Recent Stanford Publications in PubMed
- Biotic replacement and mass extinction of the Ediacara biota.Darroch SA, Sperling EA, Boag TH, Racicot RA, Mason SJ, Morgan AS, Tweedt S, Myrow P, Johnston DT, Erwin DH, Laflamme MProc Biol Sci
- Airway Gland Structure and Function.Widdicombe JH, Wine JJPhysiol Rev
- Novel Approach to a Giant External Iliac Vein Aneurysm Secondary to Posttraumatic Femoral Arteriovenous Fistula.Thompson PC, Ullery BW, Fleischmann D, Chandra VVasc Endovascular Surg
- Augmented Wnt-Signaling as a Therapeutic Tool to Prevent Ischemia and Reperfusion Injury in Liver: Preclinical Studies in a Mouse Model.Liu B, Zhang R, Tao G, Lehwald NC, Liu B, Koh Y, Sylvester KGLiver Transpl
- Predicting treatment response in posttraumatic stress disorder.Etkin AJ Clin Psychiatry
- Label-free characterization of vitrification-induced morphology changes in single-cell embryos with full-field optical coherence tomography.Zarnescu L, Leung MC, Abeyta M, Sudkamp H, Baer T, Behr B, Ellerbee AKJ Biomed Opt
- Glandular Proteome Identifies Antiprotease Cystatin C as a Critical Modulator of Airway Hydration and Clearance.Evans TI, Joo NS, Keiser NW, Yan Z, Tyler SR, Xie W, Zhang Y, Hsiao JJ, Cho HJ, Wright ME, Wine JJ, Engelhardt JFAm J Respir Cell Mol Biol
- Superselective Chemoembolization of HCC: Comparison of Short-term Safety and Efficacy between Drug-eluting LC Beads, QuadraSpheres, and Conventional Ethiodized Oil Emulsion.Duan F, Wang EQ, Lam MG, Abdelmaksoud MH, Louie JD, Hwang GL, Kothary N, Kuo WT, Hofmann LV, Sze DYRadiology
- Is Your Neighborhood Designed to Support Physical Activity? A Brief Streetscape Audit Tool.Sallis JF, Cain KL, Conway TL, Gavand KA, Millstein RA, Geremia CM, Frank LD, Saelens BE, Glanz K, King ACPrev Chronic Dis
- Conducting a Successful Practice Quality Improvement Project for American Board of Radiology Certification.Lee CS, Wadhwa V, Kruskal JB, Larson DBRadiographics
- Key Concepts of Patient Safety in Radiology.Larson DB, Kruskal JB, Krecke KN, Donnelly LFRadiographics
- Contemporaneous Dual Catalysis: Aldol Products from Non-Carbonyl Substrates.Trost BM, Tracy JSChemistry
- Children's Cancer and Environmental Exposures: Professional Attitudes and Practices.Zachek CM, Miller MD, Hsu C, Schiffman JD, Sallan S, Metayer C, Dahl GVJ Pediatr Hematol Oncol
- RESPONSE TO: LETTER TO THE EDITOR REGARDING COMPARISON OF PAIN SCORE REDUCTION USING TRIAMCINOLONE VS. BETAMETHASONE IN TRANSFORAMINAL EPIDURAL STEROID INJECTIONS FOR LUMBOSACRAL RADICULAR PAIN. MCCORMICK Z ET AL. AM J PHYS MED REHABIL 2015 APR 16 [EPUB AHEAD OF PRINT].McCormick Z, Kennedy DJ, Garvan C, Rivers E, Temme K, Margolis S, Zander E, Rohr A, Smith MC, Plastaras CAm J Phys Med Rehabil
- Rhesus disease: a major public health problem.Zipursky A, Bhutani VKLancet
- Novel mutations in PIEZO1 cause an autosomal recessive generalized lymphatic dysplasia with non-immune hydrops fetalis.Fotiou E, Martin-Almedina S, Simpson MA, Lin S, Gordon K, Brice G, Atton G, Jeffery I, Rees DC, Mignot C, Vogt J, Homfray T, Snyder MP, Rockson SG, Jeffery S, Mortimer PS, Mansour S, Ostergaard PNat Commun
- Tackling obesity: challenges ahead.Bodeker G, Kronenberg FLancet
- Magnetic resonance image features identify glioblastoma phenotypic subtypes with distinct molecular pathway activities.Itakura H, Achrol AS, Mitchell LA, Loya JJ, Liu T, Westbroek EM, Feroze AH, Rodriguez S, Echegaray S, Azad TD, Yeom KW, Napel S, Rubin DL, Chang SD, Harsh GR, Gevaert OSci Transl Med
- Remember…there is more to epilepsy than seizures!Kanner AM, Meador KJNeurology
- Smartphone apps for snoring.Camacho M, Robertson M, Abdullatif J, Certal V, Kram YA, Ruoff CM, Brietzke SE, Capasso RJ Laryngol Otol
- Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trial.van Nunen LX, Zimmermann FM, Tonino PA, Barbato E, Baumbach A, Engstrøm T, Klauss V, MacCarthy PA, Manoharan G, Oldroyd KG, Ver Lee PN, Van't Veer M, Fearon WF, De Bruyne B, Pijls NH, FAME Study InvestigatorsLancet
- Mapping epitopes of U1-70K autoantibodies at single-amino acid resolution.Haddon DJ, Jarrell JA, Diep VK, Wand HE, Price JV, Tangsombatvisit S, Credo GM, Mackey S, Dekker CL, Baechler EC, Liu CL, Varma M, Utz PJAutoimmunity
- The effect of gestational age at cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta-analysis.Kindinger LM, Poon LC, Cacciatore S, MacIntyre DA, Fox NS, Schuit E, Mol B, Liem S, Lim AC, Serra V, Perales A, Hermans F, Darzi A, Bennett P, Nicolaides KH, Teoh TGBJOG
- MOBE-ChIP: a large-scale chromatin immunoprecipitation assay for cell type-specific studies.Lau OS, Bergmann DCPlant J
- The Biology Behind the American College of Surgeons Oncology Group Z0011 Trial.Stone K, Wheeler AJJAMA Surg
- Distinct trafficking of cell surface and endosomal TIM-1 to the immune synapse.Echbarthi M, Zonca M, Mellwig R, Schwab Y, Kaplan GG, DeKruyff RH, Roda-Navarro P, Casasnovas JMTraffic
- Meta-analysis of Functional Neuroimaging of Major Depressive Disorder in Youth.Miller CH, Hamilton JP, Sacchet MD, Gotlib IHJAMA Psychiatry
- Improved MRI thermometry with multiple-echo spirals.Marx M, Butts Pauly KMagn Reson Med
- Inferior turbinate reconstruction using porcine small intestine submucosal xenograft demonstrates improved quality of life outcomes in patients with empty nose syndrome.Velasquez N, Huang Z, Humphreys IM, Nayak JVInt Forum Allergy Rhinol
- Immunocytochemical p63 expression discriminates between primary cutaneous follicle centre cell and diffuse large B-cell lymphoma-leg type, and is of the TAp63 isoform.Robson A, Shukur Z, Ally M, Kluk J, Liu K, Pincus L, Sahni D, Sundram U, Subtil A, Karai L, Kempf W, Schieke S, Coates PHistopathology
- The Past, Present, and Future of Nicotine Addiction Therapy.Prochaska JJ, Benowitz NLAnnu Rev Med
- Repeated Autologous Umbilical Cord Blood Infusions are Feasible and had No Acute Safety Issues in Young Babies with Congenital Hydrocephalus.Sun JM, Grant GA, McLaughlin C, Allison J, Fitzgerald A, Waters-Pick B, Kurtzberg JPediatr Res
- Members Only: Hypoxia-Induced Cell-Cycle Activation in Cardiomyocytes.Sharma A, Wu SMCell Metab
- Real-time observation of the initiation of RNA polymerase II transcription.Fazal FM, Meng CA, Murakami K, Kornberg RD, Block SMNature
- Revision total hip arthroplasty after removal of a fractured well-fixed extensively porous-coated femoral component using a trephine.Amanatullah DF, Siman H, Pallante GD, Haber DB, Sierra RJ, Trousdale RTBone Joint J
- Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFRct: outcome and resource impacts study.Douglas PS, Pontone G, Hlatky MA, Patel MR, Norgaard BL, Byrne RA, Curzen N, Purcell I, Gutberlet M, Rioufol G, Hink U, Schuchlenz HW, Feuchtner G, Gilard M, Andreini D, Jensen JM, Hadamitzky M, Chiswell K, Cyr D, Wilk A, Wang F, Rogers C, De Bruyne B, PLATFORM InvestigatorsEur Heart J
- Maintenance tocolysis with nifedipine in threatened preterm labour: 2-year follow up of the offspring in the APOSTEL II trial.van Vliet E, Seinen L, Roos C, Schuit E, Scheepers H, Bloemenkamp K, Duvekot JJ, van Eyck J, Kok JH, Lotgering FK, van Baar A, van Wassenaer-Leemhuis AG, Franssen MT, Porath MM, van der Post J, Franx A, Mol B, Oudijk MABJOG
- Missing teeth and pediatric obstructive sleep apnea.Guilleminault C, Abad VC, Chiu HY, Peters B, Quo SSleep Breath
- CORR Insights(®): Can Radiographs Predict the Use of Modular Stems in Developmental Dysplasia of the Hip?Huddleston JIClin Orthop Relat Res
- Tetraspanin CD81 promotes tumor growth and metastasis by modulating the functions of T regulatory and myeloid-derived suppressor cells.Vences-Catalan F, Rajapaksa R, Srivastava MK, Marabelle A, Kuo CC, Levy R, Levy SCancer Res
- Sustained Modafinil Treatment Effects on Control-Related Gamma Oscillatory Power in Schizophrenia.Minzenberg MJ, Yoon JH, Cheng Y, Carter CSNeuropsychopharmacology
- Insulin-like Growth Factor 1 and Adiponectin and Associations with Muscle Deficits, Disease Characteristics, and Treatments in Rheumatoid Arthritis.Baker JF, Von Feldt JM, Mostoufi-Moab S, Kim W, Taratuta E, Leonard MBJ Rheumatol
- A feasibility study on monitoring the evolution of apparent diffusion coefficient decrease during thermal ablation.Plata JC, Holbrook AB, Marx M, Salgaonkar V, Jones P, Pascal-Tenorio A, Bouley D, Diederich C, Sommer G, Pauly KBMed Phys
- A piecewise-focused high DQE detector for MV imaging.Star-Lack J, Shedlock D, Swahn D, Humber D, Wang A, Hirsh H, Zentai G, Sawkey D, Kruger I, Sun M, Abel E, Virshup G, Shin M, Fahrig RMed Phys
- Advances in hepatocellular carcinoma: Nonalcoholic steatohepatitis-related hepatocellular carcinoma.Khan FZ, Perumpail RB, Wong RJ, Ahmed AWorld J Hepatol
- Recruitment of adolescents for a smoking study: use of traditional strategies and social media.Rait MA, Prochaska JJ, Rubinstein MLTransl Behav Med
- Non-functional neuroendocrine tumors of the pancreas: Advances in diagnosis and management.Cloyd JM, Poultsides GAWorld J Gastroenterol
- Compromising the 19S proteasome complex protects cells from reduced flux through the proteasome.Tsvetkov P, Mendillo ML, Zhao J, Carette JE, Merrill PH, Cikes D, Varadarajan M, van Diemen FR, Penninger JM, Goldberg AL, Brummelkamp TR, Santagata S, Lindquist SElife
- Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies.Pasquini MC, Zhang MJ, Medeiros BC, Armand P, Hu ZH, Nishihori T, Aljurf MD, Akpek G, Cahn JY, Cairo MS, Cerny J, Copelan EA, Deol A, Freytes CO, Gale RP, Ganguly S, George B, Gupta V, Hale GA, Kamble RT, Klumpp TR, Lazarus HM, Luger SM, Liesveld JL, Litzow MR, Marks DI, Martino R, Norkin M, Olsson RF, Oran B, Pawarode A, Pulsipher MA, Ramanathan M, Reshef R, Saad AA, Saber W, Savani BN, Schouten HC, Ringdén O, Tallman MS, Uy GL, Wood WA, Wirk B, Pérez WS, Batiwalla M, Weisdorf DJBiol Blood Marrow Transplant
- Quantifying signaling pathway activation to monitor the quality of induced pluripotent stem cells.Makarev E, Fortney K, Litovchenko M, Braunewell KH, Zhavoronkov A, Atala AOncotarget
- Outcomes of active surveillance for the management of clinically localized prostate cancer in the prospective, multi-institutional Canary PASS cohort.Newcomb LF, Thompson IM, Boyer HD, Brooks JD, Carroll PR, Cooperberg MR, Dash A, Ellis WJ, Fazli L, Feng Z, Gleave ME, Kunju P, Lance RS, McKenney JK, Meng MV, Nicolas MM, Sanda MG, Simko J, So A, Tretiakova MS, Troyer DA, True LD, Vakar-Lopez F, Virgin J, Wagner AA, Wei JT, Zheng Y, Nelson PS, Lin DW, Canary Prostate Active Surveillance Study InvestigatorsJ Urol
- Multi-jet propulsion organized by clonal development in a colonial siphonophore.Costello JH, Colin SP, Gemmell BJ, Dabiri JO, Sutherland KRNat Commun
- Cis-regulatory RNA elements that regulate specialized ribosome activity.Xue S, Barna MRNA Biol
- Incidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett's Esophagus.Wolf WA, Pasricha S, Cotton C, Li N, Triadafilopoulos G, Muthusamy VR, Chmielewski GW, Corbett FS, Camara DS, Lightdale CJ, Wolfsen H, Chang KJ, Overholt BF, Pruitt RE, Ertan A, Komanduri S, Infantolino A, Rothstein RI, Shaheen NJGastroenterology
- BIOPHYSICS. Response to Comments on "Extreme electric fields power catalysis in the active site of ketosteroid isomerase".Fried SD, Boxer SGScience
- BIOPHYSICS. Comment on "Extreme electric fields power catalysis in the active site of ketosteroid isomerase".Natarajan A, Yabukarski F, Lamba V, Schwans JP, Sunden F, Herschlag DScience
- The Global Health Implications of e-Cigarettes.Chang AY, Barry MJAMA
- Gluten-Free Diet Regimens and Psychiatric Symptoms.Dell'Osso B, Elli LAm J Psychiatry
- Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer.Wu AJ, Bosch WR, Chang DT, Hong TS, Jabbour SK, Kleinberg LR, Mamon HJ, Thomas CR, Goodman KAInt J Radiat Oncol Biol Phys
- Is Equipment Development Stifling Innovation in Radiation Oncology?Brown JM, Adler JRInt J Radiat Oncol Biol Phys
- Evaluating three methods to encourage mentally competent older adults to assess their driving behavior.Uribe-Leitz T, Barmak LA, Park A, Howland J, Lee V, Lodato E, Driscoll C, Dechert T, Burke PAJ Trauma Acute Care Surg
- Coping Strategies Used by Adult Patients with Inflammatory Bowel Disease.Parekh NK, McMaster K, Nguyen DL, Shah S, Speziale A, Miller J, Melmed GSouth Med J
- Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development.Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Mérisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SL, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Lundeg G, Mkandawire NC, Raykar NP, Riesel JN, Rodas E, Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip WLancet
- Improvements in the early death rate among 9380 patients with acute myeloid leukemia after initial therapy: A SEER database analysis.Percival ME, Tao L, Medeiros BC, Clarke CACancer
- Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging Study.Farmer MA, Huang L, Martucci K, Yang CC, Maravilla KR, Harris RE, Clauw DJ, Mackey S, Ellingson BM, Mayer EA, Schaeffer AJ, Apkarian AV, MAPP Research NetworkJ Urol
- Short turn radius colonoscope in an anatomical model: retroflexed withdrawal and detection of hidden polyps.McGill SK, Kothari S, Friedland S, Chen A, Park WG, Banerjee SWorld J Gastroenterol
- Non-steroidal anti-inflammatory drugs use is associated with reduced risk of inflammation-associated cancers: NIH-AARP study.Shebl FM, Hsing AW, Park Y, Hollenbeck AR, Chu LW, Meyer TE, Koshiol JPLoS One
- Improved serotype-specific dengue virus detection in Trinidad and Tobago using a multiplex, real-time RT-PCR.Waggoner JJ, Sahadeo NS, Brown A, Mohamed-Hadley A, Hadley D, Carrington L, Carrington CV, Pinsky BADiagn Microbiol Infect Dis
- Development of the international thymic malignancy interest group international database: an unprecedented resource for the study of a rare group of tumors.Huang J, Ahmad U, Antonicelli A, Catlin AC, Fang W, Gomez D, Loehrer P, Lucchi M, Marom E, Nicholson A, Ruffini E, Travis W, Van Schil P, Wakelee H, Yao X, Detterbeck F, International Thymic Malignancy Interest Group International Database Committee and ContributorsJ Thorac Oncol
- Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans.Trockel M, Karlin BE, Taylor CB, Brown GK, Manber RSleep
- Pharmacologic therapy for acute pancreatitis.Kambhampati S, Park W, Habtezion AWorld J Gastroenterol
- Proceedings of the Fifth International Workshop on Advances in Electrocorticography.Ritaccio A, Brunner P, Gunduz A, Hermes D, Hirsch LJ, Jacobs J, Kamada K, Kastner S, Knight RT, Lesser RP, Miller K, Sejnowski T, Worrell G, Schalk GEpilepsy Behav
- SMART DOCS: a new patient-centered outcomes and coordinated-care management approach for the future practice of sleep medicine.Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JKSleep
- The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: a systematic review and meta-analysis.Camacho M, Riaz M, Capasso R, Ruoff CM, Guilleminault C, Kushida CA, Certal VSleep
- Ocular toxoplasmosis in the United States: recent and remote infections.Jones JL, Bonetti V, Holland GN, Press C, Sanislo SR, Khurana RN, Montoya JGClin Infect Dis
- A prospective evaluation of using IVUS during percutaneous superficial femoral artery interventions.Hitchner E, Zayed M, Varu V, Lee G, Aalami O, Zhou WAnn Vasc Surg
- Anatomic suitability of aortoiliac aneurysms for next generation branched systems.Pearce BJ, Varu VN, Glocker R, Novak Z, Jordan WD, Lee JTAnn Vasc Surg
- Computed tomography perfusion imaging in the selection of acute stroke patients to undergo emergent carotid endarterectomy.Devlin TG, Phade SV, Hutson RK, Fugate MW, Major GR, Albers GW, Sirelkhatim AA, Sapkota BL, Quartfordt SD, Baxter BWAnn Vasc Surg
- Cheese wire fenestration of a chronic juxtarenal dissection flap to facilitate proximal neck fixation during EVAR.Ullery BW, Chandra V, Dake M, Lee JTAnn Vasc Surg
- Stereotactic ablative radiotherapy for pulmonary oligometastases and oligometastatic lung cancer.Shultz DB, Filippi AR, Thariat J, Mornex F, Loo BW, Ricardi UJ Thorac Oncol
- Launching reappraisal: it's less common than you might think.Suri G, Whittaker K, Gross JJEmotion
- Increased functional connectivity between dorsal posterior parietal and ventral occipitotemporal cortex during uncertain memory decisions.Hutchinson JB, Uncapher MR, Wagner ADNeurobiol Learn Mem
Biotic replacement and mass extinction of the Ediacara biota.
Proc Biol Sci. 2015 Sep 7;282(1814)
Authors: Darroch SA, Sperling EA, Boag TH, Racicot RA, Mason SJ, Morgan AS, Tweedt S, Myrow P, Johnston DT, Erwin DH, Laflamme M
The latest Neoproterozoic extinction of the Ediacara biota has been variously attributed to catastrophic removal by perturbations to global geochemical cycles, 'biotic replacement' by Cambrian-type ecosystem engineers, and a taphonomic artefact. We perform the first critical test of the 'biotic replacement' hypothesis using combined palaeoecological and geochemical data collected from the youngest Ediacaran strata in southern Namibia. We find that, even after accounting for a variety of potential sampling and taphonomic biases, the Ediacaran assemblage preserved at Farm Swartpunt has significantly lower genus richness than older assemblages. Geochemical and sedimentological analyses confirm an oxygenated and non-restricted palaeoenvironment for fossil-bearing sediments, thus suggesting that oxygen stress and/or hypersalinity are unlikely to be responsible for the low diversity of communities preserved at Swartpunt. These combined analyses suggest depauperate communities characterized the latest Ediacaran and provide the first quantitative support for the biotic replacement model for the end of the Ediacara biota. Although more sites (especially those recording different palaeoenvironments) are undoubtedly needed, this study provides the first quantitative palaeoecological evidence to suggest that evolutionary innovation, ecosystem engineering and biological interactions may have ultimately caused the first mass extinction of complex life.
PMID: 26336166 [PubMed - as supplied by publisher]
Airway Gland Structure and Function.
Physiol Rev. 2015 Oct;95(4):1241-1319
Authors: Widdicombe JH, Wine JJ
Submucosal glands contribute to airway surface liquid (ASL), a film that protects all airway surfaces. Glandular mucus comprises electrolytes, water, the gel-forming mucin MUC5B, and hundreds of different proteins with diverse protective functions. Gland volume per unit area of mucosal surface correlates positively with impaction rate of inhaled particles. In human main bronchi, the volume of the glands is ∼50 times that of surface goblet cells, but the glands diminish in size and frequency distally. ASL and its trapped particles are removed from the airways by mucociliary transport. Airway glands have a tubuloacinar structure, with a single terminal duct, a nonciliated collecting duct, then branching secretory tubules lined with mucous cells and ending in serous acini. They allow for a massive increase in numbers of mucus-producing cells without replacing surface ciliated cells. Active secretion of Cl(-) and HCO3 (-) by serous cells produces most of the fluid of gland secretions. Glands are densely innervated by tonically active, mutually excitatory airway intrinsic neurons. Most gland mucus is secreted constitutively in vivo, with large, transient increases produced by emergency reflex drive from the vagus. Elevations of [cAMP]i and [Ca(2+)]i coordinate electrolyte and macromolecular secretion and probably occur together for baseline activity in vivo, with cholinergic elevation of [Ca(2+)]i being mainly responsive for transient increases in secretion. Altered submucosal gland function contributes to the pathology of all obstructive diseases, but is an early stage of pathogenesis only in cystic fibrosis.
PMID: 26336032 [PubMed - as supplied by publisher]
Novel Approach to a Giant External Iliac Vein Aneurysm Secondary to Posttraumatic Femoral Arteriovenous Fistula.
Vasc Endovascular Surg. 2015 Sep 2;
Authors: Thompson PC, Ullery BW, Fleischmann D, Chandra V
We describe a case of a 55-year-old male with a remote history of a gunshot wound to the left thigh who presented with a 1-year history of worsening high-output congestive heart failure, left lower extremity edema, and left lower abdominal discomfort. Diagnostic evaluation included a computed tomographic angiography (CTA) that demonstrated a fistulous communication between the left superficial femoral artery (SFA) and vein (SFV) as well as a 7.2-cm external iliac vein aneurysm. Given his symptomatology, an endovascular repair of his AVF was recommended, followed by antithrombotic therapy for his aneurysm. Three-month postoperative CTA confirmed AVF exclusion as well as a significant decrease in maximal diameter of the left external iliac vein aneurysm now measuring 24 mm. This case is the first reported successful mid-term repair of a iliac venous aneurysm in the setting of a traumatic arteriovenous fistula using an endovascular approach.
PMID: 26335991 [PubMed - as supplied by publisher]
Augmented Wnt-Signaling as a Therapeutic Tool to Prevent Ischemia and Reperfusion Injury in Liver: Preclinical Studies in a Mouse Model.
Liver Transpl. 2015 Sep 3;
Authors: Liu B, Zhang R, Tao G, Lehwald NC, Liu B, Koh Y, Sylvester KG
INTRODUCTION: The Wnt signaling pathway has established biologic roles in liver development, regeneration and carcinogenesis. Given the common need for cellular energy utilization in each of these processes, we hypothesized that Wnt signaling would directly regulate hepatocyte mitochondrial function.
METHODS: Mice were engineered to overexpress Wnt1 in hepatocytes under the control of a tetracycline analog. Wnt1 and wild type (WT) mice underwent ischemia reperfusion injury (IRI) to provide oxidative mitochondrial injury. AML12 hepatocytes were exposed to Wnt agonists for in vitro hypoxia reoxygenation (HR) experiments.
RESULTS: We observed stabilized mitochondrial membrane potential and reduced levels of hepatocyte apoptosis involving the mitochondrial pathway in Wnt1 mice compared to controls following IRI. Wnt1 mice also demonstrated increased mitochondrial DNA copy number, as well as increased tricarboxylic acid cycle activity and ATP levels indicating that mitochondrial function is preserved by Wnt1 overexpression following IRI. AML12 cells treated by Wnt3a or the GSK-3β inhibitor LiCl exposed to HR demonstrated decreased reactive oxygen species (ROS) and reduced apoptosis compared to controls. Increased nucleus-localized PGC-1α and phosphorylated SIRT1 was observed in both Wnt1+ mice as well as AML12 cells treated with Wnt3a or LiCl.
CONCLUSION: Activated Wnt-signaling protects hepatocytes against oxidative injury and apoptosis through mitochondrial stabilization and preserved oxidative phosphorylation function. Mechanistically, these effects are accompanied by an increase in phosphorylated SIRT1 and nucleus-localized PGC-1α. These findings expand the understanding of Wnt signaling biology in hepatocytes and suggest the potential for the therapeutic application of Wnt pathway manipulation in a variety of clinical applications including organ transplantation. This article is protected by copyright. All rights reserved.
PMID: 26335930 [PubMed - as supplied by publisher]
Predicting treatment response in posttraumatic stress disorder.
J Clin Psychiatry. 2015 Aug;76(8):e1035-e1036
Authors: Etkin A
PMID: 26335090 [PubMed - as supplied by publisher]
Label-free characterization of vitrification-induced morphology changes in single-cell embryos with full-field optical coherence tomography.
J Biomed Opt. 2015 Sep 1;20(9):96004
Authors: Zarnescu L, Leung MC, Abeyta M, Sudkamp H, Baer T, Behr B, Ellerbee AK
PMID: 26334977 [PubMed - as supplied by publisher]
Glandular Proteome Identifies Antiprotease Cystatin C as a Critical Modulator of Airway Hydration and Clearance.
Am J Respir Cell Mol Biol. 2015 Sep 3;
Authors: Evans TI, Joo NS, Keiser NW, Yan Z, Tyler SR, Xie W, Zhang Y, Hsiao JJ, Cho HJ, Wright ME, Wine JJ, Engelhardt JF
Defects in the CFTR chloride channel lead to viscous secretions from submucosal glands (SMGs) that cannot be properly hydrated and cleared by beating cilia in cystic fibrosis (CF) airways. The mechanisms by which CFTR, and the predominant epithelial sodium channel (ENaC), control the hydration and clearance of glandular secretions remain unclear. We used a proteomics approach to characterize the proteins contained in CF and non-CF SMG fluid droplets and found that differentially regulated proteases (cathepsin S and H) and their antiprotease (cystatin C) influenced the equilibration of fluid on the airway surface and tracheal mucociliary clearance (MCC). Contrary to prevailing models of airway hydration and clearance, cystatin C, or raising the airway surface liquid (ASL) pH, inhibited cathepsin-dependent ENaC-mediated fluid absorption, raised the height of ASL, and yet decreased MCC velocity. Importantly, coupling of both CFTR and ENaC activities were required for effective MCC and for effective ASL height equilibration following volume challenge. Cystatin C-inhibitable cathepsins controlled initial phases of ENaC-mediated fluid absorption, while CFTR activity was required to prevent ASL dehydration. Interestingly, CF airway epithelia absorbed fluid more slowly due to reduced cysteine protease activity in the ASL, but became abnormally dehydrated with time. Our findings demonstrate that following volume challenge, pH-dependent protease-mediated coupling of CFTR and ENaC activities are required for rapid fluid equilibration at the airway surface and effective MCC. These findings provide new insights into how glandular fluid secretions may be equilibrated at the airway surface and how this process may be impaired in CF.
PMID: 26334941 [PubMed - as supplied by publisher]
Superselective Chemoembolization of HCC: Comparison of Short-term Safety and Efficacy between Drug-eluting LC Beads, QuadraSpheres, and Conventional Ethiodized Oil Emulsion.
Radiology. 2015 Sep 3;:141417
Authors: Duan F, Wang EQ, Lam MG, Abdelmaksoud MH, Louie JD, Hwang GL, Kothary N, Kuo WT, Hofmann LV, Sze DY
Purpose To study the comparative short-term safety and efficacy of transcatheter arterial chemoembolization (TACE) with drug-eluting LC Beads loaded with doxorubicin (DEBDOX), doxorubicin-eluting QuadraSpheres (hqTACE), and conventional TACE using ethiodized oil for superselective C-arm computed tomography (CT)-guided treatment of hepatocellular carcinoma (HCC) after the onset of drug shortages. Materials and Methods From March 2010 to March 2011, 166 patients with HCC were treated with 232 superselective TACE procedures using C-arm cone-beam CT at one institution. Patients underwent treatment depending on the availability of materials after the onset of drug shortages. Conventional TACE with doxorubicin, cisplatin, and Ethiodol was performed for 159 procedures, DEBDOX TACE was performed for 47, and hqTACE was performed for 26. Toxicity and objective response were compared at 3 months after treatment. Data were stratified for the high-risk population (Child-Pugh class B, performance status 1, bilobar disease, and/or post-resection recurrence) and initial versus repeat treatment. Kruskal-Wallis H test, Mann-Whitney U test, and Fisher exact test were used to compare the groups, with Bonferroni correction where needed. Results Whole liver response rates trended higher for conventional TACE (conventional TACE, 65.4%; DEBDOX, 63.8%; hqTACE, 53.8%) (P = .085). Only minor trends for differences in toxicity were observed between the three groups. Low-risk patients had higher whole liver (P = .001) and treated lesion (P = .007) response rates when treated with conventional TACE, but no significant differences were seen for DEBDOX and hqTACE. Treatment-naive patients also had higher whole liver (P = .012) and treated lesion (P = .056) response rates. No advantages for drug-eluting microspheres were found. Conclusion Within statistical power limitations, overall toxicity and efficacy were equivalent in patients treated with LC Beads, QuadraSpheres, or ethiodized oil emulsions, including in high-risk patients, when performed superselectively with cone-beam C-arm CT guidance. (©) RSNA, 2015.
PMID: 26334787 [PubMed - as supplied by publisher]
Is Your Neighborhood Designed to Support Physical Activity? A Brief Streetscape Audit Tool.
Prev Chronic Dis. 2015;12:E141
Authors: Sallis JF, Cain KL, Conway TL, Gavand KA, Millstein RA, Geremia CM, Frank LD, Saelens BE, Glanz K, King AC
INTRODUCTION: Macro level built environment factors (eg, street connectivity, walkability) are correlated with physical activity. Less studied but more modifiable microscale elements of the environment (eg, crosswalks) may also affect physical activity, but short audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of a 15-item neighborhood environment audit tool with a full version of the tool to assess neighborhood design on physical activity in 4 age groups.
METHODS: From the 120-item Microscale Audit of Pedestrian Streetscapes (MAPS) measure of street design, sidewalks, and street crossings, we developed the 15-item version (MAPS-Mini) on the basis of associations with physical activity and attribute modifiability. As a sample of a likely walking route, MAPS-Mini was conducted on a 0.25-mile route from participant residences toward the nearest nonresidential destination for children (n = 758), adolescents (n = 897), younger adults (n = 1,655), and older adults (n = 367). Active transportation and leisure physical activity were measured with age-appropriate surveys, and accelerometers provided objective physical activity measures. Mixed-model regressions were conducted for each MAPS item and a total environment score, adjusted for demographics, participant clustering, and macrolevel walkability.
RESULTS: Total scores of MAPS-Mini and the 120-item MAPS correlated at r = .85. Total microscale environment scores were significantly related to active transportation in all age groups. Items related to active transport in 3 age groups were presence of sidewalks, curb cuts, street lights, benches, and buffer between street and sidewalk. The total score was related to leisure physical activity and accelerometer measures only in children.
CONCLUSION: The MAPS-Mini environment measure is short enough to be practical for use by community groups and planning agencies and is a valid substitute for the full version that is 8 times longer.
PMID: 26334713 [PubMed - as supplied by publisher]
Conducting a Successful Practice Quality Improvement Project for American Board of Radiology Certification.
Radiographics. 2015 Sep 4;:150024
Authors: Lee CS, Wadhwa V, Kruskal JB, Larson DB
Practice quality improvement (PQI) is a required component of the American Board of Radiology (ABR) Maintenance of Certification (MOC) cycle, with the goal to "improve the quality of health care through diplomate-initiated learning and quality improvement." The essential requirements of PQI projects include relevance to one's practice, achievability in one's clinical setting, results suited for repeat measurements during an ABR MOC cycle, and reasonable expectation to result in quality improvement (QI). PQI projects can be performed by a group or an individual or as part of a participating institution. Given the interdisciplinary nature of radiology, teamwork is critical to ensure patient safety and the success of PQI projects. Additionally, successful QI requires considerable investment of time and resources, coordination, organizational support, and individual engagement. Group PQI projects offer many advantages, especially in larger practices and for processes that cross organizational boundaries, whereas individual projects may be preferred in small practices or for focused projects. In addition to the three-phase "plan, do, study, act" model advocated by the ABR, there are several other improvement models, which are based on continuous data collection and rapid simultaneous testing of multiple interventions. When properly planned, supported, and executed, group PQI projects can improve the value and viability of a radiology practice. (©)RSNA, 2015.
PMID: 26334572 [PubMed - as supplied by publisher]
Key Concepts of Patient Safety in Radiology.
Radiographics. 2015 Sep 4;:140277
Authors: Larson DB, Kruskal JB, Krecke KN, Donnelly LF
Harm from medical error is a difficult challenge in health care, including radiology. Modern approaches to patient safety have shifted from a focus on individual performance and reaction to errors to development of robust systems and processes that create safety in organizations. Organizations that operate safely in high-risk environments have been termed high-reliability organizations. Such organizations tend to see themselves as being constantly bombarded by errors. Thus, the goal is not to eliminate human error but to develop strategies to prevent, identify, and mitigate errors and their effects before they result in harm. High-level reliability strategies focus on systems and organizational culture; intermediate-level reliability strategies focus on establishment of effective processes; low-level reliability strategies focus on individual performance. Although several classification schemes for human error exist, modern safety researchers caution against overreliance on error investigations to improve safety. Blaming individuals involved in adverse events when they had no intent to cause harm has been shown to undermine organizational safety. Safety researchers have coined the term just culture for the successful balance of individual accountability with accommodation for human fallibility and system deficiencies. Safety is inextricably intertwined with an organization's quality efforts. A quality management system that focuses on standardization, making errors visible, building in quality, and constantly stopping to fix problems results in a safer environment and engages personnel in a way that contributes to a culture of safety. (©)RSNA, 2015.
PMID: 26334571 [PubMed - as supplied by publisher]
Contemporaneous Dual Catalysis: Aldol Products from Non-Carbonyl Substrates.
Chemistry. 2015 Sep 3;
Authors: Trost BM, Tracy JS
The aldol reaction represents an important class of atom-economic carbon-carbon bond-forming reactions vital to modern organic synthesis. Despite the attention this reaction has received, issues related to chemo- and regioselectivity as well as reactivity of readily enolizable electrophiles remain. To help overcome these limitations, a new direct approach toward aldol products that does not rely upon carbonyl substrates is described. This approach employs room-temperature contemporaneous lanthanum/vanadium dual catalysis, whereby a vanadium-catalyzed 1,3-transposition of allenols is coupled with a lanthanum-catalyzed Meinwald rearrangement of epoxides in situ to directly form aldol products.
PMID: 26334442 [PubMed - as supplied by publisher]
Children's Cancer and Environmental Exposures: Professional Attitudes and Practices.
J Pediatr Hematol Oncol. 2015 Sep 2;
Authors: Zachek CM, Miller MD, Hsu C, Schiffman JD, Sallan S, Metayer C, Dahl GV
BACKGROUND: Epidemiologic studies worldwide have provided substantial evidence of the contributions of environmental exposures to the development of childhood cancer, yet this knowledge has not been integrated into the routine practice of clinicians who care for children with this disease. To identify the basis of this deficit, we sought to assess the environmental history-taking behavior and perceptions of environmental health among pediatric hematologists and oncologists.
PROCEDURE: A web-based survey was sent from June to October 2012 to 427 pediatric oncologists, fellows, and nurse practitioners from 20 US institutions, with an overall response rate of 45%.
RESULTS: Survey responses indicated that environmental exposures are of concern to clinicians. The vast majority of respondents (88%) reported receiving questions from families about the relationship between certain environmental exposures and the cancers they regularly treat. However, a lack of comfort with these topics seems to have limited their discussions with families about the role of environmental exposures in childhood cancer pathogenesis. Although 77% of respondents suspected that some of the cases they saw had an environmental origin, their methods of taking environmental histories varied widely. Over 90% of respondents believed that more knowledge of the associations between environmental exposures and childhood cancer would be helpful in addressing these issues with patients.
CONCLUSIONS: Although limited in size and representativeness of participating institutions, the results of this survey indicate a need for increased training for hematology/oncology clinicians about environmental health exposures related to cancer and prompt translation of emerging research findings in biomedical journals that clinicians read.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/.
PMID: 26334434 [PubMed - as supplied by publisher]
RESPONSE TO: LETTER TO THE EDITOR REGARDING COMPARISON OF PAIN SCORE REDUCTION USING TRIAMCINOLONE VS. BETAMETHASONE IN TRANSFORAMINAL EPIDURAL STEROID INJECTIONS FOR LUMBOSACRAL RADICULAR PAIN. MCCORMICK Z ET AL. AM J PHYS MED REHABIL 2015 APR 16 [EPUB AHEAD OF PRINT].
Am J Phys Med Rehabil. 2015 Sep 2;
Authors: McCormick Z, Kennedy DJ, Garvan C, Rivers E, Temme K, Margolis S, Zander E, Rohr A, Smith MC, Plastaras C
PMID: 26334424 [PubMed - as supplied by publisher]
Rhesus disease: a major public health problem.
Lancet. 2015 Aug 15;386(9994):651
Authors: Zipursky A, Bhutani VK
PMID: 26334154 [PubMed - as supplied by publisher]
Novel mutations in PIEZO1 cause an autosomal recessive generalized lymphatic dysplasia with non-immune hydrops fetalis.
Nat Commun. 2015;6:8085
Authors: Fotiou E, Martin-Almedina S, Simpson MA, Lin S, Gordon K, Brice G, Atton G, Jeffery I, Rees DC, Mignot C, Vogt J, Homfray T, Snyder MP, Rockson SG, Jeffery S, Mortimer PS, Mansour S, Ostergaard P
Generalized lymphatic dysplasia (GLD) is a rare form of primary lymphoedema characterized by a uniform, widespread lymphoedema affecting all segments of the body, with systemic involvement such as intestinal and/or pulmonary lymphangiectasia, pleural effusions, chylothoraces and/or pericardial effusions. This may present prenatally as non-immune hydrops. Here we report homozygous and compound heterozygous mutations in PIEZO1, resulting in an autosomal recessive form of GLD with a high incidence of non-immune hydrops fetalis and childhood onset of facial and four limb lymphoedema. Mutations in PIEZO1, which encodes a mechanically activated ion channel, have been reported with autosomal dominant dehydrated hereditary stomatocytosis and non-immune hydrops of unknown aetiology. Besides its role in red blood cells, our findings indicate that PIEZO1 is also involved in the development of lymphatic structures.
PMID: 26333996 [PubMed - in process]
Tackling obesity: challenges ahead.
Lancet. 2015 Aug 22;386(9995):740-1
Authors: Bodeker G, Kronenberg F
PMID: 26333974 [PubMed - in process]
Magnetic resonance image features identify glioblastoma phenotypic subtypes with distinct molecular pathway activities.
Sci Transl Med. 2015 Sep 2;7(303):303ra138
Authors: Itakura H, Achrol AS, Mitchell LA, Loya JJ, Liu T, Westbroek EM, Feroze AH, Rodriguez S, Echegaray S, Azad TD, Yeom KW, Napel S, Rubin DL, Chang SD, Harsh GR, Gevaert O
Glioblastoma (GBM) is the most common and highly lethal primary malignant brain tumor in adults. There is a dire need for easily accessible, noninvasive biomarkers that can delineate underlying molecular activities and predict response to therapy. To this end, we sought to identify subtypes of GBM, differentiated solely by quantitative magnetic resonance (MR) imaging features, that could be used for better management of GBM patients. Quantitative image features capturing the shape, texture, and edge sharpness of each lesion were extracted from MR images of 121 single-institution patients with de novo, solitary, unilateral GBM. Three distinct phenotypic "clusters" emerged in the development cohort using consensus clustering with 10,000 iterations on these image features. These three clusters-pre-multifocal, spherical, and rim-enhancing, names reflecting their image features-were validated in an independent cohort consisting of 144 multi-institution patients with similar tumor characteristics from The Cancer Genome Atlas (TCGA). Each cluster mapped to a unique set of molecular signaling pathways using pathway activity estimates derived from the analysis of TCGA tumor copy number and gene expression data with the PARADIGM (Pathway Recognition Algorithm Using Data Integration on Genomic Models) algorithm. Distinct pathways, such as c-Kit and FOXA, were enriched in each cluster, indicating differential molecular activities as determined by the image features. Each cluster also demonstrated differential probabilities of survival, indicating prognostic importance. Our imaging method offers a noninvasive approach to stratify GBM patients and also provides unique sets of molecular signatures to inform targeted therapy and personalized treatment of GBM.
PMID: 26333934 [PubMed - in process]
Remember…there is more to epilepsy than seizures!
Neurology. 2015 Sep 2;
Authors: Kanner AM, Meador KJ
PMID: 26333797 [PubMed - as supplied by publisher]
Smartphone apps for snoring.
J Laryngol Otol. 2015 Sep 3;:1-6
Authors: Camacho M, Robertson M, Abdullatif J, Certal V, Kram YA, Ruoff CM, Brietzke SE, Capasso R
OBJECTIVE: To identify and systematically evaluate user-friendly smartphone snoring apps.
METHODS: The Apple iTunes app store was searched for snoring apps that allow recording and playback. Snoring apps were downloaded, evaluated and rated independently by four authors. Two patients underwent polysomnography, and the data were compared with simultaneous snoring app recordings, and one patient used the snoring app at home.
RESULTS: Of 126 snoring apps, 13 met the inclusion and exclusion criteria. The most critical app feature was the ability to graphically display the snoring events. The Quit Snoring app received the highest overall rating. When this app's recordings were compared with in-laboratory polysomnography data, app snoring sensitivities ranged from 64 to 96 per cent, and snoring positive predictive values ranged from 93 to 96 per cent. A chronic snorer used the app nightly for one month and tracked medical interventions. Snoring decreased from 200 to 10 snores per hour, and bed partner snoring complaint scores decreased from 9 to 2 (on a 0-10 scale).
CONCLUSION: Select smartphone apps are user-friendly for recording and playing back snoring sounds. Preliminary comparison of more than 1500 individual snores demonstrates the potential clinical utility of such apps; however, further validation testing is recommended.
PMID: 26333720 [PubMed - as supplied by publisher]
Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trial.
Lancet. 2015 Aug 28;
Authors: van Nunen LX, Zimmermann FM, Tonino PA, Barbato E, Baumbach A, Engstrøm T, Klauss V, MacCarthy PA, Manoharan G, Oldroyd KG, Ver Lee PN, Van't Veer M, Fearon WF, De Bruyne B, Pijls NH, FAME Study Investigators
BACKGROUND: In the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) study, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) improved outcome compared with angiography-guided PCI for up to 2 years of follow-up. The aim in this study was to investigate whether the favourable clinical outcome with the FFR-guided PCI in the FAME study persisted over a 5-year follow-up.
METHODS: The FAME study was a multicentre trial done in Belgium, Denmark, Germany, the Netherlands, Sweden, the UK, and the USA. Patients (aged ≥18 years) with multivessel coronary artery disease were randomly assigned to undergo angiography-guided PCI or FFR-guided PCI. Before randomisation, stenoses requiring PCI were identified on the angiogram. Patients allocated to angiography-guided PCI had revascularisation of all identified stenoses. Patients allocated to FFR-guided PCI had FFR measurements of all stenotic arteries and PCI was done only if FFR was 0·80 or less. No one was masked to treatment assignment. The primary endpoint was major adverse cardiac events at 1 year, and the data for the 5-year follow-up are reported here. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00267774.
FINDINGS: After 5 years, major adverse cardiac events occurred in 31% of patients (154 of 496) in the angiography-guided group versus 28% (143 of 509 patients) in the FFR-guided group (relative risk 0·91, 95% CI 0·75-1·10; p=0·31). The number of stents placed per patient was significantly higher in the angiography-guided group than in the FFR-guided group (mean 2·7 [SD 1·2] vs 1·9 [1·3], p<0·0001).
INTERPRETATION: The results confirm the long-term safety of FFR-guided PCI in patients with multivessel disease. A strategy of FFR-guided PCI resulted in a significant decrease of major adverse cardiac events for up to 2 years after the index procedure. From 2 years to 5 years, the risks for both groups developed similarly. This clinical outcome in the FFR-guided group was achieved with a lower number of stented arteries and less resource use. These results indicate that FFR guidance of multivessel PCI should be the standard of care in most patients.
FUNDING: St Jude Medical, Friends of the Heart Foundation, and Medtronic.
PMID: 26333474 [PubMed - as supplied by publisher]
Mapping epitopes of U1-70K autoantibodies at single-amino acid resolution.
Autoimmunity. 2015 Sep 3;:1-11
Authors: Haddon DJ, Jarrell JA, Diep VK, Wand HE, Price JV, Tangsombatvisit S, Credo GM, Mackey S, Dekker CL, Baechler EC, Liu CL, Varma M, Utz PJ
The mechanisms underlying development of ribonucleoprotein (RNP) autoantibodies are unclear. The U1-70K protein is the predominant target of RNP autoantibodies, and the RNA binding domain has been shown to be the immunodominant autoantigenic region of U1-70K, although the specific epitopes are not known. To precisely map U1-70K epitopes, we developed silicon-based peptide microarrays with >5700 features, corresponding to 843 unique peptides derived from the U1-70K protein. The microarrays feature overlapping peptides, with single-amino acid resolution in length and location, spanning amino acids 110-170 within the U1-70K RNA binding domain. We evaluated the serum IgG of a cohort of patients with systemic lupus erythematosus (SLE; n = 26) using the microarrays, and identified multiple reactive epitopes, including peptides 116-121 and 143-148. Indirect peptide ELISA analysis of the sera of patients with SLE (n = 88) revealed that ∼14% of patients had serum IgG reactivity to 116-121, while reactivity to 143-148 appeared to be limited to a single patient. SLE patients with serum reactivity to 116-121 had significantly lower SLE Disease Activity Index (SLEDAI) scores at the time of sampling, compared to non-reactive patients. Minimal reactivity to the peptides was observed in the sera of healthy controls (n = 92). Competitive ELISA showed antibodies to 116-121 bind a common epitope in U1-70K (68-72) and the matrix protein M1 of human influenza B viruses. Institutional Review Boards approved this study. Knowledge of the precise epitopes of U1-70K autoantibodies may provide insight into the mechanisms of development of anti-RNP, identify potential clinical biomarkers and inform ongoing clinical trails of peptide-based therapeutics.
PMID: 26333287 [PubMed - as supplied by publisher]
The effect of gestational age at cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta-analysis.
BJOG. 2015 Sep 1;
Authors: Kindinger LM, Poon LC, Cacciatore S, MacIntyre DA, Fox NS, Schuit E, Mol B, Liem S, Lim AC, Serra V, Perales A, Hermans F, Darzi A, Bennett P, Nicolaides KH, Teoh TG
OBJECTIVE: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy.
DESIGN: Individual patient data (IPD) meta-analysis.
SETTING: International multicentre study.
POPULATION: Asymptomatic twin pregnancy.
METHODS: MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28(+0) , 28(+1) to 32(+0) , 32(+1) to 36(+0) , and ≥36(+1) weeks as a function of GA at screening and CL measurements.
MAIN OUTCOME MEASURES: Predicted probabilities for preterm birth at ≤28(+0) , 28(+1) to 32(+0) , and 32(+1) to 36(+0) .
RESULTS: A total of 6188 CL measurements were performed on 4409 twin pregnancies in 12 studies. Both GA at screening and CL had a significant and non-linear effect on GA at birth. The best prediction of birth at ≤28(+0) weeks was provided by screening at ≤18(+0) weeks (P < 0.001), whereas the best prediction of birth between 28(+1) and 36(+0) weeks was provided by screening at ≥24(+0) weeks (P < 0.001). Negative prediction value of 100% for birth at ≤28(+0) weeks is achieved at CL 65 mm and 43 mm at ultrasound GA at ≤18(+0) weeks and at 22(+1) to 24(+0) weeks, respectively.
CONCLUSION: In twin pregnancies, prediction of preterm birth depends on both CL and the GA at screening. When CL is <30 mm, screening at ≤18(+0) weeks is most predictive for birth at ≤28(+0) weeks. Later screening at >22(+0) weeks is most predictive of delivery at 28(+1) to 36(+0) weeks. In twins, we recommend CL screening in twins to commence from ≤18(+0) weeks.
TWEETABLE ABSTRACT: An individual patient meta-analysis assessing gestation and CL in the prediction of preterm birth in twins.
PMID: 26333191 [PubMed - as supplied by publisher]
MOBE-ChIP: a large-scale chromatin immunoprecipitation assay for cell type-specific studies.
Plant J. 2015 Sep 1;
Authors: Lau OS, Bergmann DC
Cell type-specific transcriptional regulators play critical roles in the generation and maintenance of multicellularity. Since they are often expressed at low levels, in vivo DNA-binding studies of these regulators by standard chromatin immunoprecipitation (ChIP) assays are technically challenging. We describe here an optimized ChIP protocol termed Maximized Objects for Better Enrichment (MOBE)-ChIP, which enhances the sensitivity of ChIP assays for detecting cell type-specific signals. The protocol, which is based on the disproportional increase of target signals over background at higher scales, uses substantially larger starting materials than conventional ChIPs to achieve high signal enrichment. This technique can capture weak binding events that are ambiguous in standard ChIP assays and is useful both in gene-specific and whole-genome analysis. This protocol has been optimized for Arabidopsis, but should be applicable to other model systems with minor modifications. The full procedure can be completed within 3 days. This article is protected by copyright. All rights reserved.
PMID: 26332947 [PubMed - as supplied by publisher]
The Biology Behind the American College of Surgeons Oncology Group Z0011 Trial.
JAMA Surg. 2015 Sep 2;:1
Authors: Stone K, Wheeler AJ
PMID: 26332793 [PubMed - as supplied by publisher]
Distinct trafficking of cell surface and endosomal TIM-1 to the immune synapse.
Traffic. 2015 Aug 31;
Authors: Echbarthi M, Zonca M, Mellwig R, Schwab Y, Kaplan GG, DeKruyff RH, Roda-Navarro P, Casasnovas JM
The T cell/transmembrane, mucin and immunoglobulin domain protein 1 (TIM-1) is a phosphatidlyserine (PtdSer) receptor and a T cell costimulatory molecule linked to the development of atopic diseases. TIM-1 locates preferentially in intracellular compartments. Here we show that in human and mouse lymphoid cells, TIM-1 localizes in different types of endosomes and that its domain structure is important for protein sorting to intracellular vesicles. The BALB/c mouse TIM-1 protein, which has a longer mucin domain, is sorted more efficiently to endosomes than the shorter C57BL/6 variant. High affinity ligands such as PtdSer increase the amount of cell surface TIM-1; the protein also polarizes toward cell contacts with apoptotic cells. The large pool of intracellular TIM-1 translocates to the immune synapse (IS) with the CD3-TCR (T cell receptor) complex and colocalizes to the central supramolecular activation clusters (cSMAC). In contrast, cell surface TIM-1 does not traffic to the IS, but is located away from it. The bipolar TIM-1 sorting observed during IS formation is determined by differences in its subcellular location, and might modulate antigen-driven immune responses.
PMID: 26332704 [PubMed - as supplied by publisher]
Meta-analysis of Functional Neuroimaging of Major Depressive Disorder in Youth.
JAMA Psychiatry. 2015 Sep 2;
Authors: Miller CH, Hamilton JP, Sacchet MD, Gotlib IH
Importance: Despite its high prevalence and morbidity, the underlying neural basis of major depressive disorder (MDD) in youth is not well understood.
Objectives: To identify in youth diagnosed as having MDD the most reliable neural abnormalities reported in existing functional neuroimaging studies and characterize their relations with specific psychological dysfunctions.
Data Sources: Searches were conducted in PubMed and Web of Science to identify relevant studies published from November 2006 through February 2015. The current analysis took place from August 21, 2014, to March 28, 2015.
Study Selection: We retained articles that conducted a comparison of youth aged 4 to 24 years diagnosed as having MDD and age-matched healthy controls using task-based functional magnetic resonance imaging and a voxelwise whole-brain approach.
Data Extraction and Synthesis: We extracted coordinates of brain regions exhibiting differential activity in youth with MDD compared with healthy control participants. Multilevel kernel density analysis was used to examine voxelwise between-group differences throughout the whole brain. Correction for multiple comparisons was performed by computing null hypothesis distributions from 10 000 Monte Carlo simulations and calculating the cluster size necessary to obtain the familywise error rate control at P < .05.
Main Outcomes and Measures: Abnormal levels of activation in youth diagnosed as having MDD compared with control participants during a variety of affective processing and executive functioning tasks.
Results: Compared with age-matched healthy control participants (n = 274), youth with MDD (n = 246) showed reliable patterns of abnormal activation, including the following task-general and task-specific effects: hyperactivation in subgenual anterior cingulate cortex (P < .05) and ventrolateral prefrontal cortex (P < .05) and hypoactivation in caudate (P < .01) across aggregated tasks; hyperactivation in thalamus (P < .03) and parahippocampal gyrus (P < .003) during affective processing tasks; hypoactivation in cuneus (P < .001), dorsal cingulate cortex (P < .05), and dorsal anterior insula (P < .05) during executive functioning tasks; hypoactivity in posterior insula (P < .005) during positive valence tasks; and hyperactivity in dorsolateral prefrontal cortex (P < .001) and superior temporal cortex (P < .003) during negative valence tasks.
Conclusions and Relevance: Altered activations in several distributed brain networks may help explain the following seemingly disparate symptoms of MDD in youth: hypervigilance toward emotional stimuli from the overactivation of central hubs in the subgenual anterior cingulate cortex and thalamus that lead to a cascade of other symptoms; ineffective emotion regulation despite increased activation of the dorsolateral prefrontal cortex and ventrolateral prefrontal cortex during affective processing, which may reverse across development or the clinical course; maladaptive rumination and poor executive control from difficulties shifting from default mode network activity to task-positive network activity during cognitively demanding tasks; and anhedonia from hypoactivation of the cuneus and posterior insula during reward processing.
PMID: 26332700 [PubMed - as supplied by publisher]
Improved MRI thermometry with multiple-echo spirals.
Magn Reson Med. 2015 Aug 29;
Authors: Marx M, Butts Pauly K
PURPOSE: Low-bandwidth PRF shift thermometry is used to guide HIFU ablation treatments. Low sampling bandwidth is needed for high signal-to-noise ratio with short acquisition times, but can lead to off-resonance artifacts. In this work, improved multiple-echo thermometry is presented that allows for high bandwidth and reduced artifacts. It is also demonstrated with spiral sampling, to improve the trade-off between resolution, speed, and measurement precision.
METHODS: Four multiple-echo thermometry sequences were tested in vivo, one using two-dimensional Fourier transform (2DFT) sampling and three using spirals. The spiral sequences were individually optimized for resolution, for speed, and for precision. Multifrequency reconstruction was used to correct for off-resonance spiral artifacts. Additionally, two different multiecho temperature reconstructions were compared.
RESULTS: Weighted combination of per-echo phase differences gave significantly better precision than least squares off-resonance estimation. Multiple-echo 2DFT sequence obtained precision similar to single-echo 2DFT, while greatly increasing sampling bandwidth. The multiecho spiral acquisitions achieved 2× better resolution, 2.9× better uncertainty, or 3.4× faster acquisition time, without negatively impacting the other two design parameters as compared to single-echo 2DFT.
CONCLUSION: Multiecho spiral thermometry greatly improves the capabilities of temperature monitoring, and could improve transcranial treatment monitoring capabilities. Magn Reson Med, 2015. © 2015 Wiley Periodicals, Inc.
PMID: 26332512 [PubMed - as supplied by publisher]
Inferior turbinate reconstruction using porcine small intestine submucosal xenograft demonstrates improved quality of life outcomes in patients with empty nose syndrome.
Int Forum Allergy Rhinol. 2015 Sep 2;
Authors: Velasquez N, Huang Z, Humphreys IM, Nayak JV
BACKGROUND: We describe the surgical technique for use of small intestine submucosal (SIS) xenograft implant for inferior turbinate reconstruction and report our early results in a pilot case series of patients suffering from symptoms consistent with empty nose syndrome (ENS).
METHODS: We report an observational prospective cohort study of ENS patients undergoing inferior turbinate reconstruction using porcine SIS xenograft. Effects of the procedure on quality of life (QOL) were assessed through serial 25-item Sino-Nasal Outcome Test (SNOT-25) scores and analyzed by 1-way analysis of variance (ANOVA) between the initial visit and 1, 4, and 12 weeks after surgery.
RESULTS: Three patients with ENS underwent inferior turbinate reconstruction. No unexpected complications were noted over the 12-week follow-up course. Despite mild partial reabsorption of the SIS implant, neoturbinates were maintained in all patients. The mean preoperative score SNOT-25 was 77.6 (maximum 125). The mean postoperative scores were 65 at 1 week, 57 at 4 weeks, and 55 at 12 weeks (p < 0.01). Furthermore, for the "difficulty with nasal breathing" and "nose is too open" subdomains, statistically significant improvement was also noted at weeks 4 and 12 postoperatively (p < 0.05 and p <0.01, respectively).
CONCLUSION: The use of porcine SIS xenograft for inferior turbinate reconstruction appears to be safe and effective in the treatment of patients diagnosed with ENS. This study demonstrates statistically significant improvement in global QOL metrics and nasal-specific subdomains following inferior turbinate reconstruction/neoturbinate creation for ENS as evaluated through serial SNOT-25 scores.
PMID: 26332403 [PubMed - as supplied by publisher]
Immunocytochemical p63 expression discriminates between primary cutaneous follicle centre cell and diffuse large B-cell lymphoma-leg type, and is of the TAp63 isoform.
Histopathology. 2015 Sep 2;
Authors: Robson A, Shukur Z, Ally M, Kluk J, Liu K, Pincus L, Sahni D, Sundram U, Subtil A, Karai L, Kempf W, Schieke S, Coates P
INTRODUCTION: The p63 gene shares structural and functional homologies with the p53 family of transcriptional activators, but differs in exhibiting a consistent expression pattern in normal tissues. Although p63 is rarely mutated in malignancy studies of primary human tumours and cell lines suggest p63 may promote tumour development. In non-Hodgkin's nodal lymphoma, TAp63 expression in follicular lymphoma (54%) and diffuse large B-cell lymphoma (34%) has been described and correlated with proliferative index. In this study, we analysed a series of primary cutaneous B-cell lymphomas for immunohistochemical expression of p63.
METHODS: 30 cases of diffuse large B-cell lymphoma leg type (pcDLBCLL) and 34 cases follicle centre cell lymphoma (pcFCCL) were stained using a generic antibody to p63, and a subset of these with an antibody specific for delta-Np63 isoform.
RESULTS: Results indicate a significant difference between pcDLBCLL (21/30) & pcFCCL(4/34) in p63 expression (p=0.000); expression correlated strongly with proliferation rate as assessed by Ki-67 (p= 0.015). None of the p63(+) cases tested expressed delta-Np63 isoform suggesting expression is of the TAP isoform.
CONCLUSION: Functional studies are required to clarify the significance of p63 overexpression in primary cutaneous B-cell lymphoma. This article is protected by copyright. All rights reserved.
PMID: 26332336 [PubMed - as supplied by publisher]
The Past, Present, and Future of Nicotine Addiction Therapy.
Annu Rev Med. 2015 Aug 26;
Authors: Prochaska JJ, Benowitz NL
The tobacco addiction treatment field is progressing through innovations in medication development, a focus on precision medicine, and application of new technologies for delivering support in real time and over time. This article reviews the evidence for combined and extended cessation pharmacotherapy and behavioral strategies including provider advice, individual counseling, group programs, the national quitline, websites and social media, and incentives. Healthcare policies are changing to offer cessation treatment to the broad population of smokers. With knowledge of the past and present, this review anticipates what is likely on the horizon in the clinical and public health effort to address tobacco addiction. Expected final online publication date for the Annual Review of Medicine Volume 67 is January 14, 2016. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
PMID: 26332005 [PubMed - as supplied by publisher]
Repeated Autologous Umbilical Cord Blood Infusions are Feasible and had No Acute Safety Issues in Young Babies with Congenital Hydrocephalus.
Pediatr Res. 2015 Sep 2;
Authors: Sun JM, Grant GA, McLaughlin C, Allison J, Fitzgerald A, Waters-Pick B, Kurtzberg J
BACKGROUND: Babies with congenital hydrocephalus often experience developmental disabilities due to brain injury associated with prolonged increased pressure on the developing brain parenchyma. Umbilical cord blood (CB) infusion has favorable effects in animal models of brain hypoxia and stroke and is being investigated in clinical trials of brain injury in both children and adults. We sought to establish the safety and feasibility of repeated intravenous infusions of autologous CB in young babies with congenital hydrocephalus.
METHODS: Infants with severe congenital hydrocephalus and an available qualified autologous CB unit traveled to Duke for evaluation and CB infusion. When possible, the CB unit was utilized for multiple infusions. Patient and CB data were obtained at the time of infusion and analyzed retrospectively.
RESULTS: From October 2006 to August 2014, 76 patients with congenital hydrocephalus received 143 autologous CB infusions. Most babies received repeated doses, for a total of two (n=45), three (n=18), or four (n=4) infusions. There were no infusion-related adverse events. As expected, all babies experienced developmental delays.
CONCLUSION: Cryopreserved CB products may be effectively manipulated to provide multiple CB doses. Repeated intravenous infusion of autologous CB is safe and feasible in young babies with congenital hydrocephalus.Pediatric Research (2015); doi:10.1038/pr.2015.161.
PMID: 26331765 [PubMed - as supplied by publisher]
Members Only: Hypoxia-Induced Cell-Cycle Activation in Cardiomyocytes.
Cell Metab. 2015 Sep 1;22(3):365-6
Authors: Sharma A, Wu SM
A low level of cardiomyocyte turnover occurs in the adult mammalian heart, but the source of these new cells remains unknown. Kimura et al., 2015 utilized a novel hypoxia-induced fate mapping system to identify a rare population of adult cardiomyocytes undergoing cell-cycle entry and expansion in healthy adult hearts and following ischemic injury.
PMID: 26331604 [PubMed - in process]
Real-time observation of the initiation of RNA polymerase II transcription.
Nature. 2015 Sep 2;
Authors: Fazal FM, Meng CA, Murakami K, Kornberg RD, Block SM
Biochemical and structural studies have shown that the initiation of RNA polymerase II transcription proceeds in the following stages: assembly of the polymerase with general transcription factors and promoter DNA in a 'closed' preinitiation complex (PIC); unwinding of about 15 base pairs of the promoter DNA to form an 'open' complex; scanning downstream to a transcription start site; synthesis of a short transcript, thought to be about 10 nucleotides long; and promoter escape. Here we have assembled a 32-protein, 1.5-megadalton PIC derived from Saccharomyces cerevisiae, and observe subsequent initiation processes in real time with optical tweezers. Contrary to expectation, scanning driven by the transcription factor IIH involved the rapid opening of an extended transcription bubble, averaging 85 base pairs, accompanied by the synthesis of a transcript up to the entire length of the extended bubble, followed by promoter escape. PICs that failed to achieve promoter escape nevertheless formed open complexes and extended bubbles, which collapsed back to closed or open complexes, resulting in repeated futile scanning.
PMID: 26331540 [PubMed - as supplied by publisher]
Revision total hip arthroplasty after removal of a fractured well-fixed extensively porous-coated femoral component using a trephine.
Bone Joint J. 2015 Sep;97-B(9):1192-6
Authors: Amanatullah DF, Siman H, Pallante GD, Haber DB, Sierra RJ, Trousdale RT
When fracture of an extensively porous-coated femoral component occurs, its removal at revision total hip arthroplasty (THA) may require a femoral osteotomy and the use of a trephine. The remaining cortical bone after using the trephine may develop thermally induced necrosis. A retrospective review identified 11 fractured, well-fixed, uncemented, extensively porous-coated femoral components requiring removal using a trephine with a minimum of two years of follow-up. The mean time to failure was 4.6 years (1.7 to 9.1, standard deviation (sd) 2.3). These were revised using a larger extensively porous coated component, fluted tapered modular component, a proximally coated modular component, or a proximal femoral replacement. The mean clinical follow-up after revision THA was 4.9 years (2 to 22, sd 3.1). The mean diameter of the femoral component increased from 12.7 mm (sd 1.9) to 16.2 mm (sd 3.4; p > 0.001). Two revision components had radiographic evidence of subsidence that remained radiographically stable at final follow-up. The most common post-operative complication was instability affecting six patients (54.5%) on at least one occasion. A total of four patients (36.4%) required further revision: three for instability and one for fracture of the revision component. There was no statistically significant difference in the mean Harris hip score before implant fracture (82.4; sd 18.3) and after trephine removal and revision THA (81.2; sd 14.8, p = 0.918). These findings suggest that removal of a fractured, well-fixed, uncemented, extensively porous-coated femoral component using a trephine does not compromise subsequent fixation at revision THA and the patient's pre-operative level of function can be restored. However, the loss of proximal bone stock before revision may be associated with a high rate of dislocation post-operatively. Cite this article: Bone Joint J 2015;97-B:1192-6.
PMID: 26330584 [PubMed - in process]
Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFRct: outcome and resource impacts study.
Eur Heart J. 2015 Sep 1;
Authors: Douglas PS, Pontone G, Hlatky MA, Patel MR, Norgaard BL, Byrne RA, Curzen N, Purcell I, Gutberlet M, Rioufol G, Hink U, Schuchlenz HW, Feuchtner G, Gilard M, Andreini D, Jensen JM, Hadamitzky M, Chiswell K, Cyr D, Wilk A, Wang F, Rogers C, De Bruyne B, PLATFORM Investigators
AIMS: In symptomatic patients with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) improves patient selection for invasive coronary angiography (ICA) compared with functional testing. The impact of measuring fractional flow reserve by CTA (FFRCT) is unknown.
METHODS AND RESULTS: At 11 sites, 584 patients with new onset chest pain were prospectively assigned to receive either usual testing (n = 287) or CTA/FFRCT (n = 297). Test interpretation and care decisions were made by the clinical care team. The primary endpoint was the percentage of those with planned ICA in whom no significant obstructive CAD (no stenosis ≥50% by core laboratory quantitative analysis or invasive FFR < 0.80) was found at ICA within 90 days. Secondary endpoints including death, myocardial infarction, and unplanned revascularization were independently and blindly adjudicated. Subjects averaged 61 ± 11 years of age, 40% were female, and the mean pre-test probability of obstructive CAD was 49 ± 17%. Among those with intended ICA (FFRCT-guided = 193; usual care = 187), no obstructive CAD was found at ICA in 24 (12%) in the CTA/FFRCT arm and 137 (73%) in the usual care arm (risk difference 61%, 95% confidence interval 53-69, P< 0.0001), with similar mean cumulative radiation exposure (9.9 vs. 9.4 mSv, P = 0.20). Invasive coronary angiography was cancelled in 61% after receiving CTA/FFRCT results. Among those with intended non-invasive testing, the rates of finding no obstructive CAD at ICA were 13% (CTA/FFRCT) and 6% (usual care; P = 0.95). Clinical event rates within 90 days were low in usual care and CTA/FFRCT arms.
CONCLUSIONS: Computed tomographic angiography/fractional flow reserve by CTA was a feasible and safe alternative to ICA and was associated with a significantly lower rate of invasive angiography showing no obstructive CAD.
PMID: 26330417 [PubMed - as supplied by publisher]
Maintenance tocolysis with nifedipine in threatened preterm labour: 2-year follow up of the offspring in the APOSTEL II trial.
BJOG. 2015 Aug 27;
Authors: van Vliet E, Seinen L, Roos C, Schuit E, Scheepers H, Bloemenkamp K, Duvekot JJ, van Eyck J, Kok JH, Lotgering FK, van Baar A, van Wassenaer-Leemhuis AG, Franssen MT, Porath MM, van der Post J, Franx A, Mol B, Oudijk MA
OBJECTIVE: To evaluate long-term effects of maintenance tocolysis with nifedipine on neurodevelopmental outcome of the infant.
DESIGN, SETTING AND POPULATION: Follow up of infants of women who participated in a multicentre randomised controlled trial on maintenance tocolysis with nifedipine versus placebo.
METHODS: Two years after the APOSTEL II trial on maintenance tocolysis with nifedipine versus placebo, we asked participants to complete the Ages and Stages Questionnaire.
MAIN OUTCOME MEASURES: Infant development was measured in five domains. Developmental delay was defined as a score of ≤1 SD in one or more developmental domains. We performed exploratory subgroup analysis in women with preterm prolonged rupture of the membranes, and in women with a cervical length <10 mm at study entry.
RESULTS: Of the 276 women eligible for follow up, 135 (52.5%) returned the questionnaire, encompassing data of 170 infants. At 2 years of age, infants of women with nifedipine maintenance tocolysis compared with placebo had a higher overall incidence of fine motor problems (22.2 versus 7.6%, OR 3.43, 95% CI 1.29-9.14, P = 0.01), and a lower incidence of poor problem-solving (21.1 versus 29.1%, OR 0.27, 95% CI 0.08-0.95, P = 0.04).
CONCLUSIONS: This follow-up study revealed no clear benefit of nifedipine maintenance tocolysis at 2 years of age. As short-term adverse perinatal outcome was not reduced in the original APOSTEL II trial, we conclude that maintenance tocolysis does not appear to be beneficial at this time.
TWEETABLE ABSTRACT: No clear benefit of nifedipine maintenance tocolysis in preterm labour on 2-year infant outcome.
PMID: 26330379 [PubMed - as supplied by publisher]
Missing teeth and pediatric obstructive sleep apnea.
Sleep Breath. 2015 Sep 2;
Authors: Guilleminault C, Abad VC, Chiu HY, Peters B, Quo S
BACKGROUND: Missing teeth in early childhood can result in abnormal facial morphology with narrow upper airway. The potential association between dental agenesis or early dental extractions and the presence of obstructive sleep apnea (OSA) was investigated.
METHODS: We reviewed clinical data, results of polysomnographic sleep studies, and orthodontic imaging studies of children with dental agenesis (n = 32) or early extraction of permanent teeth (n = 11) seen during the past 5 years and compared their findings to those of age-, gender-, and body mass index-matched children with normal teeth development but tonsilloadenoid (T&A) hypertrophy and symptoms of OSA (n = 64).
RESULTS: The 31 children with dental agenesis and 11 children with early dental extractions had at least 2 permanent teeth missing. All children with missing teeth (n = 43) had clinical complaints and signs evoking OSA. There was a significant difference in mean apnea-hypopnea indices (AHI) in the three dental agenesis, dental extraction, and T&A studied groups (p < 0.001), with mean abnormal AHI lowest in the pediatric dental agenesis group. In the children with missing teeth (n = 43), aging was associated with the presence of a higher AHI (R (2) = 0.71, p < 0.0001).
CONCLUSION: Alveolar bone growth is dependent on the presence of the teeth that it supports. The dental agenesis in the studied children was not part of a syndrome and was an isolated finding. Our children with permanent teeth missing due to congenital agenesis or permanent teeth extraction had a smaller oral cavity, known to predispose to the collapse of the upper airway during sleep, and presented with OSA recognized at a later age. Due to the low-grade initial symptomatology, sleep-disordered breathing may be left untreated for a prolonged period with progressive worsening of symptoms over time.
PMID: 26330227 [PubMed - as supplied by publisher]
CORR Insights(®): Can Radiographs Predict the Use of Modular Stems in Developmental Dysplasia of the Hip?
Clin Orthop Relat Res. 2015 Sep 2;
Authors: Huddleston JI
PMID: 26329793 [PubMed - as supplied by publisher]
Tetraspanin CD81 promotes tumor growth and metastasis by modulating the functions of T regulatory and myeloid-derived suppressor cells.
Cancer Res. 2015 Sep 1;
Authors: Vences-Catalan F, Rajapaksa R, Srivastava MK, Marabelle A, Kuo CC, Levy R, Levy S
Tumor cells counteract innate and adaptive antitumor immune responses by recruiting regulatory T cells (Treg) and innate myeloid-derived suppressor cells (MDSC), which facilitate immune escape and metastatic dissemination. Here we report a role in these recruitment processes for CD81, a member of the tetraspanin family of proteins that have been implicated previously in cancer progression. We found that genetic deficiency in CD81 reduced tumor growth and metastasis in two genetic mouse backgrounds and multiple tumor models. Mechanistic investigations revealed that CD81 was not required for normal development of Treg and MDSC but was essential for immunosuppressive functions. Notably, adoptive transfer of wildtype Treg into CD81-deficient mice was sufficient to promote tumor growth and metastasis. Our findings suggested that CD81 modulates adaptive and innate immune responses, warranting further investigation of CD81 in immunomodulation in cancer and its progression.
PMID: 26329536 [PubMed - as supplied by publisher]
Sustained Modafinil Treatment Effects on Control-Related Gamma Oscillatory Power in Schizophrenia.
Neuropsychopharmacology. 2015 Sep 2;
Authors: Minzenberg MJ, Yoon JH, Cheng Y, Carter CS
Control-related cognitive processes such as rule-selection and maintenance are associated with cortical oscillations in the gamma range, and modulated by catecholamine neurotransmission. Control-related gamma power is impaired in schizophrenia, and an understudied treatment target. It remains unknown whether pro-catecholamine pharmacological agents augment control-related gamma oscillations in schizophrenia. We tested the effects of 4-week fixed-dose daily adjunctive modafinil (MOD) 200 mg, in a randomized double-blind, placebo-controlled, parallel-groups design. 27 stable schizophrenia patients performed a cognitive control task during EEG, at baseline and after 4 weeks of treatment. EEG data underwent time-frequency decomposition with Morlet wavelets to determine power of 4-80 Hz oscillations. The modafinil group (n=14), relative to placebo group (n=13), exhibited enhanced oscillatory power associated with high-control rule-selection in the gamma range after treatment, with additional effects during rule maintenance in gamma and sub-gamma ranges. MOD-treated patients who exhibited improved task performance with treatment also showed greater treatment-related delay-period gamma compared to MOD-treated patients without improved performance. This is the first evidence in schizophrenia of augmentation of cognition-related gamma oscillations by an FDA-approved agent with therapeutic potential. Gamma oscillations represent a novel treatment target in this disorder, and modulation of catecholamine signaling may represent a viable strategy at this target.Neuropsychopharmacology accepted article preview online, 02 September 2015. doi:10.1038/npp.2015.271.
PMID: 26329382 [PubMed - as supplied by publisher]
Insulin-like Growth Factor 1 and Adiponectin and Associations with Muscle Deficits, Disease Characteristics, and Treatments in Rheumatoid Arthritis.
J Rheumatol. 2015 Sep 1;
Authors: Baker JF, Von Feldt JM, Mostoufi-Moab S, Kim W, Taratuta E, Leonard MB
OBJECTIVE: Rheumatoid arthritis (RA) is associated with low muscle mass and density. The objective of our study was to evaluate associations between 2 serum biomarkers [insulin-like growth factor 1 (IGF-1) and adiponectin] and skeletal muscle in RA.
METHODS: Whole-body dual energy X-ray absorptiometry measures of the appendicular lean mass index (ALMI; kg/m(2)) and total fat mass index (kg/m(2)), as well as the peripheral quantitative computed tomography measures of the lower leg muscle and fat cross-sectional area (CSA; cm(2)) and muscle density (an index of fat infiltration) were obtained from 50 participants with RA, ages 18-70 years. Multivariable linear regression analyses evaluated associations between body composition and levels of adiponectin and IGF-1, adjusted for age, sex, and adiposity.
RESULTS: Greater age was associated with higher adiponectin (p = 0.06) and lower IGF-1 (p = 0.004). Eight subjects had IGF-1 levels below the reference range for their age and sex. These subjects had significantly lower ALMI and muscle CSA in multivariable models. Lower IGF-1 levels were associated with greater clinical disease activity and severity, as well as low ALMI, muscle CSA, and muscle density (defined as 1 SD below normative mean). After adjusting for age and sex, greater adiponectin levels were associated with lower BMI (p = 0.02) as well as lower ALMI, and lower muscle CSA, independent of adiposity (p < 0.05). Only greater Health Assessment Questionnaire scores were significantly associated with lower adiponectin levels.
CONCLUSION: Low IGF-1 and greater adiponectin levels are associated with lower muscle mass in RA. Lower IGF-1 levels were seen in subjects with greater disease activity and severity.
PMID: 26329340 [PubMed - as supplied by publisher]
A feasibility study on monitoring the evolution of apparent diffusion coefficient decrease during thermal ablation.
Med Phys. 2015 Sep;42(9):5130
Authors: Plata JC, Holbrook AB, Marx M, Salgaonkar V, Jones P, Pascal-Tenorio A, Bouley D, Diederich C, Sommer G, Pauly KB
PURPOSE: Evaluate whether a decrease in apparent diffusion coefficient (ADC), associated with loss of tissue viability (LOTV), can be observed during the course of thermal ablation of the prostate.
METHODS: Thermal ablation was performed in a healthy in vivo canine prostate model (N = 2, ages: 5 yr healthy, mixed breed, weights: 13-14 kg) using a transurethral high-intensity ultrasound catheter and was monitored using a strategy that interleaves diffusion weighted images and gradient-echo images. The two sequences were used to measure ADC and changes in temperature during the treatment. Changes in temperature were used to compute expected changes in ADC. The difference between expected and measured ADC, ADCDIFF, was analyzed in regions ranging from moderate hyperthermia to heat fixation. A receiver operator characteristic (ROC) curve analysis was used to select a threshold of detection of LOTV. Time of threshold activation, tLOTV, was compared with time to reach CEM43 = 240, tDOSE.
RESULTS: The observed relationship between temperature and ADC in vivo (2.2%/ °C, 1.94%-2.47%/ °C 95% confidence interval) was not significantly different than the previously reported value of 2.4%/ °C in phantom. ADCDIFF changes after correction for temperature showed a mean decrease of 25% in ADC 60 min post-treatment in regions where sufficient thermal dose (CEM43 > 240) was achieved. Following our ROC analysis, a threshold of 2.25% decrease in ADCDIFF for three consecutive time points was chosen as an indicator of LOTV. The ADCDIFF was found to decrease quickly (1-2 min) after reaching CEM43 = 240 in regions associated with heat fixation and more slowly (10-20 min) in regions that received slower heating.
CONCLUSIONS: Simultaneous monitoring of ADC and temperature during treatment might allow for a more complete tissue viability assessment of ablative thermal treatments in the prostate. ADCDIFF decreases during the course of treatment may be interpreted as loss of tissue viability.
PMID: 26328964 [PubMed - in process]
A piecewise-focused high DQE detector for MV imaging.
Med Phys. 2015 Sep;42(9):5084
Authors: Star-Lack J, Shedlock D, Swahn D, Humber D, Wang A, Hirsh H, Zentai G, Sawkey D, Kruger I, Sun M, Abel E, Virshup G, Shin M, Fahrig R
PURPOSE: Electronic portal imagers (EPIDs) with high detective quantum efficiencies (DQEs) are sought to facilitate the use of the megavoltage (MV) radiotherapy treatment beam for image guidance. Potential advantages include high quality (treatment) beam's eye view imaging, and improved cone-beam computed tomography (CBCT) generating images with more accurate electron density maps with immunity to metal artifacts. One approach to increasing detector sensitivity is to couple a thick pixelated scintillator array to an active matrix flat panel imager (AMFPI) incorporating amorphous silicon thin film electronics. Cadmium tungstate (CWO) has many desirable scintillation properties including good light output, a high index of refraction, high optical transparency, and reasonable cost. However, due to the 0 1 0 cleave plane inherent in its crystalline structure, the difficulty of cutting and polishing CWO has, in part, limited its study relative to other scintillators such as cesium iodide and bismuth germanate (BGO). The goal of this work was to build and test a focused large-area pixelated "strip" CWO detector.
METHODS: A 361 × 52 mm scintillator assembly that contained a total of 28 072 pixels was constructed. The assembly comprised seven subarrays, each 15 mm thick. Six of the subarrays were fabricated from CWO with a pixel pitch of 0.784 mm, while one array was constructed from BGO for comparison. Focusing was achieved by coupling the arrays to the Varian AS1000 AMFPI through a piecewise linear arc-shaped fiber optic plate. Simulation and experimental studies of modulation transfer function (MTF) and DQE were undertaken using a 6 MV beam, and comparisons were made between the performance of the pixelated strip assembly and the most common EPID configuration comprising a 1 mm-thick copper build-up plate attached to a 133 mg/cm(2) gadolinium oxysulfide scintillator screen (Cu-GOS). Projection radiographs and CBCT images of phantoms were acquired. The work also introduces the use of a lightweight edge phantom to generate MTF measurements at MV energies and shows its functional equivalence to the more cumbersome slit-based method.
RESULTS: Measured and simulated DQE(0)'s of the pixelated CWO detector were 22% and 26%, respectively. The average measured and simulated ratios of CWO DQE(f) to Cu-GOS DQE(f) across the frequency range of 0.0-0.62 mm(-1) were 23 and 29, respectively. 2D and 3D imaging studies confirmed the large dose efficiency improvement and that focus was maintained across the field of view. In the CWO CBCT images, the measured spatial resolution was 7 lp/cm. The contrast-to-noise ratio was dramatically improved reflecting a 22 × sensitivity increase relative to Cu-GOS. The CWO scintillator material showed significantly higher stability and light yield than the BGO material.
CONCLUSIONS: An efficient piecewise-focused pixelated strip scintillator for MV imaging is described that offers more than a 20-fold dose efficiency improvement over Cu-GOS.
PMID: 26328960 [PubMed - in process]
Advances in hepatocellular carcinoma: Nonalcoholic steatohepatitis-related hepatocellular carcinoma.
World J Hepatol. 2015 Aug 28;7(18):2155-61
Authors: Khan FZ, Perumpail RB, Wong RJ, Ahmed A
An increase in the prevalence of obesity and diabetes mellitus has been associated with the rise in nonalcoholic fatty liver disease (NAFLD). Two-thirds of the obese and diabetic populations are estimated to develop NAFLD. Currently, NAFLD is the most common etiology for chronic liver disease globally. The clinical spectrum of NAFLD ranges from simple steatosis, an accumulation of fat greater than 5% of liver weight, to nonalcoholic steatohepatitis (NASH), a more aggressive form with necroinflammation and fibrosis. Among the patients who develop NASH, up to 20% may advance to cirrhosis and are at risk for complications of end-stage liver disease. One of the major complications observed in patients with NASH-related cirrhosis is hepatocellular carcinoma (HCC), which has emerged as the sixth most common cancer and second leading etiology of cancer-related deaths worldwide. The incidence of HCC in the United States alone has tripled over the last three decades. In addition, emerging data are suggesting that a small proportion of patients with NAFLD may be at higher risk for HCC in the absence of cirrhosis - implicating obesity and diabetes mellitus as potential risk factors for HCC.
PMID: 26328027 [PubMed]
Recruitment of adolescents for a smoking study: use of traditional strategies and social media.
Transl Behav Med. 2015 Sep;5(3):254-9
Authors: Rait MA, Prochaska JJ, Rubinstein ML
Engaging and retaining adolescents in research studies is challenging. Social media offers utility for expanding the sphere of research recruitment. This study examined and compared traditional and Facebook-based recruitment strategies on reach, enrollment, cost, and retention. Substance users aged 13-17 years were recruited through several methods, including social media, a study website, fliers, talks in schools, bus ads, and referrals. Study involvement included a one-time visit and semiannual follow-up surveys. 1265 individuals contacted study personnel; 629 were ineligible; 129 declined; and 200 participants enrolled. Facebook drew the greatest volume but had a high rate of ineligibles. Referrals were the most successful and cost-effective ($7 per enrolled participant); school talks were the least. Recruitment source was unrelated to retention success. Facebook may expand recruitment reach, but had greater financial costs and more ineligible contacts, resulting in fewer enrollees relative to traditional interpersonal recruitment methods. Referrals, though useful for study engagement, did not provide a differential benefit in terms of long-term retention.
PMID: 26327930 [PubMed]
Non-functional neuroendocrine tumors of the pancreas: Advances in diagnosis and management.
World J Gastroenterol. 2015 Aug 28;21(32):9512-25
Authors: Cloyd JM, Poultsides GA
Nonfunctional neuroendocrine tumors of the pancreas (NF-PNETs) are a heterogeneous group of neoplasms. Although rare, the incidence of NF-PNETs is increasing significantly. The classification of PNETs has evolved over the past decades and is now based on a proliferation grading system. While most NF-PNETs are slow growing, tumors with more aggressive biology may become incurable once they progress to unresectable metastatic disease. Tumors of higher grade can be suspected preoperatively based on the presence of calcifications, hypoenhancement on arterial phase computed tomography, positron emission technology avidity and lack of octreotide scan uptake. Surgery is the only curative treatment and is recommended for most patients for whom complete resection is possible. Liver-directed therapies (thermal ablation, transarterial embolization) can be useful in controlling unresectable hepatic metastatic disease. In the presence of unresectable progressive disease, somatostatin analogues, everolimus and sunitinib can prolong progression-free survival. This article provides a comprehensive review of NF-PNETs with special emphasis on recent advances in diagnosis and management.
PMID: 26327759 [PubMed - in process]
Compromising the 19S proteasome complex protects cells from reduced flux through the proteasome.
Authors: Tsvetkov P, Mendillo ML, Zhao J, Carette JE, Merrill PH, Cikes D, Varadarajan M, van Diemen FR, Penninger JM, Goldberg AL, Brummelkamp TR, Santagata S, Lindquist S
Proteasomes are central regulators of protein homeostasis in eukaryotes. Proteasome function is vulnerable to environmental insults, cellular protein imbalance and targeted pharmaceuticals. Yet, mechanisms that cells deploy to counteract inhibition of this central regulator are little understood. To find such mechanisms, we reduced flux through the proteasome to the point of toxicity with specific inhibitors and performed genome-wide screens for mutations that allowed cells to survive. Counter to expectation, reducing expression of individual subunits of the proteasome's 19S regulatory complex increased survival. Strong 19S reduction was cytotoxic but modest reduction protected cells from inhibitors. Protection was accompanied by an increased ratio of 20S to 26S proteasomes, preservation of protein degradation capacity and reduced proteotoxic stress. While compromise of 19S function can have a fitness cost under basal conditions, it provided a powerful survival advantage when proteasome function was impaired. This means of rebalancing proteostasis is conserved from yeast to humans.
PMID: 26327695 [PubMed - in process]
Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies.
Biol Blood Marrow Transplant. 2015 Aug 29;
Authors: Pasquini MC, Zhang MJ, Medeiros BC, Armand P, Hu ZH, Nishihori T, Aljurf MD, Akpek G, Cahn JY, Cairo MS, Cerny J, Copelan EA, Deol A, Freytes CO, Gale RP, Ganguly S, George B, Gupta V, Hale GA, Kamble RT, Klumpp TR, Lazarus HM, Luger SM, Liesveld JL, Litzow MR, Marks DI, Martino R, Norkin M, Olsson RF, Oran B, Pawarode A, Pulsipher MA, Ramanathan M, Reshef R, Saad AA, Saber W, Savani BN, Schouten HC, Ringdén O, Tallman MS, Uy GL, Wood WA, Wirk B, Pérez WS, Batiwalla M, Weisdorf DJ
The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, N=240) and in myelodysplastic syndrome (MK+MDS, N=221) on hematopoietic cell transplantation (HCT) outcomes compared to other cytogenetically defined groups (AML, N=3,360; MDS, N=1,373) as reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1998 to 2011. MK+AML was associated with higher disease relapse (hazard ratio [HR] 1.98, p<0.01), similar transplant related mortality (TRM, HR 1.01, p=0.9) and worse survival (HR 1.67, p<0.01) compared to other cytogenetically defined AML. Among patients with MDS, MK+MDS was associated with higher disease relapse (HR 2.39, p<0.01), higher TRM (HR 1.80, p<0.01) and worse survival (HR 2.02, p<0.01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (HR 1.72, p<0.01) and MDS (HR1.79, p<0.01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.
PMID: 26327629 [PubMed - as supplied by publisher]
Quantifying signaling pathway activation to monitor the quality of induced pluripotent stem cells.
Oncotarget. 2015 Aug 22;
Authors: Makarev E, Fortney K, Litovchenko M, Braunewell KH, Zhavoronkov A, Atala A
Many attempts have been made to evaluate the safety and potency of human induced pluripotent stem cells (iPSCs) for clinical applications using transcriptome data, but results so far have been ambiguous or even contradictory. Here, we characterized stem cells at the pathway level, rather than at the gene level as has been the focus of previous work. We meta-analyzed publically-available gene expression data sets and evaluated signaling and metabolic pathway activation profiles for 20 human embryonic stem cell (ESC) lines, 12 human iPSC lines, five embryonic body lines, and six fibroblast cell lines. We demonstrated the close resemblance of iPSCs with ESCs at the pathway level, and provided examples of how pathway activity can be applied to identify iPSC line abnormalities or to predict in vitro differentiation potential. Our results indicate that pathway activation profiling is a promising strategy for evaluating the safety and potency of iPSC lines in translational medicine applications.
PMID: 26327604 [PubMed - as supplied by publisher]
Outcomes of active surveillance for the management of clinically localized prostate cancer in the prospective, multi-institutional Canary PASS cohort.
J Urol. 2015 Aug 28;
Authors: Newcomb LF, Thompson IM, Boyer HD, Brooks JD, Carroll PR, Cooperberg MR, Dash A, Ellis WJ, Fazli L, Feng Z, Gleave ME, Kunju P, Lance RS, McKenney JK, Meng MV, Nicolas MM, Sanda MG, Simko J, So A, Tretiakova MS, Troyer DA, True LD, Vakar-Lopez F, Virgin J, Wagner AA, Wei JT, Zheng Y, Nelson PS, Lin DW, Canary Prostate Active Surveillance Study Investigators
PURPOSE: Active surveillance represents a strategy to address the overtreatment of prostate cancer, yet uncertainty regarding individual patient outcomes remains a concern. We evaluated outcomes in a prospective multi-center study of active surveillance.
METHODS: We studied 905 men in the prospective Canary Prostate cancer Active Surveillance Study (PASS) enrolled between 2008 to 2013. We collected clinical data at study entry and at pre-specified intervals and determined associations with adverse reclassification defined as increased Gleason grade or greater cancer volume on follow-up biopsy. We also evaluated the relationships of clinical parameters with pathology findings in participants who underwent surgery after a period of active surveillance.
RESULTS: During a median follow-up of 28 months, 24% of participants experienced adverse reclassification, of whom 53% underwent treatment while 31% continued active surveillance. Overall, 19% of participants received treatment, 68% with adverse reclassification while 32% opted for treatment without disease reclassification. In multivariate Cox proportional hazards modeling, percent of biopsy cores with cancer, BMI, and PSA density were associated with adverse reclassification (P = 0.01, 0.04, 0.04). Of 103 participants subsequently treated by radical prostatectomy, 34% had adverse pathology, defined as primary pattern 4-5 or non-organ confined disease, including two with positive lymph nodes, with no significant relationship between risk category at diagnosis and findings at surgery (P = 0.76).
CONCLUSION: Most men remain on active surveillance at five years without adverse reclassification or adverse pathology at surgery. However, clinical factors had only modest association with disease reclassification, supporting the need for approaches that improve prediction of this outcome.
PMID: 26327354 [PubMed - as supplied by publisher]
Multi-jet propulsion organized by clonal development in a colonial siphonophore.
Nat Commun. 2015;6:8158
Authors: Costello JH, Colin SP, Gemmell BJ, Dabiri JO, Sutherland KR
Physonect siphonophores are colonial cnidarians that are pervasive predators in many neritic and oceanic ecosystems. Physonects employ multiple, clonal medusan individuals, termed nectophores, to propel an aggregate colony. Here we show that developmental differences between clonal nectophores of the physonect Nanomia bijuga produce a division of labour in thrust and torque production that controls direction and magnitude of whole-colony swimming. Although smaller and less powerful, the position of young nectophores near the apex of the nectosome allows them to dominate torque production for turning, whereas older, larger and more powerful individuals near the base of the nectosome contribute predominantly to forward thrust production. The patterns we describe offer insight into the biomechanical success of an ecologically important and widespread colonial animal group, but, more broadly, provide basic physical understanding of a natural solution to multi-engine organization that may contribute to the expanding field of underwater-distributed propulsion vehicle design.
PMID: 26327286 [PubMed - in process]
Cis-regulatory RNA elements that regulate specialized ribosome activity.
RNA Biol. 2015 Sep 1;:0
Authors: Xue S, Barna M
Recent evidence has shown that the ribosome itself can play a highly regulatory role in the specialized translation of specific subpools of mRNAs, in particular at the level of ribosomal proteins (RP). However, the mechanism(s) by which this selection takes place has remained poorly understood. In our recent study, we discovered a combination of unique RNA elements in the 5'UTRs of mRNAs that allows for such control by the ribosome. These mRNAs contain a Translation Inhibitory Element (TIE) that inhibits general cap-dependent translation, and an Internal Ribosome Entry Site (IRES) that relies on a specific RP for activation. The unique combination of an inhibitor of general translation and an activator of specialized translation is key to ribosome-mediated control of gene expression. Here we discuss how these RNA regulatory elements provide a new level of control to protein expression and their implications for gene expression, organismal development and evolution.
PMID: 26327194 [PubMed - as supplied by publisher]
Incidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett's Esophagus.
Gastroenterology. 2015 Aug 28;
Authors: Wolf WA, Pasricha S, Cotton C, Li N, Triadafilopoulos G, Muthusamy VR, Chmielewski GW, Corbett FS, Camara DS, Lightdale CJ, Wolfsen H, Chang KJ, Overholt BF, Pruitt RE, Ertan A, Komanduri S, Infantolino A, Rothstein RI, Shaheen NJ
BACKGROUND & AIMS: Radiofrequency ablation (RFA) is commonly used to treat Barrett's esophagus (BE). We assessed the incidence of esophageal adenocarcinoma (EAC) after RFA, factors associated with the development of EAC, and EAC-specific and all-cause mortality.
METHODS: We collected data on outcomes of patients who underwent RFA for BE from July, 2007 through July, 2011 from the US multi-center RFA Patient Registry. Patients were followed until July, 2014. Kaplan-Meier curves of EAC incidence were stratified by baseline histology. Crude EAC incidence and mortality (all-cause and EAC-specific) were calculated, and adjusted all-cause mortality was assessed. Logistic regression models were constructed to assess predictors of EAC and all-cause mortality.
RESULTS: Among 4982 patients, 100 (2%) developed EAC (7.8/1000 person-years (PY)) and 9 patients (0.2%) died of EAC (0.7/1000 PY) in a mean 2.7±1.6 years. The incidence of EAC in non-dysplastic BE was 0.5/1000 PY. Overall, 157 patients (3%) died during follow-up (all-cause mortality, 11.2/1000 PY). On multi-variate logistic regression, baseline BE length (odds ratio, 1.1/cm) and baseline histology (odds ratios, 5.8 and 50.3 for low-grade dysplasia and high-grade dysplasia [HGD] respectively) predicted EAC incidence. Among 9 EAC deaths, 6 (67%) had baseline HGD and 3 (33%) had baseline intra-mucosal EAC. The most common causes of death were cardiovascular (15%) and extra-esophageal cancers (15%). No deaths were associated with RFA.
CONCLUSION: Based on analysis of a multicenter registry of patients who underwent RFA of BE, less than 1% died from EAC. The incidence of EAC was markedly lower in this study than in other studies of disease progression, with the greatest absolute benefit observed in patients with HGD.
PMID: 26327132 [PubMed - as supplied by publisher]
BIOPHYSICS. Response to Comments on "Extreme electric fields power catalysis in the active site of ketosteroid isomerase".
Science. 2015 Aug 28;349(6251):936
Authors: Fried SD, Boxer SG
Natarajan et al. and Chen and Savidge comment that comparing the electric field in ketosteroid isomerase's (KSI's) active site to zero overestimates the catalytic effect of KSI's electric field because the reference reaction occurs in water, which itself exerts a sizable electrostatic field. To compensate, Natarajan et al. argue that additional catalytic weight arises from positioning of the general base, whereas Chen and Savidge propose a separate contribution from desolvation of the general base. We note that the former claim is not well supported by published results, and the latter claim is intriguing but lacks experimental basis. We also take the opportunity to clarify some of the more conceptually subtle aspects of electrostatic catalysis.
PMID: 26315428 [PubMed - indexed for MEDLINE]
BIOPHYSICS. Comment on "Extreme electric fields power catalysis in the active site of ketosteroid isomerase".
Science. 2015 Aug 28;349(6251):936
Authors: Natarajan A, Yabukarski F, Lamba V, Schwans JP, Sunden F, Herschlag D
Fried et al. (Reports, 19 December 2014, p. 1510) demonstrated a strong correlation between reaction rate and the carbonyl stretching frequency of a product analog bound to ketosteroid isomerase oxyanion hole mutants and concluded that the active-site electric field provides 70% of catalysis. Alternative comparisons suggest a smaller contribution, relative to the corresponding solution reaction, and highlight the importance of atomic-level descriptions.
PMID: 26315426 [PubMed - indexed for MEDLINE]
The Global Health Implications of e-Cigarettes.
JAMA. 2015 Aug 18;314(7):663-4
Authors: Chang AY, Barry M
PMID: 26284714 [PubMed - indexed for MEDLINE]
Gluten-Free Diet Regimens and Psychiatric Symptoms.
Am J Psychiatry. 2015 Jul;172(7):685-6
Authors: Dell'Osso B, Elli L
PMID: 26130204 [PubMed - indexed for MEDLINE]
Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer.
Int J Radiat Oncol Biol Phys. 2015 Jul 15;92(4):911-20
Authors: Wu AJ, Bosch WR, Chang DT, Hong TS, Jabbour SK, Kleinberg LR, Mamon HJ, Thomas CR, Goodman KA
PURPOSE/OBJECTIVE(S): Current guidelines for esophageal cancer contouring are derived from traditional 2-dimensional fields based on bony landmarks, and they do not provide sufficient anatomic detail to ensure consistent contouring for more conformal radiation therapy techniques such as intensity modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to derive contouring guidelines and generate an atlas for the clinical target volume (CTV) in esophageal or gastroesophageal junction (GEJ) cancer.
METHODS AND MATERIALS: Eight expert academically based gastrointestinal radiation oncologists participated. Three sample cases were chosen: a GEJ cancer, a distal esophageal cancer, and a mid-upper esophageal cancer. Uniform computed tomographic (CT) simulation datasets and accompanying diagnostic positron emission tomographic/CT images were distributed to each expert, and the expert was instructed to generate gross tumor volume (GTV) and CTV contours for each case. All contours were aggregated and subjected to quantitative analysis to assess the degree of concordance between experts and to generate draft consensus contours. The panel then refined these contours to generate the contouring atlas.
RESULTS: The κ statistics indicated substantial agreement between panelists for each of the 3 test cases. A consensus CTV atlas was generated for the 3 test cases, each representing common anatomic presentations of esophageal cancer. The panel agreed on guidelines and principles to facilitate the generalizability of the atlas to individual cases.
CONCLUSIONS: This expert panel successfully reached agreement on contouring guidelines for esophageal and GEJ IMRT and generated a reference CTV atlas. This atlas will serve as a reference for IMRT contours for clinical practice and prospective trial design. Subsequent patterns of failure analyses of clinical datasets using these guidelines may require modification in the future.
PMID: 26104943 [PubMed - indexed for MEDLINE]
Is Equipment Development Stifling Innovation in Radiation Oncology?
Int J Radiat Oncol Biol Phys. 2015 Jul 15;92(4):713-4
Authors: Brown JM, Adler JR
PMID: 26104924 [PubMed - indexed for MEDLINE]
Evaluating three methods to encourage mentally competent older adults to assess their driving behavior.
J Trauma Acute Care Surg. 2015 Jul;79(1):125-31
Authors: Uribe-Leitz T, Barmak LA, Park A, Howland J, Lee V, Lodato E, Driscoll C, Dechert T, Burke PA
BACKGROUND: Fourteen percent (43.1 million) of the population in the United States was 65 years and older in 2012. This population is projected to reach 20% (88.5 million) by 2050. Older adults accounted for 17% of all traffic fatalities and 9% of all vehicle occupant injuries in 2012. We explored the effectiveness of three interventions to help older adults assess their current driving behaviors at a Level 1 trauma center.
METHODS: During 2010 to 2012, 1,216 inpatients 70 years and older admitted for surgical and medical services were screened for eligibility, and 120 were enrolled. Participants completed a driving assessment and preintervention questionnaires and were subsequently randomized to one of the following interventions: (1) brief negotiated interview plus an educational kit by the American Automobile Association about older driving plus an accompanying list of Web-based resources for older adult drivers; (2) American Automobile Association document and a list of Web-based resources; (3) online referral sheet of the list of Web-based resources only. A 3-month postintervention follow-up questionnaire was administered over the telephone to measure changes in (1) driving-related knowledge, attitudes, and beliefs as well as (2) driving-related behaviors and intended behaviors.
RESULTS: A total of 113 randomized patients were included in the analysis. The mean (SD) age was 76.8 (5.23) years; majority of patients were white (64%), followed by black African American (33%); and 51% were males and 49% were females. Multivariate analysis showed that older adults' driving knowledge, attitudes, and beliefs (p < 0.0001, R = 0.37) as well as behaviors and intentions (p < 0.0001, R = 0.27) toward driving were positively correlated, controlling for other predictors in the model. Intervention assignment did not affect changes in outcomes, although outcomes improved across experimental conditions.
CONCLUSION: Our pilot study suggests that older adults are likely to make changes in their driving behavior on the basis of minimal hospital-based intervention.
PMID: 26091325 [PubMed - indexed for MEDLINE]
Coping Strategies Used by Adult Patients with Inflammatory Bowel Disease.
South Med J. 2015 Jun;108(6):337-42
Authors: Parekh NK, McMaster K, Nguyen DL, Shah S, Speziale A, Miller J, Melmed G
OBJECTIVES: Symptoms of and treatments for inflammatory bowel disease (IBD) have a significant impact on patients' quality of life (QOL) and result in an increased prevalence of depression and anxiety disorders. Little is known about the type of coping strategies used by adult patients with IBD to better cope with their chronic illness, however. The objectives of this study were to identify the types of coping styles and their impact on the QOL of patients with IBD.
METHODS: The first 150 consecutive participants with IBD were recruited at five major tertiary hospitals and given an anonymous survey consisting of demographic information, the Jalowiec Coping Scale, and the Shortened Inflammatory Bowel Disease Questionnaire.
RESULTS: The cohort was 51.3% men and included 150 participants with a mean age of 39.3 years. The primary coping mechanisms used were confrontive (46.7%), evasiveness (30.0%), optimistic (18.7%), and fatalistic (4.6%) coping. Participants rated confrontive (62.0%), optimistic (26.6%), and evasive (11.4%) coping styles as the most effective. Those who reported an increased frequency of flares scored lower on QOL (P <0.05) and more often used evasive and fatalistic coping styles (P < 0.05) compared with other coping strategies; however, after controlling for disease activity, QOL was significantly better for those who primarily used adaptive coping styles compared with those who used maladaptive styles (P <0.001).
CONCLUSIONS: We demonstrated that confrontive, evasive, and optimistic styles of coping are most widely used among patients with IBD. Despite controlling for disease activity, we demonstrated that those who used adaptive coping styles had a higher QOL compared with those who used maladapative coping styles. Future research on coping is warranted to assess coping styles on therapeutic compliance and disease perception.
PMID: 26079458 [PubMed - indexed for MEDLINE]
Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development.
Lancet. 2015 Aug 8;386(9993):569-624
Authors: Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Mérisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SL, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Lundeg G, Mkandawire NC, Raykar NP, Riesel JN, Rodas E, Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip W
PMID: 25924834 [PubMed - indexed for MEDLINE]
Improvements in the early death rate among 9380 patients with acute myeloid leukemia after initial therapy: A SEER database analysis.
Cancer. 2015 Jun 15;121(12):2004-12
Authors: Percival ME, Tao L, Medeiros BC, Clarke CA
BACKGROUND: Acute myeloid leukemia (AML) is treated with conventional induction chemotherapy shortly after diagnosis for the majority of patients aged ≤ 65 years. A recent report suggested a substantial decline in the early, or 1-month, mortality rate in patients treated on clinical trials over the past 2 decades. It is unknown whether a similar improvement has been observed in the general population.
METHODS: The authors examined the 1-month mortality rate in a large population-based series of 9380 patients with AML who were aged ≤ 65 years and were diagnosed and treated with chemotherapy between 1973 and 2010.
RESULTS: A significant decline was observed in the 1-month mortality rate from 18.7% among patients diagnosed from 1973 through 1977 (95% confidence interval [95% CI], 16.4%-21.2%) to 5.8% for those diagnosed between 2008 and 2010 (95% CI, 4.5%-7.6%) (P <.001). The median overall survival improved significantly from 6 months (95% CI, 5 months-7 months) in 1973 to 1977 to 23 months (95% CI, 16 months-20 months) in 2008 to 2010 (P <.001). Although age and geographic variation were found to significantly influence the 1-month mortality for the period between 1973 and 1977, these differences in 1-month mortality were no longer significant among patients with AML who were treated more recently (2008-2010).
CONCLUSIONS: Over the past 4 decades, early mortality has become uncommon in younger patients (aged ≤ 65 years) with newly diagnosed AML undergoing induction chemotherapy. It is encouraging that the improvements noted in 1-month mortality rate among a selective cohort of patients in clinical trials have also been observed in a population-based analysis.
PMID: 25739348 [PubMed - indexed for MEDLINE]
Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging Study.
J Urol. 2015 Jul;194(1):118-26
Authors: Farmer MA, Huang L, Martucci K, Yang CC, Maravilla KR, Harris RE, Clauw DJ, Mackey S, Ellingson BM, Mayer EA, Schaeffer AJ, Apkarian AV, MAPP Research Network
PURPOSE: Several chronic pain conditions may be distinguished by condition specific brain anatomical and functional abnormalities on imaging, which are suggestive of underlying disease processes. We present what is to our knowledge the first characterization of interstitial cystitis/bladder pain syndrome associated white matter (axonal) abnormalities based on multicenter neuroimaging from the MAPP Research Network.
MATERIALS AND METHODS: We assessed 34 women with interstitial cystitis/bladder pain syndrome and 32 healthy controls using questionnaires on pain, mood and daily function. White matter microstructure was evaluated by diffusion tensor imaging to model directional water flow along axons or fractional anisotropy. Regions correlating with clinical parameters were further examined for gender and syndrome dependence.
RESULTS: Women with interstitial cystitis/bladder pain syndrome showed numerous white matter abnormalities that correlated with pain severity, urinary symptoms and impaired quality of life. Interstitial cystitis/bladder pain syndrome was characterized by decreased fractional anisotropy in aspects of the right anterior thalamic radiation, the left forceps major and the right longitudinal fasciculus. Increased fractional anisotropy was detected in the right superior and bilateral inferior longitudinal fasciculi.
CONCLUSIONS: To our knowledge we report the first characterization of brain white matter abnormalities in women with interstitial cystitis/bladder pain syndrome. Regional decreases and increases in white matter integrity across multiple axonal tracts were associated with symptom severity. Given that white matter abnormalities closely correlated with hallmark symptoms of interstitial cystitis/bladder pain syndrome, including bladder pain and urinary symptoms, brain anatomical alterations suggest that there are neuropathological contributions to chronic urological pelvic pain.
PMID: 25711200 [PubMed - indexed for MEDLINE]
Short turn radius colonoscope in an anatomical model: retroflexed withdrawal and detection of hidden polyps.
World J Gastroenterol. 2015 Jan 14;21(2):593-9
Authors: McGill SK, Kothari S, Friedland S, Chen A, Park WG, Banerjee S
AIM: To evaluate the new RetroView™ colonoscope and compare its ability to detect simulated polyps "hidden" behind colonic folds with that of a conventional colonoscope, utilizing anatomic colon models.
METHODS: Three anatomic colon models were prepared, with twelve simulated polyps "hidden" behind haustral folds and five placed in easily viewed locations in each model. Five blinded endoscopists examined two colon models in random order with the conventional or RetroView™ colonoscope, utilizing standard withdrawal technique. The third colon model was then examined with the RetroView™ colonoscope withdrawn initially in retroflexion and then in standard withdrawal. Polyp detection rates during standard and retroflexed withdrawal of the conventional and RetroView™ colonoscopes were determined. Polyp detection rates for combined standard and retroflexed withdrawal (combination withdrawal) with the RetroView™ colonoscope were also determined.
RESULTS: For hidden polyps, retroflexed withdrawal using the RetroView™ colonoscope detected more polyps than the conventional colonoscope in standard withdrawal (85% vs 12%, P = 0.0001). For hidden polyps, combination withdrawal with the RetroView™ colonoscope detected more polyps than the conventional colonoscope in standard withdrawal (93% vs 12%, P ≤ 0.0001). The RetroView™ colonoscope in "combination withdrawal" was superior to other methods in detecting all (hidden + easily visible) polyps, with successful detection of 80 of 85 polyps (94%) compared to 28 (32%) polyps detected by the conventional colonoscope in standard withdrawal (P < 0.0001) and 67 (79%) polyps detected by the RetroView™ colonoscope in retroflexed withdrawal alone (P < 0.01). Continuous withdrawal of the colonoscope through the colon model while retroflexed was achieved by all endoscopists. In a post-test survey, four out of five colonoscopists reported that manipulation of the colonoscope was easy or very easy.
CONCLUSION: In simulated testing, the RetroView™ colonoscope increased detection of hidden polyps. Combining standard withdrawal with retroflexed withdrawal may become the new paradigm for "complete screening colonoscopy".
PMID: 25593483 [PubMed - indexed for MEDLINE]
Non-steroidal anti-inflammatory drugs use is associated with reduced risk of inflammation-associated cancers: NIH-AARP study.
PLoS One. 2014;9(12):e114633
Authors: Shebl FM, Hsing AW, Park Y, Hollenbeck AR, Chu LW, Meyer TE, Koshiol J
BACKGROUND: Chronic inflammation has been linked to cancers, and use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risk of several cancers. To further refine the magnitude of NSAID-related associations, in particular for cancers related to inflammation, such as alcohol-, infection-, obesity-, and smoking-related cancers, as well as for less common cancers, we evaluated the use of NSAIDs and cancer risk in a very large cohort. We used propensity scores to account for potential selection bias and hypothesized that NSAID use is associated with decreased cancer incidence.
METHODS: We conducted a prospective study among 314,522 participants in the NIH-AARP Diet and Health Study. Individuals who completed the lifestyle questionnaire, which included NSAID use, in 1996-1997 were followed through 2006. Information on cancer incidence was ascertained by linking to cancer registries and vital status databases.
FINDINGS: During 2,715,994 person-years of follow-up (median 10.1 person-years), there were 51,894 incident cancers. Compared with non-users of NSAIDs, individuals who reported use in the 12 months prior to interview had a significantly lower risk of all inflammation-related cancer, alcohol-related, infection-related, obesity-related, and smoking-related cancers [hazard ratio (HR) (95% CI)) 0.90 (0.87-0.93), 0.80 (0.74-0.85), 0.82 (0.78-0.87), 0.88 (0.84-0.92), and 0.88 (0.85-0.92) respectively)].
CONCLUSIONS: After accounting for potential selection bias, our data showed an inverse association between NSAID use and alcohol-related, infection-related, obesity-related, and smoking-related cancers and support the hypothesis that inflammation is related to an increased risk of certain cancers.
PMID: 25551641 [PubMed - indexed for MEDLINE]
Improved serotype-specific dengue virus detection in Trinidad and Tobago using a multiplex, real-time RT-PCR.
Diagn Microbiol Infect Dis. 2015 Feb;81(2):105-6
Authors: Waggoner JJ, Sahadeo NS, Brown A, Mohamed-Hadley A, Hadley D, Carrington L, Carrington CV, Pinsky BA
Dengue virus (DENV) transmission occurs throughout the Caribbean, though laboratory confirmation and epidemiologic surveillance are limited by the availability of serotype-specific molecular diagnostics. In this study, we show that a serotype-specific DENV multiplex, real-time reverse transcriptase-PCR (RT-PCR) detected DENV RNA in significantly more samples (82/182) than a reference hemi-nested RT-PCR (57/182; P=0.01).
PMID: 25533614 [PubMed - indexed for MEDLINE]
Development of the international thymic malignancy interest group international database: an unprecedented resource for the study of a rare group of tumors.
J Thorac Oncol. 2014 Oct;9(10):1573-8
Authors: Huang J, Ahmad U, Antonicelli A, Catlin AC, Fang W, Gomez D, Loehrer P, Lucchi M, Marom E, Nicholson A, Ruffini E, Travis W, Van Schil P, Wakelee H, Yao X, Detterbeck F, International Thymic Malignancy Interest Group International Database Committee and Contributors
BACKGROUND: Our knowledge of thymic malignancies has largely been derived from small, single-institution series. Recognition of the need for broad collaboration led to the creation of the International Thymic Malignancy Interest Group (ITMIG) and the development of a large, centralized database to advance knowledge of these rare tumors.
METHODS: A multidisciplinary Database Committee was convened to define a common set of data elements a priori. Retrospective data were solicited from ITMIG members and collated using standardized fields. Patients with thymoma, thymic carcinoma, or thymic carcinoid were included.
RESULTS: Over a 6-month period, 47 institutions spanning 15 countries contributed a total of 6097 cases (mean, 129 [range, 10-1209]). The sex distribution was equal for thymomas, but there was a greater proportion of men with thymic carcinoma and thymic carcinoid (p < 0.0001). Nearly all cases (99%) were treated surgically. WHO type B2 was the most frequent histologic classification among thymomas, whereas squamous was the most common among thymic carcinomas. In total, 38% of patients with thymoma had myasthenia gravis compared with less than or equal to 5% for thymic carcinoma and thymic carcinoid. Median overall survival was 18.9 years (95% confidence interval [CI], 17.4-20.3) for thymoma, 6.8 years (95% CI, 5.5-7.9) for thymic carcinoma, and 7.5 years (95% CI, 6.5-8.5) for thymic carcinoid.
CONCLUSIONS: The rapid creation of the ITMIG database demonstrates the feasibility of international collaboration for this rare set of malignancies and attests to the engagement of its membership. This database represents the largest collective data set ever assembled and provides an unprecedented resource for research of these tumors.
PMID: 25521402 [PubMed - indexed for MEDLINE]
Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans.
Authors: Trockel M, Karlin BE, Taylor CB, Brown GK, Manber R
OBJECTIVE: To examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on suicidal ideation among Veterans with insomnia.
DESIGN: Longitudinal data collected in the course of an uncontrolled evaluation of a large-scale CBT-I training program.
SETTING: Outpatient and residential treatment facilities.
PARTICIPANTS: Four hundred five Veterans presenting for treatment of insomnia.
INTERVENTIONS: Cognitive behavioral therapy for insomnia (CBT-I).
MEASUREMENT AND RESULTS: At baseline, 32% of patients, compared with 21% at final assessment, endorsed some level of suicidal ideation [χ(2)(df = 1) = 125; P < 0.001]. After adjusting for demographic variables and baseline insomnia severity, each 7-point decrease in Insomnia Severity Index (ISI) score achieved during CBT-I treatment was associated with a 65% (OR = 0.35; 95% CI = 0.24 to 0.52) reduction in odds of suicidal ideation. The effect of change in insomnia severity on change in depression severity was also significant. After controlling for change in depression severity and other variables in the model, the effect of change in insomnia severity on change in suicidal ideation remained significant.
CONCLUSION: This evaluation of the largest dissemination of CBT-I in the United States found a clinically meaningful reduction in suicidal ideation among Veterans receiving CBT-I. The mechanisms by which effective treatment of insomnia with CBT-I reduces suicide risk are unknown and warrant investigation. The current results may have significant public health implications for preventing suicide among Veterans.
PMID: 25515115 [PubMed - indexed for MEDLINE]
Pharmacologic therapy for acute pancreatitis.
World J Gastroenterol. 2014 Dec 7;20(45):16868-80
Authors: Kambhampati S, Park W, Habtezion A
While conservative management such as fluid, bowel rest, and antibiotics is the mainstay of current acute pancreatitis management, there is a lot of promise in pharmacologic therapies that target various aspects of the pathogenesis of pancreatitis. Extensive review of preclinical studies, which include assessment of therapies such as anti-secretory agents, protease inhibitors, anti-inflammatory agents, and anti-oxidants are discussed. Many of these studies have shown therapeutic benefit and improved survival in experimental models. Based on available preclinical studies, we discuss potential novel targeted pharmacologic approaches that may offer promise in the treatment of acute pancreatitis. To date a variety of clinical studies have assessed the translational potential of animal model effective experimental therapies and have shown either failure or mixed results in human studies. Despite these discouraging clinical studies, there is a great clinical need and there exist several preclinical effective therapies that await investigation in patients. Better understanding of acute pancreatitis pathophysiology and lessons learned from past clinical studies are likely to offer a great foundation upon which to expand future therapies in acute pancreatitis.
PMID: 25493000 [PubMed - indexed for MEDLINE]
Proceedings of the Fifth International Workshop on Advances in Electrocorticography.
Epilepsy Behav. 2014 Dec;41:183-92
Authors: Ritaccio A, Brunner P, Gunduz A, Hermes D, Hirsch LJ, Jacobs J, Kamada K, Kastner S, Knight RT, Lesser RP, Miller K, Sejnowski T, Worrell G, Schalk G
The Fifth International Workshop on Advances in Electrocorticography convened in San Diego, CA, on November 7-8, 2013. Advancements in methodology, implementation, and commercialization across both research and in the interval year since the last workshop were the focus of the gathering. Electrocorticography (ECoG) is now firmly established as a preferred signal source for advanced research in functional, cognitive, and neuroprosthetic domains. Published output in ECoG fields has increased tenfold in the past decade. These proceedings attempt to summarize the state of the art.
PMID: 25461213 [PubMed - indexed for MEDLINE]
SMART DOCS: a new patient-centered outcomes and coordinated-care management approach for the future practice of sleep medicine.
Authors: Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JK
ABSTRACT: The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control.
CLINICAL TRIALS NUMBER: http://www.clinicaltrials.gov, NCT02037438.
PMID: 25409112 [PubMed - indexed for MEDLINE]
The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: a systematic review and meta-analysis.
Authors: Camacho M, Riaz M, Capasso R, Ruoff CM, Guilleminault C, Kushida CA, Certal V
BACKGROUND: The relationship between nasal surgery and its effect on continuous positive airway pressure (CPAP) device therapeutic treatment pressures and CPAP device use has not been previously systematically examined.
STUDY OBJECTIVES: To conduct a systematic review and meta-analysis evaluating the effect of isolated nasal surgery on therapeutic CPAP device pressures and use in adults with obstructive sleep apnea (OSA).
METHODS: MEDLINE, Scopus, Web of Science, and The Cochrane Library were searched through July 15, 2014. The MOOSE consensus statement and PRISMA statement were followed.
RESULTS: Eighteen studies (279 patients) reported CPAP data after isolated nasal surgery. Seven studies (82 patients) reported preoperative and postoperative mean therapeutic CPAP device pressures and standard deviations (SD), which reduced from 11.6 ± 2.2 to 9.5 ± 2.0 centimeters of water pressure (cwp) after nasal surgery. Pooled random effects analysis demonstrated a statistically significant pressure reduction, with a mean difference (MD) of -2.66 cwp (95% confidence interval (CI), -3.65 to -1.67); P < 0.00001. Eleven studies (153 patients) reported subjective, self-reported data for CPAP use; and a subgroup analysis demonstrated that 89.1% (57 of 64 patients) who were not using CPAP prior to nasal surgery subsequently accepted, adhered to, or tolerated it after nasal surgery. Objective, device meter-based hours of use increased in 33 patients from 3.0 ± 3.1 to 5.5 ± 2.0 h in the short term (<6 mo of follow-up).
CONCLUSION: Isolated nasal surgery in patients with OSA and nasal obstruction reduces therapeutic CPAP device pressures and the currently published literature's objective and subjective data consistently suggest that it also increases CPAP use in select patients.
PMID: 25325439 [PubMed - indexed for MEDLINE]
Ocular toxoplasmosis in the United States: recent and remote infections.
Clin Infect Dis. 2015 Jan 15;60(2):271-3
Authors: Jones JL, Bonetti V, Holland GN, Press C, Sanislo SR, Khurana RN, Montoya JG
We tested all samples from patients with ocular toxoplasmosis sent to the Palo Alto Medical Foundation Toxoplasma Reference Laboratory from June 2004 through August 2010 for serologic evidence of recent Toxoplasma gondii infection. Of 205 patients aged 10-96 years, 11.7% had recent infection. Many people develop ocular disease soon after T. gondii infection.
PMID: 25301214 [PubMed - indexed for MEDLINE]
A prospective evaluation of using IVUS during percutaneous superficial femoral artery interventions.
Ann Vasc Surg. 2015 Jan;29(1):28-33
Authors: Hitchner E, Zayed M, Varu V, Lee G, Aalami O, Zhou W
BACKGROUND: The outcomes of endovascular interventions of the superficial femoral artery (SFA) are variable. Completion angiography is typically performed to confirm satisfactory outcomes after SFA angioplasty and/or stenting. However, two-dimensional angiography may not accurately reflect the extent of residual stenosis. We sought to determine whether intravascular ultrasound (IVUS) can help with residual disease assessment and procedure outcome.
METHODS: Patients with anticipated SFA disease were prospectively recruited to the study. Patients with primary SFA disease on diagnostic angiography were included. After SFA endovascular intervention with angioplasty and/or stenting, a completion angiogram was performed to confirm satisfactory results before IVUS evaluation. IVUS-detected maximal residual stenosis, maximal residual lesion volume, and number of nonconsecutive posttreatment SFA segments with >50% residual stenosis were evaluated. Periprocedural ankle-brachial indexes (ABIs), Short Form 36 (SF-36) surveys, and Walking Impairment Questionnaires were also collected.
RESULTS: Fifty-nine patients were prospectively enrolled. Thirty-three received angioplasty only, and 26 received angioplasty and stenting. All patients were men, mean age was 67 years, and major comorbidities included coronary artery disease (53%), active smoking (56%), hypertension (88%), and diabetes (68%). The angioplasty-only cohort had more nonconsecutive areas of >50% residual stenosis (P = 0.004), greater residual stenosis (P = 0.03), and smaller minimal lumen diameters after treatment (P = 0.01) than the angioplasty and stenting cohort. However, there was no significant difference in ABI between the 2 groups and no difference in ABI improvement after intervention. Sixty-four percent of all patients demonstrated a >0.2 increase in postintervention ABI. Improvement in ABI at 1 month after procedure significantly correlated with postintervention SF-36 survey physical scores (r = 0.435, P = 0.007).
CONCLUSIONS: IVUS evaluation provides more-accurate intraprocedural insight on the extent of residual stenosis after SFA interventions. Future studies are warranted to determine whether IVUS-guided postangioplasty and/or stenting can impact long-term interventional outcome.
PMID: 25194552 [PubMed - indexed for MEDLINE]
Anatomic suitability of aortoiliac aneurysms for next generation branched systems.
Ann Vasc Surg. 2015 Jan;29(1):69-75
Authors: Pearce BJ, Varu VN, Glocker R, Novak Z, Jordan WD, Lee JT
BACKGROUND: Preservation of internal iliac flow is an important consideration to prevent ischemic complications during endovascular aneurysm repair. We sought to determine the suitability of aortoiliac aneurysms for off-the-shelf iliac branched systems currently in clinical trial.
METHODS: Patients undergoing abdominal aortic aneurysm repair from 2004 to 2013 at 2 institutions were reviewed. Centerline diameters and lengths of aortoiliac morphology were measured using three-dimensional workstations and compared with inclusion/exclusion criteria for both Cook and Gore iliac branch devices.
RESULTS: Of the nearly 2,400 aneurysm repairs performed during the study period, 99 patients had common iliac aneurysms suitable for imaging review. Eighteen of the 99 (18.2%) patients and 25/99 (25.3%) patients fit the inclusion criteria and would have been able to be treated using the Cook and Gore iliac branch devices, respectively. The most common reason for exclusion from Cook was internal iliac diameter of <6 or >9 mm (68/99, 68.7%). The most common reason for exclusion from Gore was proximal common iliac diameter of <17 mm (39/99, 39.4%) and inadequate internal iliac artery diameter of <6.5 or >13.5 mm (37/99, 37.3%). Comparing the included patients across both devices, a total of 35/99 (35.4%) of patients would be eligible for the treatment of aortoiliac aneurysms based on anatomic criteria.
CONCLUSIONS: Only 35% of the aneurysm repairs involving common iliac arteries would have been candidates for the 2 iliac branch devices currently in trial based on anatomic criteria. The major common reason for exclusion is the internal iliac landing zone for both devices. Design modifications for future generation iliac branch technology should focus on diameter accommodations for the hypogastric branch stent and proximal and distal sizes of the iliac branch components. Familiarity with alternate branch preserving techniques is still needed in the majority of cases.
PMID: 25194549 [PubMed - indexed for MEDLINE]
Computed tomography perfusion imaging in the selection of acute stroke patients to undergo emergent carotid endarterectomy.
Ann Vasc Surg. 2015 Jan;29(1):125.e1-11
Authors: Devlin TG, Phade SV, Hutson RK, Fugate MW, Major GR, Albers GW, Sirelkhatim AA, Sapkota BL, Quartfordt SD, Baxter BW
Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA. Acute stroke patients underwent unenhanced brain CT imaging to exclude pathology that would contraindicate emergent therapy. Emergent CTAs of the intracranial and extracranial vessels were utilized to identify patients who presented with stroke symptoms based on the presence of isolated extracranial carotid disease in the absence of intracranial thromboembolism. CTP was then used to assess the extent of potentially reversible cerebral ischemia (penumbral tissue). Patients with isolated extracranial carotid lesions with significant reversible ischemia in the absence of large areas of irreversible cerebral damage underwent emergent CEA to salvage ischemic penumbra. In 1 year, 3 patients presented with large acute strokes in which CTA disclosed symptomatic extracranial internal carotid artery preocclusive or occlusive lesions without intracranial thromboembolic occlusions. CTP indicated a large area of ischemic penumbra with limited permanent injury. Mean age, time to presentation, and National Institutes of Health stroke score (NIHSS) were 66 years, 4.2 hr, and 19.3. All patients underwent emergent CEA with cervical carotid thrombectomy. Average time from stroke symptom onset to revascularization was 12.5 (range 5.9-19.0) hr. There were no perioperative deaths. At day 5, the mean NIHSS decreased to 7.6 and at day 30 was 4.7. The modified Rankin scale score dropped from a poststroke, preoperative level of 5 to 2.3 by day 30. Emergent CEA should be considered in patients presenting with large acute strokes based on favorable CT, CTA, and CTP findings. Emergent clot localization and physiological assessment of brain "tissue at risk" relative to irreversible cerebral infarction using CT, CTA, and CTP is now available. Utilization of this information by an experienced stroke team of neurologists, radiologists, and surgeons may aid in the recognition of a select group of patients in which emergent CEA may drive to improved outcomes.
PMID: 25194548 [PubMed - indexed for MEDLINE]
Cheese wire fenestration of a chronic juxtarenal dissection flap to facilitate proximal neck fixation during EVAR.
Ann Vasc Surg. 2015 Jan;29(1):124.e1-5
Authors: Ullery BW, Chandra V, Dake M, Lee JT
BACKGROUND: To describe successful endovascular repair of a complex chronic aortoiliac dissection facilitated by a unique endovascular fenestration technique at the proximal neck.
METHODS: A 57-year-old man presented with disabling lower extremity claudication and a remote history of medically treated type B aortic dissection. Computed tomographic angiography demonstrated a complex dissection with 7.1-cm false lumen aneurysmal dilatation and significant true lumen compression within bilateral iliac aneurysms and no suitable proximal infrarenal neck free of dissection.
RESULTS: Using intravascular ultrasound, guidewires were introduced into true and false lumens. A 9F sheath was placed on the right side, and a 20-ga Chiba needle was positioned at the level of the celiac artery and oriented toward the dissection flap. The needle was advanced to puncture the flap, and a 0.014-in wire was then snared from the true to the false lumen. Shearing of the dissection flap in the juxtarenal segment was performed using a "cheese wire" technique, whereby both ends of the guidewire were pulled caudally in a sawing motion down through the infrarenal neck and into the aneurysm sac. Angiography confirmed absence of residual dissection and perfusion of the visceral vessels via the true lumen. Given the newly created infrarenal neck, standard endovascular aortic repair (EVAR) was performed and antegrade and retrograde false lumen flow was obliterated from the visceral vessels. Postoperative imaging confirmed aneurysm exclusion, no endoleak, and patent bilateral common iliac arteries with resolution of claudication symptoms and normal ankle-brachial indices.
CONCLUSIONS: Endovascular management of false lumen aneurysms in the setting of chronic dissection is limited by the ability of stent grafts to obtain adequate proximal or distal fixation. Endovascular fenestration of these chronic flaps facilitates generation of suitable landing zones, thereby serving as a useful adjunct to standard EVAR.
PMID: 25192823 [PubMed - indexed for MEDLINE]
Stereotactic ablative radiotherapy for pulmonary oligometastases and oligometastatic lung cancer.
J Thorac Oncol. 2014 Oct;9(10):1426-33
Authors: Shultz DB, Filippi AR, Thariat J, Mornex F, Loo BW, Ricardi U
An increasing body of experience suggests that oligometastasis represents a minimal metastatic state with the potential for cure or prolonged survival in selected patients treated with radical local therapy to all identified sites of disease. The main clinical scenarios managed by thoracic oncology specialists are pulmonary oligometastases from primary malignancies of other anatomic sites and primary lung cancer with oligometastases to lung or other organs. Surgery has been a mainstay of treatment in these situations, with remarkably favorable outcomes following pulmonary metastasectomy in well-selected patient cohorts. As with early stage lung cancer in patients who are medically inoperable, stereotactic ablative radiotherapy is emerging as a prominent local treatment option for oligometastatic disease. We review the role and clinical experience of stereotactic ablative radiotherapy for pulmonary oligometastases and oligometastatic lung cancer.
PMID: 25170641 [PubMed - indexed for MEDLINE]
Launching reappraisal: it's less common than you might think.
Emotion. 2015 Feb;15(1):73-7
Authors: Suri G, Whittaker K, Gross JJ
Cognitive reappraisal is thought to be ubiquitous. However, no studies have quantified how frequently people reappraise (vs. letting their emotional response go unregulated). To address this issue, the authors created a laboratory decision context in which participants watched a series of negatively valenced images, and in each case had the option of electing to reappraise to decrease negative affect. Given the many benefits and few costs associated with reappraisal, we expected that most images would be reappraised. However, to our surprise, participants implemented reappraisals for only 16% of images (Study 1). Regulatory rates remained low for both low- and high-intensity images, even when another regulatory option (i.e., distraction) was available (Study 2). The authors hypothesized that participants did not proactively reappraise because there were hidden costs associated with reappraisal. They considered 2 classes of costs: overcoming default bias and cognitive effort, and they measured the percentage of trials for which participants chose to reappraise using a fully crossed 2 × 2 design that examined the effects of removing defaults and of providing support in creating reappraisals. Removing defaults, but not providing reappraisal support, increased rates of reappraisal (Study 3). Everyday decision-making frequently involves default options. These results suggest that contextual variables (such as the presence of defaults) may play a large role in the decision to regulate emotions.
PMID: 24999912 [PubMed - indexed for MEDLINE]
Increased functional connectivity between dorsal posterior parietal and ventral occipitotemporal cortex during uncertain memory decisions.
Neurobiol Learn Mem. 2015 Jan;117:71-83
Authors: Hutchinson JB, Uncapher MR, Wagner AD
Retrieval of episodic memories is a multi-component act that relies on numerous operations ranging from processing the retrieval cue, evaluating retrieved information, and selecting the appropriate response given the demands of the task. Motivated by a rich functional neuroimaging literature, recent theorizing about various computations at retrieval has focused on the role of posterior parietal cortex (PPC). In a potentially promising line of research, recent neuroimaging findings suggest that different subregions of dorsal PPC respond distinctly to different aspects of retrieval decisions, suggesting that better understanding of their contributions might shed light on the component processes of retrieval. In an attempt to understand the basic operations performed by dorsal PPC, we used functional MRI and functional connectivity analyses to examine how activation in, and connectivity between, dorsal PPC and ventral temporal regions representing retrieval cues varies as a function of retrieval decision uncertainty. Specifically, participants made a five-point recognition confidence judgment for a series of old and new visually presented words. Consistent with prior studies, memory-related activity patterns dissociated across left dorsal PPC subregions, with activity in the lateral IPS tracking the degree to which participants perceived an item to be old, whereas activity in the SPL increased as a function of decision uncertainty. Importantly, whole-brain functional connectivity analyses further revealed that SPL activity was more strongly correlated with that in the visual word-form area during uncertain relative to certain decisions. These data suggest that the involvement of SPL during episodic retrieval reflects, at least in part, the processing of the retrieval cue, perhaps in service of attempts to increase the mnemonic evidence elicited by the cue.
PMID: 24825621 [PubMed - indexed for MEDLINE]
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