid plaques, 5-(5-(2-(2-(2-¹⁸F-fluoroethoxy)ethoxy)ethoxy)benzofuran-2-yl)-N-methylpyridin-2-amine (¹⁸F-FPYBF-2) (Ono et al., J Med Chem 54:2971–9, 2011). The aim of this study was to assess the feasibility of ¹⁸F-FPYBF-2 as an amyloid imaging PET tracer in a first clinical study with healthy volunteers and patients with various dementia and in comparative dual tracer study using ¹¹C-Pittsburgh Compound B (¹¹C-PiB).

Methods

61 healthy volunteers (age: 53.7 ± 13.1 years old; 19 male and 42 female; age range 24–79) and 55 patients with suspected dementia [Alzheimer's Disease (AD); early AD: n = 19 and moderate stage AD: n = 8, other dementia: n = 9, mild cognitive impairment (MCI): n = 16, cognitively normal: n = 3] for first clinical study underwent static head PET/CT scan using ¹⁸ F⁻ FPYBF-2 at 50–70 min after injection. 13 volunteers and 14 patients also underwent dynamic PET scan at 0–50 min at the same instant. 16 subjects (volunteers: n = 5, patients with dementia: n = 11) (age: 66.3 ± 14.2 years old; 10 males and 6 females) were evaluated for comparative study (50–70 min after injection) using ¹⁸F-FPYBF-2 and ¹¹C-PiB on separate days, respectively. Quantitative analysis of mean cortical uptake was calculated using Mean Cortical Index of SUVR (standardized uptake value ratio) based on the established method for ¹¹C-PiB analysis using cerebellar cortex as control.

Results

Studies with healthy volunteers showed that ¹⁸F-FPYBF-2 uptake was mainly observed in cerebral white matter and that average Mean Cortical Index at 50–70 min was low and stable (1.066 ± 0.069) basically independent from age or gender. In patients with AD, ¹⁸F-FPYBF-2 uptake was observed both in cerebral white and gray matter, and Mean Cortical Index was significantly higher (early AD: 1.288 ± 0.134, moderate AD: 1.342 ± 0.191) than those of volunteers and other dementia (1.018 ± 0.057). In comparative study, the results of ¹⁸F-FPYBF-2 PET/CT were comparable with those of ¹¹C-PiB, and the Mean Cortical Index (¹⁸F-FPYBF-2: 1.173 ± 0.215; ¹¹C-PiB: 1.435 ± 0.474) showed direct proportional relationship with each other (p < 0.0001).

Conclusions

Our first clinical study suggest that ¹⁸F-FPYBF-2 is a useful PET tracer for the evaluation of β-amyloid deposition and that quantitative analysis of Mean Cortical Index of SUVR is a reliable diagnostic tool for the diagnosis of AD.

http://ift.tt/2rVRuZZ

Mitosis event recognition and detection based on evolution of feature in time domain

Abstract

Mitosis detection and recognition in phase-contrast microscopy image sequences is a fundamental problem in many biomedical applications. Traditionally, researchers detect all mitotic cells from these image sequences with human eyes, which is tedious and time consuming. In recent years, many computer vision technologies were proposed to help humans to achieve the mitosis detection automatically. In this paper, we present an approach which utilized the evolution of feature in the time domain to represent the feature of mitosis. Firstly, the feature of each cell image is extracted by the different method (GIST, SIFT, CNN). Secondly, we construct the levels of motorists according to the steps of mitosis. The pooling method is utilized to handle the feature fusion in each dimension and in different time segments. Third, the pooling features were combined to one vector to represent the characters of this video. Finally, tradition machine learning method SVM is used to handle the mortises recognition problem. In order to demonstrate the performance of our approach, motorists event detection is made in some microscopy image sequences. In the experiment, some classic methods as comparison method are made in this paper. The corresponding experiments also demonstrate the superiority of our approach.

http://ift.tt/2GBiYYs

Expert’s comment concerning Grand Rounds case entitled “Type V osteogenesis imperfecta undergoing surgical correction for scoliosis” by M. Jones et al. (Eur Spine J; 2018: doi 10.1007/s00586-018-5465-8)

http://ift.tt/2GzTomD

Shaping conservative spinal services with the Spine Tango Registry

Abstract

Purpose

This study reports the results of a registry data collection project within a secondary care spinal osteopathy service.

Methods

Clinical and demographic data were collected using the Spine Tango Conservative registry data collection tool. Outcomes were assessed using the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Neck Disability Index (NDI), COMI Low Back Conservative (COMI-LBC), COMI Neck Conservative (COMI-NC) and EQ5D. Global treatment outcome (GTO), satisfaction with care and therapeutic complications were reported using the Spine Tango Patient Self Assessment form (STPSA). The correlation of GTO and PROM change scores was analysed using Spearman's rank correlation coefficient.

Results

262 patients presented during the study period. 100% of patients had chronic spinal pain and 98.8% had previously received other interventions for the same episode. Mean (standard deviation) improvements by PROM: NPRS low back 2.1 (2.5); NPRS neck 2.3 (2.3); COMI-LBC 2.1 (2.2); COMI-NC 2.0 (1.7); ODI 10.5 (12.1); NDI 14.5 (12.2); EQ5D 0.2 (0.3). 83.2% of patients reported that osteopathy had 'helped a lot' or 'helped'. 96.2% of patients were 'very satisfied' or 'satisfied' with care. There were no serious therapeutic complications.

Conclusions

The secondary care spinal osteopathy service demonstrated high satisfaction, few therapeutic complications and positive outcomes on all PROMs. Registry participation has facilitated robust clinical governance and the data support the use of osteopaths to deliver a conservative spinal service in this setting. Registry data collection is a significant administrative and clinical task which should be structured to minimise burden on patients and resources.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

http://ift.tt/2rSifyB

The Filon construct for moving dislocations

Abstract

Filon's construct, originally developed for plane isotropic linear elastostatics, examines the difference between solutions to the same boundary value problem but for two different values of the elastic moduli, and relates the difference solution to one occurring in a corresponding stationary dislocation problem. This paper generalises the result to three-dimensional linear elastodynamics with particular reference to moving dislocations. Also studied is the inverse procedure which derives the pair of elastodynamical problems from a given distribution of dislocations. Body-forces and an auxiliary plastic distortion tensor are novel and essential features of the argument. Specialisation to the static and quasi-static theories is straightforward. The inverse Filon construct is illustrated by the stationary edge dislocation and uniformly moving screw dislocation in a homogeneous isotropic linear elastic whole space.

http://ift.tt/2nolrxn

Neural Network Based Adaptive Actuator Fault Detection Algorithm for Robot Manipulators

Abstract

In order to improve the reliability of robotic systems, various fault detection and isolation (FDI) algorithms have been proposed. However, most of these algorithms are model-based and thus, an accurate model of the robot is required although it is hard to obtain and often time-varying. Acceleration estimation is an additional challenge in dynamic model-based algorithms as it is hard to measure accurately in practice. In this study, a neural network based fault detection algorithm that does not require the use of physical robot model and acceleration is proposed. By utilizing neural network, the fault torque can be estimated, which allows effective fault detection and diagnosis. The feasibility of the proposed fault detection algorithm is validated through various simulations and experiments.

http://ift.tt/2E3eNpO

Intraosseous pseudomeningocele of the mobile spine: a case report and review of the literature

Abstract

Background

Pseudomeningoceles most commonly occur due to prior trauma or surgery and are often located in the posterior paraspinous tissues. Here, we report a case of an intraosseous pseudomeningocele that mimicked an intra-osseous T2 hyperintense lesion in the L1 vertebral body.

Case description

A 64-year-old male presented with back, left lateral thigh and left knee pain lasting several months. He had no prior history of trauma or surgery. Radiographs of the lumbar spine showed mild levoscoliotic curvature of the lumbar spine, Baastrup's changes between the spinous processes, multilevel degenerative disc disease and facet arthropathy. Magnetic resonance imaging (MRI) of the lumbar spine performed without intravenous contrast showed severe spinal canal stenosis from L1–L2 to L3–L4 and moderate spinal canal stenosis at L4–L5. MRI also showed a 2.5-cm T2 hyperintense lesion involving the posterior aspect of the L1 vertebral body, with questionable contiguity with cerebrospinal fluid. Computed tomography (CT) myelogram was performed instead of biopsy. CT myelogram showed contiguity of the lesion with the intrathecal contrast and a rent in the posterior longitudinal ligament and anterior dura consistent with an intraosseous pseudomeningocele. The patient opted for non-operative management of the pseudomeningocele and his lumbar stenosis due to medical comorbidities.

Conclusions

This case illustrates a rare case of an intra-osseous pseudomeningocele and highlights the importance of CT myelogram for diagnosis.

http://ift.tt/2no5dEt

The Role of PET/CT with 18 F-FDG in the Assessment of Therapeutic Response of Head and Neck Cancer

Abstract

Purpose of Review

To make a brief review on the pre-treatment evaluation of head and neck squamous cell carcinoma (HNSCC) with positron emission tomography/computed tomography with 18F-Fluoro-deoxy-glucose (¹⁸F-FDG PET/CT) and to discuss the use of this method after treatment, with emphasis on the evaluation of therapeutic response.

Recent Findings

The ¹⁸F-FDG PET/CT pre-treatment evaluation is recommended at III–IV staging to determine metastasis foci. At post-evaluation, the use of ¹⁸F-FDG PET/CT is very important to confirm the therapeutic response based on its high negative predictive value (NPV), mostly when it is made after 12 weeks the last radiotherapy dose. Specific imaging criteria aid in the detection of active tumor lesions. Moreover, the ¹⁸F-FDG PET/CT can determine early failure treatment and overall survival and progression-free survival. Recently, the ¹⁸F-FDG PET/CT surveillance was showed an important tool to follow up HNSCC patients with stage N2 or N3 disease.

Summary

The ¹⁸F-FDG PET/CT is essential in the management of HNSCC, mainly at post-treatment evaluation. Its findings can determine a complementary therapy or even avoid an aggressive and unnecessary approach. So, careful analysis using imaging interpretation criteria has been central to an accurate assessment of HNSCC patients.

http://ift.tt/2DR63jm

SMER28 is a mTOR-independent small molecule enhancer of autophagy that protects mouse bone morrow and liver against radiotherapy

Summary

Effective cytoprotectors that are selective for normal tissues could decrease radiotherapy and chemotherapy sequelae and facilitate the safe administration of higher radiation doses. This could improve the cure rates of radiotherapy for cancer patients. Autophagy is a cytoplasmic cellular process that is necessary for the clearance of damaged or aged proteins and organelles. It is a strong determinant of post-irradiation cell fate. In this study, we investigated the effect of the mTOR-independent small molecule enhancer of autophagy (SMER28) on mouse liver autophagy and post-irradiation recovery of mouse bone marrow and liver. SMER28 enhanced the autophagy flux and improved the survival of normal hepatocytes. This effect was specific for normal cells because SMER28 had no protective effect on hepatoma or other cancer cell line survival in vitro. In vivo subcutaneous administration of SMER28 protected mouse liver and bone marrow against radiation damage and facilitated survival of mice after lethal whole body or abdominal irradiation. These findings open a new field of research on autophagy-targeting radioprotectors with clinical applications in oncology, occupational, and space medicine.

http://ift.tt/2Fwhq0o

Glycan recognition by human blood mononuclear cells with an emphasis on dendritic cells

Abstract

Dendritic cells (DCs) play crucial roles in innate and adaptive immune response, for which reason targeting antigen to these cells is an important strategy for improvement of vaccine development. To this end, we explored recognition of DCs lectins by glycans. For selection of the glycan "vector", a library of 229 fluorescent glycoprobes was employed to assess interaction with the CD14^low/-CD16⁺CD83⁺ blood mononuclear cell population containing the DCs known for their importance in antigen presentation to T-lymphocytes. It was found that: 1) the glycan-binding profiles of this CD14^low/-CD16⁺CD83⁺ subpopulation were similar but not identical to DCs of monocyte origin (moDCs); 2) the highest percentage of probe-positive cells in this CD14 ^low/-CD16⁺CD83⁺ subpopulation was observed for GalNAcα1-2Galβ (A_di), (Neu5Acα)₃ and three mannose-reach glycans; 3) subpopulation of CD14^low/-CD16⁺ cells preferentially bound 4'-O-Su-LacdiNAc. Considering the published data on specificity of DCs binding, the glycans showing particular selectivity for the CD14 ^low/-CD16⁺CD83⁺ cells are likely interacting with macrophage galactose binding lectin (MGL), siglec-7 and dectin-2. In contrast, DC-SIGN is not apparently involved, even in case of mannose-rich glycans. Taking into consideration potential in vivo competition between glycan "vectors" and glycans within glycocalyx, attempting to target vaccine to DCs glycan-binding receptors should focus on A_di and (Neu5Acα)₃ as the most promising vectors.

http://ift.tt/2E2vEZC

Participation in Home Visitation is Associated with Higher Utilization of Early Intervention

Abstract

Objectives To determine whether participation in a home visiting program increases and expedites utilization of early intervention services for suspected developmental delays. Methods Children participating in Every Child Succeeds (ECS), a large home visiting (HV) program serving greater Cincinnati, between 2006 and 2012, were propensity score matched to a sample of children identified from birth records who did not receive services from ECS. Data were linked to early intervention (EI) data acquired from the Ohio Department of Health. Descriptive statistics were employed to evaluate success of the matching. Chi square and log-rank tests evaluated whether the proportion of children accessing EI and the time to EI services differed for families participating in HV compared to eligible children not participating. Logistic regression and Cox proportional hazards regression modeled the associations. Results Among 3574 HV and 3574 comparison participants, there was no difference in the time to EI service utilization; however a higher percentage of HV participants accessed services. Overall, 6% of the HV group and 4.3% of the comparison group accessed services (p = 0.001). Modeling revealed an odd ratio = 1.43 [95% confidence interval (CI) 1.16–1.78, p value = 0.001] and hazard ratio = 1.42 [95% CI 1.15–1.75, p value = 0.001]. Differences in utilization were greatest directly after birth and between approximately 2 and 3 years. Conclusions for Practise Participation in home visiting was associated with greater utilization of EI services during two important developmental time points, demonstrating that home visiting may serve as an important resource for facilitating access to early intervention services.

http://ift.tt/2DNLZxX

Renewable eugenol-based functional polymers with self-healing and high temperature resistance properties

Abstract

A novel small molecule 1,3-bis(eugenyl) glycerol diether is synthesized from renewable eugenol and epichlorohydrin in 60% total yield, and its structure is confirmed by ¹H–NMR spectrum. Then, this small molecule is utilized to prepare oligomer, linear polymer and the corresponding crosslinked polymer (denoted as P₂ ) by using thiol-ene and thiol-oxidation reactions. The polymer P₂ can form brown film on a glass substrate and can be easily put off from the substrate. Mechanical properties of P₂ show that tensile strength value is about 6 MPa, with elongation at break of around 300%. Glass transition temperature (Tg) of P₂ is −2.76 °C, meaning that P₂ is at rubber state. There are hydroxyl groups in the prepared linear polymer, which further reacts with 1,6-hexanediisocyanate (HDI) to form polyurethane P₄ with crosslinked structures. Compared with P₂ , the polyurethane P₄ forms yellow film on a glass substrate. But the film of P₄ is not so flexible as that of P₂ , presumably because of relatively higher Tg (5.85 °C) of P₄ than P₂ . Due to the existence of dynamic disulfide bonds as well as hydrogen bonds in both P₂ and P₄ , these thermoset resins show repeatable self-healing behavior stimulated by UV irradiation. Furthermore, the polyurethane P₄ exhibits ultrahigh temperature resistance performance, with Td₅ = 375 °C and Td₁₀ = 1000 °C according to TGA curve. This work is expected to expand research and potential applications of the renewable resource eugenol in preparation of smart materials.

http://ift.tt/2rRfc9T

Adaptive locally affine-invariant shape matching

Abstract

Matching deformable objects using their shapes are an important problem in computer vision since shape is perhaps the most distinguishable characteristic of an object. The problem is difficult due to many factors such as intra-class variations, local deformations, articulations, viewpoint changes and missed and extraneous contour portions due to errors in shape extraction. While small local deformations have been handled in the literature by allowing some leeway in the matching of individual contour points via methods such as Chamfer distance and Hausdorff distance, handling more severe deformations and articulations has been done by applying local geometric corrections such as similarity or affine. However, determining which portions of the shape should be used for the geometric corrections is very hard, although some methods have been tried. In this paper, we address this problem by an efficient search for the group of contour segments to be clustered together for a geometric correction using dynamic programming by essentially searching for the segmentations of two shapes that lead to the best matching between them. At the same time, we allow portions of the contours to remain unmatched to handle missing and extraneous contour portions. Experiments indicate that our method outperforms other algorithms, especially when the shapes to be matched are more complex.

http://ift.tt/2DRBcqZ

Partners in crime: neutrophils and monocytes/macrophages in inflammation and disease

Abstract

Neutrophils are becoming recognized as highly versatile and sophisticated cells that display de novo synthetic capacity and potentially prolonged lifespan. Emerging concepts such as neutrophil heterogeneity and plasticity have revealed that, under pathological conditions, neutrophils may differentiate into discrete subsets defined by distinct phenotypic and functional characteristics. Indeed, these newly described neutrophil subsets will undoubtedly add to the already complex interactions between neutrophils and other immune cell types for an effective immune response. The interactions between neutrophils and monocytes/macrophages enable the host to efficiently defend against and eliminate foreign pathogens. However, it is also becoming increasingly clear that these interactions can be detrimental to the host if not tightly regulated. In this review, we will explore the functional cooperation of neutrophil and monocytes/macrophages in homeostasis, during acute inflammation and in various disease settings. We will discuss this in the context of cardiovascular disease in the form of atherosclerosis, an autoimmune disease mainly occurring in the kidneys, as well as the unique intestinal immune response of the gut that does not conform to the norms of the typical immune system.

http://ift.tt/2nucIca

ISEP/INESC TEC Aerial Robotics Team for Search and Rescue Operations at the euRathlon 2015

Abstract

This paper presents the results from search and rescue missions performed with the aerial robot OTUS in the the context of the ISEP/INESC TEC aerial robotics team participation on the euRathlon 2015 robotics competition. The multi-domain (land, sea and air) search and rescue scenario is described and technical solution adopted is presented with emphasis on the perception system. The calibration of the image based system is addressed. Results from the operational missions performed are also discussed. The aerial autonomous vehicle was able to successfully perform multiple tasks from the aerial reconnaissance and 3D mapping to the identification of leaking pipes, obstructed passages and missing workers. The system was validated a realistic operational scenario and won the Grand Challenge in cooperation with land and marine robotics partner teams. This challenge was the first time that a real time collaborative team of aerial, land and marine robots was deployed successfully in a search and rescue mission.

http://ift.tt/2DYj2D7

First report of Borrelia miyamotoi in an Ixodes ricinus tick in Augsburg, Germany

Abstract

Borrelia miyamotoi, a spirochete found in the hard tick Ixodes ricinus, is thought to cause relapsing fever. The disease caused by this bacterium can manifest with high fever, fatigue and other symptoms. It may also lead to central nervous system involvement with symptoms similar to meningoencephalitis. DNA from ticks from the greater Augsburg region in Germany was subjected to qPCR for Borrelia spp., followed by nested PCR and subsequent sequencing for species identification of the qPCR positive samples. From 112 ticks, 20 were found to be positive for Borrelia. The DNA sequenced showed 50% Borrelia afzelli, 15% Borrelia garinii, 5% Borrelia valaisiana and one sequence was identified as Borrelia miyamotoi. The positive identification of Borrelia miyamotoi is unlikely to be due to contamination. In conclusion, Borrelia miyamotoi has been found in a tick in the Augsburg region for the first time. This follows on from previous reports of a low incidence of this bacterium in southern Germany around Lake Constance and in the Munich region. This infectious agent should be taken into account when patients present with recurring fever or neurological symptoms which cannot be otherwise explained. Tick-borne relapsing fever should now be considered as a cause of such symptoms and medical professionals should contemplate differential Borrelia testing when presented with corresponding symptoms.

http://ift.tt/2npGpM4

Ricoseius loxocheles (Acari: Phytoseiidae) is not a predator of false spider mite on coffee crops: What does it eat?

Abstract

Ricoseius loxocheles (De Leon) (Acari: Phytoseiidae) is often found in coffee crops and is known to feed on coffee leaf rust, Hemileia vastatrix Berkeley and Broome (Uredinales). As the occurrence of coffee leaf rust is limited primarily to the rainy season, the mite may use other food sources to survive during the periods of low pathogen prevalence. It is well known that phytoseiid mites can survive on a variety of food sources, such as herbivorous mites, fungi and pollen. We evaluated the ability of R. loxocheles to survive and reproduce on a diet of Brevipalpus phoenicis Geijskes (Acari: Tenuipalpidae), cattail pollen (Typha spp.), clover rust (Puccinia oxalidis), bee pollen (Santa Bárbara^® dehydrated pollen, Santa Bárbara, MG, Brazil) and coffee leaf rust. Ricoseius loxocheles did not survive or reproduce on any B. phoenicis stages tested (egg, larva, adult). The survival and oviposition of R. loxocheles were directly affected by the presence of coffee rust urediniospores, but not by the presence of the prey. Survival and oviposition of the phytoseiid were similar when fed cattail pollen, clover rust and coffee leaf rust but was lower when fed bee pollen. Our results show that R. loxocheles is not a predator of B. phoenicis but it is able to utilize other resources besides coffee leaf rust.

http://ift.tt/2BF6cV3

Ticks (Acari: Ixodidae) of the state of Amazonas, Brazil

Abstract

The tick fauna of Brazil is currently composed by 72 species. The state of Amazonas is the largest of Brazil, with an area of ≈ 19% of the Brazilian land. Besides its vast geographic area, only 19 tick species have been reported for Amazonas. Herein, lots containing ticks from the state of Amazonas were examined in three major tick collections from Brazil. A total of 5933 tick specimens were examined and recorded, comprising 2693 males, 1247 females, 1509 nymphs, and 484 larvae. These ticks were identified into the following 22 species: Amblyomma cajennense sensu lato, Amblyomma calcaratum, Amblyomma coelebs, Amblyomma dissimile, Amblyomma dubitatum, Amblyomma geayi, Amblyomma goeldii, Amblyomma humerale, Amblyomma latepunctatun, Amblyomma longirostre, Amblyomma naponense, Amblyomma oblongoguttatum, Amblyomma ovale, Amblyomma rotundatum, Amblyomma scalpturatum, Amblyomma varium, Dermacentor nitens, Haemaphysalis juxtakochi, Ixodes cf. Ixodes fuscipes, Ixodes luciae, Rhipicephalus microplus, Rhipicephalus sanguineus sensu lato. Ticks were collected from 17 (27.4%) out of the 62 municipalities that currently compose the state of Amazonas. The following four species are reported for the first time in the state of Amazonas: A. coelebs, A. dubitatum, H. juxtakochi, and Ixodes cf. I. fuscipes. The only tick species previously reported for Amazonas and not found in the present study is Amblyomma parvum. This study provides a great expansion of geographical and host records of ticks for the state of Amazonas, which is now considered to have a tick fauna composed by 23 species. It is noteworthy that we report 1391 Amblyomma nymphs that were identified to 13 different species.

http://ift.tt/2npvTo8

Altered goblet cell function in Hirschsprung’s disease

Abstract

Aims and objectives

Hirschsprung's disease-associated enterocolitis (HAEC) is the most serious complication of Hirschsprung's disease (HSCR). HAEC occurs in 17–50% of patients with HSCR and may occur before or after a properly performed pull-through operation. The pathogenesis of HAEC is poorly understood. It is well recognized that a complex mucosal barrier protects, as the first line of defense, the surface of healthy intestinal tract from adhesion and invasion by luminal micro-organisms. Within the intestinal epithelium, goblet cells secrete gel-forming mucins, the major component of mucus, which block the direct attachment of commensal bacteria to the epithelial layer. Mucin 2 (MUC2) is the predominant mucin expressed in humans. Trefoil factor 3 (TFF3) synergizes with mucin and enhances the protective barrier properties of the mucus layer. SAM pointed domain-containing ETS transcription factor (SPDEF) drives terminal differentiation and maturation of secretory progenitors into goblet cells. Krueppel-like factor 4 (KLF4) is a goblet cell-specific differentiation factor in the colon and controls goblet cell differentiation and activates mucin synthesis. We hypothesized that the goblet cell function in the ganglionic pulled-through bowel in HSCR is abnormal and, therefore, we investigated the changes in goblet cell differentiation and functional expression of mucin in the bowel specimens from patients with HSCR.

Material and methods

We investigated MUC2, TFF3, SPDEF and KLF4 expression, and the goblet cell population in the ganglionic and aganglionic bowel of HSCR patients (n = 10) and controls (n = 10) by qPCR, Western blotting, confocal immunofluorescence, and alcian blue staining.

Results

The qPCR and Western blotting analysis revealed that TFF3, SPDEF and KLF4 expressions were significantly downregulated in the aganglionic and ganglionic colon of patients with HSCR as compared to controls (p < 0.05). Alcian blue staining revealed that the goblet cell population was significantly decreased in aganglionic and ganglionic colon as compared to controls (p < 0.05). Confocal microscopy revealed a markedly decreased expression of TFF3, SPDEF and KLF4 in colonic epithelium of patients with HSCR as compared to controls.

Conclusion

This is, to our knowledge, the first report of decreased expression of TFF3, SPDEF, KLF4, and goblet cell population in the colon of patients with HSCR. Altered goblet cell function may result in intestinal barrier dysfunction contributing to the development of HAEC.

http://ift.tt/2rRD39A

Fatigue in Patients with Major Depressive Disorder: Prevalence, Burden and Pharmacological Approaches to Management

Abstract

Fatigue is a frequently reported symptom in major depressive disorder, occurring in over 90% of patients. Clinical presentations of fatigue within major depressive disorder encompass overlapping physical, cognitive and emotional aspects. While this review addresses the epidemiology, burden, functional impact and management of fatigue in major depressive disorder, the main focus is on available pharmacotherapy options and their comparative efficacies. Our review of the effects of pharmacological treatments on fatigue in major depressive disorder found that medications with dopaminergic and/or noradrenergic action such as modafinil, flupenthixol and atomoxetine were most effective in improving symptoms of fatigue and low energy. However, significant variation across studies in assessment tools and study inclusion/exclusion criteria may have contributed to inconsistent findings. The efficacy of non-pharmacological interventions is also discussed, including light therapy and exercise.

http://ift.tt/2FuQsX2

Vulnerability of crops and croplands in the US Northern Plains to predicted climate change

Abstract

The states of Colorado, Montana, Nebraska, North Dakota, South Dakota, and Wyoming comprise the Northern Great Plains region of the USA. The soil and water resources contained in this region have historically supported highly diverse and productive agriculture enterprises that provide a significant proportion of the food, feed, and oilseed for the nation. The region also provides ecological services that influence air, water, and soil quality along with biological diversity. Combined with livestock production and a biofuel industry, crop production forms an integrated system that can offer producers flexibility in management decisions. Projected climatic changes for this region include increasing atmospheric CO₂, a longer, warmer growing season, and increased precipitation, likely received in more frequent extreme events. These changes will impact soil and water resources in the region and create opportunities and challenges for land managers. The objectives of this paper are to describe anticipated impacts of projected mid-(2050) and late-(2085) climatic changes on crop production systems in the Northern Great Plains and provide adaptation strategies that should be developed to take advantage of positive and mitigate negative changes. Projected climatic changes will influence agricultural productivity directly as well as indirectly due to changes in weed pressure, insect populations, and diseases. A warmer, longer growing season will change the crops and distribution of those crops grown within the region. An increase in the number of extreme temperature events (high daytime highs or nighttime lows) will decrease crop yields due to increased plant stress during critical pollination and grain fill periods. Adaptation strategies to reduce vulnerability of soil and water resources to projected climatic changes include increasing cropping intensity, reducing tillage intensity, and use of cover crops to provide surface cover to reduce erosion potential and improve nutrient and water use efficiency. Increased use of perennial forages, crop residue, and failed crops in integrated crop-livestock systems will add biological diversity and provide options for converting vegetation biomass into animal protein. Socio-economic changes will need to be incorporated into adaptation strategies planning to insure that sustaining ecosystem services and meeting desired production and conservation goals is accomplished. Education and extension services will be needed to transfer adaptive knowledge in a timely manner to producers in the field.

http://ift.tt/2rQLulp

Effects of Corrective Feedback on EFL Learners’ Acquisition of Third-Person Singular Form and the Mediating Role of Cognitive Style

Abstract

The present study investigated the effectiveness of recasts and prompts on the acquisition of the English third-person singular form and the mediating role of cognitive style on the effects of feedback. One hundred and seventy-five college students from four intact classes were assigned to four groups: form-focused instruction with recast (FFI-recast), FFI with prompt (FFI-prompt), FFI, and control. The group embedded figures test (Witkin et al. in Rev Educ Res 47:1–64, 1977) was adopted to test learners' cognitive style (field dependence/independence). The results show that the FFI-prompt group outperformed the FFI-recast group and the control group on the immediate post-test; the FFI-prompt group also achieved significantly higher scores than the other groups on the delayed post-test in the written test. However, no significant difference was found among groups in the text-completion test. Regression analyses reveal that in the text-completion test, field dependence/independence mediates the effect of recasts on the immediate post-test.

http://ift.tt/2EnFyTw

NSAIDs utilization for musculoskeletal indications in elderly patients with cerebro/cardiovascular disease

Abstract

Objectives

To describe NSAID utilization for musculoskeletal conditions in a large cohort of Italian elderly with cerebro/cardiovascular disease, a population in which NSAIDs should be generally avoided due to the prothrombotic potential.

Methods

Administrative data from five Italian geographic areas were analyzed. Patients aged ≥ 65 with a cerebro/cardiovascular event recorded between 2008 and 2011 (cohort entry) were selected. Prescription NSAIDs reimbursed for musculoskeletal conditions and dispensed during 1 year follow-up were retrieved to describe (i) prevalence of use, (ii) average amount of defined daily doses of NSAIDs claimed by users per day of follow-up, and (iii) distribution of the received daily dose (RDD) among patients with ≥ 2 dispensings. Among new users, i.e., patients without NSAID dispensings during 2 years before cohort entry, the first dispensed NSAID molecule was observed.

Results

Overall, 511,989 patients were selected. Across the five geographic areas, prevalence of use ranged from 48 to 21% and average consumption ranged between 30 and 67 DDD/1000 users/day. Around 10% of patients in the overall cohort had a RDD > 1. Nimesulide (9.6%) and diclofenac (7.5%) had the highest prevalence of use. The most consumed NSAIDs were nimesulide and coxibs with 10.6 and 7.5 DDD/1000 users/day, respectively. Among new users recruited in 2011, 30% had diclofenac or a coxibs as the first prescription.

Conclusions

NSAID use was common in the study cohort, particularly in central-southern areas. In contrast with current recommendations, coxibs and diclofenac were among the most prescribed active principles, even in new users. Interventions to promote appropriateness of use are warranted.

http://ift.tt/2GyjGWb

Correction to: Multiple sperm tracking in microscopic videos using modified GM-PHD filter

Abstract

In the original article, one of the co-author's (Hamed Danandeh Hesar) first name has been published incorrectly. The correct given name should be Hamed.

http://ift.tt/2BCvd2Z

Answer to the Letter to the Editor of Qi Sun et al. concerning “Robot-assisted and conventional freehand pedicle screw placement: a systematic review and meta-analysis of randomized controlled trials” by Gao ST, et al. (Eur Spine J; 2017: DOI 10.1007/s00586-017-5333-y)

http://ift.tt/2Gu9TQW

Factors affecting forwarder productivity

Abstract

Modern forwarders are an effective extraction option for timber harvesting operations that provide the opportunity for higher levels of mechanization. With their ability to carry logs from the forest to the roadside or processing areas, they have an established lower environmental impact in comparison to tree-length skidding options. However, little is published regarding their productivity potential or the factors that influence productivity. Three case studies were carried out; (1) a selective harvest in Calabria, Italy, with a smaller 12 t capacity John Deere 1110E, (2) a clear-cut on the West Coast of New Zealand, with a larger 19 t capacity John Deere 1910E and (3) a larger clear-cut operation in Canterbury, New Zealand, with two John Deere 1910E forwarders. An elemental time and motion study was used resulting in 73.4 h of detailed data, with 159 cycles extracting 2241 m³ of timber. Productivity models were created for all three sites as well as one combined model. Average cycle time was 33.2, 24.2 and 22.8 min, and average productivity 24.6, 37.1 and 42.7 t per productive machine hour, respectively. Cycle time was the fastest, and consequently productivity the highest, at the Canterbury site where the terrain roughness was low, overcoming any effect of the average small piece size (0.59 m³). Travel speed was slowest at the West Coast site showing the effect of wet and difficult terrain, with travel empty speed being just 3.8 km/h, compared to 6.7 and 6.9 km/h at the other two sites. Productivity at the two clear-cut operations was significantly higher than the selective cut, compounded by the use of the larger capacity forwarders. Distance and payload were significant factors for each cycle time model; in the combined model the sites were also significant. The calculated unit cost of forwarder extraction in the sites ranged from €2.55 to €4.70/m³. For regions such as southern Italy that have relatively low levels of forest mechanization, this information can be used to help design and improve more traditional labor-intensive harvesting systems.

http://ift.tt/2FvMvRF

Famous people recognition through personal name: a normative study

Abstract

In this normative study, we investigated famous people recognition through personal name, using as stimuli the names of the same 40 Italian famous persons whose faces and voices had been utilized for the normative study of the Famous People Recognition Battery. For each famous people, we assessed name familiarity, person identification (when the name had been considered as familiar), and false alarms. The investigation was carried out on 143 normal subjects who varied in age and education. Name familiarity and semantic scores were affected by educational level, whereas age influenced false alarms. A comparison between results obtained with names in this research and with faces and voices of the same famous people in our previous study showed that familiarity scores were higher for personal names than those for faces and voices, which obtained the worst scores. Person identification scores were not significantly different from names and from faces, but both these scores were significantly higher than the semantic scores obtained by voices. Taken together, these results are inconsistent with the influential interactive activation and competition model of person recognition.

http://ift.tt/2DLCsHH

Multiple brain metastases: a surgical series and neurosurgical perspective

Abstract

Despite review papers claim for radical treatment of oligometastatic patients, only few surgical series have been published. In this study, we analyze results and actual role of surgical resection for the management of patients with multiple brain metastases. This retrospective study compares surgical results of two groups of patients consecutively treated in our Institute from January 2004 to June 2015. The first group comprises all 32 patients with multiple brain metastases with only 2–3 lesions who underwent surgical resection of all lesions; the second group comprises 30 patients with a single surgically treated brain mestastasis compatible with the first group (match-paired control series). Median survival was 14.6 months for patients with multiple brain metastases (range 1–28 months) and 17.4 months for patients with a single brain metastasis (range 4–38 months); the difference was not statistically significant (P = 0.2). Neurological condition improved in 59.4% of patients with multiple metastases, it remained unchanged in 37.5% and worsened in 3.1%. In our series, selected patients with only 2–3 lesions with well-controlled systemic disease, life expectancy of more than 3 months, Karnofsky's performance status > 60, and surgically accessible lesions, benefited from surgical treatment in terms of survival and quality of life, with reduction or disappearance of significant neurological deficits. The prognosis for these patients is similar to that of patients with a single metastasis. It seems that patients with breast cancer included in our series had the worst prognosis if compared to other histotypes.

http://ift.tt/2Epf7wC

Assessment of Snaith-Hamilton Pleasure Scale (SHAPS): the dimension of anhedonia in Italian healthy sample

Abstract

The Snaith-Hamilton Pleasure Scale (SHAPS) is a rapid screening battery created for assessing the presence of anhedonia, namely the inability to experience pleasure. Although, this symptom has widely been investigated in clinical settings, individual differences in anhedonia are also present in healthy population. The aim of present study was to validate the translated Italian version of this test. One thousand six hundred ninety-seven consecutive healthy subjects (55% female) of different ages (age 18–82 years) underwent SHAPS. Participants who showed mild level of anhedonia also completed the Apathy Evaluation Scale (AES), Beck Depression Inventory (BDI), Toronto Alexithymia Scale-20 (TAS), Mood Disorders Insight Scale (MDIS), and Beck Hopelessness Scale (BHS). The SHAPS showed good internal consistency and discriminant validity; moreover, the factorial analysis highlighted that SHAPS had a three-factor structure for explaining the anhedonic construct. 14.9% showed a significant reduction of hedonic tone (SHAPS ≥ 3). Finally, the degree of anhedonia was significantly correlated with BDI and BHS scores, but not with age or gender. Although anhedonia is a prominent feature of many psychiatric and neurological disorders, the presence of this symptom in the healthy population highlighted the importance to develop reliable tool. SHAPS shows good psychometric properties to assess multidimensional anhedonia symptoms also in Italian healthy population.

http://ift.tt/2DO723t

Comparison of odor identification among amnestic and non-amnestic mild cognitive impairment, subjective cognitive decline, and early Alzheimer’s dementia

Abstract

Olfactory impairment might be an important clinical marker and predictor of Alzheimer's disease (AD). In the present study, we aimed to compare the degree of olfactory identification impairment in each mild cognitive impairment (MCI) subtype, subjective memory impairment, and early AD dementia and assessed the relationship between olfactory identification and cognitive performance. We consecutively included 50 patients with amnestic MCI, 28 patients with non-amnestic MCI, 20 patients with mild AD, and 17 patients with subjective memory impairment (SMI). All patients underwent clinical and neuropsychological assessments. A multiple choice olfactory identification cross-cultural smell identification test was also utilized. Controlling for age and gender, olfactory impairment was significantly more severe in patients with AD and amnestic MCI compared with the results from the non-amnestic MCI and SMI groups. Higher scores on MMSE, verbal and non-verbal memory, and frontal executive function tests were significantly related to olfactory identification ability. In conclusion, olfactory identification is impaired in amnestic MCI and AD. These findings are consistent with previous studies. In amnestic MCI patients, this dysfunction is considered to be caused by underlying AD pathology.

http://ift.tt/2EkZwy9

Broken dynasty: how Jean Batiste Charcot relinquished his father’s neurological empire to conquer the seven seas

Abstract

The authors review the relationship between Jean-Martin Charcot, the most celebrate Professor of Neurology of the XIX century, and his son, Jean-Baptiste Charcot, former a physician and neurologist and after Professor Charcot's death, a worldwide famous maritime explorer, the "Commander Charcot."

http://ift.tt/2DPcSBC

Cognitive Function of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder in a 2-Year Open-Label Study of Lisdexamfetamine Dimesylate

Abstract

Background

SPD489-404 was the first 2-year safety study of lisdexamfetamine dimesylate in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. In accordance with advice from the European Medicines Agency, assessment of cognitive function was a predefined safety outcome in SPD489-404.

Objective

The objective of this study was to assess cognitive function over 2 years in study SPD489-404, using the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Methods

Participants aged 6–17 years received dose-optimised open-label lisdexamfetamine dimesylate (30, 50 or 70 mg/day) for 104 weeks. Cognition was assessed using four CANTAB tasks; Delayed Matching to Sample (DMS), Spatial Working Memory (SWM), Stop Signal Task (SST) and Reaction Time (RTI). Key and additional variables were pre-specified for each CANTAB task; groupwise mean percentage changes in key variables from baseline of > 5% were considered potentially clinically significant.

Results

All 314 enrolled participants received lisdexamfetamine dimesylate and were included in the safety population, and 191 (60.8%) completed the study. No potentially clinically significant deteriorations from baseline were observed in any key CANTAB variable over the 2 years of the study. Based on predefined thresholds, potentially clinically significant improvements from baseline were observed at 6 months (DMS median reaction time, mean per cent change, − 6.6%; SWM total between-search errors, − 22.8%; SST stop signal reaction time, –18.9%), and at the last on-treatment assessment (DMS median reaction time, − 6.5%; SWM total between-search errors, − 32.6%; SST stop signal reaction time, − 25.7%).

Conclusions

Lisdexamfetamine dimesylate treatment for 2 years was not associated with deterioration of cognitive function in children and adolescents with attention-deficit/hyperactivity disorder. Although improvements in some cognitive measures were observed, lack of a control group makes interpretation of the findings difficult. Further studies of the impact of stimulants on cognition are required.

ClinicalTrials.gov identifier

NCT01328756.

http://ift.tt/2DN3L8W

Vitamin D and the Athlete: Current Perspectives and New Challenges

Abstract

The last decade has seen a dramatic increase in general interest in and research into vitamin D, with many athletes now taking vitamin D supplements as part of their everyday dietary regimen. The most recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship between vitamin D and bone health in non-athletic individuals. In contrast, data have consistently failed to demonstrate any relationship between serum 25[OH]D and bone health, which may in part be due to the osteogenic stimulus of exercise. Vitamin D may interact with extra-skeletal tissues such as muscle and the immune system to modulate recovery from damaging exercise and infection risk. Given that many athletes now engage in supplementation, often consuming extreme doses of vitamin D, it is important to assess whether excessive vitamin D can be detrimental to health. It has been argued that toxic effects only occur when serum 25[OH]D concentrations are greater than 180 nmol·l⁻¹, but data from our laboratory have suggested high-dose supplementation could be problematic. Finally, there is a paradoxical relationship between serum 25[OH]D concentration, ethnicity, and markers of bone health: Black athletes often present with low serum 25[OH]D without physiological consequences. One explanation for this could be genetic differences in vitamin D binding protein due to ethnicity, resulting in greater concentrations of bioavailable (or free) vitamin D in some ethnic groups. In the absence of any pathology, screening may be unnecessary and could result in incorrect supplementation. Data must now be re-examined, taking into consideration bioavailable or "free" vitamin D in ethnically diverse groups to enable new thresholds and target concentrations to be established; perhaps, for now, it is time to "set vitamin D free".

http://ift.tt/2Ftq7IL

Administration of Caffeine in Alternate Forms

Abstract

There has been recent interest in the ergogenic effects of caffeine delivered in low doses (~ 200 mg or ~ 3 mg/kg body mass) and administered in forms other than capsules, coffee and sports drinks, including chewing gum, bars, gels, mouth rinses, energy drinks and aerosols. Caffeinated chewing gum is absorbed quicker through the buccal mucosa compared with capsule delivery and absorption in the gut, although total caffeine absorption over time is not different. Rapid absorption may be important in many sporting situations. Caffeinated chewing gum improved endurance cycling performance, and there is limited evidence that repeated sprint cycling and power production may also be improved. Mouth rinsing with caffeine may stimulate nerves with direct links to the brain, in addition to caffeine absorption in the mouth. However, caffeine mouth rinsing has not been shown to have significant effects on cognitive performance. Delivering caffeine with mouth rinsing improved short-duration, high-intensity, repeated sprinting in normal and depleted glycogen states, while the majority of the literature indicates no ergogenic effect on aerobic exercise performance, and resistance exercise has not been adequately studied. Studies with caffeinated energy drinks have generally not examined the individual effects of caffeine on performance, making conclusions about this form of caffeine delivery impossible. Caffeinated aerosol mouth and nasal sprays may stimulate nerves with direct brain connections and enter the blood via mucosal and pulmonary absorption, although little support exists for caffeine delivered in this manner. Overall, more research is needed examining alternate forms of caffeine delivery including direct measures of brain activation and entry of caffeine into the blood, as well as more studies examining trained athletes and female subjects.

http://ift.tt/2E0KL68

Assessing the Role of Muscle Protein Breakdown in Response to Nutrition and Exercise in Humans

Abstract

Muscle protein breakdown (MPB) is an important metabolic component of muscle remodeling, adaptation to training, and increasing muscle mass. Degradation of muscle proteins occurs via the integration of three main systems—autophagy and the calpain and ubiquitin-proteasome systems. These systems do not operate independently, and the regulation is complex. Complete degradation of a protein requires some combination of the systems. Determination of MPB in humans is technically challenging, leading to a relative dearth of information. Available information on the dynamic response of MPB primarily comes from stable isotopic methods with expression and activity measures providing complementary information. It seems clear that resistance exercise increases MPB, but not as much as the increase in muscle protein synthesis. Both hyperaminoacidemia and hyperinsulinemia inhibit the post-exercise response of MPB. Available data do not allow a comprehensive examination of the mechanisms behind these responses. Practical nutrition recommendations for interventions to suppress MPB following exercise are often made. However, it is likely that some degree of increased MPB following exercise is an important component for optimal remodeling. At this time, it is not possible to determine the impact of nutrition on any individual muscle protein. Thus, until we can develop and employ better methods to elucidate the role of MPB following exercise and the response to nutrition, recommendations to optimize post exercise nutrition should focus on the response of muscle protein synthesis. The aim of this review is to provide a comprehensive examination of the state of knowledge, including methodological considerations, of the response of MPB to exercise and nutrition in humans.

http://ift.tt/2FqO57B

Protection Before Impact: the Potential Neuroprotective Role of Nutritional Supplementation in Sports-Related Head Trauma

Abstract

Even in the presence of underreporting, sports-related concussions/mild traumatic brain injuries (mTBI) are on the rise. In the absence of proper diagnosis, an athlete may return to play prior to full recovery, increasing the risk of second-impact syndrome or protracted symptoms. Recent evidence has demonstrated that sub-concussive impacts, those sustained routinely in practice and competition, result in a quantifiable pathophysiological response and the accumulation of both concussive and sub-concussive impacts sustained over a lifetime of sports participation may lead to long-term neurological impairments and an increased risk of developing neurodegenerative diseases. The pathophysiological, neurometabolic, and neurochemical cascade that initiates subsequent to the injury is complex and involves multiple mechanisms. While pharmaceutical treatments may target one mechanism, specific nutrients and nutraceuticals have been discovered to impact several pathways, presenting a broader approach. Several studies have demonstrated the neuroprotective effect of nutritional supplementation in the treatment of mTBI. However, given that many concussions go unreported and sub-concussive impacts result in a pathophysiological response that, too, may contribute to long-term brain health, protection prior to impact is warranted. This review discusses the current literature regarding the role of nutritional supplements that, when provided before mTBI and traumatic brain injury, may provide neurological protection.

http://ift.tt/2DZawUh

Focal disorders of the spine with compensatory deformities: how to define them

Abstract

Purpose

In this paper, the authors propose classifying the epiphenomenon of spinal deformity in two different categories: structural deformity, when the main driver of the observed deformity is a fixed and stiff alteration of the spinal segments, and compensatory deformity, which includes cases where the observed deformity is due to focal abnormalities. This last category comprises, but is not limited to, spinal stenosis, spondylolisthesis, disc herniation, infection or tumor, hip disease or neurological disease (such as Parkinson's disease).

Method

Narrative review article.

Results

We analyzed the focal diseases of the spine that may cause a compensatory deformity inducing adaptation in the unaffected part of the spine.

Conclusion

The compensatory mechanisms involved in adaptive deformity represent an attempt to maintain a global alignment, to escape from pain or to control body posture.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material.

http://ift.tt/2ns5vJp

102 lumbar pedicle subtraction osteotomies: one surgeon’s learning curve

Abstract

Purpose

Pedicle Subtraction Osteotomy (PSO) is an effective surgical technique for the correction of fixed sagittal malalignment of the spine. It is a demanding technique that requires a long learning curve. The aim of this study is to analyze a surgeon's learning curve for lumbar PSO in relation to the preoperative, perioperative, and postoperative management, with assessment of the global outcome.

Materials and methods

102 patients operated over an 8-year period were included, distributed in 3 groups over the time, and retrospectively analyzed. The following data were collected: demographic characteristics, preoperative and postoperative radiological parameters, operative technical details, and complications. Multiple regression analysis was performed, and while the number of cases was the predictor, other variables such as demographic, radiographical, and surgical variables were considered as a covariate in the final model.

Results

When comparing the first group and the last group of patients, the mean surgical time had decreased by 50 min, the estimated blood loss was decreased by 655 ml, and a significant decrease in dural tear occurrence was noticed. In addition, we found a significant decrease in the hospital stay length. Multivariate linear regression analysis showed that when the surgeon's experience doubles, the operative time decreases by 29 min, the blood loss by 281 ml, and the odds of hospital stay ≥ 21 days decrease by 0.66 times.

Conclusion

PSO technique has a relatively long learning curve. This study showed that accumulating the experience over the years, while performing cases on a regular basis, is definitely the key in mastering this complex and risky technique, with significant improvements in the perioperative parameters that directly impact the recovery and global outcome.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

http://ift.tt/2DN9FXj

Patient-Centered Values and Experiences with Emergency Department and Mental Health Crisis Care

Abstract

Little is known about what patients value in psychiatric crisis services or how they compare community-based services with those received in the emergency department. Three focus groups (n = 27) were held of participants who had received psychiatric crisis services in emergency departments or a community mental health center. Participants described care experiences and preferences. Focus groups were audio recorded, transcribed, and coded using a value-based lens. Themes included appreciation for feeling respected, basic comforts, and shared decision-making as foundations of quality care. Participants preferred the community mental health center. Research should address long-term outcomes to motivate change in psychiatric crisis care.

http://ift.tt/2nrTbJh

Trend and causes of neonatal mortality in a level III children’s hospital in Shanghai: a 15-year retrospective study

Abstract

Background

To determine the trend and causes of neonatal mortality in a large level III neonatal intensive care unit in Shanghai during a 15-year period.

Methods

This is a retrospective, single-centered study. All neonates who died during the period from January 1, 1999 to December 31, 2013 at Children's Hospital of Fudan University were included. We extracted relevant clinical information from their medical records, analyzed neonatal mortality rate and the characteristics of these patients, and compared neonatal deaths between different periods and populations.

Results

Among a total of 50,957 admissions during the study period, there were 929 neonatal deaths. The neonatal mortality rate was 1.82%. Trends in neonatal mortality rate showed an increase in the period from 1.0% in 2003 to 2.2% in 2013. The main causes of neonatal mortality were complications of preterm birth (33.6%), congenital anomalies (21.3%), infections (12.6%), and birth asphyxia (9.1%). The proportions of complications of preterm birth (P < 0.001) and congenital anomalies (P = 0.018) increased yearly, while the proportions of birth asphyxia (P < 0.001) and infections (P < 0.001) decreased. Proportions of deaths caused by birth asphyxia (P = 0.005) and infections (P < 0.001) were both higher in the migrating population than in the permanent residents.

Conclusions

Neonatal mortality rate increased from 2003 to 2013 in our study. The proportion of preterm infants in neonatal deaths also increased within the same period. Complications of preterm birth were the main cause of neonatal mortality and the percentage increased year by year. Neonates in the migrating population appeared to be at a higher risk of death during the neonatal period compared to those in the permanent residents, and efforts should be made towards improving perinatal care to prevent infections and birth asphyxia in this vulnerable population.

http://ift.tt/2DW7vnN

Pediatrics in China: challenges and prospects

http://ift.tt/2FtV9R1

Thoracic Imaging of Solid Tumor Patients Treated with Immune Checkpoint Inhibitors

Abstract

Purpose of Review

Immune checkpoint inhibitors harness the patient's own immune system to fight cancer. They are now approved for treating a number of solid malignancies, with more agents and indications expected in the coming months and years. Because of their unique mechanism of action, these agents may lead to unusual imaging appearances.

Recent Findings

Rare patients may experience pseudoprogression, whereby tumors may initially increase in size or number despite response to therapy. Many patients will experience autoimmune side effects including pneumonitis, which may lead to respiratory compromise and will necessitate cessation of therapy. Occasionally pneumonitis or a sarcoid-like reaction can mimic metastatic disease.

Summary

It is imperative that radiologists be aware of these unusual imaging manifestations in patients on immunotherapy so that they are able to assist oncologists in appropriately treating these patients. In particular, we urge caution in interpreting new or enlarging lesions, since these may not always mean progression of disease. Additionally, radiologists should look out for potential immune-related side effects of these therapies.

http://ift.tt/2EnRxQR

Effects of competition and climate variables on modelling height to live crown for three boreal tree species in Alberta, Canada

Abstract

Using tree data from permanent sample plots and climate data from the ClimateWNA model, mixed-effects height to live crown (HTC) models were developed for three boreal tree species in Alberta, Canada: trembling aspen (Populus tremuloides Michx.), lodgepole pine (Pinus contorta var. latifolia Engelm.) and white spruce (Picea glauca (Moench) Voss). Three model forms, the Wykoff model, a logistic model and an exponential model, were evaluated for each species. Tree height was the most significant predictor of HTC and was used in all models. In addition, we investigated the effects of competition and climatic variables on HTC modelling. Height–diameter ratio and either total stand basal area or basal area of coniferous trees were used as competition measures in the models. Different climate variables were evaluated, and spring degree-days below 0 °C, mean annual precipitation and summer heat–moisture index were incorporated into the aspen, lodgepole pine and white spruce models, respectively. Site index was only significant in lodgepole pine models. Residual variances were modelled as functions of tree height to account for heteroscedasticity still present in the mixed-effects models after the inclusion of random parameters. Based on model fitting and validation results as well as biological realism, the mixed-effects Wykoff models were the best for aspen and white spruce, and the mixed-effects logistic model was the best for lodgepole pine.

http://ift.tt/2DUsw2f

A method using uniform yellowing pigmentation to model the color perception of the elderly people

Abstract

As the usage of color images in presenting information via Web sites and smartphone applications increases, the color perception loss may affect the accuracy of the information when it is presented to elderly people. The earlier study considered non-uniform yellowing pigmentation model to mimic the color perception loss of elderly people. Recently, two clinical studies have shown that uniform yellowing pigmentation occurs on the human crystalline lens. In this paper, we propose a mathematical model using uniform yellowing pigmentation to mimic the color perception experienced by elderly people. The uniform yellowing pigmentation is formed using the measured transmittance functions of the LCD display and the spectral transmission factor. The uniform yellowing pigmentation formed is in agreement with the results of the clinical studies. Moreover, subjective evaluation showed that the results from the proposed method are closer to the clinical data and showed improvement when compared to the results from the non-uniform yellowing pigmentation method.

http://ift.tt/2DQIriM