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Sample records for current evidence suggests

  1. Techniques of tumour bed boost irradiation in breast conserving therapy: Current evidence and suggested guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Jalali, Rakesh; Singh, Suruchi; Budrukkar, Ashwini [Tata Memorial Hospital, Mumbai (India)

    2007-10-15

    Breast conservation surgery followed by external beam radiotherapy to breast has become the standard of care in management of early carcinoma breast. A boost to the tumour bed after whole breast radiotherapy is employed in view of the pattern of tumour bed recurrences in the index quadrant and was particularly considered in patients with some adverse histopathological characteristics such as positive margins, extensive intraductal carcinoma (EIC), lymphovascular invasion (LVI), etc. There is however, now, a conclusive evidence of improvement in local control rates after a boost radiotherapy dose in patients even without such factors and for all age groups. The maximum absolute reduction of local recurrences by the addition of boost is especially seen in young premenopausal patients. At the same time, the addition of boost is associated with increased risk of worsening of cosmesis and no clear cut survival advantage. Radiological modalities such as fluoroscopy, ultrasound and CT scan have aided in accurate delineation of tumour bed with increasing efficacy. A widespread application of these techniques might ultimately translate into improved local control with minimal cosmetic deficit. The present article discusses the role of radiotherapy boost and the means to delineate and deliver the same, identify the high risk group, optimal technique and the doses and fractionations to be used. It also discusses the extent of adverse cosmetic outcome after boost delivery, means to minimise it and relevance of tumour bed in present day scenario of advanced radiotherapy delivery techniques like (IMRT)

  2. Hepatitis B Vaccination in Bangladesh: a Suggestion Based on Current Evidence

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    Shafquat Mohammed Rafiq

    2006-12-01

    Full Text Available IntroductionThe hepatitis B virus (HBV causes up to a million deaths worldwide and 16 million health care related infections in the tropics each year(1,2, and over 350 million become chronically infected carriers who have no significant liver disease; approximately three quarters of them are in Asia and the western pacific region(3,4. HBV infection is a potentially life threatening condition as many of the affected individuals progress to chronic hepatitis,cirrhosis and hepatocellular carcinoma (HCC(3. In infants and children, acute hepatitis B infection is nearly always asymptomatic, whereas in adults it is usually the opposite. But on the other hand, the risk of becoming chronic carriage is much greater in children than in adults; as many as 90% of infants born to Hepatitis B e Antigen (HBeAg positive mothers become carriers themselves and, therefore, in long term are more likely to developchronic liver disease(5. Currently, though several antiviral drugs are used,there is no reliable curative treatment for HBV once it has been acquired and prevention by universal immunization remains the strategy for reducing the number of acute infections, chronic carriage and the long-term burden from diseases such as HCC(4,6. In 1991, in an attempt to reduce the global impact of HBV infection, WHO recommended that hepatitis B vaccination should be integrated into national immunization programs in all countries(7.Some Asian countries, for instance, Thailand, haveadopted the policy of immunizing children universally against the disease as early as 1992, however many others lagged behind(4.The true prevalence of Hepatitis B in Bangladesh is yet to be ascertained by a reliable study. Data available from different studies show that it ranges between 0.8 and 5.4% depending on the study design, samples and laboratory methods used(8-10.These data were based on detection of HBsAg antigen; the rates would have been higher, had they been based on anti-HBc antibody(11

  3. Advancing Implementation of Evidence-Based Public Health in China: An Assessment of the Current Situation and Suggestions for Developing Regions.

    Science.gov (United States)

    Shi, Jianwei; Jiang, Chenghua; Tan, Duxun; Yu, Dehua; Lu, Yuan; Sun, Pengfei; Pan, Ying; Zhang, Hanzhi; Wang, Zhaoxin; Yang, Beilei

    2016-01-01

    Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively. Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR). Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system. Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion.

  4. Advancing Implementation of Evidence-Based Public Health in China: An Assessment of the Current Situation and Suggestions for Developing Regions

    Directory of Open Access Journals (Sweden)

    Jianwei Shi

    2016-01-01

    Full Text Available Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively. Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR. Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system. Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion.

  5. Advancing Implementation of Evidence-Based Public Health in China: An Assessment of the Current Situation and Suggestions for Developing Regions

    Science.gov (United States)

    Shi, Jianwei; Tan, Duxun; Yu, Dehua; Lu, Yuan; Sun, Pengfei; Pan, Ying; Zhang, Hanzhi; Yang, Beilei

    2016-01-01

    Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively. Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR). Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system. Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion. PMID:27597958

  6. [Evidence that suggest the reality of reincarnation].

    Science.gov (United States)

    Bonilla, Ernesto

    2015-06-01

    Worldwide, children can be found who reported that they have memories of a previous life. More than 2,500 cases have been studied and their specifications have been published and preserved in the archives of the Division of Perceptual Studies at the University of Virginia (United States). Many of those children come from countries where the majority of the inhabitants believe in reincarnation, but others come from countries with different cultures and religions that reject it. In many cases, the revelations of the children have been verified and have corresponded to a particular individual, already dead. A good number of these children have marks and birth defects corresponding to wounds on the body of his previous personality. Many have behaviors related to their claims to their former life: phobias, philias, and attachments. Others seem to recognize people and places of his supposed previous life, and some of their assertions have been made under controlled conditions. The hypothesis of reincarnation is controversial. We can never say that it does not occur, or will obtain conclusive evidence that it happens. The cases that have been described so far, isolated or combined, do not provide irrefutable proof of reincarnation, but they supply evidence that suggest its reality.

  7. Current evidence for osteoarthritis treatments.

    Science.gov (United States)

    Anandacoomarasamy, Ananthila; March, Lyn

    2010-02-01

    Osteoarthritis (OA) is the most common form of arthritis and the leading cause of chronic disability among older people. The burden of the disease is expected to rise with an aging population and the increasing prevalence of obesity. Despite this, there is as yet no cure for OA. However, in recent years, a number of potential therapeutic advances have been made, in part due to improved understanding of the underlying pathophysiology. This review provides the current evidence for symptomatic management of OA including nonpharmacological, pharmacological and surgical approaches. The current state of evidence for disease-modifying therapy in OA is also reviewed.

  8. [Evidence of work-related musculo-skeletal disorders of the upper extremities and current methods of risk assessment: can Charlie Chaplin give us any suggestions in "modern times"].

    Science.gov (United States)

    Apostoli, P; Sala, Emma

    2009-01-01

    in some sequences of the film "Modern Times" Chaplin is clearly involved in activities at high risk for work-related musculo-skeletal disorders of the upper extremities (UEWMSDs), but evidence and perception of any complaint are not evident. To evaluate the extent of the biomechanical risk using current risk assessment methods and discuss the possible reasons for lack of complaints. we made an analysis using six of the current methods for ergonomic risk assessment (State of Washington, check list OCRA, HAL by ACGIH, RULA Strain Index, OREGE). All the methods applied demonstrated high-to-very high levels of biomechanical risk for the upper extremities, with evident psychic effects but without apparent musculo-skeletal disorders. The discrepancy between evident psychological disorders ad apparent absence of UEWMSDs are discussed as being due to either: an artistic choice by Charlie Chaplin who focused on the aspects thought to be more immediately and easily comic; the short duration of the physical load exertion; or because of a different perception of muscular work and fatigue that was also typical until the 1970's and 1980's, which also confirmed the principles and practices of our preventive and medical disciplines at that time.

  9. Factor structure of suggestibility revisited: new evidence for direct and indirect suggestibility

    Directory of Open Access Journals (Sweden)

    Romuald Polczyk

    2016-05-01

    Full Text Available Background Yielding to suggestions can be viewed as a relatively stable individual trait, called suggestibility. It has been long proposed that there are two kinds of suggestible influence, and two kinds of suggestibility corresponding to them: direct and indirect. Direct suggestion involves overt unhidden influence, while indirect suggestion concerns influence that is hidden, and the participant does not know that the suggestibility is being measured. So far however, empirical evidence for the existence of the two factors has been scarce. In the present study, more sophisticated and reliable tools for measuring suggestibility were applied than in the previous research, in the hope that better measurement would reveal the factor structure of suggestibility. Two tests of direct suggestibility were used: the Harvard Group Scale of Hypnotic Susceptibility, Form A, measuring hypnotic susceptibility, and the Barber Suggestibility Scale, measuring non-hypnotic direct imaginative suggestibility. Three tests served to measure indirect suggestibility: the Sensory Suggestibility Scale, measuring indirect suggestibility relating to perception; the Gudjonsson Suggestibility Scale, measuring the tendency to yield to suggestive questions and changing answers after negative feedback; and the Emotional Dialogs Tests, measuring the tendency to perceive nonexistent aggression. Participants and procedure In sum, 115 participants were tested, 69 women, 49 men, mean age 22.20 years, SD = 2.20. Participants were tested in two sessions, lasting for a total of four hours. Results Confirmatory factor analyses confirmed the existence of two uncorrelated factors of suggestibility: direct and indirect. Conclusions Suggestibility may indeed involve two factors, direct and indirect, and failure to discover them in previous research may be due to methodological problems.

  10. Current and Suggested focus on Sustainability in Pyrometallurgy

    Science.gov (United States)

    See, J. B.; Robertson, D. G. C.; Mackey, P. J.

    The production of iron and steel and non-ferrous metals by pyrometallurgical processes will remain a critical element in meeting the demand for materials in both developed and developing nations. Given the important need to reduce and minimise greenhouse gas emissions the technological focus of future pyrometallurgical R&D by universities and industry alike must concentrate on sustainability issues such as improved energy efficiency, recycling and waste minimization. Continued efforts are also needed on process optimization and new process development with a view to reducing capital and operating costs of the new large "mega" plants. Using the academic and industrial backgrounds of the authors, the present paper reviews the current status of R&D in pyrometallurgy in university departments with a particular emphasis on sustainability issues. The role of industry and government laboratories is also reviewed although primarily for developed countries. The paper also includes comments and suggestions on the future requirements for education and R&D in pyrometallurgy in developed countries to maximise sustainability. It is also suggested that future R&D in pyrometallurgy will be even more concentrated in developing countries — most notably China.

  11. Current Situation in Vocational Schools: Issues and Some Suggested Solutions

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    Reha Metin ALKAN

    2014-12-01

    Full Text Available Vocational Schools which have undertaken various missions throughout history were established in order to train intermediate staff s with suff icient knowledge and skills in their fields, in accordance with the requirements of trade, industry and services sectors and they are the most important components of ‘vocational and technical education system' today. Analyzing the education given in the vocational schools in accordance with the national and international requirements, developing technologies and the needs of business world and making the necessary arrangements in line with these will contribute to the employability and preferability of graduates of these schools in an eff icient way. Many industrialists/businessmen in our country stated that they experienced serious problems in the supply of qualified staff with suff icient knowledge and skills needed in sectors. Although much progress has been achieved in this subject, it is a fact that there are still a lot of work to be done. In this study, current situation and main troubles in vocational schools are discussed in the light of the experiences gained at Hitit University Vocational School which was established about 40 years ago in Çorum and which is one of the first high schools in Turkey and some solutions are suggested in accordance with the problems mentioned.

  12. The Current State of China's Freshwater Resources and Related Suggestions

    Institute of Scientific and Technical Information of China (English)

    Wu Ruijin

    2001-01-01

    China has many lakes, marshlands and rivers. Due to their uneven geographical distribution and varied degrees of salinity, their exploitable freshwater resources are limited. In the wake of the highspeed growth of national economy in recent years, human infringement upon their natural settings has been increasingly intense, leading to the degeneration of China's lacustrine ecosystems and the degradation of their surrounding environments. Lakes are shrinking and becoming more saline. In arid and semi-arid inland areas, some of them have even disappeared. In addition, lake water pollution and eutrophication in densely populated areas are getting worse, resulting in serious water shortages in some places. Silt deposition in lake basins, water surface shrinkage caused by hectic and irrational reclamation for farmland, the prevalence of flooding and water-logging calamities and ecosystem depletion caused by predatory exploitation of fishery resources, all of these have become restrictive factors in regional sustainable development. The author of this article suggests measures for the protection and sustainable exploitation of limnetic settings in China.

  13. Evidence suggesting possible SCA1 gene involvement in schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Diehl, S.R.; Wange, S.; Sun, C. [NIDR, Bethesda, MD (United States)] [and others

    1994-09-01

    Several findings suggest a possible role for the SCA1 gene on chromosome 6p in some cases of schizophrenia. First, linkage analyses in Irish pedigrees provided LOD scores up to 3.0 for one model tested using microsatellites closely linked to SCA1. Reanalysis of these data using affected sibpair methods yielded a significant result (p = 0.01) for one marker. An attempt to replicate this linkage finding was made using 44 NIMH families (206 individuals, 80 affected) and 12 Utah families (120 individuals, 49 affected). LOD scores were negative in these new families, even allowing for heterogeneity, as were results using affected sibpair methods. However, one Utah family provided a LOD score of 1.3. We also screened the SCA1 trinucleotide repeat to search for expansions characteristic of this disorder in these families and in 38 additional unrelated schizophrenics. We found 1 schizophrenic with 41 repeats, which is substantially larger than the maximum size of 36 repeats observed in previous studies of several hundred controls. We are now assessing whether the distribution of SCA1 repeats differs significantly in schizophrenia versus controls. Recent reports suggest possible anticipation in schizophrenia (also characteristic of SCA1) and a few cases of psychiatric symptoms suggesting schizophrenia have been observed in the highly related disorder DRPLA (SCA2), which is also based on trinucleotide repeat expansion. These findings suggest that further investigations of this gene and chromosome region may be a priority.

  14. Personal space invasions in the lavatory: suggestive evidence for arousal.

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    Middlemist, R D; Knowles, E S; Matter, C F

    1976-05-01

    The hypothesis that personal space invasions produce arousal was investigated in a field experiment. A men's lavatory provided a setting where norms for privacy were salient, where personal space invasions could occur in the case of men urinating, where the opportunity for compensatory responses to invasion were minimal, and where proximity-induced arousal could be measured. Research on micturation indicates that social stressors inhibit relaxation of the external urethral sphincter, which would delay the onset of micturation, and that they increase intravesical pressure, which would shorten the duration of micturation once begun. Sixty lavatory users were randomly assigned to one of three levels of interpersonal distance and their micturation times were recorded. In a three-urinal lavatory, a confederate stood immediately adjacent to a subject, one urinal removed, or was absent. Paralleling the results of a correlational pilot study, close interpersonal distances increased the delay of onset and decreased the persistence of micturation. These findings provide objective evidence that personal space invasions produce physiological changes associated with arousal.

  15. Evidences Suggesting Involvement of Viruses in Oral Squamous Cell Carcinoma

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    Kanupriya Gupta

    2013-01-01

    Full Text Available Oral cancer is one of the most common cancers and it constitutes a major health problem particularly in developing countries. Oral squamous cell carcinoma (OSCC represents the most frequent of all oral neoplasms. Several risk factors have been well characterized to be associated with OSCC with substantial evidences. The etiology of OSCC is complex and involves many factors. The most clearly defined potential factors are smoking and alcohol, which substantially increase the risk of OSCC. However, despite this clear association, a substantial proportion of patients develop OSCC without exposure to them, emphasizing the role of other risk factors such as genetic susceptibility and oncogenic viruses. Some viruses are strongly associated with OSCC while the association of others is less frequent and may depend on cofactors for their carcinogenic effects. Therefore, the exact role of viruses must be evaluated with care in order to improve the diagnosis and treatment of OSCC. Although a viral association within a subset of OSCC has been shown, the molecular and histopathological characteristics of these tumors have yet to be clearly defined.

  16. Fever management: Evidence vs current practice.

    Science.gov (United States)

    El-Radhi, A Sahib Mehdi

    2012-12-08

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it's potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice.

  17. Current clinical evidence on pioglitazone pharmacogenomics

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    Marina eKawaguchi-Suzuki

    2013-11-01

    Full Text Available Pioglitazone is the most widely used thiazolidinedione and acts as an insulin-sensitizer through activation of the Peroxisome Proliferator-Activated Receptor-γ (PPARγ. Pioglitazone is approved for use in the management of type 2 diabetes mellitus, but its use in other therapeutic areas is increasing due to pleiotropic effects. In this hypothesis article, the current clinical evidence on pioglitazone pharmacogenomics is summarized and related to variability in pioglitazone response. How genetic variation in the human genome affects the pharmacokinetics and pharmacodynamics of pioglitazone was examined. For pharmacodynamic effects, hypoglycemic and anti-atherosclerotic effects, risks of fracture or edema, and the increase in body mass index in response to pioglitazone based on genotype were examined. The genes CYP2C8 and PPARG are the most extensively studied to date and selected polymorphisms contribute to respective variability in pioglitazone pharmacokinetics and pharmacodynamics. We hypothesized that genetic variation in pioglitazone pathway genes contributes meaningfully to the clinically observed variability in drug response. To test the hypothesis that genetic variation in PPARG associates with variability in pioglitazone response, we conducted a meta-analysis to synthesize the currently available data on the PPARG p.Pro12Ala polymorphism. The results showed that PPARG 12Ala carriers had a more favorable change in fasting blood glucose from baseline as compared to patients with the wild-type Pro12Pro genotype (p=0.018. Unfortunately, findings for many other genes lack replication in independent cohorts to confirm association; further studies are needed. Also, the biological functionality of these polymorphisms is unknown. Based on current evidence, we propose that pharmacogenomics may provide an important tool to individualize pioglitazone therapy and better optimize therapy in patients with T2DM or other conditions for which pioglitazone

  18. Management and prevention of neonatal anemia: current evidence and guidelines.

    Science.gov (United States)

    von Lindern, Jeannette S; Lopriore, Enrico

    2014-04-01

    Neonatal anemia is a common disorder, particularly in (very) preterm neonates. Management of neonatal anemia is based principally on red blood cell (RBC) transfusion. Although the use of blood products is nowadays widespread in neonatal medicine, evidence on the potential benefit is extremely limited. Recent studies suggest that RBC transfusions in newborns may be associated with an increased risk for necrotizing enterocolitis, transfer of infectious agents and negative effects on neurodevelopmental outcome. Whether the benefits of RBC transfusions outweigh the risks is controversial and requires further studies. In this review, we summarize the current evidence on the management of neonatal anemia and compare the various international guidelines. In addition, we discuss the various strategies to prevent neonatal anemia and reduce the need for RBC transfusions and discuss important trials currently enrolling patients to improve the management in neonatal anemia.

  19. Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions-key messages

    DEFF Research Database (Denmark)

    Gottrup, Finn; Apelqvist, Jan; Bjarnsholt, Thomas;

    2014-01-01

    This article constitutes an extraction of key messages originally presented in the Document: Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions written by the European Wound Management Association (EWMA), and originally published by the Journal of Wound Care in 2013. All...

  20. Culture Teaching in China’s Current College English Class and Some Suggestions

    Institute of Scientific and Technical Information of China (English)

    李思远

    2014-01-01

    Culture is an important part in foreign language learning because no language can leave its culture contexts. Therefore, if one wants to learn a foreign language well, the acculturation is very important. But in the Chinese EFL classroom, for kinds of reasons, teachers often pay more attention to the explanation of grammatical rules and ignored the culture input which makes many Chinese students lack of pragmatic competence and can not use English in a proper way. This article will analyze the cur-rent culture teaching in our college English class and propose some suggestions.

  1. Current evidence supporting "letrozole" for ovulation induction

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    Sujata Kar

    2013-01-01

    Full Text Available Aromatase inhibitor "letrozole" was first introduced as a potential ovulation induction (OI drug almost a decade back. Large number of studies has been published using letrozole for OI: In polycystic ovary syndrome (PCOS women, clomiphene citrate (CC resistant women, for intrauterine insemination and also in various protocols of mild stimulation for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI. Letrozole appears to be a good option, with its oral route of administration, cost, shorter half-life and negligible side effects. However, the verdict on efficacy and safety of letrozole is still uncertain. This review explores the current scientific data supporting letrozole for OI.

  2. Current clinical evidence on topiramate pharmacokinetics

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    Jakovljević Mihajlo

    2009-01-01

    Full Text Available Topiramate is biochemically classified as a fructopyranose sulphamate. Discovered as early as 1979, during middle 1980's it was approved in many countries for the treatment of epilepsies and migraine prevention. More recently, in the experimental stage, possible new indications have been disclosed: treatment of obesity, bipolar disorder, also cessation of smoking, neuropathic pain, cerebral pseudotumour, bulimia, periventricular leucomalatia in preterm infants and alcohol addiction. Most epileptologists consider it to be the first choice antiepileptic drug in severe pharmacoresistant epilepsies. A substantial corpus of evidence in paediatric population has been accumulated that confirms its efficiency in the treatment of generalised tonic-clonic seizures, Lenox-Gestaut syndrome, partial, absence and combined seizures. Having a unique monosaccharide chemical structure among other anticonvulsant drugs, characterizes it with special pharmacokinetic features. This substance exhibits a low interindividual variability in plasma levels and hence it features predictable pharmacokinetics. A steady state plasma concentration of topiramate increases linearly with higher dosages. Serum protein binding is approximately 15%, and biologic half-life in healthy volunteers is considered to range from 20 to 30 hours. Mean expected distribution volume rates from 0.55-0.8 l/kg, and accordingly, the drug shows a low and saturable binding capacity toward erythrocytes. It has not been present at the market for a sufficiently long time that would enable us to speak about a significant accumulation of data on its metabolism based on post-registration 4th stage clinical trials. For this purpose, we have done a literature review in order to summarise so far reported experience on topiramate pharmacokinetics in patients and healthy adults. Deeper understanding of its pharmacokinetic profile could enable a better technological design of the produced drug and the choice of

  3. Current demographics suggest future energy supplies will be inadequate to slow human population growth.

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    John P DeLong

    Full Text Available Influential demographic projections suggest that the global human population will stabilize at about 9-10 billion people by mid-century. These projections rest on two fundamental assumptions. The first is that the energy needed to fuel development and the associated decline in fertility will keep pace with energy demand far into the future. The second is that the demographic transition is irreversible such that once countries start down the path to lower fertility they cannot reverse to higher fertility. Both of these assumptions are problematic and may have an effect on population projections. Here we examine these assumptions explicitly. Specifically, given the theoretical and empirical relation between energy-use and population growth rates, we ask how the availability of energy is likely to affect population growth through 2050. Using a cross-country data set, we show that human population growth rates are negatively related to per-capita energy consumption, with zero growth occurring at ∼13 kW, suggesting that the global human population will stop growing only if individuals have access to this amount of power. Further, we find that current projected future energy supply rates are far below the supply needed to fuel a global demographic transition to zero growth, suggesting that the predicted leveling-off of the global population by mid-century is unlikely to occur, in the absence of a transition to an alternative energy source. Direct consideration of the energetic constraints underlying the demographic transition results in a qualitatively different population projection than produced when the energetic constraints are ignored. We suggest that energetic constraints be incorporated into future population projections.

  4. Current Situation and Suggestions of Decorative Fishery Development in Hainan Province

    Institute of Scientific and Technical Information of China (English)

    Xi; ZHANG; Ning; YANG; Hai; HUANG

    2013-01-01

    Decorative fishery is an important part of recreational fisheries,Hainan has the potential to develop decorative fishery.In this paper,on the basis of the deep-going survey on the current situation of decorative fishery development in Hainan,the main questions of decorative fish cultivation and market were discussed.At the same time,many suggestions were brought up,such as exploiting the biological resources of Hainan Island,strengthening scientific research efforts,introducing new varieties of ornamental species,strengthening industrial guidance and market management,etc.,which will benefit the rational utilization of tropical biological resources and increase the whole competitive advantage of decorative fishery in Hainan Province.

  5. Clinical utility of eslicarbazepine: current evidence

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    Zaccara G

    2015-02-01

    Full Text Available Gaetano Zaccara,1 Fabio Giovannelli,1,2 Massimo Cincotta,1 Alessia Carelli,3 Alberto Verrotti31Department of Medicine, Unit of Neurology, Florence Health Authority, Florence, Italy; 2Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA, University of Florence, Florence, Italy; 3Department of Pediatrics, University of Perugia, Perugia, ItalyAbstract: Eslicarbazepine acetate (ESL is a new antiepileptic drug whose mechanism of action is blockade of the voltage-gated sodium channel (VGSC. However, in respect to carbamazepine and oxcarbazepine, the active ESL metabolite (eslicarbazepine affects slow inactivation of VGSC and has a similar affinity for the inactivated state and a lower affinity for the resting state of the channel. This new antiepileptic drug has been recently approved in Europe (trade name Zebinix and in the United States (trade name Stedesa for adjunctive treatment in adult subjects with partial-onset seizures, with or without secondary generalization. Following oral administration, ESL is rapidly and extensively metabolized by hepatic esterases to eslicarbazepine. This active metabolite has a linear pharmacokinetic profile, a low binding to plasma proteins (<40%, and a half-life of 20–24 hours and is mainly excreted by kidneys in an unchanged form or as glucuronide conjugates. ESL is administered once a day and has a low potential for drug–drug interactions. Efficacy and safety of this drug in patients with focal seizures have been assessed in four randomized clinical trials, and responder rates (percentage of patients with a ≥50% improvement of their seizures ranged between 17% and 43%. Adverse events were usually mild to moderate, and the most common were dizziness, somnolence, diplopia, abnormal coordination, blurred vision, vertigo, headache, fatigue, nausea, and vomiting. ESL may be considered an interesting alternative to current antiepileptic drugs for the treatment of drug-resistant focal

  6. Mechanisms and Kinetics of Environmentally Assisted Cracking: Current Status, Issues, and Suggestions for Further Work

    Science.gov (United States)

    Lynch, S. P.

    2013-03-01

    Mechanisms and kinetics of metal-induced embrittlement, hydrogen-embrittlement, and stress-corrosion cracking are discussed, and long-standing controversies are addressed by reviewing critical observations. Recommendations are also made regarding further work (including repetition of previous work using more advanced measurement and characterisation techniques) that should be carried out in order to resolve some of the contentious issues. The evidence to date suggests that adsorption-based mechanisms, involving weakening of substrate interatomic bonds so that dislocation emission or decohesion is facilitated, accounts for embrittlement in many systems. Embrittling adsorbed species include some metal atoms, hydrogen, and complex ions produced by de-alloying. Other viable mechanisms of embrittlement include those based on (1) dissolution of anodic grain-boundary regions, and (2) decohesion at grain boundaries owing to segregated hydrogen and impurities. The hydrogen-enhanced localised-plasticity mechanism, based on solute hydrogen facilitating dislocation activity in the plastic zone ahead of cracks, makes a contribution in some cases, but is relatively unimportant compared with these other mechanisms for most fracture modes. The film-induced cleavage mechanism, proposed especially for stress-corrosion cracking in systems involving de-alloying at crack tips, is questionable on numerous grounds, and is probably not viable. Rate-controlling processes for environmentally assisted cracking are not well established, except for solid-metal induced embrittlement where surface self-diffusion of embrittling atoms to crack tips controls cracking kinetics. In some systems, adsorption kinetics are probably rate-controlling for liquid-metal embrittlement, hydrogen-environment embrittlement, and stress-corrosion cracking. In other cases, rate-controlling processes could include the rate of anodic or cathodic reactions at and behind crack tips (responsible for producing embrittling

  7. “Mucosal healing” in ulcerative colitis:Between clinical evidence and market suggestion

    Institute of Scientific and Technical Information of China (English)

    Cristiano; Pagnini; Francesca; Menasci; Stefano; Festa; Gianenrico; Rizzatti; Gianfranco; Delle; Fave

    2014-01-01

    In recent decades,the prominent role of endoscopy in the management of ulcerative colitis(UC)has been translated into the concept of mucosal healing(MH)as a fundamental therapeutic end-point.This is partially the consequence of growing evidence of a positive prognostic role of MH on the disease course and partially due to market cues indicating a higher rate of MH in patients treated by novel potent biologic agents.The aim of the present review is to clarify the current knowledge of MH in UC,analyzing the definition,the putative prognostic role and the association of MH with the current drugs used to treat UC patients.Because solid data about the management of UC patients based solely on the healing of the mucosa are not yet available,a tailored approach for individual patients thatconsiders the natural history of UC and the presence of prognostic indicators of aggressive disease is desirable.Consequently,unnecessary examinations and treatment would be avoided and restricted to UC patients who require the maximum amount of effort to affect the disease course in the short and long term.

  8. Molecular evidence to suggest the origin of a colonization: Drosophila subobscura in America.

    Science.gov (United States)

    Araúz, Pedro A; Peris-Bondia, Francesc; Latorre, Amparo; Serra, Luís; Mestres, Francesc

    2011-12-01

    The recent colonization of America by Drosophila subobscura represents a great opportunity for evolutionary biology studies. Knowledge of the populations from which the colonization started would provide an understanding of how genetic composition changed during adaptation to the new environment. Thus, a 793 nucleotide fragment of the Odh (Octanol dehydrogenase) gene was sequenced in 66 chromosomal lines from Barcelona (western Mediterranean) and in 66 from Mt. Parnes (Greece, eastern Mediterranean). No sequence of Odh fragment in Barcelona or Mt. Parnes was identical to any of those previously detected in America. However, an Odh sequence from Barcelona differed in only one nucleotide from another found in American populations. In both cases, the chromosomal lines presented the same inversion: O(7), and the Odh gene was located within this inversion. This evidence suggests a possible western Mediterranean origin for the colonization. Finally, the molecular and inversion data indicate that the colonization was not characterized by multiple reintroductions.

  9. Evidence for preserved novel word learning in Down syndrome suggests multiple routes to vocabulary acquisition.

    Science.gov (United States)

    Mosse, Emma K; Jarrold, Christopher

    2011-08-01

    Three studies investigated novel word learning, some requiring phonological production, each involving between 11 and 17 individuals with Down syndrome, and between 15 and 24 typically developing individuals matched for receptive vocabulary. The effect of stimuli wordlikeness and incidental procedure-based memory demands were examined to see whether these may account for an apparent impairment in word learning in Down syndrome demonstrated in earlier research. Paired associate word and nonword learning tasks were presented, requiring participants to learn the names of novel characters. The nonword stimuli varied in the degree of wordlikeness in 2 studies. A third study investigated extraneous task demand. Across 3 studies, there was no suggestion of a word learning deficit associated with Down syndrome (η(2)(p) for the main effect of group of .03, .11, and .03, respectively), despite the level of phonological representation required. There was evidence that novel word learning by participants with Down syndrome exceeded that which their verbal short-term memory capacity would predict. Vocabulary acquisition in Down syndrome may not rely on verbal short-term memory to the same extent as in typically developing children, lending support to the suggestion that new word learning may be underpinned by an additional memory process.

  10. Poor quality evidence suggests that failure rates for atraumatic restorative treatment and conventional amalgam are similar.

    Science.gov (United States)

    Hurst, Dominic

    2012-06-01

    The Medline, Cochrane CENTRAL, Biomed Central, Database of Open Access Journals (DOAJ), OpenJ-Gate, Bibliografia Brasileira de Odontologia (BBO), LILACS, IndMed, Sabinet, Scielo, Scirus (Medicine), OpenSIGLE and Google Scholar databases were searched. Hand searching was performed for journals not indexed in the databases. References of included trials were checked. Prospective clinical trials with test and control groups with a follow up of at least one year were included. Data abstraction was conducted independently and clinical and methodologically homogeneous data were pooled using a fixed-effects model. Eighteen trials were included. From these 32 individual dichotomous datasets were extracted and analysed. The majority of the results show no differences between both types of intervention. A high risk of selection-, performance-, detection- and attrition bias was identified. Existing research gaps are mainly due to lack of trials and small sample size. The current evidence indicates that the failure rate of high-viscosity GIC/ART restorations is not higher than, but similar to that of conventional amalgam fillings after periods longer than one year. These results are in line with the conclusions drawn during the original systematic review. There is a high risk that these results are affected by bias, and thus confirmation by further trials with suitably high numbers of participants is needed.

  11. Bruxism: overview of current knowledge and suggestions for dental implants planning

    NARCIS (Netherlands)

    Manfredini, D.; Bucci, M.B.; Sabattini, V.B.; Lobbezoo, F.

    2011-01-01

    Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures and representing a risk factor for dental implant survival. The available literature does not provide evidence-based guidelines for the management of bruxers undergoing implant-

  12. Low Level Evidence Suggests That Librarian-Led Instruction in Evidence Based Practice is Effective Regardless of Instructional Model

    Directory of Open Access Journals (Sweden)

    Lindsay J. Alcock

    2017-06-01

    studies which included descriptive statistics and many also included inferential statistics intended to show significance. Differences between groups were assessed with parametric measures in 9 studies and non-parametric measures in 15 studies. Good to high statistical significance on at least 1 measurement was achieved in 23 studies. Given the absence of effect sizes, the level of differences between study groups could not be determined. Conclusion – Numerous pedagogical methods are used in librarian-led instruction in evidence based practice. However, there is a paucity of high level evidence and the literature suggests that no instructional method is demonstrated to be more effective than another.

  13. Evidence to suggest that teeth act as human ornament displays signalling mate quality.

    Directory of Open Access Journals (Sweden)

    Colin A Hendrie

    Full Text Available Ornament displays seen in animals convey information about genetic quality, developmental history and current disease state to both prospective sexual partners and potential rivals. In this context, showing of teeth through smiles etc is a characteristic feature of human social interaction. Tooth development is influenced by genetic and environmental factors. Adult teeth record environmental and traumatic events, as well as the effects of disease and ageing. Teeth are therefore a rich source of information about individuals and their histories. This study examined the effects of digital manipulations of tooth colour and spacing. Results showed that deviation away from normal spacing and/or the presence of yellowed colouration had negative effects on ratings of attractiveness and that these effects were markedly stronger in female models. Whitening had no effect beyond that produced by natural colouration. This indicates that these colour induced alterations in ratings of attractiveness are mediated by increased/decreased yellowing rather than whitening per se. Teeth become yellower and darker with age. Therefore it is suggested that whilst the teeth of both sexes act as human ornament displays, the female display is more complex because it additionally signals residual reproductive value.

  14. Electroencephalographic neurofeedback: Level of evidence in mental and brain disorders and suggestions for good clinical practice.

    Science.gov (United States)

    Micoulaud-Franchi, J-A; McGonigal, A; Lopez, R; Daudet, C; Kotwas, I; Bartolomei, F

    2015-12-01

    The technique of electroencephalographic neurofeedback (EEG NF) emerged in the 1970s and is a technique that measures a subject's EEG signal, processes it in real time, extracts a parameter of interest and presents this information in visual or auditory form. The goal is to effectuate a behavioural modification by modulating brain activity. The EEG NF opens new therapeutic possibilities in the fields of psychiatry and neurology. However, the development of EEG NF in clinical practice requires (i) a good level of evidence of therapeutic efficacy of this technique, (ii) a good practice guide for this technique. Firstly, this article investigates selected trials with the following criteria: study design with controlled, randomized, and open or blind protocol, primary endpoint related to the mental and brain disorders treated and assessed with standardized measurement tools, identifiable EEG neurophysiological targets, underpinned by pathophysiological relevance. Trials were found for: epilepsies, migraine, stroke, chronic insomnia, attentional-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, major depressive disorder, anxiety disorders, addictive disorders, psychotic disorders. Secondly, this article investigates the principles of neurofeedback therapy in line with learning theory. Different underlying therapeutic models are presented didactically between two continua: a continuum between implicit and explicit learning and a continuum between the biomedical model (centred on "the disease") and integrative biopsychosocial model of health (centred on "the illness"). The main relevant learning model is to link neurofeedback therapy with the field of cognitive remediation techniques. The methodological specificity of neurofeedback is to be guided by biologically relevant neurophysiological parameters. Guidelines for good clinical practice of EEG NF concerning technical issues of electrophysiology and of learning are suggested. These require validation by

  15. Mixed signals? Morphological and molecular evidence suggest a color polymorphism in some neotropical polythore damselflies.

    Directory of Open Access Journals (Sweden)

    Melissa Sánchez Herrera

    Full Text Available The study of color polymorphisms (CP has provided profound insights into the maintenance of genetic variation in natural populations. We here offer the first evidence for an elaborate wing polymorphism in the Neotropical damselfly genus Polythore, which consists of 21 described species, distributed along the eastern slopes of the Andes in South America. These damselflies display highly complex wing colors and patterning, incorporating black, white, yellow, and orange in multiple wing bands. Wing colors, along with some components of the male genitalia, have been the primary characters used in species description; few other morphological traits vary within the group, and so there are few useful diagnostic characters. Previous research has indicated the possibility of a cryptic species existing in P. procera in Colombia, despite there being no significant differences in wing color and pattern between the populations of the two putative species. Here we analyze the complexity and diversity of wing color patterns of individuals from five described Polythore species in the Central Amazon Basin of Peru using a novel suite of morphological analyses to quantify wing color and pattern: geometric morphometrics, chromaticity analysis, and Gabor wavelet transformation. We then test whether these color patterns are good predictors of species by recovering the phylogenetic relationships among the 5 species using the barcode gene (COI. Our results suggest that, while highly distinct and discrete wing patterns exist in Polythore, these "wingforms" do not represent monophyletic clades in the recovered topology. The wingforms identified as P. victoria and P. ornata are both involved in a polymorphism with P. neopicta; also, cryptic speciation may have taking place among individuals with the P. victoria wingform. Only P. aurora and P. spateri represent monophyletic species with a single wingform in our molecular phylogeny. We discuss the implications of this

  16. Spectroscopic observations of evolving flare ribbon substructure suggesting origin in current sheet waves

    Science.gov (United States)

    Brannon, Sean R.; Longcope, Dana; Qiu, Jiong

    2015-04-01

    A flare ribbon is the chromospheric image of reconnection at a coronal current sheet. The dynamics and structure of the ribbon can thus reveal properties of the current sheet, including motion of the reconnecting flare loops. We present imaging and spectroscopic observations from the Interface Region Imaging Spectrograph (IRIS) of the evolution of a flare ribbon at high spatial resolution and time cadence. These reveal small-scale substructure in the ribbon, which manifest as oscillations in both position and Doppler velocities. We consider various alternative explanations for these oscillations, including modulation of chromospheric evaporation flows. Among these we find the best support for some form of elliptical wave localized to the coronal current sheet, such as a tearing mode or Kelvin-Helmholtz instability.IRIS is a NASA Small Explorer mission developed and operated by Lockheed Martin Solar and Astrophysics Laboratory. This work is supported by contract 8100002702 from Lockheed Martin to Montana State University, a Montana Space Grant Consortium fellowship, and by NASA through HSR.

  17. Current evidence on perinatal home visiting and intimate partner violence.

    Science.gov (United States)

    Sharps, Phyllis W; Campbell, Jacquelyn; Baty, Marguerite L; Walker, Keisha S; Bair-Merritt, Megan H

    2008-01-01

    To describe current evidence on home visiting interventions for pregnant or postpartum women with specific intimate partner violence assessment and content. Online bibliographic databases including PubMed, CINAHL Plus, and Web of Science and a hand search of bibliographies of relevant articles. Original research and intervention studies were included that contained (a) a well-described prenatal and/or postpartum home visitation; (b) an assessment of perinatal intimate partner violence; and (c) quantitative data describing health outcomes for the women and their infants. The search yielded 128 articles, and 8 relevant articles met all of the inclusion criteria. Nonresearch, nonintervention, and international articles were excluded. No perinatal home visiting interventions were designed to address intimate partner violence. Programs that screened for intimate partner violence found high rates, and the presence of intimate partner violence limited the ability of the intervention to improve maternal and child outcomes. Perinatal home visitation programs likely improve pregnancy and infant outcomes. Home visiting interventions addressing intimate partner violence in nonperinatal population groups have been effective in minimizing intimate partner violence and improving outcomes. This suggests that perinatal home visiting programs adding specific intimate partner violence interventions may reduce intimate partner violence and improve maternal and infant health. Continued rigorous research is needed.

  18. The rings of Saturn: State of current knowledge and some suggestions for future studies

    Science.gov (United States)

    Cuzzi, J. N.

    1978-01-01

    The state of our current knowledge of the properties of the ring system as a whole, and of the particles individually, is assessed. Attention is primarily devoted to recent results and possibilities for exploration of the ring system by a Saturn orbiter. In particular, the infrared and microwave properties of the ring system are discussed. The behavior of the ring brightness is not well understood in the critical transition spectral region from approximately 100 micrometers to approximately 1 cm. Also, the dynamical behavior of the ring system is discussed. Recent theoretical studies show that ongoing dynamical effects continually affect the ring structure in azimuth (possibly producing the A ring brightness asymmetry) and in the vertical direction. Orbital spacecraft-based studies of the rings will offer several unique advantages and impact important cosmogonical questions. Bistatic radar studies and millimeter-wavelength spectrometer/radiometry will give particle sizes and composition limits needed to resolve the question of the density of the rings, and provide important boundary conditions on the state of Saturn's protoplanetary nebula near the time of planetary formation.

  19. Diabetic peripheral neuropathy may not be as its name suggests: evidence from magnetic resonance imaging.

    Science.gov (United States)

    Tesfaye, Solomon; Selvarajah, Dinesh; Gandhi, Rajiv; Greig, Marni; Shillo, Pallai; Fang, Fang; Wilkinson, Iain D

    2016-02-01

    Diabetic peripheral neuropathy (DPN) affects up to 50% of patients with diabetes and is a major cause of morbidity and increased mortality. Its clinical manifestations include distressing painful neuropathic symptoms and insensitivity to trauma that result in foot ulcerations and amputations. Several recent studies have implicated poor glycemic control, duration of diabetes, hyperlipidemia (particularly hypertryglyceridaemia), elevated albumin excretion rates, and obesity as risk factors for the development of DPN. However, similar data are not available for painful DPN. Moreover, although there is now strong evidence for the importance of peripheral nerve microvascular disease in the pathogenesis of DPN, peripheral structural biomarkers of painful DPN are lacking. However, there is now emerging evidence for the involvement of the central nervous system in both painful and painless DPN afforded by magnetic resonance imaging. This review will focus on this emerging evidence for central changes in DPN, hitherto considered a peripheral nerve disease only.

  20. Evaluate and Suggest Evidence for the Relationship between Attainment and Learner Variables

    Institute of Scientific and Technical Information of China (English)

    贾颖

    2010-01-01

    <正>English as a popular foreign language in China is learned by many students.The attainment is often considered and talked.There are many factors which affect the learning outcomes. This essay will give a brief introduction of the aspects concerning the evidence for the relationship between attainment and learner variables.

  1. 16 CFR Figures 1 and 2 to Part 1204 - Suggested Instrumentation for Current Monitoring Device and High Voltage Facility

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Suggested Instrumentation for Current Monitoring Device and High Voltage Facility 1 Figures 1 and 2 to Part 1204 Commercial Practices CONSUMER... Instrumentation for Current Monitoring Device and High Voltage Facility EC03OC91.008...

  2. Debating Curricular Strategies for Teaching Statistics and Research Methods: What Does the Current Evidence Suggest?

    Science.gov (United States)

    Barron, Kenneth E.; Apple, Kevin J.

    2014-01-01

    Coursework in statistics and research methods is a core requirement in most undergraduate psychology programs. However, is there an optimal way to structure and sequence methodology courses to facilitate student learning? For example, should statistics be required before research methods, should research methods be required before statistics, or…

  3. Debating Curricular Strategies for Teaching Statistics and Research Methods: What Does the Current Evidence Suggest?

    Science.gov (United States)

    Barron, Kenneth E.; Apple, Kevin J.

    2014-01-01

    Coursework in statistics and research methods is a core requirement in most undergraduate psychology programs. However, is there an optimal way to structure and sequence methodology courses to facilitate student learning? For example, should statistics be required before research methods, should research methods be required before statistics, or…

  4. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    OpenAIRE

    Yoshihiro Abiko; Hirofumi Matsuoka; Itsuo Chiba; Akira Toyofuku

    2012-01-01

    Patients with atypical odontalgia (AO) complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i) What is the prevalence of AO in the community? (ii) What psychological problems are experienced by patients with AO? (iii) A...

  5. Therapeutic use of prebiotics, probiotics, and postbiotics to prevent necrotizing enterocolitis: what is the current evidence?

    Science.gov (United States)

    Patel, Ravi Mangal; Denning, Patricia Wei

    2013-03-01

    Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality, and preventive therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants, and probiotics are currently the most promising therapy for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical use of probiotics in preterm infants. This article summarizes the current evidence regarding the use of probiotics, prebiotics, and postbiotics in the preterm infant, including their therapeutic role in preventing NEC.

  6. Dietary options and behavior suggested by plant biomarker evidence in an early human habitat

    Science.gov (United States)

    Magill, Clayton R.; Ashley, Gail M.; Domínguez-Rodrigo, Manuel; Freeman, Katherine H.

    2016-03-01

    The availability of plants and freshwater shapes the diets and social behavior of chimpanzees, our closest living relative. However, limited evidence about the spatial relationships shared between ancestral human (hominin) remains, edible resources, refuge, and freshwater leaves the influence of local resources on our species' evolution open to debate. Exceptionally well-preserved organic geochemical fossils-biomarkers-preserved in a soil horizon resolve different plant communities at meter scales across a contiguous 25,000 m2 archaeological land surface at Olduvai Gorge from about 2 Ma. Biomarkers reveal hominins had access to aquatic plants and protective woods in a patchwork landscape, which included a spring-fed wetland near a woodland that both were surrounded by open grassland. Numerous cut-marked animal bones are located within the wooded area, and within meters of wetland vegetation delineated by biomarkers for ferns and sedges. Taken together, plant biomarkers, clustered bone debris, and hominin remains define a clear spatial pattern that places animal butchery amid the refuge of an isolated forest patch and near freshwater with diverse edible resources.

  7. The current state of evidence-based pediatric surgery.

    Science.gov (United States)

    Ostlie, Daniel J; St Peter, Shawn D

    2010-10-01

    The efficiency of medical care in the United States has become intensely scrutinized with expectations from patients, families, payors, lawmakers, and, currently, the President. The most effective vehicle to bring more efficient care is the employment of evidence-based medicine whenever possible. Evidence-based medicine is dependent on best evidence, and best evidence is generated from prospective trials. To evaluate current state of evidence based practice in pediatric surgery we reviewed the literature for trials conducted in our field the past 10 years. All randomized controlled trials from January 1999 through December 2009 published in the English literature were identified through a literature search using PubMed (www.pubmed.com). We included only those in pediatric general surgery excluding transplant, oncology, and the other nongeneral subspecialties. The search criteria produced 56 manuscripts, of which 51 described appropriate randomization techniques. A definitive trial design with a sample size calculation was utilized in only 19 studies (34%). A statistically significant difference between treatment arms was identified in 29 of the 56 (52%) trials. There were 26 different journals of publication, with the Journal of Pediatric Surgery being most common (20) followed by Pediatric Surgery International (7). The combined total publications from January 1999 through December 2009 for the 26 journals these randomized trials represent 0.04% of all publications. Appendicitis was the most common condition that was studied (n = 10) followed by pyloric stenosis (n = 4). Trials originated in 19 different countries led by the United States (28%), United Kingdom (14%), and Turkey (12%). There was a generally progressive increase in published trials from 1999 to 2009, however, the percentage of prospective articles published in pediatric surgery was similar to a previous review published in 1999. The current state of evidence-based surgery in pediatric surgery has

  8. Image guided robotic surgery: Current evidence for effectiveness in urology

    Directory of Open Access Journals (Sweden)

    Anum Pervez

    2014-12-01

    Full Text Available Objectives: Discussion of the evolution of image guided surgery (IGS and its fundamental components and current evidence for effectiveness of IGS in clinical urology. Methods: Literature search for image-guided robotic urology. Results: Current literature in image-guided robotic urology with its use in robot assisted radical prostatectomy and robot assisted partial nephrectomy are shown. Conclusions: Image guided surgery can be a useful aid to improve visualisation of anatomy and subsurface structures during minimally invasive surgery. Soft-tissue deformation makes it difficult to implement IGS in urology but current studies have shown an attempt to address this issue. The feasibility of IGS requires randomised control trials assessing in particular its accuracy and affect on clinical outcome.

  9. Genomic and archaeological evidence suggest a dual origin of domestic dogs.

    Science.gov (United States)

    Frantz, Laurent A F; Mullin, Victoria E; Pionnier-Capitan, Maud; Lebrasseur, Ophélie; Ollivier, Morgane; Perri, Angela; Linderholm, Anna; Mattiangeli, Valeria; Teasdale, Matthew D; Dimopoulos, Evangelos A; Tresset, Anne; Duffraisse, Marilyne; McCormick, Finbar; Bartosiewicz, László; Gál, Erika; Nyerges, Éva A; Sablin, Mikhail V; Bréhard, Stéphanie; Mashkour, Marjan; Bălăşescu, Adrian; Gillet, Benjamin; Hughes, Sandrine; Chassaing, Olivier; Hitte, Christophe; Vigne, Jean-Denis; Dobney, Keith; Hänni, Catherine; Bradley, Daniel G; Larson, Greger

    2016-06-03

    The geographic and temporal origins of dogs remain controversial. We generated genetic sequences from 59 ancient dogs and a complete (28x) genome of a late Neolithic dog (dated to ~4800 calendar years before the present) from Ireland. Our analyses revealed a deep split separating modern East Asian and Western Eurasian dogs. Surprisingly, the date of this divergence (~14,000 to 6400 years ago) occurs commensurate with, or several millennia after, the first appearance of dogs in Europe and East Asia. Additional analyses of ancient and modern mitochondrial DNA revealed a sharp discontinuity in haplotype frequencies in Europe. Combined, these results suggest that dogs may have been domesticated independently in Eastern and Western Eurasia from distinct wolf populations. East Eurasian dogs were then possibly transported to Europe with people, where they partially replaced European Paleolithic dogs.

  10. Structural evidence suggests that antiactivator ExsD from Pseudomonas aeruginosa is a DNA binding protein

    Energy Technology Data Exchange (ETDEWEB)

    Bernhards, R.C.; Robinson, H.; Jing, X.; Vogelaar, N. J.; Schubot, F. D.

    2009-03-01

    The opportunistic pathogen P. aeruginosa utilizes a type III secretion system (T3SS) to support acute infections in predisposed individuals. In this bacterium, expression of all T3SS-related genes is dependent on the AraC-type transcriptional activator ExsA. Before host contact, the T3SS is inactive and ExsA is repressed by the antiactivator protein ExsD. The repression, thought to occur through direct interactions between the two proteins, is relieved upon opening of the type III secretion (T3S) channel when secretion chaperone ExsC sequesters ExsD. We have solved the crystal structure of ?20ExsD, a protease-resistant fragment of ExsD that lacks only the 20 amino terminal residues of the wild-type protein at 2.6 {angstrom}. Surprisingly the structure revealed similarities between ExsD and the DNA binding domain of transcriptional repressor KorB. A model of an ExsD-DNA complex constructed on the basis of this homology produced a realistic complex that is supported by the prevalence of conserved residues in the putative DNA binding site and the results of differential scanning fluorimetry studies. Our findings challenge the currently held model that ExsD solely acts through interactions with ExsA and raise new questions with respect to the underlying mechanism of ExsA regulation.

  11. Suggestive evidence for association of two potassium channel genes with different idiopathic generalised epilepsy syndromes.

    Science.gov (United States)

    Chioza, B; Osei-Lah, A; Wilkie, H; Nashef, L; McCormick, D; Asherson, P; Makoff, A J

    2002-12-01

    Several potassium channel genes have been implicated in epilepsy. We have investigated three such genes, KCNJ3, KCNJ6 and KCNQ2, by association studies using a broad sample of idiopathic generalised epilepsy (IGE) unselected by syndrome. One of the two single nucleotide polymorphisms (SNPs) examined in one of the inward rectifying potassium channel genes, KCNJ3, was associated with IGE by genotype (P=0.0097), while its association by allele was of borderline significance (P=0.051). Analysis of the different clinical subgroups within the IGE sample showed more significant association with the presence of absence seizures (P=0.0041) and which is still significant after correction for multiple testing. Neither SNP in the other rectifying potassium channel gene, KCNJ6, was associated with IGE or any subgroup. None of the three SNPs in the voltage-gated potassium channel gene, KCNQ2, was associated with IGE. However, one SNP was associated with epilepsy with generalised tonic clonic seizures only (P=0.016), as was an SNP approximately 56 kb distant in the closely linked nicotinic acetylcholine gene CHRNA4 (P=0.014). These two SNPs were not in linkage disequilibrium with each other, suggesting that if they are not true associations they have independently occurred by chance. Neither association remains significant after correcting for multiple testing.

  12. Genomic evidence for rod monochromacy in sloths and armadillos suggests early subterranean history for Xenarthra.

    Science.gov (United States)

    Emerling, Christopher A; Springer, Mark S

    2015-02-07

    Rod monochromacy is a rare condition in vertebrates characterized by the absence of cone photoreceptor cells. The resulting phenotype is colourblindness and low acuity vision in dim-light and blindness in bright-light conditions. Early reports of xenarthrans (armadillos, sloths and anteaters) suggest that they are rod monochromats, but this has not been tested with genomic data. We searched the genomes of Dasypus novemcinctus (nine-banded armadillo), Choloepus hoffmanni (Hoffmann's two-toed sloth) and Mylodon darwinii (extinct ground sloth) for retinal photoreceptor genes and examined them for inactivating mutations. We performed PCR and Sanger sequencing on cone phototransduction genes of 10 additional xenarthrans to test for shared inactivating mutations and estimated the timing of inactivation for photoreceptor pseudogenes. We concluded that a stem xenarthran became an long-wavelength sensitive-cone monochromat following a missense mutation at a critical residue in SWS1, and a stem cingulate (armadillos, glyptodonts and pampatheres) and stem pilosan (sloths and anteaters) independently acquired rod monochromacy early in their evolutionary history following the inactivation of LWS and PDE6C, respectively. We hypothesize that rod monochromacy in armadillos and pilosans evolved as an adaptation to a subterranean habitat in the early history of Xenarthra. The presence of rod monochromacy has major implications for understanding xenarthran behavioural ecology and evolution.

  13. Involving fathers in prevention of mother to child transmission initiatives – what the evidence suggests

    Directory of Open Access Journals (Sweden)

    Natasha Croome

    2012-07-01

    Full Text Available Introduction: The current UNAIDS goal towards virtual ending or elimination of infants acquiring HIV by 2015 is perhaps the most achievable goal to date. Yet, models show that delivery of antiretroviral compounds alone will not suffice to achieve this goal, and a broader community-based approach to pregnancy, families and HIV is needed. Such an approach would highlight the important role of men in reproduction. Although early studies have shown it is cost-effective to include males, very few interventions have proceeded to involve men. Methods: This review utilized systematic review techniques to explore the literature on effective interventions for the inclusion of men in the prevention of HIV to infants. A key word search of literature sources generated 248 studies for hand sorting and interrogation. Of these, 13 were found to contain some information on involvement of males in some form of provision. Data were abstracted from these and form the basis of this review. Results: Background descriptive studies painted a picture of low male involvement, poor male inclusion and barriers to engagement at all stages. Yet, pregnancy intentions among men affected by HIV are high and the importance of fathers to family functioning – from relationships, through conception, pregnancy and parenting – is well established. Search strategies for interventions for males in HIV and pregnancy were used to generate studies of sufficient quality to inform strategies on the future of male involvement. Of the 317,434 papers on pregnancy and HIV, only 4178 included the term male (paternal or father. When these were restricted to intervention studies, only 248 remained for hand sorting, generating 13 studies of relevance for data extraction. The results show that all these interventions were concentrated around male partner HIV testing. In general, male partner testing was low and was amenable to change by offering voluntary counselling and testing (VCT information

  14. Empirical evidence suggests adverse climate events have not affected Australian women's health and well-being.

    Science.gov (United States)

    Powers, Jennifer R; Loxton, Deborah; Baker, Jeanine; Rich, Jane L; Dobson, Annette J

    2012-10-01

    To compare the health and well-being of women by exposure to adverse climate events. An Exceptional Circumstance declaration (EC) was used as a proxy for adverse climate events. The Australian government may provide financial support to people living in EC areas, i.e. areas experiencing a one in 20-25 year event (drought, flood or fire) that results in a severe, extended downturn in farm or farm-related income. Data from 6,584 53-58 year old non-metropolitan women participating in the 2004 survey of the Australian Longitudinal Study on Women's Health (ALSWH) were linked to EC data. Generalised linear models were used to analyse differences in SF-36 General Health (GH) and Mental Health (MH) and perceived stress by EC for all women. Models were adjusted for demographic, health-related and psychosocial factors potentially on the pathway between EC and health. Given that the effects on health were expected to be greater in vulnerable people, analyses were repeated for women with worse socioeconomic circumstances. GH, MH and stress did not differ for the 3,366 women in EC areas and 3,218 women in non-EC areas. GH, MH and stress were worse among vulnerable women (who had difficulty managing on available income) regardless of EC. This research adds to the existing literature on climate change, associated adverse climate events and health, by suggesting that multiple resources available in high income countries, including government support and individual psychosocial resources may mitigate some of the health impacts of adverse climate events, even among vulnerable people. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  15. Evidence for current diagnostic criteria of diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ritesh; Kumar[1; Lakshmana; Perumal; Nandhini[1; Sadishkumar; Kamalanathan[1; Jayaprakash; Sahoo[1; Muthupillai; Vivekanadan[1

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies.The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

  16. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Meredith Harrell

    2014-01-01

    Full Text Available Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC. Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014 using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease.

  17. Evidence for current diagnostic criteria of diabetes mellitus

    Science.gov (United States)

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications. PMID:27660696

  18. Kame deltas provide evidence for a new glacial lake and suggest early glacial retreat from central Lower Michigan, USA

    Science.gov (United States)

    Schaetzl, Randall J.; Lepper, Kenneth; Thomas, Sarah E.; Grove, Leslie; Treiber, Emma; Farmer, Alison; Fillmore, Austin; Lee, Jordan; Dickerson, Bethany; Alme, Kayleigh

    2017-03-01

    In association with an undergraduate Honors Seminar at Michigan State University, we studied two small kame deltas in north-central Lower Michigan. These recently identified deltas provide clear evidence for a previously unknown proglacial lake (Glacial Lake Roscommon) in this large basin located in an interlobate upland. Our first goal was to document and characterize the geomorphology of these deltas. Because both deltas are tied to ice-contact ridges that mark the former position of the retreating ice margin within the lake, our second goal was to establish the age of one of the deltas, thereby constraining the timing of ice retreat in this part of Michigan, for which little information currently exists. Both deltas are composed of well-sorted fine and medium sands with little gravel, and have broad, nearly flat surfaces and comparatively steep fronts. Samples taken from the upper 1.5 m of the deltas show little spatial variation in texture, aside from a general fining toward their outer margins. Gullies on the outer margins of both deltas probably postdate the formation of the deltas proper; we suggest that they formed by runoff during a permafrost period, subsequent to lake drawdown. We named the ice lobe that once covered this area the Mackinac Lobe, because it had likely advanced into the region across the Mackinac Straits area. Five of six optically stimulated luminescence (OSL) ages from one of the deltas had minimal scatter and were within ± 1000 years of one another, with a mean age of 23.1 ± 0.4 ka. These ages suggest that the Mackinac Lobe had started to retreat from the region considerably earlier than previously thought, even while ice was near its maximum extent in Illinois and Indiana, and the remainder of Michigan was ice-covered. This early retreat, which appears to coincide with a short-lived warm period indicated from the Greenland ice core, formed an "opening" that was at least occasionally flooded. Thick and deep, fine-textured deposits

  19. Current evidence and insights about genetics in thoracic aorta disease.

    Science.gov (United States)

    Bisleri, Gianluigi; Bagozzi, Lorenzo; Muneretto, Claudio

    2013-01-01

    Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve.

  20. Current Evidence and Insights about Genetics in Thoracic Aorta Disease

    Directory of Open Access Journals (Sweden)

    Gianluigi Bisleri

    2013-01-01

    Full Text Available Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve.

  1. The Intertemporal Approach to the Current Account: Evidence for Chile

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    Sergio A. Salas Landeau

    2002-03-01

    Full Text Available This paper studies the existence of "excess" current-account imbalances in Chile in the 1960-1999 period. This phenomenon is modelled using present value tests that allow for variable interest rates and exchange rate fluctuations. Despite its simplicity, most of the observed imbalances in the current account are accounted for by the model. Results suggest that using models where agents behave as forward-looking rational agents, is a valid framework. Moreover, the analysis highlights the rel-evance of variable interest rates and exchange rates. Results also imply that capital controls, that were widely used in the period under study, were not effective.

  2. Therapeutic Use of Prebiotics, Probiotics, and Postbiotics to Prevent Necrotizing Enterocolitis: What is the Current Evidence?

    OpenAIRE

    2013-01-01

    Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality and preventative therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants and probiotics are currently the most promising therapy on the horizon for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical ...

  3. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

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    Yoshihiro Abiko

    2012-01-01

    Full Text Available Patients with atypical odontalgia (AO complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i What is the prevalence of AO in the community?\t(ii What psychological problems are experienced by patients with AO? (iii Are there any comorbidities of AO? (iv Is local anesthesia effective for the relief of pain in AO? (v Are there any characteristic symptoms of AO other than spontaneous pain? (vi Are antidepressants effective for treatment of AO? (vii Are anticonvulsants effective for treatment of AO? Our literature search provided answers for these questions; however, there is insufficient evidence-based data to establish guidelines for the diagnosis and treatment of AO. Overall, some diagnostic criteria for neuropathic pain and persistent dentoalveolar pain disorder may be applied to AO patients. The patient's psychogenic background should always be considered in the treatment and/or management of AO. The clinicians may need to treat AO patients using Patient-Oriented Evidence that Matters approach.

  4. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    Science.gov (United States)

    Abiko, Yoshihiro; Matsuoka, Hirofumi; Chiba, Itsuo; Toyofuku, Akira

    2012-01-01

    Patients with atypical odontalgia (AO) complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i) What is the prevalence of AO in the community? (ii) What psychological problems are experienced by patients with AO? (iii) Are there any comorbidities of AO? (iv) Is local anesthesia effective for the relief of pain in AO? (v) Are there any characteristic symptoms of AO other than spontaneous pain? (vi) Are antidepressants effective for treatment of AO? (vii) Are anticonvulsants effective for treatment of AO? Our literature search provided answers for these questions; however, there is insufficient evidence-based data to establish guidelines for the diagnosis and treatment of AO. Overall, some diagnostic criteria for neuropathic pain and persistent dentoalveolar pain disorder may be applied to AO patients. The patient's psychogenic background should always be considered in the treatment and/or management of AO. The clinicians may need to treat AO patients using Patient-Oriented Evidence that Matters approach. PMID:22844283

  5. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

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    Bhavani Shankar Kodali

    2014-01-01

    Full Text Available Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 . Most recent Advanced Cardiac Life Support (ACLS guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR. Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO 2 (PETCO 2 and cardiac output that can indicate the return of spontaneous circulation (ROSC. Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO 2 values can guide the initiation of extracorporeal life support (ECLS in refractory cardiac arrest (RCA. There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO 2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

  6. Evidences of a coastal current in the Campeche Bank

    Science.gov (United States)

    Gomez-Valdes, J.; Ruiz-Castillo, E.; Rioja-Nieto, R.

    2013-12-01

    The Campeche Bank is the largest continental shelf of the Gulf of Mexico. It is located at the north edge of the Yucatan peninsula. In this paper, we present some evidences of a coastal current that flows westward trough the bank. The analysis of the climatology of sea surface temperature obtained from a 23-year record of Advanced Very High Resolution (AVHRR) data unveiled an alongshore cold-water band which origin is in the Yucatan Channel. The cold-water band, which is visible from May to October, is in the coastal zone where turbulence is the dominant mixing mechanism. In addition, shipboard observations were carried out in September 2002, April 2005, August 2007, and July 2009 in order to observe the temporal and spatial variability of the water mass structure in the bank. Under the assumption of geostrophy, a westward flow trough the bank is deduced from the conductivity-temperature-depth (CTD) data. The westward current occurs in the entire water column with a velocity of the order of 20 cm/s at 10 m depth. The most likely forcing mechanism for this coastal current is the wind. The analysis of the climatology of sea surface winds obtained from a 23-year record of cross-calibrated, multiplatform (CCMP) data revealed a strong semiannual fluctuation of the trade winds over the bank. From May to October the trade winds are parallel to the coast and in the rest of the year its direction changes. The relationship between current and wind is examined using coastal continental shelf models. SST mean in the Campeche Bank. Solid lines indicate isobaths.

  7. Current evidence and applications of photodynamic therapy in dermatology

    Science.gov (United States)

    Wan, Marilyn T; Lin, Jennifer Y

    2014-01-01

    In photodynamic therapy (PDT) a photosensitizer – a molecule that is activated by light – is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT. PMID:24899818

  8. DNA evidence: current perspective and future challenges in India.

    Science.gov (United States)

    Verma, Sunil K; Goswami, Gajendra K

    2014-08-01

    Since the discovery of DNA fingerprinting technology in 1985 it has been used extensively as evidence in the court of law world-wide to establish the individual identity both in civil and criminal matters. In India, the first case of parentage dispute solved by the use of DNA fingerprinting technology was in 1989. Since then till date, the DNA technology has been used not only to resolve the cases of paternity and maternity disputes, but also for the establishment of individual identity in various criminal cases and for wildlife forensic identification. Since last half a decade, India is exercising to enact legislation on the use of DNA in the judicial realm and the draft 'Human DNA Bill-2012' is pending in the parliament. Largely, the promoters of forensic DNA testing have anticipated that DNA tests are nearly infallible and DNA technology could be the greatest single advance step in search for truth, conviction of the perpetrator, and acquittal of the innocent. The current article provides a comprehensive review on the status of DNA testing in India and elucidates the consequences of the admissibility of DNA as 'evidence' in the judicial dominion. In this backdrop of civil and criminal laws and changing ethical and societal attitudes, it is concluded that the DNA legislation in India and world-wide needs to be designed with utmost care.

  9. Migraine and Risk of Stroke: Review of Current Evidence

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    Sadeghi

    2014-07-01

    Full Text Available Context Migraine is a kind of primary headache that affects 10% to 20% of people worldwide. Recent studies have shown that migraines can be involved in strokes incidences, especially ischemic strokes.Hence, the current study aimed to review evidence in relation to migraine and risk of stroke. Evidence Acquisition A literature search was done for related articles dated between 1993 and 2013 on PubMed, Science Direct, Embase, Web of Science and Scopus for both English and non-English language articles by entering “migraine”, “migraine with aura”, “headache” and “ischemic and hemorrhagic stroke” as keywords. Results In most evaluated studies, there was a positive association between migraine with aura (MA and strokes incidences, especially ischemic strokes. Moreover, patients with high frequency of migraine attacks had greater odds of having a stroke compared with those who had low frequency of migraine attacks. Also, the association between migraine and stroke was more significant in subjects under 45 years old. Some migraine symptoms such as vomiting and nausea had a protective role in the development of ischemic strokes. Conclusions Migraine, especially MA, is a risk factor for incidences of strokes, especially ischemic strokes. However, due to conflicting results on the association between different types of migraine and stroke, more studies are needed in this field.

  10. Vascular interventional radiology. Current evidence in endovascular surgery. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Cowling, Mark G. (ed.) [Univ. Hospital North Staffordshire, Stoke-on-Trent (United Kingdom). Dept. of Radiology

    2012-11-01

    Succinct chapters that will allow readers to identify quickly the information that they need. Ideally sized book for storage and use in the interventional suite. Contains sufficient detail for trainees in endovascular therapy/interventional radiology to gain a thorough grasp of the relevant issues. Fully updated to reflect recent advances. This new edition of Vascular Interventional Radiology: Current Evidence in Endovascular Surgery provides a thorough yet succinct and accessible review of the latest knowledge in the field of endovascular surgery. All chapters have been updated to reflect the advances that have occurred during the past five years, and new chapters are included on carotid artery stenting and day case intervention. The chapter on lower limb veno-occlusive disease has been expanded to include management of deep venous thrombosis. Among the other topics considered are the endovascular treatment options in different arterial territories, aneurysm repair techniques, and the management of venous stenosis and venous insufficiency. The aim throughout is to tackle issues of evidence-based practice in order to assist trainees and experienced practitioners in making and implementing treatment decisions. This book will be an invaluable source of information for both interventional radiologists and vascular surgeons with an interest in endovascular techniques.

  11. Level of evidence and citation index in current neurosurgical publications.

    Science.gov (United States)

    Rothoerl, Ralf D; Klier, Joerg; Woertgen, Chris; Brawanski, A

    2003-10-01

    Systematic clinical reviews or meta-analyses offer scientifically valid sources of clinical information. They provide information in a concise form and can contribute to clinical quality management. Such studies, however, are only able to reflect the quality of the articles reviewed. The aim of this study was to evaluate the quality of the neurosurgical literature according to evidence-based medicine (EBM) standards. We reviewed all articles published in 1999 in three major neurosurgical journals. These articles were subdivided according to the level of evidence (LOE) scale (from 0 to V), article type, and citation index. Nine hundred eighty-two articles were published in these journals in 1999. Of these, 346 (35%) were clinical studies, 287 (29%) case reports, 153 (16%) experimental studies, 122 (13%) technical reports, and 74 ( 8%) other types. Subdivision according to LOE was: Ia 0.3%, Ib 2.5%, IIa 0.2%, IIb 4.3%, IIc 9.5%, IIIa 0.1%, IIIb 3.9%, IV 22.4%, and V 1.6%. Fifty-five percent of all published studies were case reports, experimental studies, technical reports, or others and thus could not be subdivided according to the EBM standards. The number of articles published with high LOE seems to be rather low in 1999. If these data reflect overall publication practice, it seems unclear whether enough articles with high LOE are published to propose scientifically sound clinical treatment suggestions according to EBM standards.

  12. Cellular phones and their hazards: the current evidence.

    Science.gov (United States)

    Munshi, Anusheel; Jalali, Rakesh

    2002-01-01

    The past decade has seen an exponential increase globally in the use of cellular phones (popularly known as mobile or cell phones). These phones are convenient and trendy. Discarding the wire means that the communication is through electromagnetic waves, which could have potential hazards. Alarmist reports in the lay press and high profile lawsuits, particularly in the West, have attracted attention to the possible harmful effects of cellular phones. Adverse effects investigated by various clinical trials include the possible link to increased risk of vehicular accidents, leukaemias, sleep disturbances and the more serious brain tumours. Available level II evidence suggests that the only proven side-effect is an increased risk of vehicular accidents. So far, all studies have consistently negated any association between cellular phones and brain tumours. Yet, the final word remains to be said.

  13. Sublingual administration of tacrolimus: current trends and available evidence.

    Science.gov (United States)

    Doligalski, Christina Teeter; Liu, Esther C; Sammons, Chelsea M; Silverman, Andrew; Logan, Angela Tong

    2014-11-01

    Widespread anecdotal use of sublingual tacrolimus administration has arisen, although little literature exists to guide practice. Given the paucity of data, we conducted a survey to evaluate the practice of sublingual tacrolimus administration at transplant centers across the United States and evaluated the literature that is currently available. A 10-question online survey assessing the current state of sublingual tacrolimus use was distributed to pharmacists at transplant centers that each performed more than 100 solid organ transplantations in 2013. In addition, a literature review was performed by searching the PubMed database to identify available evidence for the sublingual administration of tacrolimus. The online survey was completed by 59 (65.6%) of the 90 targeted transplant centers, representing 51.3% of all solid organ transplantations performed in 2013. Sublingual administration of tacrolimus was used in all solid organ transplant populations, with ~67% of lung transplant centers using this route for tacrolimus. The most common dose conversion was 2 mg oral to 1 mg sublingual, with 92% of centers opening oral capsules and administering the contents sublingually. Home use of sublingual administration and use in the pediatric population was uncommon. Seven peer-reviewed reports and one abstract were identified in the literature review. Seven of the eight publications reported favorably on sublingual administration, although no consistent dose conversion or method of administration was elucidated. The majority of the transplant centers surveyed found sublingual tacrolimus a viable alternative when oral administration is unavailable. A large robust prospective evaluation of sublingual administration of tacrolimus is imperative to provide the most effective care to solid organ transplant recipients and to ensure optimal safety for both patients and providers who administer the drug.

  14. [Hierarchy of evidence: levels of evidence and grades of recommendation from current use].

    Science.gov (United States)

    Manterola, Carlos; Asenjo-Lobos, Claudla; Otzen, Tamara

    2014-12-01

    There are multiple proposals and classifications that hierarchize evidence, which may confuse those who are dedicated to generate it both in health technology assessments, as for the development of clinical guidelines, etc. The aim of this manuscript is to describe the most commonly used classifications of levels of evidence and grades of recommendation, analyzing their main differences and applications so that the user can choose the one that better suits your needs and take this health decisions basing their practice on the best available evidence. A systematic literature search was performed in PubMed and MEDLINE databases and in Google, Yahoo and Ixquick search engines. A wealth of information concerning levels of evidence and degrees recommendation was obtained. It was summarized the information of the 11 proposals more currently used (CTFPHC, Sackett, USPSTF, CEBM, GRADE, SIGN, NICE, NHMRC, PCCRP, ADA y ACCF/AHA), between which it emphasizes the GRADE WORKING GROUP, incorporated by around 90 national and international organizations such as the World Health Organization, The Cochrane Library, American College of Physicians, American Thoracic Society, UpToDate, etc.; and locally by the Ministry of Health to create clinical practice guidelines.

  15. Preventing skin cancer through reduction of indoor tanning: current evidence.

    Science.gov (United States)

    Watson, Meg; Holman, Dawn M; Fox, Kathleen A; Guy, Gery P; Seidenberg, Andrew B; Sampson, Blake P; Sinclair, Craig; Lazovich, DeAnn

    2013-06-01

    Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices.

  16. Targeted temperature management: Current evidence and practices in critical care

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2015-01-01

    Full Text Available Targeted temperature management (TTM in today′s modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21 st century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI, meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios.

  17. Infant Nutrition and Later Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Caroline Fall

    2012-07-01

    Full Text Available There is a growing recognition of the need for a lifecourse approach to understanding the aetiology of adult disease, and there is now significant evidence that links patterns of infant feeding to differences in health outcomes, both in the short and longer term. Breastfeeding is associated with lower rates of infection in infancy; in high-income populations, it is associated with reductions in blood pressure and total blood cholesterol, and lower risks of obesity and diabetes in adult life. Breastfeeding rates are suboptimal in many countries, and strategies to promote breastfeeding could therefore confer important benefits for health at a population level. However, there are particular challenges in defining nutritional exposures in infancy, including marked social gradients in initiation and duration of breastfeeding. In recent studies of low and middle-income populations of children and young adults, where the influences on infant feeding practice differ, beneficial effects of breastfeeding on blood pressure, BMI and risk of diabetes have not been confirmed, and further information is needed. Little is currently known about the long-term consequences of differences in the timing and nature of the weaning diet. Future progress will depend on new studies that provide detailed prospective data on duration and exclusivity of breastfeeding together with appropriate characterisation of the weaning diet.

  18. Medicinal mushroom science: Current perspectives, advances, evidences, and challenges

    Directory of Open Access Journals (Sweden)

    Solomon P Wasser

    2014-12-01

    Full Text Available The main target of the present review is to draw attention to the current perspectives, advances, evidences, challenges, and future development of medicinal mushroom science in the 21 st century. Medicinal mushrooms and fungi are thought to possess approximately 130 medicinal functions, including antitumor, immunomodulating, antioxidant, radical scavenging, cardiovascular, anti-hypercholesterolemic, antiviral, antibacterial, anti-parasitic, antifungal, detoxification, hepatoprotective, and antidiabetic effects. Many, if not all, higher Basidiomycetes mushrooms contain biologically active compounds in fruit bodies, cultured mycelium, and cultured broth. Special attention is paid to mushroom polysaccharides. The data on mushroom polysaccharides and different secondary metabolites are summarized for approximately 700 species of higher hetero- and homobasidiomycetes. Numerous bioactive polysaccharides or polysaccharide-protein complexes from the medicinal mushrooms described appear to enhance innate and cell-mediated immune responses, and exhibit antitumor activities in animals and humans. Whilst the mechanism of their antitumor actions is still not completely understood, stimulation and modulation of key host immune responses by these mushroom compounds appear central. Polysaccharides and low-molecular-weight secondary metabolites are particularly important due to their antitumor and immunostimulating properties. Several of the mushroom compounds have been subjected to Phase I, II, and III clinical trials, and are used extensively and successfully in Asia to treat various cancers and other diseases. Special attention is given to many important unsolved problems in the study of medicinal mushrooms.

  19. Screening for prostate cancer: the current evidence and guidelines controversy.

    Science.gov (United States)

    Gomella, Leonard G; Liu, Xiaolong S; Trabulsi, Edouard J; Kelly, Wm Kevin; Myers, Ronald; Showalter, Timothy; Dicker, Adam; Wender, Richard

    2011-10-01

    -metastatic, early disease. Prostate cancer screening guidelines vary widely between countries and between different medical organizations within individual countries including the United States. Further, the evidence for and against prostate cancer screening remains highly controversial. Longitudinal follow up of completed screening trials is ongoing and may yield additional findings as the time course of prostate cancer outcomes can be protracted. The literature controversy suggests that no standard of care exists for prostate cancer screening today. Until there is agreement in guidelines between major professional organizations who have weighed in on this topic, patients and physicians should be encouraged to consider engaging in shared and informed decision process concerning screening for prostate cancer.

  20. Therapeutic Use of Prebiotics, Probiotics, and Postbiotics to Prevent Necrotizing Enterocolitis: What is the Current Evidence?

    Science.gov (United States)

    Patel, Ravi Mangal; Denning, Patricia Wei

    2013-01-01

    Synopsis Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality and preventative therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants and probiotics are currently the most promising therapy on the horizon for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical use of probiotics in preterm infants. In addition, prebiotics and postbiotics may be potential alternatives or adjunctive therapies to the administration of live microorganisms, although studies demonstrating their clinical efficacy in preventing NEC are lacking. This review summarizes the current evidence regarding the use of probiotics, prebiotics and postbiotics in the preterm infant, including its therapeutic role in preventing NEC. PMID:23415261

  1. Anesthesia and cancer recurrences: The current knowledge and evidence

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available Surgical removal of solid tumors is of utmost importance as total resection can be curative. The surgical insult however itself may result in tumor micrometastasis coupled with depression of cell-mediated immunity culminating in tumor recurrence. Recent research suggests that few anesthetic agents or procedures can influence pathophysiology of metastasis in the postoperative period. Whereas opioids and volatile anesthetics have been implicated in angiogenesis and immunosuppression, evidences accumulated over the recent years have undoubtedly highlighted the attenuation of immunosuppression by regional anesthetic agents thereby making it superior over general anesthesia in preventing cancer recurrence. As anesthetic drugs are given at that time when patient is at the maximum risk of spread of metastasis, thus an understanding of the effect of anesthesia drugs and their impact on tumor metastasis is important so that appropriate anesthetic strategy can be made to improve long term survival in these patients. The purpose of the present review is therefore to emphasize the pivotal role of various anesthetic agents and anesthesia techniques in preventing tumor recurrence after surgery.

  2. Dietary copper and human health: Current evidence and unresolved issues.

    Science.gov (United States)

    Bost, Muriel; Houdart, Sabine; Oberli, Marion; Kalonji, Esther; Huneau, Jean-François; Margaritis, Irène

    2016-05-01

    Although copper (Cu) is recognized as an essential trace element, uncertainties remain regarding Cu reference values for humans, as illustrated by discrepancies between recommendations issued by different national authorities. This review examines human studies published since 1990 on relationships between Cu intake, Cu balance, biomarkers of Cu status, and health. It points out several gaps and unresolved issues which make it difficult to assess Cu requirements. Results from balance studies suggest that daily intakes below 0.8 mg/day lead to net Cu losses, while net gains are consistently observed above 2.4 mg/day. However, because of an incomplete collection of losses in all studies, a precise estimation of Cu requirements cannot be derived from available data. Data regarding the relationship between Cu intake and potential biomarkers are either too preliminary or inconclusive because of low specificity or low sensitivity to change in dietary Cu over a wide range of intakes. Results from observation and intervention studies do not support a link between Cu and a risk of cardiovascular disease, cognitive decline, arthritis or cancer for intakes ranging from 0.6 to 3mg/day, and limited evidence exists for impaired immune function in healthy subjects with a very low (0.38 mg/day) Cu intake. However, data from observation studies should be regarded with caution because of uncertainties regarding Cu concentration in various foods and water. Further studies that accurately evaluate Cu exposure based on reliable biomarkers of Cu status are needed.

  3. Application of lipoarabinomannan antigen in tuberculosis diagnostics: current evidence.

    Science.gov (United States)

    Sarkar, Pronoti; Biswas, Debasis; Sindhwani, Girish; Rawat, Jagdish; Kotwal, Aarti; Kakati, Barnali

    2014-03-01

    Tests based on the detection of mycobacterial lipoarabinomannan (LAM) antigen in urine have emerged as potential point-of-care tests for tuberculosis (TB). We aimed to assimilate the current evidence regarding the diagnostic performance of LAM assays and to ascertain their clinical indication in settings with high and low prevalence of HIV-TB co-infection. Owing to suboptimal sensitivity, the urinary LAM assays are unsuitable as general screening tests for TB. However, unlike traditional diagnostic methods, they demonstrate improved sensitivity in HIV-TB co-infection which further increases with low CD4 counts. Accordingly, these assays are indicated as rule-in tests for TB in patients with advanced HIV-induced immunosuppression, and facilitate the early initiation of antituberculous treatment in them. They also offer incremental sensitivity and specificity when used as adjunct tests to smear microscopy and chest radiography in HIV-TB co-infection. They obviate the biohazards associated with sputum samples and provide an alternative diagnostic tool in sputum-scarce patients. Notwithstanding these advantages, the specificity of these assays is variable, which is mostly attributable to misclassification bias and cross-reactivity with non-tuberculous mycobacteria or other commensal flora. Furthermore, the inability to detect low titres of antigen in HIV-uninfected patients makes these assays unsuitable for use in settings with a low HIV prevalence. Future research targeted towards inclusion of specific monoclonal antibodies and more sensitive immunoassay platforms might help to improve the diagnostic performance of these assays and extend their applicability to the general population of patients with TB.

  4. Mitochondrial dysfunction in psychiatric morbidity: current evidence and therapeutic prospects

    Directory of Open Access Journals (Sweden)

    Toker L

    2015-09-01

    Full Text Available Lilach Toker,1 Galila Agam2,3 1Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; 2Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 3Mental Health Center, Beer-Sheva, Israel Abstract: Cumulating evidence for the involvement of mitochondrial dysfunction in psychiatric disorders leaves little to no doubt regarding the involvement of this pathology in mood disorders. However, mitochondrial abnormalities are also observed in a wide range of disorders spanning from cancer and diabetes to various neurodegenerative and neurodevelopmental disorders such as Parkinson’s, Alzheimer’s, Huntington’s, autism, and amyotrophic lateral sclerosis. The apparent lack of specificity questions the role of mitochondrial dysfunction in psychiatric disorders, in general, and in mood disorders, in particular. Is mitochondrial dysfunction a general phenomenon, simplistically rendering brain cells to be more vulnerable to a variety of disease-specific perturbations? Or is it an epiphenomenon induced by various disease-specific factors? Or possibly, the severity and the anatomical region of the dysfunction are the ones responsible for the distinct features of the disorders. Whichever of the aforementioned ones, if any, is correct, “mitochondrial dysfunction” became more of a cliché than a therapeutic target. In this review, we summarize current studies supporting the involvement of mitochondrial dysfunction in different psychiatric disorders. We address the question of specificity and causality of the different findings and provide an alternative explanation for some of the aforementioned questions. Keywords: bipolar disorder, psychiatric disorders, schizophrenia, Stanley Foundation Brain Collection

  5. Bariatric emergencies: current evidence and strategies of management

    Science.gov (United States)

    2013-01-01

    Background The demand for bariatric surgery is increasing and the postoperative complications are seen more frequently. The aim of this paper is to review the current outcomes of bariatric surgery emergencies and to formulate a pathway of safe management. Methods The PubMed and Google search for English literatures relevant to emergencies of bariatric surgery was made, 6358 articles were found and 90 papers were selected based on relevance, power of the study, recent papers and laparoscopic workload. The pooled data was collected from these articles that were addressing the complications and emergency treatment of bariatric patients. 830,998 patients were included in this review. Results Bariatric emergencies were increasingly seen in the Accident and Emergency departments, the serious outcomes were reported following complex operations like gastric bypass but also after gastric band and the causes were technical errors, suboptimal evaluation, failure of effective communication with bariatric teams who performed the initial operation, patients factors, and delay in the presentation. The mortality ranged from 0.14%-2.2% and increased for revisional surgery to 6.5% (p = 0.002). Inspite of this, mortality following bariatric surgery is still less than that of control group of obese patients (p = value 0.01). Conclusions Most mortality and catastrophic outcomes following bariatric surgery are preventable. The awareness of bariatric emergencies and its effective management are the gold standards for best outcomes. An algorithm is suggested and needs further evaluation. PMID:24373182

  6. Asthma and obesity in children: current evidence and potential systems biology approaches.

    Science.gov (United States)

    Frey, U; Latzin, P; Usemann, J; Maccora, J; Zumsteg, U; Kriemler, S

    2015-01-01

    Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective.

  7. Postpartum family planning: current evidence on successful interventions

    Directory of Open Access Journals (Sweden)

    Blazer C

    2016-04-01

    Full Text Available Cassandra Blazer, Ndola Prata Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California, Berkeley, CA, USA Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations. Keywords: postpartum period, family planning, birth spacing, interventions, systematic review, contraception, less developed countries

  8. Current evidence on dietary pattern and cognitive function.

    Science.gov (United States)

    Cheung, Bernice H K; Ho, Ivan C H; Chan, Ruth S M; Sea, Mandy M M; Woo, Jean

    2014-01-01

    With global aging population, age-related cognitive decline becomes epidemic. Lifestyle-related factor is one of the key preventative measures. Dietary pattern analysis which considers dietary complexity has recently used to examine the linkage between nutrition and cognitive function. A priori approach defines dietary pattern based on existing knowledge. Results of several dietary pattern scores were summarized. The heterogeneity of assessment methods and outcome measurements lead to inconsistent results. Posteriori approach derives a dietary pattern independently of the existing nutrition-disease knowledge. It showed a dietary pattern abundant with plant-based food, oily fish, lower consumption of processed food, saturated fat, and simple sugar which appears to be beneficial to cognitive health. Despite inconclusive evidence from both approaches, diet and exercise, beneficial for other diseases, remains to be the two key modifiable factors for cognitive function. Large-scale prospective studies in multiethics population are required to provide stronger evidence in the future.

  9. Current Evidence and Insights about Genetics in Thoracic Aorta Disease

    OpenAIRE

    2013-01-01

    Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also s...

  10. [A review of current concepts in evidence-based radiology].

    Science.gov (United States)

    Roldán-Valadez, Ernesto; Lee, Angel; Jiménez-Corona, Aída; Vega-González, Iván; Martínez-López, Manuel; Vázquez-LaMadrid, Jorge

    2007-01-01

    It has been noted that "Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. " Evidence-based medicine (EBM) is defined as the process of systematically finding, critically appraising, and using contemporary research published in the medical literature as a basis to make decisions regarding individual patient care and health care policy. In radiology, including its diagnostic and interventional aspects, the principles and practice of EBM have not been thoroughly studied. In this brief review article, we describe key aspects of evidence-based radiology (EBR), concepts and steps followed in EBM and meta-analysis. The skills required to practice EBR are identified, and the roles of EBR in radiologic practice, education, and research are discussed. The application of EBM principles to diagnostic imaging facilitates the interpretation of imaging studies and produces a sound and comprehensive radiologic evaluation. This review could be useful for radiologists and clinicians at any stage of their training or career. It encourages the practice of EBM and EBR especially in developing countries.

  11. Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

    Science.gov (United States)

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-10-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  12. Voice rest after vocal fold surgery: current practice and evidence.

    Science.gov (United States)

    Coombs, A C; Carswell, A J; Tierney, P A

    2013-08-01

    Voice rest is commonly recommended after vocal fold surgery, but there is a lack of evidence base and no standard protocol. The aim of this study was to establish common practice regarding voice rest following vocal fold surgery. An online survey was circulated via e-mail invitation to members of the ENT UK Expert Panel between October and November 2011. The survey revealed that 86.5 per cent of respondents agreed that 'complete voice rest' means no sound production at all, but there was variability in how 'relative voice rest' was defined. There was no dominant type of voice rest routinely recommended after surgery for laryngeal papillomatosis or intermediate pathologies. There was considerable variability in the duration of voice rest recommended, with no statistically significant, most popular response (except for malignant lesions). Surgeons with less than 10 years of experience were more likely to recommend fewer days of voice rest. There is a lack of consistency in advice given to patients after vocal fold surgery, in terms of both type and length of voice rest. This may arise from an absence of robust evidence on which to base practice.

  13. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    Directory of Open Access Journals (Sweden)

    Nurul Haswani Embong

    2015-10-01

    Full Text Available Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  14. Ebola Virus Shedding and Transmission: Review of Current Evidence.

    Science.gov (United States)

    Vetter, Pauline; Fischer, William A; Schibler, Manuel; Jacobs, Michael; Bausch, Daniel G; Kaiser, Laurent

    2016-10-15

     The magnitude of the 2013-2016 Ebola virus disease outbreak in West Africa was unprecedented, with >28 500 reported cases and >11 000 deaths. Understanding the key elements of Ebola virus transmission is necessary to implement adequate infection prevention and control measures to protect healthcare workers and halt transmission in the community.  We performed an extensive PubMed literature review encompassing the period from discovery of Ebola virus, in 1976, until 1 June 2016 to evaluate the evidence on modes of Ebola virus shedding and transmission.  Ebola virus has been isolated by cell culture from blood, saliva, urine, aqueous humor, semen, and breast milk from infected or convalescent patients. Ebola virus RNA has been noted in the following body fluids days or months after onset of illness: saliva (22 days), conjunctiva/tears (28 days), stool (29 days), vaginal fluid (33 days), sweat (44 days), urine (64 days), amniotic fluid (38 days), aqueous humor (101 days), cerebrospinal fluid (9 months), breast milk (16 months [preliminary data]), and semen (18 months). Nevertheless, the only documented cases of secondary transmission from recovered patients have been through sexual transmission. We did not find strong evidence supporting respiratory or fomite-associated transmission. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  15. Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions.

    Science.gov (United States)

    Jarrar, Mu'taman; Abdul Rahman, Hamzah; Don, Mohammad Sobri

    2015-10-20

    Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme "1 Care for 1 Malaysia" in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.

  16. Omega-3 Fatty Acids in Modern Parenteral Nutrition: A Review of the Current Evidence.

    Science.gov (United States)

    Klek, Stanislaw

    2016-03-07

    Intravenous lipid emulsions are an essential component of parenteral nutrition regimens. Originally employed as an efficient non-glucose energy source to reduce the adverse effects of high glucose intake and provide essential fatty acids, lipid emulsions have assumed a larger therapeutic role due to research demonstrating the effects of omega-3 and omega-6 polyunsaturated fatty acids (PUFA) on key metabolic functions, including inflammatory and immune response, coagulation, and cell signaling. Indeed, emerging evidence suggests that the effects of omega-3 PUFA on inflammation and immune response result in meaningful therapeutic benefits in surgical, cancer, and critically ill patients as well as patients requiring long-term parenteral nutrition. The present review provides an overview of the mechanisms of action through which omega-3 and omega-6 PUFA modulate the immune-inflammatory response and summarizes the current body of evidence regarding the clinical and pharmacoeconomic benefits of intravenous n-3 fatty acid-containing lipid emulsions in patients requiring parenteral nutrition.

  17. Climate change and respiratory health: current evidence and knowledge gaps.

    Science.gov (United States)

    Takaro, Tim K; Knowlton, Kim; Balmes, John R

    2013-08-01

    Climate change is a key driver of the accelerating environmental change affecting populations around the world. Many of these changes and our response to them can affect respiratory health. This is an expert opinion review of recent peer-reviewed literature, focused on more recent medical journals and climate-health relevant modeling results from non-biomedical journals pertaining to climate interactions with air pollution. Global health impacts in low resource countries and migration precipitated by environmental change are addressed. The major findings are of respiratory health effects related to heat, air pollution, shifts in infectious diseases and allergens, flooding, water, food security and migration. The review concludes with knowledge gaps and research need that will support the evidence-base required to address the challenges ahead.

  18. Current Scientific Evidence for a Polarized Cardiovascular Endurance Training Model.

    Science.gov (United States)

    Hydren, Jay R; Cohen, Bruce S

    2015-12-01

    Recent publications have provided new scientific evidence for a modern aerobic or cardiovascular endurance exercise prescription that optimizes the periodization cycle and maximizes potential endurance performance gains in highly trained individuals. The traditional threshold, high volume, and high-intensity training models have displayed limited improvement in actual race pace in (highly) trained individuals while frequently resulting in overreaching or overtraining (physical injury and psychological burnout). A review of evidence for replacing these models with the proven polarized training model seems warranted. This review provides a short history of the training models, summarizes 5 key studies, and provides example training programs for both the pre- and in-season periods. A polarized training program is characterized by an undulating nonlinear periodization model with nearly all the training time spent at a "light" (≤13) and "very hard" (≥17) pace with very limited time at "hard" (14-16) or race pace (6-20 Rating of Perceived Exertion [RPE] scale). To accomplish this, the polarization training model has specific high-intensity workouts separated by one or more long slow distance workouts, with the exercise intensity remaining below ventilatory threshold (VT) 1 and/or blood lactate of less than 2 mM (A.K.A. below race pace). Effect sizes for increasing aerobic endurance performance for the polarized training model are consistently superior to that of the threshold training model. Performing a polarized training program may be best accomplished by: going easy on long slow distance workouts, avoiding "race pace" and getting after it during interval workouts.

  19. Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective.

    Science.gov (United States)

    Fiore, Marco; Leone, Sebastiano

    2016-09-14

    Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment. We reviewed, in order to focus the epidemiology, characteristics, and, considering the high mortality rate of SFP, the use of optimal empirical antifungal therapy the current literature.

  20. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Taraka V. Gadiraju

    2015-10-01

    Full Text Available Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week. Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying, temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

  1. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence.

    Science.gov (United States)

    Gadiraju, Taraka V; Patel, Yash; Gaziano, J Michael; Djoussé, Luc

    2015-10-06

    Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week). Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying), temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

  2. Phylogenetic relationships of Mesoamerican spider monkeys (Ateles geoffroyi): Molecular evidence suggests the need for a revised taxonomy.

    Science.gov (United States)

    Morales-Jimenez, Alba Lucia; Cortés-Ortiz, Liliana; Di Fiore, Anthony

    2015-01-01

    Mesoamerican spider monkeys (Ateles geoffroyi sensu lato) are widely distributed from Mexico to northern Colombia. This group of primates includes many allopatric forms with morphologically distinct pelage color and patterning, but its taxonomy and phylogenetic history are poorly understood. We explored the genetic relationships among the different forms of Mesoamerican spider monkeys using mtDNA sequence data, and we offer a new hypothesis for the evolutionary history of the group. We collected up to ∼800 bp of DNA sequence data from hypervariable region 1 (HV1) of the control region, or D-loop, of the mitochondrion for multiple putative subspecies of Ateles geoffroyi sensu lato. Both maximum likelihood and Bayesian reconstructions, using Ateles paniscus as an outgroup, showed that (1) A. fusciceps and A. geoffroyi form two different monophyletic groups and (2) currently recognized subspecies of A. geoffroyi are not monophyletic. Within A. geoffroyi, our phylogenetic analysis revealed little concordance between any of the classifications proposed for this taxon and their phylogenetic relationships, therefore a new classification is needed for this group. Several possible clades with recent divergence times (1.7-0.8 Ma) were identified within Ateles geoffroyi sensu lato. Some previously recognized taxa were not separated by our data (e.g., A. g. vellerosus and A. g. yucatanensis), while one distinct clade had never been described as a different evolutionary unit based on pelage or geography (Ateles geoffroyi ssp. indet. from El Salvador). Based on well-supported phylogenetic relationships, our results challenge previous taxonomic arrangements for Mesoamerican spider monkeys. We suggest a revised arrangement based on our data and call for a thorough taxonomic revision of this group. Copyright © 2014. Published by Elsevier Inc.

  3. Micronutrients and Leptospirosis: A Review of the Current Evidence

    Science.gov (United States)

    Herman, Heather S.; Mehta, Saurabh; Cárdenas, Washington B.; Stewart-Ibarra, Anna M.

    2016-01-01

    Background Leptospirosis is one of the most widespread zoonoses and represents a major threat to human health. Due to the high burden of disease, limitations in diagnostics, and limited coverage and availability of effective human and veterinary vaccines, leptospirosis remains an important neglected zoonotic disease. Improved surveillance and identification of modifiable risk factors for leptospirosis are urgently needed to inform preventive interventions and reduce the risk and severity of Leptospira infection. Methodology/Principal Findings This review was conducted to examine the evidence that links micronutrient status and Leptospira infection. A total of 56 studies were included in this review: 28 in vitro, 17 animal, and 11 observational human studies. Findings indicated that Leptospira infection is associated with higher iron and calcium concentrations and hypomagnesemia. Conclusions/Significance Few prospective studies and no randomized trials have been conducted to date to examine the potential role of micronutrients in Leptospira infection. The limited literature in this area constrains our ability to make specific recommendations; however, the roles of iron, calcium, and magnesium in leptospirosis represent important areas for future research. The role of micronutrients in leptospirosis risk and severity needs to be elucidated in larger prospective human studies to inform public health interventions. PMID:27387046

  4. Target Therapies for Uterine Carcinosarcomas: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Salvatore Giovanni Vitale

    2017-05-01

    Full Text Available Carcinosarcomas (CS in gynecology are very infrequent and represent only 2–5% of uterine cancers. Despite surgical cytoreduction and subsequent chemotherapy being the primary treatment for uterine CS, the overall five-year survival rate is 30 ± 9% and recurrence is extremely common (50–80%. Due to the poor prognosis of CS, new strategies have been developed in the last few decades, targeting known dysfunctional molecular pathways for immunotherapy. In this paper, we aimed to gather the available evidence on the latest therapies for the treatment of CS. We performed a systematic review using the terms “uterine carcinosarcoma”, “uterine Malignant Mixed Müllerian Tumors”, “target therapies”, “angiogenesis therapy”, “cancer stem cell therapy”, “prognostic biomarker”, and “novel antibody-drug”. Based on our results, the differential expression and accessibility of epithelial cell adhesion molecule-1 on metastatic/chemotherapy-resistant CS cells in comparison to normal tissues and Human Epidermal Growth Factor Receptor 2 (HER2 open up new possibilities in the field of target therapy. Nevertheless, future investigations are needed to clarify the impact of these new therapies on survival rate and medium-/long-term outcomes.

  5. HDL and glucose metabolism: current evidence and therapeutic potential.

    Science.gov (United States)

    Siebel, Andrew L; Heywood, Sarah Elizabeth; Kingwell, Bronwyn A

    2015-01-01

    High-density lipoprotein (HDL) and its principal apolipoprotein A-I (ApoA-I) have now been convincingly shown to influence glucose metabolism through multiple mechanisms. The key clinically relevant observations are that both acute HDL elevation via short-term reconstituted HDL (rHDL) infusion and chronically raising HDL via a cholesteryl ester transfer protein (CETP) inhibitor reduce blood glucose in individuals with type 2 diabetes mellitus (T2DM). HDL may mediate effects on glucose metabolism through actions in multiple organs (e.g., pancreas, skeletal muscle, heart, adipose, liver, brain) by three distinct mechanisms: (i) Insulin secretion from pancreatic beta cells, (ii) Insulin-independent glucose uptake, (iii) Insulin sensitivity. The molecular mechanisms appear to involve both direct HDL signaling actions as well as effects secondary to lipid removal from cells. The implications of glucoregulatory mechanisms linked to HDL extend from glycemic control to potential anti-ischemic actions via increased tissue glucose uptake and utilization. Such effects not only have implications for the prevention and management of diabetes, but also for ischemic vascular diseases including angina pectoris, intermittent claudication, cerebral ischemia and even some forms of dementia. This review will discuss the growing evidence for a role of HDL in glucose metabolism and outline related potential for HDL therapies.

  6. Botulinum toxins: Pharmacology and its current therapeutic evidence for use

    Directory of Open Access Journals (Sweden)

    Muthane U

    2003-10-01

    Full Text Available Botulinum toxins are, as a group, among the most potent neuromuscular toxins known, yet they are clinically useful in the management of conditions associated with muscular and glandular over-activity. Botulinum toxins act by preventing release of acetylcholine into the neuromuscular junction. While botulinum toxin type A is commonly available, different manufacturers produce specific products, which are not directly interchangeable and should not be considered as generically equivalent formulations. Type B is also available in the market. Each formulation of botulinum toxin is unique with distinct dosing, efficacy and safety profiles for each use to which it is applied. Botulinum toxin type A is the treatment of choice based on its depth of evidence in dystonias and most other conditions. Botulinum toxin type A is established as useful in the management of spasticity, tremors, headache prophylaxis and several other neurological conditions. Active research is underway to determine the parameters for which the type B toxin can be used in these conditions, as covered in this review. Botulinum toxin use has spread to several fields of medicine.

  7. Finding current evidence: search strategies and common databases.

    Science.gov (United States)

    Gillespie, Lesley Diane; Gillespie, William John

    2003-08-01

    With more than 100 orthopaedic, sports medicine, or hand surgery journals indexed in MEDLINE, it is no longer possible to keep abreast of developments in orthopaedic surgery by reading a few journals each month. Electronic resources are easier to search and more current than most print sources. We provide a practical approach to finding useful information to guide orthopaedic practice. We focus first on where to find the information by providing details about many useful databases and web links. Sources for identifying guidelines, systematic reviews, and randomized controlled trials are identified. The second section discusses how to find the information, from the first stage of formulating a question and identifying the concepts of interest, through to writing a simple strategy. Sources for additional self-directed learning are provided.

  8. Evidence Suggesting that Fasciola gigantica Might be the Most Prevalent Causal Agent of Fascioliasis in Northern Iran

    Directory of Open Access Journals (Sweden)

    K Ashrafi

    2004-10-01

    Full Text Available Following the occurrence of two large outbreaks in Gilan province, northern Iran, the public health importance of human fascioliasis has increased significantly. The mixed infections of Fasciola gigantica and F. hepatica within a given domestic animal individual suggest a very complicate picture of possible circulation ways of the parasite and the possibility for humans to be infected with both species. Elucidating these circulation ways is very critical for understanding the epidemiology and transmission of the disease and being ascertain how animals and humans enter the different liver fluke circulations in this endemic zone. The main objective of the present study was to investigate the distribution and natural infections of local lymnaeids, environmental characteristics related to the disease transmission and determining the most prevalent fasciolids and definitive hosts in human endemic areas of Gilan province. Bandar-Anzali and Rasht are the most important endemic areas with most of the cases of human disease during the epidemics and inter-epidemic periods. Sheep raising is not normal in these regions, while cattle is the most common definitive host. According to the data obtained from slaughterhouse observations in Bandar-Anzali and Rasht, the main fasciolid in local cattle is F. gigantica. Of 928 adult liver flukes collected from 13 infected livers of cattle, in Rasht and Bandar-Anzali slaughterhouses, 91.1% were diagnosed as F. gigantica and 8.9% as F. hepatica. L. gedrosiana and L. palustris were the most prevalent lymnaeid snails in this endemic zone. It appears that L. truncatula is not prevalent in Bandar-Anzali and Rasht and surroundings of these endemic cities. Of 4830 different snails studied, only seven L. gedrosiana were found to be infected with larval stages (rediae and cercariae of Fasciola sp. Experimental infections of 15 common laboratory mice by metacercariae, obtained from those naturally infected snails, were carried

  9. Immunotherapy in prostate cancer: review of the current evidence.

    Science.gov (United States)

    Fernández-García, E M; Vera-Badillo, F E; Perez-Valderrama, B; Matos-Pita, A S; Duran, I

    2015-05-01

    Prostate cancer is the most common male malignancy in the Western world. Once it metastasizes, it is incurable. The current gold standard for metastatic disease is the combined docetaxel/prednisone regimen. Prostate cancer shows several characteristics that make it a suitable candidate for immunotherapy, as recently exemplified by the approval of sipuleucel-T, the first vaccine to treat any malignancy. Here, we review different tumor-associated antigen immunotherapy strategies currently being investigated, from a humanized radiolabeled monoclonal antibody (J-591) that targets radiation into tumor cells, moving on to vaccines and through to immunomodulator agents such as anti-CPLA-4 and anti-PD-1 monoclonal antibodies that activate T-cell responses via immune checkpoint inhibition. We explore different opinions on the best approach to integrate immunotherapy into existing standard therapies, such as androgen-deprivation therapy, radiotherapy or chemotherapy, and review different combination sequences, patient types and time points during the course of the disease to achieve a lasting immune response. We present data from recent phase III clinical trials that call for a change in trial endpoint design with immunotherapy agents, from the traditional tumor progression to overall survival and how such trials should include immune response measurements as secondary or intermediate endpoints to help identify patient clinical benefit in the earlier phases of treatment. Finally, we join in the recent questioning on the validity of RECIST criteria to measure response to immunotherapeutic agents, as initial increases in the size of tumors/lymph nodes, which are part of a normal immune response, could be categorized as disease progression under RECIST.

  10. Design and array signal suggestion of array type pulsed eddy current probe for health monitoring of metal tubes

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Young Kil [Dept. of Electrical Engineering, Kunsan National University, Kunsan (Korea, Republic of)

    2015-10-15

    An array type probe for monitoring metal tubes is proposed in this paper which utilizes peak value and peak time of a pulsed eddy current(PEC) signal. The probe consists of an array of encircling coils along a tube and the outside of coils is shielded by ferrite to prevent source magnetic fields from directly affecting sensor signals since it is the magnetic fields produced by eddy currents that reflect the condition of metal tubes. The positions of both exciter and sensor coils are consecutively moved automatically so that manual scanning is not necessary. At one position of send-receive coils, peak value and peak time are extracted from a sensor PEC signal and these data are accumulated for all positions to form an array type peak value signal and an array type peak time signal. Numerical simulation was performed using the backward difference method in time and the finite element method for spatial analysis. Simulation results showed that peak value increases and the peak appears earlier as the defect depth or length increases. The proposed array signals are shown to be excellent in reflecting the defect location as well as variations of defect depth and length within the array probe.

  11. Preparing for the introduction of hospital autonomy in Laos: an assessment of current situation and suggestions for policy-making.

    Science.gov (United States)

    Geng, Jinsong; Yu, Hao; Chen, Yingyao

    2016-04-01

    The National Assembly of Lao People's Democratic Republic (Laos) approved the Health Sector Reform Strategy in 2012, which called for an assessment as to whether Laos should introduce hospital autonomy, and if so, in which ways. The purpose of this study is to assess the status quo of hospital governance in Laos and propose policy suggestions for hospital autonomy in the country. We formulated an analytic framework for hospital autonomy based on previous work by other researchers, collected qualitative data through key informant interviews and focus group discussions, and also performed secondary data analysis. Public hospitals in Laos enjoyed some informal autonomy with little accountability and Laos is facing key challenges of hospital governance. As a result, introducing hospital autonomy in Laos could bring risks, benefits and debates. Before Laos decides on granting autonomy to its public hospitals, we strongly suggest that the government do pilot in selected public hospitals with well-regulated governance framework first and conduct rigorous evaluations to examine whether the granted autonomy leads to the intended social goals of equity, quality, efficiency and sustainability. We recommend residual claimants should be monitored by the government and by the society with open and transparent approach, and active measures should be taken to improve performance and ensure social functions. The study findings may also provide some suggestions for low- and middle-income countries, which are contemplating the introduction of hospital autonomy in the public sector. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Shy Cian Khor

    2014-01-01

    Full Text Available Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies.

  13. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

    Science.gov (United States)

    Abdul Karim, Norwahidah; Wan Ngah, Wan Zurinah

    2014-01-01

    Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS) can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies. PMID:25097722

  14. Current Evidence Supporting the Link Between Dietary Fatty Acids and Cardiovascular Disease.

    Science.gov (United States)

    Hammad, Shatha; Pu, Shuaihua; Jones, Peter J

    2016-05-01

    Lack of consensus exists pertaining to the scientific evidence regarding effects of various dietary fatty acids on cardiovascular disease (CVD) risk. The objective of this article is to review current evidence concerning cardiovascular health effects of the main dietary fatty acid types; namely, trans (TFA), saturated (SFA), polyunsaturated (PUFA; n-3 PUFA and n-6 PUFA), and monounsaturated fatty acids (MUFA). Accumulating evidence shows negative health impacts of TFA and SFA; both may increase CVD risk. Policies have been proposed to reduce TFA and SFA consumption to less than 1 and 7 % of energy intake, respectively. Cardiovascular health might be promoted by replacing SFA and TFA with n-6 PUFA, n-3 PUFA, or MUFA; however, the optimal amount of PUFA or MUFA that can be used to replace SFA and TFA has not been defined yet. Evidence suggests of the potential importance of restricting n-6 PUFA up to 10 % of energy and obtaining an n-6/n-3 ratio as close as possible to unity, along with a particular emphasis on consuming adequate amounts of essential fatty acids. The latest evidence shows cardioprotective effects of MUFA-rich diets, especially when MUFA are supplemented with essential fatty acids; namely, docosahexaenoic acid. MUFA has been newly suggested to be involved in regulating fat oxidation, energy metabolism, appetite sensations, weight maintenance, and cholesterol metabolism. These favorable effects might implicate MUFA as the preferable choice to substitute for other fatty acids, especially given the declaration of its safety for up to 20 % of total energy.

  15. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas.

    Science.gov (United States)

    Hoffman, Aubri S; Volk, Robert J; Saarimaki, Anton; Stirling, Christine; Li, Linda C; Härter, Martin; Kamath, Geetanjali R; Llewellyn-Thomas, Hilary

    2013-01-01

    In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension-the delivery of patient decision aids on the Internet-is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies.

  16. Program experience with micronutrient powders and current evidence.

    Science.gov (United States)

    Rah, Jee Hyun; dePee, Saskia; Kraemer, Klaus; Steiger, Georg; Bloem, Martin W; Spiegel, Paul; Wilkinson, Caroline; Bilukha, Oleg

    2012-01-01

    The efficacy of micronutrient powders (MNP) in the treatment of anemia in moderately anemic children aged 6-24 mo has been clearly demonstrated. The evidence of the effectiveness of MNP in large-scale programs, however, is scarce. This article describes the program experience and findings of large-scale MNP distribution in refugee camps and in an emergency context in Bangladesh, Nepal, and Kenya. The MNP contained 15-16 micronutrients as per the WHO/World Food Programme/UNICEF joint statement, whereas the iron content was reduced to 2.5 mg from NaFeEDTA in a malaria-endemic area in Kenya. Hundreds of thousands of children aged 6-59 mo and pregnant and lactating women were targeted to consume MNP either daily or every other day over an extended period of time. Extensive social marketing campaigns were undertaken to promote regular use of the product. A number of studies were embedded in the programs to assess the impact of MNP on the nutritional status of target beneficiaries. Some improvements in anemia prevalence estimates were observed in particular subgroups, but other results did not show significant improvements. A significant decrease in the prevalence of stunting was observed in Nepal and Kenya but not in Bangladesh. Diarrhea episodes decreased significantly among children receiving MNP in Nepal. A key challenge is to ensure high MNP acceptance and adherence among beneficiaries. Investigation of non-nutritional causes of anemia is warranted in settings with high compliance but no improvement in hemoglobin status. Further investigation into the most appropriate manner to use MNP in malaria endemic settings is warranted.

  17. Photocatalytic effects of titanium dioxide nanoparticles on aquatic organisms-Current knowledge and suggestions for future research.

    Science.gov (United States)

    Haynes, Vena N; Ward, J Evan; Russell, Brandon J; Agrios, Alexander G

    2017-04-01

    Nanoparticles are entering natural systems through product usage, industrial waste and post-consumer material degradation. As the production of nanoparticles is expected to increase in the next decade, so too are predicted environmental loads. Engineered metal-oxide nanomaterials, such as titanium dioxide, are known for their photocatalytic capabilities. When these nanoparticles are exposed to ultraviolet radiation in the environment, however, they can produce radicals that are harmful to aquatic organisms. There have been a number of studies that have reported the toxicity of titanium dioxide nanoparticles in the absence of light. An increasing number of studies are assessing the interactive effects of nanoparticles and ultraviolet light. However, most of these studies neglect environmentally-relevant experimental conditions. For example, researchers are using nanoparticle concentrations and light intensities that are too high for natural systems, and are ignoring water constituents that can alter the light field. The purpose of this review is to summarize the current knowledge of the photocatalytic effects of TiO2 nanoparticles on aquatic organisms, discuss the limitations of these studies, and outline environmentally-relevant factors that need to be considered in future experiments. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Intrinsic association between diet and the gut microbiome: current evidence

    Directory of Open Access Journals (Sweden)

    Winglee K

    2015-10-01

    Full Text Available Kathryn Winglee, Anthony A Fodor Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC, USA Abstract: The gut microbiome performs many crucial functions for the human host, but the molecular mechanisms by which host, microbe, and diet interact to mediate health and disease are only starting to be revealed. Here, we review the literature on how changes in the diet affect the microbiome. A number of studies have shown that within a geographic region, different diets (such as vegan vs omnivore are associated with differences in a modest number of taxa, but do not reliably produce radical differences within the gut microbial community. In contrast, studies that look across continents consistently find profoundly different microbial communities between Westernized and traditional populations, although it remains unclear to what extent diet or other differences in lifestyle drive these distinct microbial community structures. Furthermore, studies that place subjects on controlled short-term experimental diets have found the resulting alterations to the gut microbial community to generally be small in scope, with changes that do not overcome initial individual differences in microbial community structure. These results emphasize that the human gut microbial community is relatively stable over time. In contrast, short-term changes in diet can cause large changes in metabolite profiles, including metabolites processed by the gut microbial community. These results suggest that commensal gut microbes have a great deal of genetic plasticity and can activate different metabolic pathways independent of changes to microbial community composition. Thus, future studies of how the diet impacts host health via the microbiome may wish to focus on functional assays such as transcriptomics and metabolomics, in addition to 16S rRNA and whole-genome metagenome shotgun analyses of DNA. Taken together, the literature is most

  19. Subcutaneous immunoglobulin therapy for inflammatory neuropathy: current evidence base and future prospects.

    Science.gov (United States)

    Rajabally, Yusuf A

    2014-06-01

    Intravenous immunoglobulin therapy is of proven effect in chronic inflammatory neuropathies, including chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). In more recent years, there have been a number of anecdotal case reports and small series, followed by a few trials of variable design, of subcutaneous immunoglobulin therapy in these neuropathies. To date, limited evidence suggests that the subcutaneous route may be a more clinically effective, better-tolerated, at least cost-equivalent and a more patient-friendly option than the still more used intravenous alternative. Long-term efficacy is not as yet established in neuropathic indications by randomised controlled clinical trial evidence, and it is likely that the subcutaneous route may not be suitable in all cases with some hints to this effect appearing from the limited data available to date. Further studies are ongoing, including those of dose comparison, and more are likely to be planned in future. The literature on the use of subcutaneous immunoglobulin therapy in chronic inflammatory neuropathy is reviewed here. The current use in clinical practice, day-to-day benefits, including quality of life measures and health economics as published thus far, are evaluated. The limitations of this form of treatment in CIDP and MMN are also analysed in the light of current literature and taking into account the remaining unknowns. Future prospects and research with this mode of immunoglobulin therapy administration are discussed.

  20. Current concepts on posterior meniscal root lesion: A treatment algorithm based on the currently available evidence

    Directory of Open Access Journals (Sweden)

    Guan-Yang Song

    2014-07-01

    Full Text Available Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. The purposes of this review are to develop a current understanding of how the posterior meniscal root functions and to review the available treatment options for posterior meniscal root lesion.

  1. Music therapy with disorders of consciousness: current evidence and emergent evidence-based practice.

    Science.gov (United States)

    Magee, Wendy L; O'Kelly, Julian

    2015-03-01

    Patients with prolonged disorders of consciousness (PDOC) stemming from acquired brain injury present one of the most challenging clinical populations in neurological rehabilitation. Because of the complex clinical presentation of PDOC patients, treatment teams are confronted with many medicolegal, ethical, philosophical, moral, and religious issues in day-to-day care. Accurate diagnosis is of central concern, relying on creative approaches from skilled clinical professionals using combined behavioral and neurophysiological measures. This paper presents the latest evidence for using music as a diagnostic tool with PDOC, including recent developments in music therapy interventions and measurement. We outline standardized clinical protocols and behavioral measures to produce diagnostic outcomes and examine recent research illustrating a range of benefits of music-based methods at behavioral, cardiorespiratory, and cortical levels using video, electrocardiography, and electroencephalography methods. These latest developments are discussed in the context of evidence-based practice in rehabilitation with clinical populations. © 2014 New York Academy of Sciences.

  2. Behavioral evidence of hunting and foraging techniques by a top predator suggests the importance of scavenging for preadults.

    Science.gov (United States)

    Margalida, Antoni; Colomer, MªÀngels; Sánchez, Roberto; Sánchez, Francisco Javier; Oria, Javier; González, Luis Mariano

    2017-06-01

    Scavenging may be a regular feeding behavior for some facultative raptor species occupying low quality habitats and/or with little experience in hunting techniques. However, its importance has been largely underestimated due to methodological limitations in identifying the real proportion in the diet. Here, through direct observations, we assessed the hunting and foraging success of the threatened Spanish imperial eagle Aquila adalberti determining the influence of age, sex, breeding status, habitat quality, prey type, and landscape characteristics. From 465 observations, Spanish imperial eagles used hunting in flight (42%), scavenging (30%), hunting from a perch (16%) and kleptoparasitism (12%). Our model suggests that Prey size and Prey type best explain hunting success, followed by Landscape and Sex. Our findings suggest that Spanish imperial eagles increase hunting success with age, with scavenging and kleptoparasitism regularly used as juveniles. The absence of relationships with any of the variables considered suggests that kleptoparasitism is an opportunistic behavior used sporadically. Scavenging is also independent of habitat quality and landscape characteristics. Accordingly, low prey density is not a driver of carrion use for preadult individuals, suggesting that a lack of hunting ability obliges this age-class to use this alternative feeding technique regularly. As a result, the threatened Spanish imperial eagle population is also prone to mortality related to the illegal use of poison baits and, potentially, veterinary drugs (i.e., diclofenac).

  3. Evidence Suggesting that Fasciola gigantica Might be the Most Prevalent Causal Agent of Fascioliasis in Northern Iran

    OpenAIRE

    K Ashrafi; Massoud, J.; K Holakouei; M Mahmoodi; MA Joafshani; MA Valero; MV Fuentes; M Khoubbane; P Artigas; MD Bargues; S Mas-Coma

    2004-01-01

    Following the occurrence of two large outbreaks in Gilan province, northern Iran, the public health importance of human fascioliasis has increased significantly. The mixed infections of Fasciola gigantica and F. hepatica within a given domestic animal individual suggest a very complicate picture of possible circulation ways of the parasite and the possibility for humans to be infected with both species. Elucidating these circulation ways is very critical for understanding the epidemiology and...

  4. Implementing supported self-management for asthma: a systematic review and suggested hierarchy of evidence of implementation studies.

    Science.gov (United States)

    Pinnock, Hilary; Epiphaniou, Eleni; Pearce, Gemma; Parke, Hannah; Greenhalgh, Trish; Sheikh, Aziz; Griffiths, Chris J; Taylor, Stephanie J C

    2015-06-01

    Asthma self-management remains poorly implemented in clinical practice despite overwhelming evidence of improved healthcare outcomes, reflected in guideline recommendations over three decades. To inform delivery in routine care, we synthesised evidence from implementation studies of self-management support interventions. We systematically searched eight electronic databases (1980 to 2012) and research registers, and performed snowball and manual searches for studies evaluating implementation of asthma self-management in routine practice. We included, and adapted systematic review methodology to reflect, a broad range of implementation study designs. We extracted data on study characteristics, process measures (for example, action plan ownership), asthma control (for example, patient reported control questionnaires, days off school/work, symptom-free days) and use of health services (for example, admissions, emergency department attendances, unscheduled consultations). We assessed quality using the validated Downs and Black checklist, and conducted a narrative synthesis informed by Kennedy's whole systems theoretical approach (considering patient, practitioner and organisational components and the interaction between these). We included 18 studies (6 randomised trials, 2 quasi-experimental studies, 8 with historical controls and 3 with retrospective comparators) from primary, secondary, community and managed care settings serving a total estimated asthma population of 800,000 people in six countries. In these studies, targeting professionals (n = 2) improved process, but had no clinically significant effect on clinical outcomes. Targeting patients (n = 6) improved some process measures, but had an inconsistent impact on clinical outcomes. Targeting the organisation (n = 3) improved process measures, but had little/no effect on clinical outcomes. Interventions that explicitly addressed patient, professional and organisational factors (n = 7) showed the most

  5. Quick evidence reviews using Epistemonikos: a thorough, friendly and current approach to evidence in health

    Directory of Open Access Journals (Sweden)

    Gabriel Rada

    2014-07-01

    Full Text Available Those who make decisions on healthcare should do so informed by the best scientific evidence at one’s disposal. During the last few years, it has become undeniable that identifying and synthesizing all scientific studies that respond a question constitutes an unapproachable challenge for a clinician. The quantity of information has increased excessively, some facts are not available, investigations are of either bad quality or even fraudulent, and the methods for achieving a combination and synthesis of all studies are each time more sophisticated. Moreover, if this inaccurate process is carried out, there exists a high risk of arriving at a biased conclusion.

  6. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  7. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  8. Haplotype transmission analysis provides evidence of association for DISC1 to schizophrenia and suggests sex-dependent effects.

    Science.gov (United States)

    Hennah, William; Varilo, Teppo; Kestilä, Marjo; Paunio, Tiina; Arajärvi, Ritva; Haukka, Jari; Parker, Alex; Martin, Rory; Levitzky, Steve; Partonen, Timo; Meyer, Joanne; Lönnqvist, Jouko; Peltonen, Leena; Ekelund, Jesper

    2003-12-01

    We have previously reported a linkage peak on 1q42 in a Finnish schizophrenia sample. In this study we genotyped 28 single nucleotide polymorphisms (SNPs) from 1q42 covering the three candidate genes TRAX, DISC1 and DISC2, using a study sample of 458 Finnish families ascertained for schizophrenia. Two-point and haplotype association analysis revealed a significant region of interest within the DISC1 gene. A common haplotype (HEP3) was observed to be significantly under-transmitted to affected individuals (P=0.0031). HEP3 represents a two SNP haplotype spanning from intron 1 to exon 2 of DISC1. This haplotype also displayed sex differences in transmission distortion, the under-transmission being significant only to affected females (P=0.00024). Three other regions of interest were observed in the TRAX and DISC genes. However, analysis of only those families with complete genotype information specifically highlights the HEP3 haplotype as a true observation. The finding of a common under-transmitted SNP haplotype might imply that this particular allele offers some protection from the development of schizophrenia. Analysis of component-traits of schizophrenia, derived from the Operational Criteria Checklist of Psychotic Illness (OCCPI), displayed association of HEP3 to features of the general phenotype of schizophrenia, including traits representing delusions, hallucinations and negative symptoms. This study provides further evidence for the hypothesis that the DISC1 gene is involved in the aetiology of schizophrenia, and implies a putative sex difference for the effect of the gene. Our findings would also encourage more detailed analyses of the effect of DISC1 on the component-traits of schizophrenia.

  9. Evidence of a Vocalic Proto-System in the Baboon (Papio papio) Suggests Pre-Hominin Speech Precursors

    Science.gov (United States)

    Boë, Louis-Jean; Berthommier, Frédéric; Legou, Thierry; Captier, Guillaume; Kemp, Caralyn; Sawallis, Thomas R.; Becker, Yannick; Rey, Arnaud; Fagot, Joël

    2017-01-01

    Language is a distinguishing characteristic of our species, and the course of its evolution is one of the hardest problems in science. It has long been generally considered that human speech requires a low larynx, and that the high larynx of nonhuman primates should preclude their producing the vowel systems universally found in human language. Examining the vocalizations through acoustic analyses, tongue anatomy, and modeling of acoustic potential, we found that baboons (Papio papio) produce sounds sharing the F1/F2 formant structure of the human [ɨ æ ɑ ɔ u] vowels, and that similarly with humans those vocalic qualities are organized as a system on two acoustic-anatomic axes. This confirms that hominoids can produce contrasting vowel qualities despite a high larynx. It suggests that spoken languages evolved from ancient articulatory skills already present in our last common ancestor with Cercopithecoidea, about 25 MYA. PMID:28076426

  10. Structural Evidence Suggests that the Antiactivator ExsD from Pseudomonas aeruginosa is a DNA binding protein

    Energy Technology Data Exchange (ETDEWEB)

    Bernhards, R.; Jing, X; Vogelaar, N; Robinson, H; Schubot, F

    2009-01-01

    The opportunistic pathogen P. aeruginosa utilizes a type III secretion system (T3SS) to support acute infections in predisposed individuals. In this bacterium, expression of all T3SS-related genes is dependent on the AraC-type transcriptional activator ExsA. Before host contact, the T3SS is inactive and ExsA is repressed by the antiactivator protein ExsD. The repression, thought to occur through direct interactions between the two proteins, is relieved upon opening of the type III secretion (T3S) channel when secretion chaperone ExsC sequesters ExsD. We have solved the crystal structure of {Delta}20ExsD, a protease-resistant fragment of ExsD that lacks only the 20 amino terminal residues of the wild-type protein at 2.6 {angstrom}. Surprisingly the structure revealed similarities between ExsD and the DNA binding domain of transcriptional repressor KorB. A model of an ExsD-DNA complex constructed on the basis of this homology produced a realistic complex that is supported by the prevalence of conserved residues in the putative DNA binding site and the results of differential scanning fluorimetry studies. Our findings challenge the currently held model that ExsD solely acts through interactions with ExsA and raise new questions with respect to the underlying mechanism of ExsA regulation.

  11. Genomic, RNAseq, and molecular modeling evidence suggests that the major allergen domain in insects evolved from a homodimeric origin.

    Science.gov (United States)

    Randall, Thomas A; Perera, Lalith; London, Robert E; Mueller, Geoffrey A

    2013-01-01

    The major allergen domain (MA) is widely distributed in insects. The crystal structure of a single Bla g 1 MA revealed a novel protein fold in which the fundamental structure was a duplex of two subsequences (monomers), which had diverged over time. This suggested that the evolutionary origin of the MA structure may have been a homodimer of this smaller subsequence. Using publicly available genomic data, the distribution of the basic unit of this class of proteins was determined to better understand its evolutionary history. The duplication and divergence is examined at three distinct levels of resolution: 1) within the orders Diptera and Hymenoptera, 2) within one genus Drosophila, and 3) within one species Aedes aegypti. Within the family Culicidae, we have found two separate occurrences of monomers as independent genes. The organization of the gene family in A. aegypti shows a common evolutionary origin for its monomer and several closely related MAs. Molecular modeling of the A. aegypti monomer with the unique Bla g 1 fold confirms the distant evolutionary relationship and supports the feasibility of homodimer formation from a single monomer. RNAseq data for A. aegypti confirms that the monomer is expressed in the mosquito similar to other A. aegypti MAs after a blood meal. Together, these data support the contention that the detected monomer shares similar functional characteristics to related MAs in other insects. An extensive search for this domain outside of Insecta confirms that the MAs are restricted to insects.

  12. Omega-3 Fatty Acids in Modern Parenteral Nutrition: A Review of the Current Evidence

    Directory of Open Access Journals (Sweden)

    Stanislaw Klek

    2016-03-01

    Full Text Available Intravenous lipid emulsions are an essential component of parenteral nutrition regimens. Originally employed as an efficient non-glucose energy source to reduce the adverse effects of high glucose intake and provide essential fatty acids, lipid emulsions have assumed a larger therapeutic role due to research demonstrating the effects of omega-3 and omega-6 polyunsaturated fatty acids (PUFA on key metabolic functions, including inflammatory and immune response, coagulation, and cell signaling. Indeed, emerging evidence suggests that the effects of omega-3 PUFA on inflammation and immune response result in meaningful therapeutic benefits in surgical, cancer, and critically ill patients as well as patients requiring long-term parenteral nutrition. The present review provides an overview of the mechanisms of action through which omega-3 and omega-6 PUFA modulate the immune-inflammatory response and summarizes the current body of evidence regarding the clinical and pharmacoeconomic benefits of intravenous n-3 fatty acid-containing lipid emulsions in patients requiring parenteral nutrition.

  13. Convergent evidence from mouse and human studies suggests the involvement of zinc finger protein 326 gene in antidepressant treatment response.

    Directory of Open Access Journals (Sweden)

    Ying-Jay Liou

    Full Text Available OBJECTIVES: The forced swim test (FST is a commonly used model to predict antidepressant efficacy. Uncovering the genetic basis of the model may unravel the mechanism of antidepressant treatment. METHODS: FVB/NJ (FVB and C57BL/6J (B6 were first identified as the response and non-response strains to fluoxetine (a serotonin-specific reuptake inhibitor antidepressant treatment in the mouse FST. Simple-interval (SIM and composite-interval (CIM mappings were applied to map the quantitative trait loci (QTLs of the anti-immobility effect of fluoxetine in FST (FST(FLX in 865 male B6×FVB-F2 mice. The brain mRNA expressions of the gene with the maximum QTL-linkage signal for FST(FLX after the FST were compared between B6 and FVB mice and also compared between fluoxetine and saline treatment. The association of the variants in the human homologue of the mouse FST(FLX-QTL gene with major depressive disorder (MDD and antidepressant response were investigated in 1080 human subjects (MDD/control = 582/498. RESULTS: One linkage signal for FST(FLX-QTL was detected at an intronic SNP (rs6215396 of the mouse Zfp326 gene (maximal CIM-LOD = 9.36. The Zfp326 mRNA expression in the FVB thalamus was significantly down-regulated by fluoxetine in the FST, and the higher FVB-to-B6 Zfp326 mRNA expressions in the frontal cortex, striatum and hypothalamus diminished after fluoxetine treatment. Two coding-synonymous SNPs (rs2816881 and rs10922744 in the human homologue of Zfp326, ZNF326, were significantly associated with the 8-week antidepressant treatment response in the MDD patients (Bonferroni-corrected p = 0.004-0.028. CONCLUSIONS: The findings suggest the involvement of the Zfp326 and ZNF326 genes in antidepressant treatment response.

  14. Treatment of gastric outlet obstruction that results fromunresectable gastric cancer: Current evidence

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Malignant gastric outlet obstruction (GOO) is a commoncondition that results from locally advanced malignanciesin the upper gastrointestinal tract, such aspancreatic, gastric, and other carcinomas. Two typesof procedures for malignant GOO, namely, gastrojejunostomy(GJ) with laparotomy or a laparoscopicapproach and endoscopic stenting (ES), are currentlyavailable. Although numerous previous reports haveclarified the benefits and drawbacks of each procedure,whether GJ or ES should be used in patients with GOOthat results from gastric cancer who may have a longerlife expectancy than patients with other malignancieshas not been determined. In this review, which focuseson gastric cancer-induced GOO, we analyzed the twosystematic reviews and a meta-analysis that comparedGJ and ES and outlined the current status of GOOtreatment. We also provide an updated review thatincludes laparoscopic GJ. Various data from 13 studiesin one review and 6 studies in another review wereanalyzed. Although the main results of the presentreview indicated that both GJ and ES were efficacioustreatments in patients with GOO that resulted fromgastric cancer, current evidence suggests that GJ maybe the preferable procedure given its good performancestatus and improved prognosis in gastric cancer patients.

  15. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    Science.gov (United States)

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  16. How Is Working Memory Training Likely to Influence Academic Performance? Current Evidence and Methodological Considerations.

    Science.gov (United States)

    Bergman Nutley, Sissela; Söderqvist, Stina

    2017-01-01

    Working memory (WM) is one of our core cognitive functions, allowing us to keep information in mind for shorter periods of time and then work with this information. It is the gateway that information has to pass in order to be processed consciously. A well-functioning WM is therefore crucial for a number of everyday activities including learning and academic performance (Gathercole et al., 2003; Bull et al., 2008), which is the focus of this review. Specifically, we will review the research investigating whether improving WM capacity using Cogmed WM training can lead to improvements on academic performance. Emphasis is given to reviewing the theoretical principles upon which such investigations rely, in particular the complex relation between WM and mathematical and reading abilities during development and how these are likely to be influenced by training. We suggest two possible routes in which training can influence academic performance, one through an effect on learning capacity which would thus be evident with time and education, and one through an immediate effect on performance on reading and mathematical tasks. Based on the theoretical complexity described we highlight some methodological issues that are important to take into consideration when designing and interpreting research on WM training and academic performance, but that are nonetheless often overlooked in the current research literature. Finally, we will provide some suggestions for future research for advancing the understanding of WM training and its potential role in supporting academic attainment.

  17. How Is Working Memory Training Likely to Influence Academic Performance? Current Evidence and Methodological Considerations

    Science.gov (United States)

    Bergman Nutley, Sissela; Söderqvist, Stina

    2017-01-01

    Working memory (WM) is one of our core cognitive functions, allowing us to keep information in mind for shorter periods of time and then work with this information. It is the gateway that information has to pass in order to be processed consciously. A well-functioning WM is therefore crucial for a number of everyday activities including learning and academic performance (Gathercole et al., 2003; Bull et al., 2008), which is the focus of this review. Specifically, we will review the research investigating whether improving WM capacity using Cogmed WM training can lead to improvements on academic performance. Emphasis is given to reviewing the theoretical principles upon which such investigations rely, in particular the complex relation between WM and mathematical and reading abilities during development and how these are likely to be influenced by training. We suggest two possible routes in which training can influence academic performance, one through an effect on learning capacity which would thus be evident with time and education, and one through an immediate effect on performance on reading and mathematical tasks. Based on the theoretical complexity described we highlight some methodological issues that are important to take into consideration when designing and interpreting research on WM training and academic performance, but that are nonetheless often overlooked in the current research literature. Finally, we will provide some suggestions for future research for advancing the understanding of WM training and its potential role in supporting academic attainment.

  18. Tafenoquine treatment of Plasmodium vivax malaria: suggestive evidence that CYP2D6 reduced metabolism is not associated with relapse in the Phase 2b DETECTIVE trial.

    Science.gov (United States)

    St Jean, Pamela L; Xue, Zhengyu; Carter, Nick; Koh, Gavin C K W; Duparc, Stephan; Taylor, Maxine; Beaumont, Claire; Llanos-Cuentas, Alejandro; Rueangweerayut, Ronnatrai; Krudsood, Srivicha; Green, Justin A; Rubio, Justin P

    2016-02-18

    Tafenoquine (TQ) and primaquine (PQ) are 8-aminoquinolines (8-AQ) with anti-hypnozoite activity against vivax malaria. PQ is the only FDA-approved medicine for preventing relapsing Plasmodium vivax infection and TQ is currently in phase 3 clinical trials for the same indication. Recent studies have provided evidence that cytochrome P450 (CYP) metabolism via CYP2D6 plays a role in PQ efficacy against P. vivax and have suggested that this effect may extend to other 8-AQs, including TQ. Here, a retrospective pharmacogenetic (PGx) investigation was performed to assess the impact of CYP2D6 metabolism on TQ and PQ efficacy in the treatment of P. vivax in the DETECTIVE study (TAF112582), a recently completed, randomized, phase 2b dose-ranging clinical trial. The impact of CYP2D6 on TQ pharmacokinetics (PK) was also investigated in TAF112582 TQ-treated subjects and in vitro CYP metabolism of TQ was explored. A limitation of the current study is that TAF112582 was not designed to be well powered for PGx, thus our findings are based on TQ or PQ efficacy in CYP2D6 intermediate metabolizers (IM), as there were insufficient poor metabolizers (PM) to draw any conclusion on the impact of the PM phenotype on efficacy. The impact of genetically-predicted CYP2D6 reduced metabolism on relapse-free efficacy six months post-dosing of TQ or PQ, both administered in conjunction with chloroquine (CQ), was assessed using exact statistical methods in 198 P. vivax-infected study participants comparing IM to extensive metabolizers (EM). The influence of CYP2D6 metabolizer phenotypes on TQ PK was assessed comparing median TQ area under the curve (AUC). In vitro metabolism of TQ was investigated using recombinant, over-expressed human CYP enzymes and human hepatocytes. Metabolite identification experiments were performed using liquid chromatography-mass spectrometry. Reduction of CYP2D6 activity was not associated with an increase in relapse-rate in TQ-treated subjects (p = 0.57). In contrast

  19. Evidence for breathing modes in direct current, pulsed, and high power impulse magnetron sputtering plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yuchen [State Key Lab for Materials Processing and Die & Mold Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China); Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Zhou, Xue [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Department of Electrical Engineering, Harbin Institute of Technology, Harbin 150000 (China); Liu, Jason X. [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Department of Physics, University of California, Berkeley, Berkeley, California 94720 (United States); Anders, André, E-mail: aanders@lbl.gov [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States)

    2016-01-18

    We present evidence for breathing modes in magnetron sputtering plasmas: periodic axial variations of plasma parameters with characteristic frequencies between 10 and 100 kHz. A set of azimuthally distributed probes shows synchronous oscillations of the floating potential. They appear most clearly when considering the intermediate current regime in which the direction of azimuthal spoke motion changes. Breathing oscillations were found to be superimposed on azimuthal spoke motion. Depending on pressure and current, one can also find a regime of chaotic fluctuations and one of stable discharges, the latter at high current. A pressure-current phase diagram for the different situations is proposed.

  20. Assessing the Effect of Waterpipe Smoking on Cancer Outcome - a Systematic Review of Current Evidence

    Science.gov (United States)

    Awan, Kamran Habib; Siddiqi, Kamran; Patil, Shankargouda; Hussain, Quratul Ann

    2017-02-01

    Background: Waterpipe smoking (WPS) is widely believed to be a safe and hazard-free tobacco habit. However, a number of studies have indicated that exposure to several toxicants and carcinogens through WPS is strongly related to serious health hazards. The current paper presents a narrative review on the effects of WPS on cancer outcome. Methods: The addressed focused question was “Is there an association between waterpipe smoking and cancer outcome?” PubMed, Medline, EMBASE, ISI Web of Science and the Cochrane databases were searched until June 2015 using the key words “Waterpipe”, “Hookah”, “Narghileh”, “Shisha”, “Hubbly Bubbly” “cancer” in various combinations. Letters to the Editor, review articles, case-reports and unpublished articles were excluded. Results: A total of 16 studies were included: six on lung cancer, three on oesophageal cancer, two on gastric cancer, two on bladder cancer, and one each on nasopharyngeal, pancreatic and prostate cancers. Our search did not yield any study that evaluated the risk of oral cancer in WPS users. The available evidence showed a significant association of WPS with lung cancer (UOR 6.0, 95% CI 1.78–20.26); however, no association was observed with bladder, nasopharyngeal, pancreatic and prostate cancers. Gastric (OR 3.4, 95% CI 1.7-7.1) and oesophageal cancers (OR 1.85, 95% CI 1.41-2.44) were observed to have weak associations with WPS. Conclusion: Regardless of the limitations, there is sufficient evidence to suggest associations of WPS with cancer, particularly in the lung. Future well-designed studies are required to identify and quantify with confidence all the health effects of this form of smoking. Creative Commons Attribution License

  1. Flavanols and Anthocyanins in Cardiovascular Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Sonia de Pascual-Teresa

    2010-04-01

    Full Text Available Nowadays it is accepted that natural flavonoids present in fruits and plant-derived-foods are relevant, not only for technological reasons and organoleptic properties, but also because of their potential health-promoting effects, as suggested by the available experimental and epidemiological evidence. The beneficial biological effects of these food bioactives may be driven by two of their characteristic properties: their affinity for proteins and their antioxidant activity. Over the last 15 years, numerous publications have demonstrated that besides their in vitro antioxidant capacity, certain phenolic compounds, such as anthocyanins, catechins, proanthocyanidins, and other non coloured flavonoids, may regulate different signaling pathways involved in cell survival, growth and differentiation. In this review we will update the knowledge on the cardiovascular effects of anthocyanins, catechins and proanthocyanidins, as implied by the in vitro and clinical studies on these compounds. We also review the available information on the structure, distribution and bioavailability of flavanols (monomeric catechins and proanthocyanidins and anthocyanins, data necessary in order to understand their role in reducing risk factors and preventing cardiovascular health problems through different aspects of their bioefficacy on vascular parameters (platelet agregation, atherosclerosis, blood pressure, antioxidant status, inflammation-related markers, etc., myocardial conditions, and whole-body metabolism (serum biochemistry, lipid profile, highlighting the need for better-designed clinical studies to improve the current knowledge on the potential health benefits of these flavonoids to cardiovascular and metabolic health.

  2. Incretin-based therapies in prediabetes: Current evidence and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Georgios; S; Papaetis

    2014-01-01

    The prevalence of type 2 diabetes(T2D) is evolving globally at an alarming rate. Prediabetes is an intermediate state of glucose metabolism that exists between normal glucose tolerance(NGT) and the clinical entity of T2 D. Relentless β-cell decline and failure is responsible for the progression from NGT to prediabetes and eventually T2 D. The huge burden resulting from the complications of T2 D created the need of therapeutic strategies in an effort to prevent or delay its development. The beneficial effects of incretin-based therapies, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1(GLP-1) receptor agonists, on β-cell function in patients with T2 D, together with their strictly glucose-depended mechanism of action, suggested their possible use in individuals with prediabetes when greater β-cell mass and function are preserved and the possibility of β-cell salvage is higher. The present paper summarizes the main molecular intracellular mechanisms through which GLP-1 exerts its activity on β-cells. It also explores the current evidence of incretin based therapies when administered in a prediabetic state, both in animal models and in humans. Finally it discusses the safety of incretin-based therapies as well as their possible role in order to delay or prevent T2 D.

  3. Brain PET imaging in obesity and food addiction: current evidence and hypothesis.

    Science.gov (United States)

    Iozzo, Patricia; Guiducci, Letizia; Guzzardi, Maria Angela; Pagotto, Uberto

    2012-01-01

    The ongoing epidemics of obesity is one main health concern of the present time. Overeating in some obese individuals shares similarities with the loss of control and compulsive behavior observed in drug-addicted subjects, suggesting that obesity may involve food addiction. Here, we review the contributions provided by the use of positron emission tomography to the current understanding of the cerebral control of obesity and food intake in humans. The available studies have shown that multiple areas in the brain are involved with the reward properties of food, such as prefrontal, orbitofrontal, somatosensory cortices, insula, thalamus, hypothalamus, amygdala, and others. This review summarizes the current evidence, supporting the concepts that i) regions involved in the somatosensory response to food sight, taste, and smell are activated by palatable foods and may be hyperresponsive in obese individuals, ii) areas controlling executive drive seem to overreact to the anticipation of pleasure during cue exposure, and iii) those involved in cognitive control and inhibitory behavior may be resistant to the perception of reward after food exposure in obese subjects. All of these features may stimulate, for different reasons, ingestion of highly palatable and energy-rich foods. Though these same regions are similarly involved in drug abusers and game-addicted individuals, any direct resemblance may be an oversimplification, especially as the heterogeneities between studies and the prevalent exclusion of sensitive groups still limit a coherent interpretation of the findings. Further work is required to comprehensively tackle the multifaceted phenotype of obesity and identify the role of food dependency in its pathophysiology. Copyright © 2012 S. Karger GmbH, Freiburg.

  4. Evidence of current impact of climate change on life : A walk from genes to the biosphere

    NARCIS (Netherlands)

    Penuelas, Josep; Sardans, Jordi; Estiarte, Marc; Ogaya, Roma; Carnicer, Jofre; Coll, Marta; Barbeta, Adria; Rivas-Ubach, Albert; Llusia, Joan; Garbulsky, Martin; Filella, Iolanda; Jump, Alistair S.

    We review the evidence of how organisms and populations are currently responding to climate change through phenotypic plasticity, genotypic evolution, changes in distribution and, in some cases, local extinction. Organisms alter their gene expression and metabolism to increase the concentrations of

  5. Body image disturbance in children and adolescents with eating disorders. Current evidence and future directions.

    Science.gov (United States)

    Legenbauer, Tanja; Thiemann, Pia; Vocks, Silja

    2014-01-01

    Body image is multifaceted and incorporates perceptual, affective, and cognitive components as well as behavioral features. Only few studies have examined the character of body-image disturbance in children/adolescents with eating disorders. It is unknown whether body-image disturbances in children/adolescent with eating disturbances are comparable to those of adult patients with eating disorders. Body-image disturbance might differ quantitatively and qualitatively according to the cognitive developmental status and the age of the individual. This paper provides an overview of the current evidence for body-image disturbance in children/adolescents with eating disorders, and how they compare with those adults with eating disorders. Current evidence indicates that older adolescent patients show similar deficits as adult patients with eating disorders, in particular for the attitudinal body-image component. However, evidence for a perceptual body-image disturbance in adolescent patients, in particular anorexia nervosa, is not conclusive. Reliable statements for childhood can hardly be made because clinical studies are not available. Investigations of body-image disturbance in children have focused on the predictive value for eating disorders. Limitations of the current evidence are discussed, and future directions for research and therapy are indicated.

  6. Institutional and legal arrangements in the Nile river basin: suggestions to improve the current situation toward adaptive integrated water resources management.

    Science.gov (United States)

    Abdalla, Khalid Mohamed El Hassan

    2008-01-01

    A comparative study was conducted in this work in order to investigate the current situation in the Nile river basin (NRB) regarding the institutional and legal arrangements needed to support the adaptive integrated water resources management (AIWRM) strategy. Two similar river basins were selected to achieve this comparison and to introduce suggestions to reform the current situation in the basin. Before that, the ideal situation is investigated to be as a yardstick for the desired situation. The study indicated that the necessary AIWRM criteria may include regulatory as well as implementation organizations that support shared-vision reaching with its all necessary features (cooperation, stakeholders' participation, subsidiarity, and information and knowledge exchange). Thus the main features of the desired situations regarding AIWRM in river basins are stakeholders' participation, learning-driven ability, quick response to risks and uncertainties, and finally a legal framework that could support these criteria. Although the AIWRM criteria seem to be satisfied in NRB, the basin lacks the necessary regulatory institutions as well as the legal framework. According to this, this study recommends to reform the current situation in NRB by creating regulator institutions (policy and decision making level) as well a legal framework to legitimate them.

  7. Cognitive behavioral therapy in anxiety disorders: current state of the evidence.

    Science.gov (United States)

    Otte, Christian

    2011-01-01

    A plethora of studies have examined the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for adult anxiety disorders. In recent years, several meta-analyses have been conducted to quantitatively review the evidence of CBT for anxiety disorders, each using different inclusion criteria for studies, such as use of control conditions or type of study environment. This review aims to summarize and to discuss the current state of the evidence regarding CBT treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Overall, CBT demonstrates both efficacy in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders. However, due to methodological issues, the magnitude of effect is currently difficult to estimate. In conclusion, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but more high-quality studies are needed to better estimate the magnitude of the effect.

  8. Evidence for large-area superemission into a high-current glow discharge

    Science.gov (United States)

    Hartmann, W.; Dominic, V.; Kirkman, G. F.; Gundersen, M. A.

    1988-10-01

    This letter presents evidence for large-area (≊1 cm2) cathode superemission (˜10 000 A/cm2) into a high-current glow discharge in a pseudospark or back lighted thyratron switch. Cathodes studied with a scannning electron microscope following operation at 6-8 kA, ≊1 μs pulse length, and 105 pulses in a low-pressure H2 discharge show evidence of melting of a thin surface layer within a radius of ˜4 mm, indicating that the discharge is a superdense glow with a cross-sectional area of the order of 1 cm2, rather than an arc. Further supporting evidence is provided by streak camera data. An ion beam present during the avalanche phase of the discharge is responsible for heating the cathode surface resulting in a significant field-enhanced thermionic emission.

  9. Current knowledge on evidence-based shockwave treatments for shoulder pathology.

    Science.gov (United States)

    Moya, Daniel; Ramón, Silvia; Guiloff, Leonardo; Gerdesmeyer, Ludger

    2015-12-01

    Shoulder pain is one of the most common musculoskeletal pathologies. Treatment by ESWT (extracorporeal shockwave therapy) has emerged as an alternative when conservative treatment fails in rotator cuff calcific tendinopathy, prior to invasive procedures. The clinical efficacy of ESWT in non-calcific tendinopathy remains controversial. The good results in the treatment of rotator cuff calcifications, have led to indications of ESWT being expanded to other shoulder pathologies. We review the current state of indications and evidence based practice.

  10. Quantized current blockade and hydrodynamic correlations in biopolymer translocation through nanopores: evidence from multiscale simulations

    CERN Document Server

    Bernaschi, Massimo; Succi, Sauro; Fyta, Maria; Kaxiras, Efthimios

    2008-01-01

    We present a detailed description of biopolymer translocation through a nanopore in the presence of a solvent, using an innovative multi-scale methodology which treats the biopolymer at the microscopic scale as combined with a self-consistent mesoscopic description for the solvent fluid dynamics. We report evidence for quantized current blockade depending on the folding configuration and offer detailed information on the role of hydrodynamic correlations in speeding-up the translocation process.

  11. The microanatomy of the rectal salt gland of the Port Jackson Shark, Heterodontus portusjacksoni (Meyer) (Heterodontidae): suggestions for a counter-current exchange system.

    Science.gov (United States)

    Newbound, D R; O'Shea, J E

    2001-01-01

    A comprehensive anatomical study was undertaken to examine the rectal salt gland in the Port Jackson shark, Heterodontus portusjacksoni, a shark known to invade estuarine environments. The microstructure and vascular organisation of the rectal salt gland was investigated using histological observation and scanning electron microscopy of vascular corrosion casts. Cellular specialisation was observed in the lining of the central lumen of this gland. This may indicate that there is some modification of the principal product of the gland prior to its secretion. The rectal salt gland has a complex structure related to its function. Contrary to previous reports, the flow in secretory tubules is in the opposite direction to that of the capillaries and thus constitutes a counter-current arrangement. The similarity in the organisation of the counter-current and lobulate arrangement of salt-secreting glands through phylogenetically diverse organisms, such as sharks and birds, suggests that this arrangement is important in achieving efficient salt secretion. Copyright 2001 S. Karger AG, Basel

  12. Evidence for a distinct light-induced calcium-dependent potassium current in Hermissenda crassicornis.

    Science.gov (United States)

    Blackwell, K T

    2000-01-01

    A model of phototransduction is developed as a first step toward a model for investigating the critical interaction of light and turbulence stimuli within the type B photoreceptor of Hermissenda crassicronis. The model includes equations describing phototransduction, release of calcium from intracellular stores, and other calcium regulatory mechanisms, as well as equations describing ligand-gating of a rhabdomeric sodium current. The model is used to determine the sources of calcium in the soma, whether calcium or IP3 is a plausible ligand of the light-induced sodium current, and whether the light-induced potassium current is equivalent to the calcium-dependent potassium current activated by light-induced calcium release. Simulations show that the early light-induced calcium elevation is due to influx through voltage-dependent channels, whereas the later calcium elevation is due to release from intracellular stores. Simulations suggest that the ligand of the fast, light-induced sodium current is IP3 but that there is a smaller, prolonged component of the light-induced sodium current that is activated by calcium. In the model, the calcium-dependent potassium current, located in the soma, is activated only slightly by light-induced calcium elevation, leading to the prediction that a calcium-dependent potassium current, active at resting potential, is located in the rhabdomere and is responsible for the light-induced potassium current.

  13. Neurocognitive and Social Cognitive Approaches for Improving Functional Outcome in Early Psychosis: Theoretical Considerations and Current State of Evidence

    Directory of Open Access Journals (Sweden)

    Cali F. Bartholomeusz

    2012-01-01

    Full Text Available Improving functional outcome, in addition to alleviating psychotic symptoms, is now a major treatment objective in schizophrenia research. Given the large body of evidence suggesting pharmacological treatments generally have minimal effects on indices of functioning, research has turned to psychosocial rehabilitation programs. Among these, neurocognitive and social cognitive interventions are at the forefront of this field and are argued to target core deficits inherent to the schizophrenia illness. However, to date, research trials have primarily focused on chronic schizophrenia populations, neglecting the early psychosis groups who are often as severely impaired in social and occupational functioning. This theoretical paper will outline the rationale for investigating adjunctive cognitive-based interventions in the early phases of psychotic illness, critically examine the current approach strategies used in these interventions, and assess the evidence supporting certain training programs for improving functional outcome in early psychosis. Potential pathways for future research will be discussed.

  14. Autonomic nervous system dysfunction in obesity and Prader-Willi syndrome: current evidence and implications for future obesity therapies.

    Science.gov (United States)

    Haqq, A M; DeLorey, D S; Sharma, A M; Freemark, M; Kreier, F; Mackenzie, M L; Richer, L P

    2011-08-01

    The autonomic nervous system (ANS) controls essential functions like breathing, heart rate, digestion, body temperature and hormone levels. Evidence suggests that ANS dysfunction is associated with adult and childhood obesity and plays a role in the distribution of total body fat and the development of obesity-related complications in humans. This review summarizes our current understanding of ANS involvement in the pathogenesis of obesity and Prader-Willi syndrome. Available evidence of ANS dysfunction in the control of energy balance is limited and, in some cases, contradictory. Further investigation in this area is warranted in order to better understand the important contributions of the ANS to regulation of body fat, development of obesity and its comorbidities. Results from these studies will guide the development of novel obesity therapeutics targeting specific ANS dysfunction.

  15. Concussions: What a neurosurgeon should know about current scientific evidence and management strategies

    Science.gov (United States)

    Neal, Matthew T.; Wilson, Jonathan L.; Hsu, Wesley; Powers, Alexander K.

    2012-01-01

    Background: There has been a tremendous amount of interest focused on the topic of concussions over the past few decades. Neurosurgeons are frequently consulted to manage patients with mild traumatic brain injuries (mTBI) that have radiographic evidence of cerebral injury. These injuries share significant overlap with concussions, injuries that typically do not reveal radiographic evidence of structural injury, in the realms of epidemiology, pathophysiology, outcomes, and management. Further, neurosurgeons often manage patients with extracranial injuries that have concomitant concussions. In these cases, neurosurgeons are often the only “concussion experts” that patients encounter. Results: The literature has been reviewed and data have been synthesized on the topic including sections on historical background, epidemiology, pathophysiology, diagnostic advances, clinical sequelae, and treatment suggestions, with neurosurgeons as the intended target audience. Conclusions: Neurosurgeons should have a fundamental knowledge of the scientific evidence that has developed regarding concussions and be prepared to guide patients with treatment plans. PMID:22439107

  16. Direct Evidence for Neutrino Flavor Transformation from Neutral-Current Interactions in the Sudbury Neutrino Observatory

    CERN Document Server

    Ahmad, Q R; Andersen, T C; Anglin, J D; Barton, J C; Beier, E W; Bercovitch, M; Bigu, J; Biller, S D; Black, R A; Blevis, I; Boardman, R J; Boger, J; Bonvin, E; Boulay, M G; Bowler, M G; Bowles, T J; Brice, S J; Browne, M C; Bullard, T V; Buhler, G; Cameron, J; Chan, Y D; Chen, H H; Chen, M; Chen, X; Cleveland, B T; Clifford, E T H; Cowan, J H M; Cowen, D F; Cox, G A; Dai, X; Dalnoki-Veress, F; Davidson, W F; Doe, P J; Doucas, G; Dragowsky, M R; Duba, C A; Duncan, F A; Dunford, M; Dunmore, J A; Earle, E D; Elliott, S R; Evans, H C; Ewan, G T; Farine, J; Fergani, H; Ferraris, A P; Ford, R J; Formaggio, J A; Fowler, M M; Frame, K; Frank, E D; Frati, W; Gagnon, N; Germani, J V; Gil, S; Graham, K; Grant, D R; Hahn, R L; Hallin, A L; Hallman, E D; Hamer, A S; Hamian, A A; Handler, W B; Haq, R U; Hargrove, C K; Harvey, P J; Hazama, R; Heeger, K M; Heintzelman, W J; Heise, J; Helmer, R L; Hepburn, J D; Heron, H; Hewett, J L; Hime, A; Howe, M; Hykawy, J G; Isaac, M C P; Jagam, P; Jelley, N A; Jillings, C; Jonkmans, G; Kazkaz, K; Keener, P T; Klein, J R; Knox, A B; Komar, R J; Kouzes, R; Kutter, T; Kyba, C C M; Law, J; Lawson, I T; Lay, M; Lee, H W; Lesko, K T; Leslie, J R; Levine, I; Locke, W; Luoma, S; Lyon, J; Majerus, S; Mak, H B; Maneira, J; Manor, J; Marino, A D; McCauley, N; McDonald, A B; McDonald, D S; McFarlane, K; McGregor, G; Meijer-Drees, R; Miin, C; Miller, G G; Milton, G; Moffat, B A; Moorhead, M E; Nally, C W; Neubauer, M S; Newcomer, F M; Ng, H S; Noble, A J; Norman, E B; Novikov, V M; O'Neill, M; Okada, C E; Ollerhead, R W; Omori, Mamoru; Orrell, J L; Oser, S M; Poon, A W P; Radcliffe, T J; Roberge, A; Robertson, B C; Robertson, R G H; Rosendahl, S S E; Rowley, J K; Rusu, V L; Saettler, E; Schaffer, K K; Schwendener, M H; Schülke, A; Seifert, H; Shatkay, M; Simpson, J J; Sims, C J; Sinclair, D; Skensved, P; Smith, A R; Smith, M W E; Spreitzer, T; Starinsky, N; Steiger, T D; Stokstad, R G; Stonehill, L C; Storey, R S; Sur, B; Tafirout, R; Tagg, N; Tanner, N W; Taplin, R K; Thorman, M; Thornewell, P M; Trent, P T; Tserkovnyak, Y; Van Berg, R; Van de Water, R G; Virtue, C J; Waltham, C E; Wang, J X; Wark, D L; West, N; Wilhelmy, J B; Wilkerson, J F; Wilson, J R; Wittich, P; Wouters, J M; Yeh, M

    2002-01-01

    Observations of neutral current neutrino interactions on deuterium in the Sudbury Neutrino Observatory are reported. Using the neutral current, elastic scattering, and charged current reactions and assuming the standard 8B shape, the electron-neutrino component of the 8B solar flux is 1.76 +/-0.05(stat.)+/-0.09(syst.) x10^6/(cm^2 s), for a kinetic energy threshold of 5 MeV. The non-electron neutrino component is 3.41+/-0.45(stat.)+0.48,-0.45(syst.) x10^6/(cm^2 s), 5.3 standard deviations greater than zero, providing strong evidence for solar electron neutrino flavor transformation. The total flux measured with the NC reaction is 5.09 +0.44,-0.43(stat.)+0.46,-0.43(syst.)x10^6/(cm^2 s), consistent with solar models.

  17. Chest Pain of Suspected Cardiac Origin: Current Evidence-based Recommendations for Prehospital Care

    Directory of Open Access Journals (Sweden)

    P. Brian Savino

    2015-12-01

    Full Text Available Introduction: In the United States, emergency medical services (EMS protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of chest pain of suspected cardiac origin and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of chest pain and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the chest pain protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were use of supplemental oxygen, aspirin, nitrates, opiates, 12-lead electrocardiogram (ECG, ST segment elevation myocardial infarction (STEMI regionalization systems, prehospital fibrinolysis and β-blockers. Results: The protocols varied widely in terms of medication and dosing choices, as well as listed contraindications to treatments. Every agency uses oxygen with 54% recommending titrated dosing. All agencies use aspirin (64% recommending 325mg, 24% recommending 162mg and 15% recommending either, as well as nitroglycerin and opiates (58% choosing morphine. Prehospital 12- Lead ECGs are used in 97% of agencies, and all but one agency has some form of regionalized care for their STEMI patients. No agency is currently employing prehospital fibrinolysis or β-blocker use. Conclusion: Protocols for chest pain of suspected cardiac origin vary widely across California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.

  18. Friend or foe? The current epidemiologic evidence on selenium and human cancer risk.

    Science.gov (United States)

    Vinceti, Marco; Crespi, Catherine M; Malagoli, Carlotta; Del Giovane, Cinzia; Krogh, Vittorio

    2013-01-01

    Scientific opinion on the relationship between selenium and the risk of cancer has undergone radical change over the years, with selenium first viewed as a possible carcinogen in the 1940s then as a possible cancer preventive agent in the 1960s-2000s. More recently, randomized controlled trials have found no effect on cancer risk but suggest possible low-dose dermatologic and endocrine toxicity, and animal studies indicate both carcinogenic and cancer-preventive effects. A growing body of evidence from human and laboratory studies indicates dramatically different biological effects of the various inorganic and organic chemical forms of selenium, which may explain apparent inconsistencies across studies. These chemical form-specific effects also have important implications for exposure and health risk assessment. Overall, available epidemiologic evidence suggests no cancer preventive effect of increased selenium intake in healthy individuals and possible increased risk of other diseases and disorders.

  19. Breast-Feeding Analgesia in Infants: An Update on the Current State of Evidence.

    Science.gov (United States)

    Benoit, Britney; Martin-Misener, Ruth; Latimer, Margot; Campbell-Yeo, Marsha

    To provide an updated synthesis of the current state of the evidence for the effectiveness of breast-feeding and expressed breast milk feeding in reducing procedural pain in preterm and full-term born infants. A systematic search of key electronic databases (PubMed, CINAHL, EMBASE) was completed. Of the 1032 abstracts screened, 21 were found eligible for inclusion. Fifteen studies reported on the use of breast-feeding or expressed breast milk in full-term infants and 6 reported on preterm infants. Direct breast-feeding was more effective than maternal holding, maternal skin-to-skin contact, topical anesthetics, and music therapy, and was as or more effective than sweet tasting solutions in full-term infants. Expressed breast milk was not consistently found to reduce pain response in full-term or preterm infants. Studies generally had moderate to high risk of bias. There is sufficient evidence to recommend direct breast-feeding for procedural pain management in full-term infants. Based on current evidence, expressed breast milk alone should not be considered an adequate intervention.

  20. Control of antibiotic resistance in China must not be delayed: The current state of resistance and policy suggestions for the government, medical facilities, and patients.

    Science.gov (United States)

    Tang, Qi; Song, Peipei; Li, Jiajia; Kong, Fanlei; Sun, Long; Xu, Lingzhong

    2016-02-01

    Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines. Antibiotic resistance is rising to dangerously high levels in all parts of the world, leading to higher medical costs, prolonged hospital stays, and increased mortality. In the European Union alone, drug-resistant bacteria are estimated to cause 25,000 deaths and cost more than US$1.5 billion every year in healthcare expenses and productivity losses. The problems of antibiotic misuse and antibiotic resistance are quite serious in China. In 2015, results of a study by the State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences indicated that the total antibiotic usage in China in 2013 was approximately 162,000 tons, including human use (48%) and use in animals (52%). This amount accounted for about half of the antibiotic usage worldwide. The per-capita use of antibiotics in China is more than 5 times that in Europe and the United States. These data mean that China is one of the world's leading countries with serious problems in terms of antibiotic misuse and antibiotic resistance. The current article analyzes the current state and harms of antibiotic misuse and causes of antibiotic resistance in China. The Government needs to pay close attention to the issue of antibiotic resistance in China and formulate a strategy at the national level. Thus, the following suggestions are offered: i) The Chinese Government should implement policies that promote antibiotic research and development; ii) Medical facilities in China should create multidisciplinary teams (MDTs) and encourage early action by MDTs to control the spread of multi-drug-resistant bacteria (MDRB); iii) An intervention in the form of health education should target patients and accompanying family members (AFM) in China. In other words, antibiotic resistance is not a personal problem but an

  1. Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions

    Directory of Open Access Journals (Sweden)

    Dariush Mozaffarian

    2009-06-01

    Full Text Available Controversy has arisen among the public and in the media regarding the health effects of fish intake in adults. Substantial evidence indicates that fish consumption reduces coronary heart disease mortality, the leading cause of death in developed and most developing nations. Conversely, concerns have grown regarding potential effects of exposure to mercury found in some fish. Seafood species are also rich in selenium, an essential trace element that may protect against both cardiovascular disease and toxic effects of mercury. Such protective effects would have direct implications for recommendations regarding optimal selenium intake and for assessing the potential impact of mercury exposure from fish intake in different populations. Because fish consumption appears to have important health benefits in adults, elucidating the relationships between fish intake, mercury and selenium exposure, and health risk is of considerable scientific and public health relevance. The evidence for health effects of fish consumption in adults is reviewed, focusing on the strength and consistency of evidence and relative magnitudes of effects of omega-3 fatty acids, mercury, and selenium. Given the preponderance of evidence, the focus is on cardiovascular effects, but other potential health effects, as well as potential effects of polychlorinated biphenyls and dioxins in fish, are also briefly reviewed. The relevant current unanswered questions and directions of further research are summarized.

  2. Complementary Medicine, Exercise, Meditation, Diet, and Lifestyle Modification for Anxiety Disorders: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    J. Sarris

    2012-01-01

    Full Text Available Use of complementary medicines and therapies (CAM and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders.

  3. Large dunes on the outer shelf off the Zambezi Delta, Mozambique: evidence for the existence of a Mozambique Current

    Science.gov (United States)

    Flemming, Burghard W.; Kudrass, Hermann-Rudolf

    2017-06-01

    studies comparing the application of slippage and non-slippage approaches—they suggest that, when applying partial slippage, a western boundary current can exist simultaneously with the southward migrating eddies. Considering the evidence presented in this paper, it is concluded that a quasi-persistent, though seasonally variable Mozambique Current does exist.

  4. Foot orthoses for pediatric flexible flatfoot: evidence and current practices among Canadian physical therapists.

    Science.gov (United States)

    Kane, Kyra

    2015-01-01

    This study aimed to examine the evidence for flatfoot intervention in children with gross motor delay of neurological origin, and to understand how physical therapists use foot orthoses (FOs) to treat this population. Thirty-four physical therapists employed in Canadian publicly funded pediatric centers were surveyed to explore current practices and beliefs related to FOs. Responses are discussed in the context of the research literature. Objective physical examination and differentiation between developmental and pathological flatfeet can help clinicians to identify suitable FO candidates, monitor foot posture over time, and evaluate treatment effectiveness. An evidence-informed approach to assessment and intervention has the potential to improve clinical outcomes for clients with pediatric flatfoot.

  5. Whole dairy matrix or single nutrients in assessment of health effects: current evidence and knowledge gaps.

    Science.gov (United States)

    Thorning, Tanja Kongerslev; Bertram, Hanne Christine; Bonjour, Jean-Philippe; de Groot, Lisette; Dupont, Didier; Feeney, Emma; Ipsen, Richard; Lecerf, Jean Michel; Mackie, Alan; McKinley, Michelle C; Michalski, Marie-Caroline; Rémond, Didier; Risérus, Ulf; Soedamah-Muthu, Sabita S; Tholstrup, Tine; Weaver, Connie; Astrup, Arne; Givens, Ian

    2017-04-12

    Foods consist of a large number of different nutrients that are contained in a complex structure. The nature of the food structure and the nutrients therein (i.e., the food matrix) will determine the nutrient digestion and absorption, thereby altering the overall nutritional properties of the food. Thus, the food matrix may exhibit a different relation with health indicators compared to single nutrients studied in isolation. The evidence for a dairy matrix effect was presented and discussed by an expert panel at a closed workshop, and the following consensus was reached: 1) Current evidence does not support a positive association between intake of dairy products and risk of cardiovascular disease (i.e., stroke and coronary heart disease) and type 2 diabetes. In contrast, fermented dairy products, such as cheese and yogurt, generally show inverse associations. 2) Intervention studies have indicated that the metabolic effects of whole dairy may be different than those of single dairy constituents when considering the effects on body weight, cardiometabolic disease risk, and bone health. 3) Different dairy products seem to be distinctly linked to health effects and disease risk markers. 4) Different dairy structures and common processing methods may enhance interactions between nutrients in the dairy matrix, which may modify the metabolic effects of dairy consumption. 5) In conclusion, the nutritional values of dairy products should not be considered equivalent to their nutrient contents but, rather, be considered on the basis of the biofunctionality of the nutrients within dairy food structures. 6) Further research on the health effects of whole dairy foods is warranted alongside the more traditional approach of studying the health effects of single nutrients. Future diet assessments and recommendations should carefully consider the evidence of the effects of whole foods alongside the evidence of the effects of individual nutrients. Current knowledge gaps and

  6. Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

    Directory of Open Access Journals (Sweden)

    Donny L. F. Chang

    2013-01-01

    Full Text Available Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

  7. [Current state of digestive system robotic surgery in the light of evidence based medicine].

    Science.gov (United States)

    Ortiz Oshiro, Elena; Fernández-Represa, Jesús Alvarez

    2009-03-01

    The incorporation of robotics in minimally invasive surgery has had mixed reception in the different fields of digestive surgery. Nowadays we are exposed to a continuous stream of publications on robotic approach techniques and outcomes, which do not always provide objective criteria and whose value, through scientific evidence analysis, is sometimes arguable. With the aim of shedding light on current knowledge on digestive robotic surgery and giving an update of its possibilities, the authors analyse the abundant literature available on the different digestive robotic surgery procedures, and sum up their own experience.

  8. Clostridium difficile infection in children with inflammatory bowel disease: current evidence.

    Science.gov (United States)

    Banaszkiewicz, Aleksandra; Pituch, Hanna

    2014-01-01

    Inflammatory bowel disease (IBD) is a chronic, immune-mediated disease of the gastrointestinal tract that develops in genetically susceptible individuals. Questions about the role of infections in the development and exacerbations of inflammatory bowel disease remain unanswered. Among numerous bacteria that have been linked to IBD, the most frequently associated is Clostridium difficile. Clinical symptoms of C. difficile infection and an exacerbation of inflammatory bowel disease are often indistinguishable. In cases of diarrhea in patients with IBD and C. difficile infection, antibiotic treatment is recommended. This review attempts to summarize C. difficile infection's epidemiology and clinical features and describes current evidence on treatment of C. difficile infection in children with IBD.

  9. Cytidine 5'-Diphosphocholine (Citicoline) in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives.

    Science.gov (United States)

    Roberti, Gloria; Tanga, Lucia; Michelessi, Manuele; Quaranta, Luciano; Parisi, Vincenzo; Manni, Gianluca; Oddone, Francesco

    2015-11-30

    Cytidine 5'-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson's disease and Alzheimer's disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma.

  10. Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Perspective on Current Evidence and Clinical Knowledge

    Directory of Open Access Journals (Sweden)

    Ali Habib

    2012-01-01

    Full Text Available This paper reviews the current published data regarding open transforaminal lumbar interbody fusion (TLIF in relation to minimally invasive transforaminal lumbar interbody fusion (MI-TLIF. Introduction. MI-TLIF, a modern method for lumbar interbody arthrodesis, has allowed for a minimally invasive method to treat degenerative spinal pathologies. Currently, there is limited literature that compares TLIF directly to MI-TLIF. Thus, we seek to discuss the current literature on these techniques. Methods. Using a PubMed search, we reviewed recent publications of open and MI-TLIF, dating from 2002 to 2012. We discussed these studies and their findings in this paper, focusing on patient-reported outcomes as well as complications. Results. Data found in 14 articles of the literature was analyzed. Using these reports, we found mean follow-up was 20 months. The mean patient study size was 52. Seven of the articles directly compared outcomes of open TLIF with MI-TLIF, such as mean duration of surgery, length of post-operative stay, blood loss, and complications. Conclusion. Although high-class data comparing these two techniques is lacking, the current evidence supports MI-TLIF with outcomes comparable to that of the traditional, open technique. Further prospective, randomized studies will help to further our understanding of this minimally invasive technique.

  11. Current Thoughts on Fat Grafting: Using the Evidence to Determine Fact or Fiction.

    Science.gov (United States)

    Sinno, Sammy; Wilson, Stelios; Brownstone, Nicholas; Levine, Steven M

    2016-03-01

    Autologous fat grafting is an increasingly popular procedure used for facial rejuvenation and body contouring. The purpose of this article is to perform an evidence-based review to determine fact from fiction for the hot topics in autologous fat grafting. A comprehensive literature search was performed. The following key words were then searched: "fat grafting," "autologous fat grafting," "autologous fat transfer," "lipotransfer," "liposculping," and "lipofilling." The authors then assessed each modality individually for the level of evidence that exists and whether the majority of evidence supports or refutes it. A review of the literature demonstrated that there is no standard test for determining fat viability or volume augmentation after grafting. Furthermore, there is no difference in cell viability seen between syringe aspiration and liposuction pump aspiration harvest techniques (Level II). The decision to wash or centrifuge the fat plays very little role in fat graft survival (Level III). There is no difference between cell viability as a function of harvest location (Level IV). Nearly all studies show no significant effect of local anesthesia on adipocyte cells (Level IV). There are excellent data that support the fact that low-shear devices maintain fat structural integrity (Level IV). There is quality evidence that supports longevity of fat grafted to the breast (Level III). Two studies support large-volume fat grafting longevity but fail to prove their results using objective measures or with sufficiently large sample sizes (Level IV). External preexpansion devices improve total graft survival rate (Level IV). There is quality evidence to support that fat should be injected soon after harvesting, as properties of fat begin to change after processing (Level IV). Microneedling (preconditioning) before fat grafting has been demonstrated to improve fat survival (Level III). Currently, the highest levels of evidence derive from human studies of clinical

  12. 海南省观赏水族行业的发展前景及对策%Current Situation of Decorative Fishery in Hainan and Development Suggestions

    Institute of Scientific and Technical Information of China (English)

    张希; 杨宁; 黄海

    2012-01-01

    An important part of recreational fisheries is decorative fishery,which will become a trend in China.Decorative fishery is also an important direction of development in the building process of Hainan international tourism Island.On the base of the deep-going analysis about the current situation of decorative fishery development in Hainan,the main questions of decorative fish cultivation and market were found.At the same time many suggestions were brought up,such as exploiting the biological resources of Hainan Island;Strengthening the efforts of research institutes aquaculture R & D;introducing new varieties of ornamental species;Strengthening market management etc,which will benefit the rational utilization of tropical biological resources and increase a whole competitive advantage of Hainan decorative fishery industry.%观赏水族业是休闲渔业的重要组成部分,海南具有大力发展热带观赏水族行业的潜力。对海南省观赏水族市场进行深入调查,分析和总结海南省观赏水族行业的发展现状和存在的问题,提出发挥海南区位优势、挖掘本地热带生物资源、加强科研力量、引进国外观赏水族新品种、加强产业引导和市场管理等建议,促进热带生物资源的合理利用和观赏水族业结构的多元化,增加海南省观赏水族业的整体竞争优势。

  13. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  14. Working conditions and health among employees at information technology - enabled services: A review of current evidence

    Directory of Open Access Journals (Sweden)

    Kesavachandran C

    2006-07-01

    Full Text Available Workers in information technology (IT - enabled services like business process outsourcing and call centers working with visual display units are reported to have various health and psycho social disorders. Evidence from previously published studies in peer- reviewed journals and internet sources were examined to explore health disorders and psycho-social problems among personnel employed in IT-based services, for a systematic review on the topic. In addition, authors executed a questionnaire- based pilot study. The available literature and the pilot study, both suggest health disorders and psychosocial problems among workers of Business Process Outsourcing. The details are discussed in the review.

  15. Plantar fasciitis – to jab or to support? A systematic review of the current best evidence

    Directory of Open Access Journals (Sweden)

    Uden H

    2011-05-01

    Full Text Available Hayley Uden1, Eva Boesch1, Saravana Kumar1,21Division of Health Sciences, 2International Centre for Allied Health Evidence, University of South Australia, North Terrace, Adelaide, South Australia, AustraliaBackground: Plantar fasciitis is a common condition routinely managed by podiatrists in the community and is widely treated conservatively. Two commonly used treatments for plantar fasciitis are customized functional foot orthoses and corticosteroid injections. While common to clinical practice, the evidence base underpinning these treatment strategies is unknown. Therefore, the aim of this systematic review was to assess the effectiveness and safety of customized functional foot orthoses and corticosteroid injections in the treatment of plantar fasciitis.Methods: A systematic literature search was conducted. Experimental studies, in English, from 1998 to 2010 were accepted for inclusion in this review. The PEDro quality assessment tool and the National Health and Medical Research Council's hierarchy of evidence were used to assess the quality of the included studies.Results: Six randomized controlled trials which met the selection criteria were included in this review. Four reported on customized functional foot orthoses and 2 on corticosteroid injections. Current best available evidence highlights that both customized functional foot orthoses and corticosteroid injections can lead to a decrease in pain associated with plantar fasciitis. Additionally, customized functional foot orthoses may also provide an additional benefit in terms of increased functional ability in patients with plantar fasciitis. Corticosteroid injections may have side effects, especially pain (from the injection.Conclusion: Both customized functional foot orthoses and corticosteroid injections can lead to reduction in pain associated with plantar fasciitis. While customized functional foot orthoses may increase the functional outcomes in patients with plantar fasciitis

  16. Direct Evidence for Neutrino Flavor Transformation from Neutral-Current Interactions in SNO

    Science.gov (United States)

    McDonald, A. B.; Ahmad, Q. R.; Allen, R. C.; Andersen, T. C.; Anglin, J. D.; Barton, J. C.; Beier, E. W.; Bercovitch, M.; Bigu, J.; Biller, S. D.; Black, R. A.; Blevis, I.; Boardman, R. J.; Boger, J.; Bonvin, E.; Boulay, M. G.; Bowler, M. G.; Bowles, T. J.; Brice, S. J.; Browne, M. C.; Bullard, T. V.; Bühler, G.; Cameron, J.; Chan, Y. D.; Chen, H. H.; Chen, M.; Chen, X.; Cleveland, B. T.; Clifford, E. T. H.; Cowan, J. H. M.; Cowen, D. F.; Cox, G. A.; Dai, X.; Dalnoki-Veress, F.; Davidson, W. F.; Doe, P. J.; Doucas, G.; Dragowsky, M. R.; Duba, C. A.; Duncan, F. A.; Dunford, M.; Dunmore, J. A.; Earle, E. D.; Elliott, S. R.; Evans, H. C.; Ewan, G. T.; Farine, J.; Fergani, H.; Ferraris, A. P.; Ford, R. J.; Formaggio, J. A.; Fowler, M. M.; Frame, K.; Frank, E. D.; Frati, W.; Gagnon, N.; Germani, J. V.; Gil, S.; Graham, K.; Grant, D. R.; Hahn, R. L.; Hallin, A. L.; Hallman, E. D.; Hamer, A. S.; Hamian, A. A.; Handler, W. B.; Haq, R. U.; Hargrove, C. K.; Harvey, P. J.; Hazama, R.; Heeger, K. M.; Heintzelman, W. J.; Heise, J.; Helmer, R. L.; Hepburn, J. D.; Heron, H.; Hewett, J.; Hime, A.; Howe, M.; Hykawy, J. G.; Isaac, M. C. P.; Jagam, P.; Jelley, N. A.; Jillings, C.; Jonkmans, G.; Kazkaz, K.; Keener, P. T.; Klein, J. R.; Knox, A. B.; Komar, R. J.; Kouzes, R.; Kutter, T.; Kyba, C. C. M.; Law, J.; Lawson, I. T.; Lay, M.; Lee, H. W.; Lesko, K. T.; Leslie, J. R.; Levine, I.; Locke, W.; Luoma, S.; Lyon, J.; Majerus, S.; Mak, H. B.; Maneira, J.; Manor, J.; Marino, A. D.; McCauley, N.; McDonald, D. S.; McFarlane, K.; McGregor, G.; Meijer Drees, R.; Mifflin, C.; Miller, G. G.; Milton, G.; Moffat, B. A.; Moorhead, M.; Nally, C. W.; Neubauer, M. S.; Newcomer, F. M.; Ng, H. S.; Noble, A. J.; Norman, E. B.; Novikov, V. M.; O'Neill, M.; Okada, C. E.; Ollerhead, R. W.; Omori, M.; Orrell, J. L.; Oser, S. M.; Poon, A. W. P.; Radcliffe, T. J.; Roberge, A.; Robertson, B. C.; Robertson, R. G. H.; Rosendahl, S. S. E.; Rowley, J. K.; Rusu, V. L.; Saettler, E.; Schaffer, K. K.; Schwendener, M. H.; Schülke, A.; Seifert, H.; Shatkay, M.; Simpson, J. J.; Sims, C. J.; Sinclair, D.; Skensved, P.; Smith, A. R.; Smith, M. W. E.; Spreitzer, T.; Starinsky, N.; Steiger, T. D.; Stokstad, R. G.; Stonehill, L. C.; Storey, R. S.; Sur, B.; Tafirout, R.; Tagg, N.; Tanner, N. W.; Taplin, R. K.; Thorman, M.; Thornewell, P. M.; Trent, P. T.; Tserkovnyak, Y. I.; van Berg, R.; van de Water, R. G.; Virtue, C. J.; Waltham, C. E.; Wang, J.-X.; Wark, D. L.; West, N.; Wilhelmy, J. B.; Wilkerson, J. F.; Wilson, J. R.; Wittich, P.; Wouters, J. M.; Yeh, M.

    2002-12-01

    The Sudbury Neutrino Observatory (SNO) is a 1,000 tonne heavy water Cerenkov-based neutrino detector situated 2,000 meters underground in INCO's Creighton Mine near Sudbury, Ontario, Canada. For the neutrinos from 8B decay in the Sun SNO observes the Charged Current neutrino reaction sensitive only to electron neutrinos and others (Neutral Current and Elastic Scattering) sensitive to all active neutrino types and thereby can search for direct evidence of neutrino flavor change. Using these reactions and assuming the standard 8B shape, the ve component of the 8B solar flux is φe = 1.76- 0.05+0.05(stat.)- 0.09+0.09 (syst.) × 106 cm-2s-1 for a kinetic energy threshold of 5 MeV. The non-ve component is fgr μτ = 3.41- 0.45+0.45(stat.)- 0.45+0.48 (syst.) × 106 cm-2s-1, 5.3σ greater than zero, providing strong evidence for solar ve flavor transformation. The total flux measured with the NC reaction is fgr NC = 5.09- 0.43+0.44(stat.)- 0.43+0.46 (syst.) × 106 cm-2s-1, consistent with solar models. For charged current events, assuming an undistorted 8B spectrum, the night minus day rate is 14.0% +/- 6.3%-1.4+1.5% of the average rate. If the total flux of active neutrinos is additionally constrained to have no asymmetry, the ve asymmetry is found to be 7.0% +/- 4.9%-1.2+1.3%. A global solar neutrino analysis in terms of matter-enhanced oscillations of two active flavors strongly favors the Large Mixing Angle (LMA) solution.

  17. Scapulothoracic bursitis and snapping scapula syndrome: a critical review of current evidence.

    Science.gov (United States)

    Warth, Ryan J; Spiegl, Ulrich J; Millett, Peter J

    2015-01-01

    Symptomatic scapulothoracic disorders, such as painful scapular crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients. To review the current knowledge pertaining to snapping scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction. Systematic review. We performed a preliminary search of the PubMed and Embase databases using the search terms "snapping scapula," "scapulothoracic bursitis," "partial scapulectomy," and "superomedial angle resection" in September 2013. All nonreview articles related to the topic of snapping scapula syndrome were included. The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of evidence obtained from this literature search was inadequate to perform a formal systematic review or meta-analysis. Therefore, a critical review of current evidence is presented. Snapping scapula syndrome, a likely underdiagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is typically unknown, specific treatments that are effective for some patients may not be effective for others. Nevertheless, bursectomy with or without partial scapulectomy is currently the most effective primary method of treatment in patients who fail nonoperative therapy. However, many patients experience continued shoulder disability even after surgical intervention. Future studies should focus on identifying the modifiable factors associated with poor outcomes after operative and nonoperative management for snapping scapula syndrome in an effort to improve clinical outcomes and patient satisfaction. © 2014 The Author(s).

  18. A phylogeny of the Lampropeltis mexicana complex (Serpentes: Colubridae) based on mitochondrial DNA sequences suggests evidence for species-level polyphyly within Lampropeltis.

    Science.gov (United States)

    Bryson, Robert W; Pastorini, Jennifer; Burbrink, Frank T; Forstner, Michael R J

    2007-05-01

    The systematic relationships of snakes in the Lampropeltis mexicana complex (L. mexicana, L. alterna, and L. ruthveni) are poorly known despite several taxonomic studies over the last 80 years. Mitochondrial DNA sequences were used to infer the phylogeny of the L. mexicana complex. At least one representative sample from the nine currently recognized species of Lampropeltis was sequenced. Our results suggest that a deep basal split resulted in the divergence of two groups of Lampropeltis, with one group occupying the upland areas of western United States and most of western and central Mexico, and the other northeastern Mexico and the lowland areas of the southern United States. Results also revealed that the L. mexicana complex and Lampropeltis triangulum are polyphyletic, with taxa from both groups nested together in deeply divergent northern and southern clades. These results are incongruent with previous hypotheses of phylogenetic relationships based on morphology, and suggest that morphological characters shared among the various tri-colored Lampropeltis (e.g., hemipenal structure and tri-colored pattern) may be difficult to interpret phylogenetically.

  19. Limited Evidence Suggests a Protective Association Between Oral Contraceptive Pill Use and Anterior Cruciate Ligament Injuries in Females: A Systematic Review.

    Science.gov (United States)

    Samuelson, Kathleen; Balk, Ethan M; Sevetson, Erika L; Fleming, Braden C

    2017-10-01

    Female athletes aged 14 to 18 years are at particular risk for anterior cruciate ligament (ACL) injuries. Hormonal factors are thought to predispose them to this injury. Oral contraceptive pills (OCPs) might reduce ACL injury risk, although the literature appears controversial. To evaluate the association between OCP use and ACL injuries in women. The secondary objective was to determine the rates of ACL injuries in the pre- and postovulatory phases of the menstrual cycle in OCP and non-OCP (NOCP) users. Searches were performed across 4 reference databases (PubMed, CINAHL, Embase, Cochrane), abstracts from 6 specialty societies, ClinicalTrials.gov , and reference lists of relevant papers. We included studies investigating the association between OCP use and ACL injuries in females of any age or the distribution of ACL injuries across the menstrual cycle in OCP and NOCP users. Systematic review. Level 3. Data regarding study design, population characteristics, OCP details, outcome definitions, analytic methods, and results were extracted from the included studies. The methodological quality of each study was assessed using the Newcastle-Ottawa scale. The search yielded 1305 citations, of which 7 retrospective observational studies met the inclusion criteria. Two large case-control studies with higher methodological quality suggested that OCP use may reduce the risk of sustaining an ACL injury. Five comparative studies examining injury distribution across the menstrual cycle in OCP and NOCP users had conflicting findings, were heterogeneous, and were limited by low methodological quality. The evidence suggests OCP use may reduce the risk of ACL injury; however, no conclusions can be drawn regarding differences in risk of ACL injuries between OCP and NOCP users across the menstrual cycle. Studies were limited by small sample sizes, heterogeneity, and methodological concerns.

  20. A review of current evidence for the causal impact of attentional bias on fear and anxiety.

    Science.gov (United States)

    Van Bockstaele, Bram; Verschuere, Bruno; Tibboel, Helen; De Houwer, Jan; Crombez, Geert; Koster, Ernst H W

    2014-05-01

    Prominent cognitive theories postulate that an attentional bias toward threatening information contributes to the etiology, maintenance, or exacerbation of fear and anxiety. In this review, we investigate to what extent these causal claims are supported by sound empirical evidence. Although differences in attentional bias are associated with differences in fear and anxiety, this association does not emerge consistently. Moreover, there is only limited evidence that individual differences in attentional bias are related to individual differences in fear or anxiety. In line with a causal relation, some studies show that attentional bias precedes fear or anxiety in time. However, other studies show that fear and anxiety can precede the onset of attentional bias, suggesting circular or reciprocal causality. Importantly, a recent line of experimental research shows that changes in attentional bias can lead to changes in anxiety. Yet changes in fear and anxiety also lead to changes in attentional bias, which confirms that the relation between attentional bias and fear and anxiety is unlikely to be unidirectional. Finally, a similar causal relation between interpretation bias and anxiety has been documented. In sum, there is evidence in favor of causality, yet a strict unidirectional cause-effect model is unlikely to hold. The relation between attentional bias and fear and anxiety is best described as a bidirectional, maintaining, or mutually reinforcing relation.

  1. Subtidal currents over the central California slope: Evidence for offshore veering of the undercurrent and for direct, wind-driven slope currents

    Science.gov (United States)

    Noble, M.A.; Ramp, S.R.

    2000-01-01

    In February 1991, an array of six current-meter moorings was deployed for one year across the central California outer shelf and slope. The main line of the array extended 30 km offshore of the shelf break, out to water depths of 1400 m. A more sparsely-instrumented line, displaced 30 km to the northwest, extended 14 km offshore. Though shorter, the northern line spanned similar water depths because the gradient of the topography steepened in the northern region. A poleward flow pattern, typical of the California undercurrent, was seen across both lines in the array over most of the year. The poleward flow was surface intensified. In general, the portion of the undercurrent that crossed the southern line had larger amplitudes and penetrated more deeply into the water column than the portion that crossed the northern line. Transport over the year ranged from 0 to 2.5 Sverdrups (Sv) poleward across the southern line; 0 to 1 Sv poleward across the northern line. We suggest the difference in transport was caused by topographic constraints, which tended to force the poleward flow offshore of the northern measurement sites. The slope of the topography steepened too abruptly to allow the poleward flow to follow isobaths when currents were strong. When current velocities lessened, a more coherent flow pattern was seen across both lines in the array. In general, the poleward flow patterns in the undercurrent were not affected by local winds or by the local alongshore pressure gradient. Nor was a strong seasonal pattern evident. Rather unexpectedly, a small but statistically significant fraction of the current variance over the mid- and outer slope was driven by the surface wind stress. An alongshelf wind stress caused currents to flow along the slope, parallel to the wind field, down to depths of 400 m below the surface and out to distances of 2 Rossby radii past the shelf break. The transfer functions were weak, 3-4 cm/s per dyn cm-2, but comparable to wind-driven current

  2. Direct Evidence for Neutrino Flavor Transformation from Neutral-Current Interactions in the Sudbury Neutrino Observatory

    Science.gov (United States)

    Ahmad, Q. R.; Allen, R. C.; Andersen, T. C.; Anglin, J. D.; Barton, J. C.; Beier, E. W.; Bercovitch, M.; Bigu, J.; Biller, S. D.; Black, R. A.; Blevis, I.; Boardman, R. J.; Boger, J.; Bonvin, E.; Boulay, M. G.; Bowler, M. G.; Bowles, T. J.; Brice, S. J.; Browne, M. C.; Bullard, T. V.; Bühler, G.; Cameron, J.; Chan, Y. D.; Chen, H. H.; Chen, M.; Chen, X.; Cleveland, B. T.; Clifford, E. T.; Cowan, J. H.; Cowen, D. F.; Cox, G. A.; Dai, X.; Dalnoki-Veress, F.; Davidson, W. F.; Doe, P. J.; Doucas, G.; Dragowsky, M. R.; Duba, C. A.; Duncan, F. A.; Dunford, M.; Dunmore, J. A.; Earle, E. D.; Elliott, S. R.; Evans, H. C.; Ewan, G. T.; Farine, J.; Fergani, H.; Ferraris, A. P.; Ford, R. J.; Formaggio, J. A.; Fowler, M. M.; Frame, K.; Frank, E. D.; Frati, W.; Gagnon, N.; Germani, J. V.; Gil, S.; Graham, K.; Grant, D. R.; Hahn, R. L.; Hallin, A. L.; Hallman, E. D.; Hamer, A. S.; Hamian, A. A.; Handler, W. B.; Haq, R. U.; Hargrove, C. K.; Harvey, P. J.; Hazama, R.; Heeger, K. M.; Heintzelman, W. J.; Heise, J.; Helmer, R. L.; Hepburn, J. D.; Heron, H.; Hewett, J.; Hime, A.; Howe, M.; Hykawy, J. G.; Isaac, M. C.; Jagam, P.; Jelley, N. A.; Jillings, C.; Jonkmans, G.; Kazkaz, K.; Keener, P. T.; Klein, J. R.; Knox, A. B.; Komar, R. J.; Kouzes, R.; Kutter, T.; Kyba, C. C.; Law, J.; Lawson, I. T.; Lay, M.; Lee, H. W.; Lesko, K. T.; Leslie, J. R.; Levine, I.; Locke, W.; Luoma, S.; Lyon, J.; Majerus, S.; Mak, H. B.; Maneira, J.; Manor, J.; Marino, A. D.; McCauley, N.; McDonald, A. B.; McDonald, D. S.; McFarlane, K.; McGregor, G.; Meijer Drees, R.; Mifflin, C.; Miller, G. G.; Milton, G.; Moffat, B. A.; Moorhead, M.; Nally, C. W.; Neubauer, M. S.; Newcomer, F. M.; Ng, H. S.; Noble, A. J.; Norman, E. B.; Novikov, V. M.; O'Neill, M.; Okada, C. E.; Ollerhead, R. W.; Omori, M.; Orrell, J. L.; Oser, S. M.; Poon, A. W.; Radcliffe, T. J.; Roberge, A.; Robertson, B. C.; Robertson, R. G.; Rosendahl, S. S.; Rowley, J. K.; Rusu, V. L.; Saettler, E.; Schaffer, K. K.; Schwendener, M. H.; Schülke, A.; Seifert, H.; Shatkay, M.; Simpson, J. J.; Sims, C. J.; Sinclair, D.; Skensved, P.; Smith, A. R.; Smith, M. W.; Spreitzer, T.; Starinsky, N.; Steiger, T. D.; Stokstad, R. G.; Stonehill, L. C.; Storey, R. S.; Sur, B.; Tafirout, R.; Tagg, N.; Tanner, N. W.; Taplin, R. K.; Thorman, M.; Thornewell, P. M.; Trent, P. T.; Tserkovnyak, Y. I.; van Berg, R.; van de Water, R. G.; Virtue, C. J.; Waltham, C. E.; Wang, J.-X.; Wark, D. L.; West, N.; Wilhelmy, J. B.; Wilkerson, J. F.; Wilson, J. R.; Wittich, P.; Wouters, J. M.; Yeh, M.

    2002-07-01

    Observations of neutral-current [nu] interactions on deuterium in the Sudbury Neutrino Observatory are reported. Using the neutral current (NC), elastic scattering, and charged current reactions and assuming the standard (sup 8)B shape, the [nu]e component of the (sup 8)B solar flux is [phi]e=1.76(sup +0.05)-0.05( stat)(sup +0.09)-0.09( syst) x10(sup 6) cm(sup -2) s(sup -1) for a kinetic energy threshold of 5 MeV. The non-[nu]e component is [phi][mu][tau]=3.41(sup +0.45)-0.45)(stat(sup +0.48)-0.45)(syst x10(sup 6) cm(sup -2) s(sup -1) , 5.3[sigma] greater than zero, providing strong evidence for solar [nu]e flavor transformation. The total flux measured with the NC reaction is [phi]NC=5.09(sup +0.44)(sub -0.43 )(stat)(sup +0.46)(sub -0.43 )(syst) x10(sup 6) cm(sup -2) s(sup -1) , consistent with solar models.

  3. Direct evidence for neutrino flavor transformation from neutral-current interactions in the Sudbury Neutrino Observatory.

    Science.gov (United States)

    Ahmad, Q R; Allen, R C; Andersen, T C; D Anglin, J; Barton, J C; Beier, E W; Bercovitch, M; Bigu, J; Biller, S D; Black, R A; Blevis, I; Boardman, R J; Boger, J; Bonvin, E; Boulay, M G; Bowler, M G; Bowles, T J; Brice, S J; Browne, M C; Bullard, T V; Bühler, G; Cameron, J; Chan, Y D; Chen, H H; Chen, M; Chen, X; Cleveland, B T; Clifford, E T H; Cowan, J H M; Cowen, D F; Cox, G A; Dai, X; Dalnoki-Veress, F; Davidson, W F; Doe, P J; Doucas, G; Dragowsky, M R; Duba, C A; Duncan, F A; Dunford, M; Dunmore, J A; Earle, E D; Elliott, S R; Evans, H C; Ewan, G T; Farine, J; Fergani, H; Ferraris, A P; Ford, R J; Formaggio, J A; Fowler, M M; Frame, K; Frank, E D; Frati, W; Gagnon, N; Germani, J V; Gil, S; Graham, K; Grant, D R; Hahn, R L; Hallin, A L; Hallman, E D; Hamer, A S; Hamian, A A; Handler, W B; Haq, R U; Hargrove, C K; Harvey, P J; Hazama, R; Heeger, K M; Heintzelman, W J; Heise, J; Helmer, R L; Hepburn, J D; Heron, H; Hewett, J; Hime, A; Howe, M; Hykawy, J G; Isaac, M C P; Jagam, P; Jelley, N A; Jillings, C; Jonkmans, G; Kazkaz, K; Keener, P T; Klein, J R; Knox, A B; Komar, R J; Kouzes, R; Kutter, T; Kyba, C C M; Law, J; Lawson, I T; Lay, M; Lee, H W; Lesko, K T; Leslie, J R; Levine, I; Locke, W; Luoma, S; Lyon, J; Majerus, S; Mak, H B; Maneira, J; Manor, J; Marino, A D; McCauley, N; McDonald, A B; McDonald, D S; McFarlane, K; McGregor, G; Meijer Drees, R; Mifflin, C; Miller, G G; Milton, G; Moffat, B A; Moorhead, M; Nally, C W; Neubauer, M S; Newcomer, F M; Ng, H S; Noble, A J; Norman, E B; Novikov, V M; O'Neill, M; Okada, C E; Ollerhead, R W; Omori, M; Orrell, J L; Oser, S M; Poon, A W P; Radcliffe, T J; Roberge, A; Robertson, B C; Robertson, R G H; Rosendahl, S S E; Rowley, J K; Rusu, V L; Saettler, E; Schaffer, K K; Schwendener, M H; Schülke, A; Seifert, H; Shatkay, M; Simpson, J J; Sims, C J; Sinclair, D; Skensved, P; Smith, A R; Smith, M W E; Spreitzer, T; Starinsky, N; Steiger, T D; Stokstad, R G; Stonehill, L C; Storey, R S; Sur, B; Tafirout, R; Tagg, N; Tanner, N W; Taplin, R K; Thorman, M; Thornewell, P M; Trent, P T; Tserkovnyak, Y I; Van Berg, R; Van de Water, R G; Virtue, C J; Waltham, C E; Wang, J-X; Wark, D L; West, N; Wilhelmy, J B; Wilkerson, J F; Wilson, J R; Wittich, P; Wouters, J M; Yeh, M

    2002-07-01

    Observations of neutral-current nu interactions on deuterium in the Sudbury Neutrino Observatory are reported. Using the neutral current (NC), elastic scattering, and charged current reactions and assuming the standard 8B shape, the nu(e) component of the 8B solar flux is phis(e) = 1.76(+0.05)(-0.05)(stat)(+0.09)(-0.09)(syst) x 10(6) cm(-2) s(-1) for a kinetic energy threshold of 5 MeV. The non-nu(e) component is phi(mu)(tau) = 3.41(+0.45)(-0.45)(stat)(+0.48)(-0.45)(syst) x 10(6) cm(-2) s(-1), 5.3sigma greater than zero, providing strong evidence for solar nu(e) flavor transformation. The total flux measured with the NC reaction is phi(NC) = 5.09(+0.44)(-0.43)(stat)(+0.46)(-0.43)(syst) x 10(6) cm(-2) s(-1), consistent with solar models.

  4. A new view on the morphology and phylogeny of eugregarines suggested by the evidence from the gregarine Ancora sagittata (Leuckart, 1860 Labbé, 1899 (Apicomplexa: Eugregarinida

    Directory of Open Access Journals (Sweden)

    Timur G. Simdyanov

    2017-05-01

    Full Text Available Background Gregarines are a group of early branching Apicomplexa parasitizing invertebrate animals. Despite their wide distribution and relevance to the understanding the phylogenesis of apicomplexans, gregarines remain understudied: light microscopy data are insufficient for classification, and electron microscopy and molecular data are fragmentary and overlap only partially. Methods Scanning and transmission electron microscopy, PCR, DNA cloning and sequencing (Sanger and NGS, molecular phylogenetic analyses using ribosomal RNA genes (18S (SSU, 5.8S, and 28S (LSU ribosomal DNAs (rDNAs. Results and Discussion We present the results of an ultrastructural and molecular phylogenetic study on the marine gregarine Ancora sagittata from the polychaete Capitella capitata followed by evolutionary and taxonomic synthesis of the morphological and molecular phylogenetic evidence on eugregarines. The ultrastructure of Ancora sagittata generally corresponds to that of other eugregarines, but reveals some differences in epicytic folds (crests and attachment apparatus to gregarines in the family Lecudinidae, where Ancora sagittata has been classified. Molecular phylogenetic trees based on SSU (18S rDNA reveal several robust clades (superfamilies of eugregarines, including Ancoroidea superfam. nov., which comprises two families (Ancoridae fam. nov. and Polyplicariidae and branches separately from the Lecudinidae; thus, all representatives of Ancoroidea are here officially removed from the Lecudinidae. Analysis of sequence data also points to possible cryptic species within Ancora sagittata and the inclusion of numerous environmental sequences from anoxic habitats within the Ancoroidea. LSU (28S rDNA phylogenies, unlike the analysis of SSU rDNA alone, recover a well-supported monophyly of the gregarines involved (eugregarines, although this conclusion is currently limited by sparse taxon sampling and the presence of fast-evolving sequences in some species

  5. Sex of parent transmission effect in Tourette's syndrome: evidence for earlier age at onset in maternally transmitted cases suggests a genomic imprinting effect.

    Science.gov (United States)

    Eapen, V; O'Neill, J; Gurling, H M; Robertson, M M

    1997-04-01

    Parent of origin effects caused by genomic imprinting may influence the phenotypic expression of a number of heritable human disorders. To test this phenomenon in Tourette's syndrome (TS), we studied 437 first degree relatives systematically ascertained through 57 probands. We compared age at onset, age at diagnosis, and phenotypic expressions as observed in the diagnosis of TS, chronic motor tics, and obsessive compulsive behavior in the offspring of affected males with the offspring of affected females. Of the 437 subjects, 16.7% had matrilineal inheritance and 13.9% had patrilineal inheritance, as determined by family history methodology. Chi-square analysis of the different phenotypic expressions and sex of the transmitting parent failed to provide evidence of significant group differences. We found no significant differences in the age at diagnosis either. However, the maternally transmitted offspring showed a significantly earlier age at onset. This points to a parent of origin effect on the putative TS gene that could be explained by meiotic events or even intrauterine environmental influences. These findings may help explain the hitherto conflicting reports about the nature of genetic transmission in TS, and suggest a need to re-examine family data separately for maternally and paternally transmitted cases, taking into account the possible role of imprinting.

  6. Efficacy and safety of haloperidol for in-hospital delirium prevention and treatment: A systematic review of current evidence.

    Science.gov (United States)

    Schrijver, E J M; de Graaf, K; de Vries, O J; Maier, A B; Nanayakkara, P W B

    2016-01-01

    Haloperidol is generally considered the drug of choice for in-hospital delirium management. We conducted a systematic review to evaluate the evidence for the efficacy and safety of haloperidol for the prevention and treatment of delirium in hospitalized patients. PubMed, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, and the Cochrane Library were systematically searched up to April 21, 2015. We included English full-text randomized controlled trials using haloperidol for the prevention or treatment of delirium in adult hospitalized patients reporting on delirium incidence, duration, or severity as primary outcome. Quality of evidence was graded. Meta-analysis was not conducted because of between-study heterogeneity. Twelve studies met our inclusion criteria, four prevention and eight treatment trials. Methodological limitations decreased the graded quality of included studies. Results from placebo-controlled prevention studies suggest a haloperidol-induced protective effect for delirium in older patients scheduled for surgery: two studies reported a significant reduction in ICU delirium incidence and one study found a significant reduction in delirium severity and duration. Although placebo-controlled trials are missing, pharmacological treatment of established delirium reduced symptom severity. Haloperidol administration was not associated with treatment-limiting side-effects, but few studies used a systematic approach to identify adverse events. Although results on haloperidol for delirium management seem promising, current prevention trials lack external validity and treatment trials did not include a placebo arm on top of standard nonpharmacological care. We therefore conclude that the current use of haloperidol for in-hospital delirium is not based on robust and generalizable evidence. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  7. Current Evidence on the Use of Antifilarial Agents in the Management of bancroftian Filariasis

    Directory of Open Access Journals (Sweden)

    Sumadhya Deepika Fernando

    2011-01-01

    Full Text Available Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level.

  8. Evidence for enhancement of critical current by intergrain Ag in YBaCuO-Ag ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Dwir, B.; Affronte, M.; Pavuna, D.

    1989-07-24

    We report the evidence for enhancement of critical current density /ital J//sub /ital c// by /similar to/50%, which occurs when /similar to/10 wt. % Ag is added to Y/sub 1/Ba/sub 2/Cu/sub 3/O/sub 7/minus//delta// ceramics. The maximal /ital J//sub /ital c// (/similar to/700 A/cm/sup 2/ at /ital T/=77 K) appears simultaneously with maximum YBaCuO compactness in the samples. The silver fills the intergranular space (holes) without Cu substitution, and the critical temperature /ital T//sub /ital c// is not reduced from the bulk value (/similar to/91 K). Normal-state resistivity of Ag-YBaCuO samples is decreased by an order of magnitude, and samples exhibit improved contact resistance and resistance to water. While the critical density is improved by adding /similar to/10 wt. % Ag, it decreases at higher Ag concentrations.

  9. Troponin elevations in patients with chronic cardiovascular disease: An analysis of current evidence and significance.

    Science.gov (United States)

    Martin, Archer K; Malhotra, Anita K; Sullivan, Breandan L; Ramakrishna, Harish

    2016-01-01

    Serum troponin elevation above the 99th percentile of the upper reference limit in healthy subjects (troponin laboratory assays) is required to establish the diagnosis the diagnosis of myocardial necrosis in acute cardiovascular syndromes, as well as guide prognosis and therapy. In the perioperative period, for patients with cardiac disease undergoing noncardiac surgery, it is a particularly critical biomarker universally used to assess the myocardial damage. The value of troponin testing and elevation (as well as its significance) in patients with chronic cardiac valvular, vascular, and renal disease is relatively less well understood. This evidence-based review seeks to examine the currently available data assessing the significance of troponin elevation in certain chronic valvular and other disease states.

  10. Cognitive rehabilitation after severe acquired brain injury: current evidence and future directions.

    Science.gov (United States)

    De Luca, Rosaria; Calabrò, Rocco Salvatore; Bramanti, Placido

    2016-07-25

    Severe acquired brain injury (SABI) is damage to the brain, occurring after birth from traumatic or non-traumatic causes, and often resulting in deterioration of physical, cognitive, and emotional functions. Cognitive rehabilitation (CR) is aimed to help brain-injured or otherwise cognitively impaired individuals to restore normal functioning, or to compensate for cognitive deficits. Over the last years, the development of new technologies in the field of CR has led to a growing use of computer-based cognitive tools in patients with SABI. This review aims to investigate the efficacy of CR in individuals suffering from SABI, and evaluates the role of virtual reality and other innovative technologies in improving behavioural and functional outcomes. The current evidence for CR in the treatment of SABI-related deficits does not allow conclusive results to be achieved and further research is needed to identity the patient and treatment factors that contribute to successful outcomes.

  11. Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions.

    Science.gov (United States)

    Qi, Wei; Gevonden, Martin; Shalev, Arieh

    2016-02-01

    Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.

  12. Collectivism and coping: current theories, evidence, and measurements of collective coping.

    Science.gov (United States)

    Kuo, Ben C H

    2013-01-01

    A burgeoning body of cultural coping research has begun to identify the prevalence and the functional importance of collective coping behaviors among culturally diverse populations in North America and internationally. These emerging findings are highly significant as they evidence culture's impacts on the stress-coping process via collectivistic values and orientation. They provide a critical counterpoint to the prevailing Western, individualistic stress and coping paradigm. However, current research and understanding about collective coping appear to be piecemeal and not well integrated. To address this issue, this review attempts to comprehensively survey, summarize, and evaluate existing research related to collective coping and its implications for coping research with culturally diverse populations from multiple domains. Specifically, this paper reviews relevant research and knowledge on collective coping in terms of: (a) operational definitions; (b) theories; (c) empirical evidence based on studies of specific cultural groups and broad cultural values/dimensions; (d) measurements; and (e) implications for future cultural coping research. Overall, collective coping behaviors are conceived as a product of the communal/relational norms and values of a cultural group across studies. They also encompass a wide array of stress responses ranging from value-driven to interpersonally based to culturally conditioned emotional/cognitive to religion- and spirituality-grounded coping strategies. In addition, this review highlights: (a) the relevance and the potential of cultural coping theories to guide future collective coping research; (b) growing evidence for the prominence of collective coping behaviors particularly among Asian nationals, Asian Americans/Canadians and African Americans/Canadians; (c) preference for collective coping behaviors as a function of collectivism and interdependent cultural value and orientation; and (d) six cultural coping scales. This

  13. Evidence of current impact of climate change on life: a walk from genes to the biosphere.

    Science.gov (United States)

    Peñuelas, Josep; Sardans, Jordi; Estiarte, Marc; Ogaya, Romà; Carnicer, Jofre; Coll, Marta; Barbeta, Adria; Rivas-Ubach, Albert; Llusià, Joan; Garbulsky, Martin; Filella, Iolanda; Jump, Alistair S

    2013-08-01

    We review the evidence of how organisms and populations are currently responding to climate change through phenotypic plasticity, genotypic evolution, changes in distribution and, in some cases, local extinction. Organisms alter their gene expression and metabolism to increase the concentrations of several antistress compounds and to change their physiology, phenology, growth and reproduction in response to climate change. Rapid adaptation and microevolution occur at the population level. Together with these phenotypic and genotypic adaptations, the movement of organisms and the turnover of populations can lead to migration toward habitats with better conditions unless hindered by barriers. Both migration and local extinction of populations have occurred. However, many unknowns for all these processes remain. The roles of phenotypic plasticity and genotypic evolution and their possible trade-offs and links with population structure warrant further research. The application of omic techniques to ecological studies will greatly favor this research. It remains poorly understood how climate change will result in asymmetrical responses of species and how it will interact with other increasing global impacts, such as N eutrophication, changes in environmental N : P ratios and species invasion, among many others. The biogeochemical and biophysical feedbacks on climate of all these changes in vegetation are also poorly understood. We here review the evidence of responses to climate change and discuss the perspectives for increasing our knowledge of the interactions between climate change and life.

  14. Smoke exposure as a risk factor for asthma in childhood: a review of current evidence.

    Science.gov (United States)

    Ferrante, Giuliana; Antona, Roberta; Malizia, Velia; Montalbano, Laura; Corsello, Giovanni; La Grutta, Stefania

    2014-01-01

    Asthma is a common chronic multifactorial disease that affects >300 million people worldwide. Outdoor and indoor pollution exposure has been associated with respiratory health effects in adults and children. Smoking still represents a huge public health problem and millions of children suffer the detrimental effects of passive smoke exposure. This study was designed to review the current evidences on exposure to passive smoke as a risk factor for asthma onset in childhood. A review of the most recent studies on this topic was undertaken to provide evidence about the magnitude of the effect of passive smoking on the risk of incidence of asthma in children. The effects of passive smoking are different depending on individual and environmental factors. Environmental tobacco smoke (ETS) is one of the most important indoor air pollutants and can interact with other air pollutants in eliciting respiratory outcomes during childhood. The increased risk of respiratory outcomes in children exposed to prenatal and early postnatal passive smoke might be caused by an adverse effect on both the immune system and the structural and functional development of the lung; this may explain the subsequent increased risk of incident asthma. The magnitude of the exposure is quite difficult to precisely quantify because it is significantly influenced by the child's daily activities. Because exposure to ETS is a likely cause for asthma onset in childhood, there is a strong need to prevent infants and children from breathing air contaminated with tobacco smoke.

  15. Role of Environmental Chemicals in Obesity: A Systematic Review on the Current Evidence

    Directory of Open Access Journals (Sweden)

    Roya Kelishadi

    2013-01-01

    Full Text Available The purpose of this paper is to systematically review the experimental and human studies on obesogenic chemicals and their mechanisms of action to provide a comprehensive view on the multifactorial aspects of obesity. The literatures were searched in available databases. The relevant papers were selected in three phases. After quality assessment, two reviewers extracted the data while another checked their extracted data. In this review, we summarized information regarding environmental chemicals that can be associated with obesity. Most evidence comes from experimental and laboratory studies; however a growing number of human studies also support the role of obesogenic chemicals. The current evidence proposes that the systemic responses to exposure to environmental factors could potentially increase the risk of excess weight. The effects of exposure to these chemicals are of crucial importance during developmental phases of life, when preprogramming for an adipogenic outcome may occur. By considering the adverse transgenerational effects of obesogen chemicals on human health, the global obesity epidemic should be considered as a multifactorial complex disorder necessitating the emphasis of public health interventions for environmental protection.

  16. Effects of exercise training on chronic inflammation in obesity : current evidence and potential mechanisms.

    Science.gov (United States)

    You, Tongjian; Arsenis, Nicole C; Disanzo, Beth L; Lamonte, Michael J

    2013-04-01

    Chronic, systemic inflammation is an independent risk factor for several major clinical diseases. In obesity, circulating levels of inflammatory markers are elevated, possibly due to increased production of pro-inflammatory cytokines from several tissues/cells, including macrophages within adipose tissue, vascular endothelial cells and peripheral blood mononuclear cells. Recent evidence supports that adipose tissue hypoxia may be an important mechanism through which enlarged adipose tissue elicits local tissue inflammation and further contributes to systemic inflammation. Current evidence supports that exercise training, such as aerobic and resistance exercise, reduces chronic inflammation, especially in obese individuals with high levels of inflammatory biomarkers undergoing a longer-term intervention. Several studies have reported that this effect is independent of the exercise-induced weight loss. There are several mechanisms through which exercise training reduces chronic inflammation, including its effect on muscle tissue to generate muscle-derived, anti-inflammatory 'myokine', its effect on adipose tissue to improve hypoxia and reduce local adipose tissue inflammation, its effect on endothelial cells to reduce leukocyte adhesion and cytokine production systemically, and its effect on the immune system to lower the number of pro-inflammatory cells and reduce pro-inflammatory cytokine production per cell. Of these potential mechanisms, the effect of exercise training on adipose tissue oxygenation is worth further investigation, as it is very likely that exercise training stimulates adipose tissue angiogenesis and increases blood flow, thereby reducing hypoxia and the associated chronic inflammation in adipose tissue of obese individuals.

  17. Agomelatine beyond Borders: Current Evidences of Its Efficacy in Disorders Other than Major Depression

    Directory of Open Access Journals (Sweden)

    Domenico De Berardis

    2015-01-01

    Full Text Available Agomelatine, a melatonergic antidepressant with a rapid onset of action, is one of the most recent drugs in the antidepressant category. Agomelatine’s antidepressant actions are attributed to its sleep-promoting and chronobiotic actions mediated by MT1 and MT2 receptors present in the suprachiasmatic nucleus, as well as to its effects on the blockade of 5-HT2c receptors. Blockade of 5-HT2c receptors causes release of both noradrenaline and dopamine at the fronto-cortical dopaminergic and noradrenergic pathways. The combined actions of agomelatine on MT1/MT2 and 5-HT2c receptors facilitate the resynchronization of altered circadian rhythms and abnormal sleep patterns. Agomelatine appeared to be effective in treating major depression. Moreover, evidence exists that points out a possible efficacy of such drug in the treatment of bipolar depression, anxiety disorders, alcohol dependence, migraines etc. Thus, the aim of this narrative review was to elucidate current evidences on the role of agomelatine in disorders other than major depression.

  18. Current trends in the global tourism industry: evidence from the United States

    Directory of Open Access Journals (Sweden)

    Nejdet Delener

    2010-10-01

    Full Text Available Tourism is one of the largest U.S. industries, serving millions of international and domestic tourists yearly. Tourists visit the U.S. to see natural wonders, cities, historic landmarks, and entertainment venues. Americans seek similar attractions as well as recreation and vacation areas. Tourism competes in the global market, so it is important to understand current trends in the U.S. travel industry. Therefore, this article offers insight into important trends and suggests strategies for policy makers involved in the travel and tourism industry.

  19. Modulation of p53 activity by IκBα: Evidence suggesting a common phylogeny between NF-κB and p53 transcription factors

    Directory of Open Access Journals (Sweden)

    Gelfand Erwin W

    2005-06-01

    Full Text Available Abstract Background In this work we present evidence that the p53 tumor suppressor protein and NF-κB transcription factors could be related through common descent from a family of ancestral transcription factors regulating cellular proliferation and apoptosis. P53 is a homotetrameric transcription factor known to interact with the ankyrin protein 53BP2 (a fragment of the ASPP2 protein. NF-κB is also regulated by ankyrin proteins, the prototype of which is the IκB family. The DNA binding sequences of the two transcription factors are similar, sharing 8 out of 10 nucleotides. Interactions between the two proteins, both direct and indirect, have been noted previously and the two proteins play central roles in the control of proliferation and apoptosis. Results Using previously published structure data, we noted a significant degree of structural alignment between p53 and NF-κB p65. We also determined that IκBα and p53 bind in vitro through a specific interaction in part involving the DNA binding region of p53, or a region proximal to it, and the amino terminus of IκBα independently or cooperatively with the ankyrin 3 domain of IκBα In cotransfection experiments, κBα could significantly inhibit the transcriptional activity of p53. Inhibition of p53-mediated transcription was increased by deletion of the ankyrin 2, 4, or 5 domains of IκBα Co-precipitation experiments using the stably transfected ankyrin 5 deletion mutant of κBα and endogenous wild-type p53 further support the hypothesis that p53 and IκBα can physically interact in vivo. Conclusion The aggregate results obtained using bacterially produced IκBα and p53 as well as reticulocyte lysate produced proteins suggest a correlation between in vitro co-precipitation in at least one of the systems and in vivo p53 inhibitory activity. These observations argue for a mechanism involving direct binding of IκBα to p53 in the inhibition of p53 transcriptional activity, analogous to

  20. Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence

    National Research Council Canada - National Science Library

    Nafiseh Shokri Mashhadi; Reza Ghiasvand; Gholamreza Askari; Mitra Hariri; Leila Darvishi; Mohammad Reza Mofid

    2013-01-01

    .... The health-promoting perspective of ginger is attributed to its rich phytochemistry. This study aimed to review the current evidence on ginger effects as an anti-inflammatory and anti-oxidative. Methods...

  1. Fatty acid and vitamin interventions in adults with schizophrenia: a systematic review of the current evidence.

    Science.gov (United States)

    Chia, Siok Ching; Henry, Jeyakumar; Mok, Yee Ming; Honer, William G; Sim, Kang

    2015-12-01

    Current psychopharmacological approaches to reduce psychotic phenomenology in schizophrenia are associated with adverse effects including extrapyramidal and metabolic side effects. In view of the emerging data on nutritional supplementation interventions in schizophrenia which are not entirely consistent, we aimed to review existent studies focusing on fatty acid and vitamin interventions and summarise current evidence on such nutritional supplementations in schizophrenia. We searched the digital databases (ScienceDirect, Scopus, SpringerLINK, PubMed/Medline) for relevant studies pertaining to fatty acid and vitamin supplementation interventions in the management of psychotic symptoms in schizophrenia up to February 2015. Overall, there were more studies conducted on fatty acid over vitamin supplementations in patients with schizophrenia. There were more positive findings in support of fatty acid supplementation compared with vitamin supplementation in the context of specific intervention features (dose of nutrient supplementation, single versus combination nutritional interventions, specific antipsychotic), subject features (older age, long duration of illness, baseline polyunsaturated fatty acid levels) and clinical outcomes (improvements of psychotic symptoms and/or extrapyramidal side effects from antipsychotics). However, investigations of both supplementation modalities were limited by relatively small study sample sizes, short study duration, which precluded further segmentation of impact on more diverse patient subtypes and symptom profiles. Future studies may consider examining larger samples over a longer time period, recruiting younger subjects with shorter duration of illness, examination of different clinical features including specific cognitive domains, and use of single versus combination nutritional interventions.

  2. Direct evidence for local oscillatory current sources and intracortical phase gradients in turtle visual cortex.

    Science.gov (United States)

    Prechtl, J C; Bullock, T H; Kleinfeld, D

    2000-01-18

    Visual stimuli induce oscillations in the membrane potential of neurons in cortices of several species. In turtle, these oscillations take the form of linear and circular traveling waves. Such waves may be a consequence of a pacemaker that emits periodic pulses of excitation that propagate across a network of excitable neuronal tissue or may result from continuous and possibly reconfigurable phase shifts along a network with multiple weakly coupled neuronal oscillators. As a means to resolve the origin of wave propagation in turtle visual cortex, we performed simultaneous measurements of the local field potential at a series of depths throughout this cortex. Measurements along a single radial penetration revealed the presence of broadband current sources, with a center frequency near 20 Hz (gamma band), that were activated by visual stimulation. The spectral coherence between sources at two well-separated loci along a rostral-caudal axis revealed the presence of systematic timing differences between localized cortical oscillators. These multiple oscillating current sources and their timing differences in a tangential plane are interpreted as the neuronal activity that underlies the wave motion revealed in previous imaging studies. The present data provide direct evidence for the inference from imaging of bidirectional wave motion that the stimulus-induced electrical waves in turtle visual cortex correspond to phase shifts in a network of coupled neuronal oscillators.

  3. Current evidence for the use of coffee and caffeine to prevent age-related cognitive decline and Alzheimer's disease.

    Science.gov (United States)

    Carman, A J; Dacks, P A; Lane, R F; Shineman, D W; Fillit, H M

    2014-04-01

    Although nothing has been proven conclusively to protect against cognitive aging, Alzheimer's disease or related dementias, decades of research suggest that specific approaches including the consumption of coffee may be effective. While coffee and caffeine are known to enhance short-term memory and cognition, some limited research also suggests that long-term use may protect against cognitive decline or dementia. In vitro and pre-clinical animal models have identified plausible neuroprotective mechanisms of action of both caffeine and other bioactive components of coffee, though epidemiology has produced mixed results. Some studies suggest a protective association while others report no benefit. To our knowledge, no evidence has been gathered from randomized controlled trials. Although moderate consumption of caffeinated coffee is generally safe for healthy people, it may not be for everyone, since comorbidities and personal genetics influence potential benefits and risks. Future studies could include short-term clinical trials with biomarker outcomes to validate findings from pre-clinical models and improved epidemiological studies that incorporate more standardized methods of data collection and analysis. Given the enormous economic and emotional toll threatened by the current epidemic of Alzheimer's disease and other dementias, it is critically important to validate potential prevention strategies such as coffee and caffeine.

  4. Microhabitat interactions of non-native pumpkinseed Lepomis gibbosus in a Mediterranean-type stream suggest no evidence for impact on endemic fishes

    Directory of Open Access Journals (Sweden)

    Top Nildeniz

    2016-01-01

    Full Text Available The pumpkinseed Lepomis gibbosus was introduced to Europe and parts of the Mediterranean Region more than 100 years ago. However, relatively little is known of its potential ecological impacts on the native species and freshwater ecosystems of Anatolia (Turkey, where the species is currently established in ponds and rivers. In this study, interactions between L. gibbosus and native and non-native stream fishes were investigated between June 2009 and May 2010 in Sarıçay Stream, a Mediterranean-type water course. Microhabitat preferences for depth, substratum composition, distance from bank and from vegetation, plant cover, velocity, turbidity and light intensity were studied by Constrained Quadratic Ordination. The species sampled in larger frequency of occurrence (and for which microhabitat relationships could be investigated comprised endemic Smyrna chub Petroleuciscus smyrnaeus and Aegean chub Squalius fellowesii, and non-native L. gibbosus (both juveniles and adults and topmouth gudgeon Pseudorasbora parva. Adult L. gibbosus were found to prefer locations closer to the bank with less turbid water, plant cover, light intensity, woody structure and with sandy substratum whilst avoiding riffle habitats with coarser debris, deeper water, dense submersed aquatic vegetation and higher velocities. These preferences overlapped with those for the other non-native species P. parva, but not with those for the endemic species and for L. gibbosus juveniles. The results of this study suggest that the potential for adverse impacts through competition for habitat of adult L. gibbosus with the native fish fauna is not apparent in Sarıçay Stream.

  5. The 'antisocial' person: an insight in to biology, classification and current evidence on treatment

    Directory of Open Access Journals (Sweden)

    Rajapakse Senaka

    2010-07-01

    Full Text Available Abstract Background This review analyses and summarises the recent advances in understanding the neurobiology of violence and empathy, taxonomical issues on defining personality disorders characterised by disregard for social norms, evidence for efficacy of different treatment modalities and ethical implications in defining 'at-risk' individuals for preventive interventions. Methods PubMed was searched with the keywords 'antisocial personality disorder', 'dissocial personality disorder' and 'psychopathy'. The search was limited to articles published in English over the last 10 years (1999 to 2009 Results Both diagnostic manuals used in modern psychiatry, the Diagnostic and Statistical Manual published by the American Psychiatric Association and the International Classification of Diseases published by the World Health Organization, identify a personality disorder sharing similar traits. It is termed antisocial personality disorder in the diagnostic and statistical manual and dissocial personality disorder in the International Classification of Diseases. However, some authors query the ability of the existing manuals to identify a special category termed 'psychopathy', which in their opinion deserves special attention. On treatment-related issues, many psychological and behavioural therapies have shown success rates ranging from 25% to 62% in different cohorts. Multisystemic therapy and cognitive behaviour therapy have been proven efficacious in many trials. There is no substantial evidence for the efficacy of pharmacological therapy. Currently, the emphasis is on early identification and prevention of antisocial behaviour despite the ethical implications of defining at-risk children. Conclusions Further research is needed in the areas of neuroendocrinological associations of violent behaviour, taxonomic existence of psychopathy and efficacy of treatment modalities.

  6. Non-medical prescribing by physiotherapists: issues reported in the current evidence.

    Science.gov (United States)

    Morris, Joanne H; Grimmer, Karen

    2014-02-01

    Physiotherapists should be proactive in preparing themselves to participate in innovative models of health care, which are emerging from the healthcare workforce reforms in Australia. One challenging outcome of workforce change is physiotherapy (non-medical) prescribing (NMP), which is part of the extension of scope of physiotherapy practice. This paper summarises the current evidence base for Australian physiotherapists seeking to obtain prescribing rights. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to NMP by physiotherapists, nationally and internationally. No critical appraisal was undertaken however literature was structured into the NHMRC hierarchy of evidence. Themes raised in the included literature were reported descriptively. There were six relevant peer-reviewed articles, of hierarchy levels III_3 and IV. There was however, comprehensive and recent grey literature to inform Australian physiotherapy NMP initiatives. Themes included the need for standard National action in relation to legislative and regulatory/registration issues, appropriate education, credentialing and supervisory requirements for physiotherapy prescribing. Many lessons can be learnt from the literature, including the importance of planned, uniform National action (rather than piecemeal state-by-state initiatives). Essential elements include appropriate training and skills-based recognition within the discipline and the broader health team, and the need to overtly demonstrate effectiveness and safety. Regularly-evaluated service-delivery models which support NMP by physiotherapists are further required, to demonstrate efficiency, timeliness, patient centredness and equity. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  7. Physical therapies in the management of osteoarthritis: current state of the evidence.

    Science.gov (United States)

    Bennell, Kim L; Buchbinder, Rachelle; Hinman, Rana S

    2015-05-01

    This review considers the role of physical therapies in osteoarthritis management, highlighting key findings from systematic reviews and randomized controlled trials published in the last 2 years. Three new trials question the role of manual therapy for hip and knee osteoarthritis. No between-group differences in outcome were detected between a multimodal programme including manual therapy and home exercise, and placebo in one trial; a second trial found no benefit of adding manual therapy to an exercise programme, while a third trial reported marginal benefits over usual care that were of doubtful importance. Recent trials have also found no or uncertain clinical benefits of transcutaneous electrical nerve stimulation (TENS) or acupuncture, or of valgus braces or lateral wedge insoles for pain and function in knee osteoarthritis. Available evidence suggests a small to moderate effect of exercise in comparison with not exercising for hip or knee osteoarthritis, although optimum exercise prescription and dosage are unclear. One trial also observed a delay in joint replacement in people with hip osteoarthritis. Two trials have reported conflicting findings about the effects of exercise for hand osteoarthritis. Other than exercise, recent data suggest that the role of physical therapies in the treatment of osteoarthritis appears limited.

  8. The relationship between the nucleolus and cancer: Current evidence and emerging paradigms.

    Science.gov (United States)

    Orsolic, Ines; Jurada, Deana; Pullen, Nick; Oren, Moshe; Eliopoulos, Aristides G; Volarevic, Sinisa

    2016-06-01

    The nucleolus is the most prominent nuclear substructure assigned to produce ribosomes; molecular machines that are responsible for carrying out protein synthesis. To meet the increased demand for proteins during cell growth and proliferation the cell must increase protein synthetic capacity by upregulating ribosome biogenesis. While larger nucleolar size and number have been recognized as hallmark features of many tumor types, recent evidence has suggested that, in addition to overproduction of ribosomes, decreased ribosome biogenesis as well as qualitative changes in this process could also contribute to tumor initiation and cancer progression. Furthermore, the nucleolus has become the focus of intense attention for its involvement in processes that are clearly unrelated to ribosome biogenesis such as sensing and responding to endogenous and exogenous stressors, maintenance of genome stability, regulation of cell-cycle progression, cellular senescence, telomere function, chromatin structure, establishment of nuclear architecture, global regulation of gene expression and biogenesis of multiple ribonucleoprotein particles. The fact that dysregulation of many of these fundamental cellular processes may contribute to the malignant phenotype suggests that normal functioning of the nucleolus safeguards against the development of cancer and indicates its potential as a therapeutic approach. Here we review the recent advances made toward understanding these newly-recognized nucleolar functions and their roles in normal and cancer cells, and discuss possible future research directions.

  9. PLASMA OXYTOCIN CONCENTRATION AND DEPRESSIVE SYMPTOMS: A REVIEW OF CURRENT EVIDENCE AND DIRECTIONS FOR FUTURE RESEARCH.

    Science.gov (United States)

    Massey, Suena H; Backes, Katherine A; Schuette, Stephanie A

    2016-04-01

    There is substantial recent interest in the role of oxytocin in social and affiliative behaviors-animal models of depression have suggested a link between oxytocin and mood. We reviewed literature to date for evidence of a potential relationship between peripheral oxytocin concentration and depressive symptoms in humans. Pubmed(®) and PsychINFO(®) were searched for biomedical and social sciences literature from 1960 to May 19, 2015 for empirical articles in English involving human subjects focused on the relationship between peripheral oxytocin concentration and depressive symptoms, excluding articles on the oxytocin receptor gene, or involving exogenous (i.e. intranasal) administration of oxytocin. Eight studies meeting criteria were identified and formally reviewed. Studies of pregnant women suggested an inverse relationship between oxytocin level and depressive symptom severity. Findings in nonpregnant women were broadly consistent with the role of oxytocin release in response to stress supported by animal studies. The relationship between oxytocin and depression in men appeared to be in the opposite direction, possibly reflecting the influence of gonadal hormones on oxytocinergic functioning found in other mammalian species. Overall, small sample sizes, heterogeneity in study designs, and other methodological limitations may account for inconsistent findings. Future research utilizing reliable oxytocin measurement protocols including measurements across time, larger sample sizes, and sample homogeneity with respect to multiple possible confounders (age, gender, race and ethnicity, ovarian status among women, and psychosocial context) are needed to elucidate the role of oxytocin in the pathogenesis of depression, and could guide the design of novel pharmacologic agents.

  10. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS).

    Science.gov (United States)

    Lefaucheur, Jean-Pascal; Antal, Andrea; Ayache, Samar S; Benninger, David H; Brunelin, Jérôme; Cogiamanian, Filippo; Cotelli, Maria; De Ridder, Dirk; Ferrucci, Roberta; Langguth, Berthold; Marangolo, Paola; Mylius, Veit; Nitsche, Michael A; Padberg, Frank; Palm, Ulrich; Poulet, Emmanuel; Priori, Alberto; Rossi, Simone; Schecklmann, Martin; Vanneste, Sven; Ziemann, Ulf; Garcia-Larrea, Luis; Paulus, Walter

    2017-01-01

    A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction. The evidence-based analysis included only studies based on repeated tDCS sessions with sham tDCS control procedure; 25 patients or more having received active treatment was required for Class I, while a lower number of 10-24 patients was accepted for Class II studies. Current evidence does not allow making any recommendation of Level A (definite efficacy) for any indication. Level B recommendation (probable efficacy) is proposed for: (i) anodal tDCS of the left primary motor cortex (M1) (with right orbitofrontal cathode) in fibromyalgia; (ii) anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) (with right orbitofrontal cathode) in major depressive episode without drug resistance; (iii) anodal tDCS of the right DLPFC (with left DLPFC cathode) in addiction/craving. Level C recommendation (possible efficacy) is proposed for anodal tDCS of the left M1 (or contralateral to pain side, with right orbitofrontal cathode) in chronic lower limb neuropathic pain secondary to spinal cord lesion. Conversely, Level B recommendation (probable inefficacy) is conferred on the absence of clinical effects of: (i) anodal tDCS of the left temporal cortex (with right orbitofrontal cathode) in tinnitus; (ii) anodal tDCS of the left DLPFC (with right orbitofrontal cathode) in drug-resistant major depressive episode. It remains to be clarified whether the probable or possible therapeutic effects of tDCS are clinically meaningful and how to optimally perform t

  11. Current Evidence for a Role of the Kynurenine Pathway of Tryptophan Metabolism in Multiple Sclerosis.

    Science.gov (United States)

    Lovelace, Michael D; Varney, Bianca; Sundaram, Gayathri; Franco, Nunzio F; Ng, Mei Li; Pai, Saparna; Lim, Chai K; Guillemin, Gilles J; Brew, Bruce J

    2016-01-01

    The kynurenine pathway (KP) is the major metabolic pathway of the essential amino acid tryptophan (TRP). Stimulation by inflammatory molecules, such as interferon-γ (IFN-γ), is the trigger for induction of the KP, driving a complex cascade of production of both neuroprotective and neurotoxic metabolites, and in turn, regulation of the immune response and responses of brain cells to the KP metabolites. Consequently, substantial evidence has accumulated over the past couple of decades that dysregulation of the KP and the production of neurotoxic metabolites are associated with many neuroinflammatory and neurodegenerative diseases, including Parkinson's disease, AIDS-related dementia, motor neurone disease, schizophrenia, Huntington's disease, and brain cancers. In the past decade, evidence of the link between the KP and multiple sclerosis (MS) has rapidly grown and has implicated the KP in MS pathogenesis. KP enzymes, indoleamine 2,3-dioxygenase (IDO-1) and tryptophan dioxygenase (highest expression in hepatic cells), are the principal enzymes triggering activation of the KP to produce kynurenine from TRP. This is in preference to other routes such as serotonin and melatonin production. In neurological disease, degradation of the blood-brain barrier, even if transient, allows the entry of blood monocytes into the brain parenchyma. Similar to microglia and macrophages, these cells are highly responsive to IFN-γ, which upregulates the expression of enzymes, including IDO-1, producing neurotoxic KP metabolites such as quinolinic acid. These metabolites circulate systemically or are released locally in the brain and can contribute to the excitotoxic death of oligodendrocytes and neurons in neurological disease principally by virtue of their agonist activity at N-methyl-d-aspartic acid receptors. The latest evidence is presented and discussed. The enzymes that control the checkpoints in the KP represent an attractive therapeutic target, and consequently several KP

  12. Current evidence for a role of the Kynurenine pathway of tryptophan metabolism in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Michael D. Lovelace

    2016-08-01

    Full Text Available The kynurenine pathway (KP is the major metabolic pathway of the essential amino acid tryptophan (TRP. Stimulation by inflammatory molecules such as interferon-γ (IFN-γ is the trigger for induction of the KP, driving a complex cascade of production of both neuroprotective and neurotoxic metabolites and in turn, regulation of the immune response and responses of brain cells to the KP metabolites. Consequently, substantial evidence has accumulated over the past couple of decades that dysregulation of the KP and the production of neurotoxic metabolites are associated with many neuroinflammatory and neurodegenerative diseases, including Parkinson’s disease, AIDS-related dementia, motor neurone disease (MND, schizophrenia, Huntington’s disease and brain cancers. In the past decade, evidence of the link between the KP and multiple sclerosis (MS has rapidly grown and has implicated the KP in MS pathogenesis. KP enzymes indoleamine 2,3-dioxygenase (IDO-1 and tryptophan dioxygenase (TDO; highest expression in hepatic cells are the principal enzymes triggering activation of the KP to produce kynurenine from TRP. This is in preference to other routes such as serotonin and melatonin production. In neurological disease, degradation of the blood-brain-barrier (BBB, even if transient, allows the entry of blood monocytes into the brain parenchyma. Like microglia and macrophages, these cells are highly responsive to IFN-γ, which upregulates the expression of enzymes including IDO-1, producing neurotoxic KP metabolites such as quinolinic acid (QUIN. These metabolites circulate systemically or are released locally in the brain, and can contribute to the excitotoxic death of oligodendrocytes and neurons in neurological disease principally by virtue of their agonist activity at NMDA receptors. The latest evidence is presented and discussed. The enzymes that control the checkpoints in the KP represent an attractive therapeutic target, and consequently several

  13. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

    LENUS (Irish Health Repository)

    Duffy, Michael J

    2012-02-01

    Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

  14. No evidence for adaptation of current egg drop syndrome 1976 viruses to chickens.

    Science.gov (United States)

    Tsukamoto, K; Kuwabara, M; Kaneko, M; Mase, M; Imai, K

    2004-01-01

    In order to determine whether the current field strains of egg drop syndrome (EDS) 1976 viruses adapt to chickens, we compared the growth efficiency of three Japanese field strains (PA-1/79, AWI/98, Gifu/01) in chicken and duck embryo liver cells. The growth efficiency in chicken or duck embryo liver cells was almost similar in these strains. The fiber protein may carry the type-specific antigen and the hemagglutination activity, and hexon protein may contain the subgroup-specific antigenic determinants. Therefore, the fiber head and hexon loop 1 DNA domain sequences of the six Japanese field strains UPA-1/79, ME/80, 44/81, Kyoto/91, AWI/98, Gifu/01) were compared, but these DNA domains were identical among the six field strains. Our data suggested that the EDS virus was maintained without discernible changes for the last two decades in the field.

  15. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

    2011-08-15

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  16. Evidence of underground electric current generation during the 2009 L'Aquila earthquake: Real or instrumental?

    Science.gov (United States)

    Masci, F.; Thomas, J. N.

    2016-06-01

    We investigate magnetic effects in correspondence of the Mw6.1 L'Aquila earthquake. Magnetic and seismic records are analyzed. Rapid and distinct changes and an offset can be seen in magnetic field components after the main shock. We show that these effects result from electromagnetic induction due to the movement of the sensors through the Earth's magnetic field and from a permanent displacement of the sensors from their original position caused by the passing seismic waves. A transient signal in total field data from an overhauser magnetometer apparently occurs in correspondence with the earthquake. Our analysis shows that the transient was not observed by other sensors that were operating in close proximity to the overhauser. Thus, the transient signal in the total magnetic field data, and the offset in the magnetic field components, cannot be associated with a hypothetical underground electric current generated by the earthquake, as suggested by Nenovski (2015).

  17. Current Evidence for Developmental, Structural, and Functional Brain Defects following Prenatal Radiation Exposure

    Directory of Open Access Journals (Sweden)

    Tine Verreet

    2016-01-01

    Full Text Available Ionizing radiation is omnipresent. We are continuously exposed to natural (e.g., radon and cosmic and man-made radiation sources, including those from industry but especially from the medical sector. The increasing use of medical radiation modalities, in particular those employing low-dose radiation such as CT scans, raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques. One of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother, of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors. In the following years, animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits. However, the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established. This review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered.

  18. Current Evidence for Developmental, Structural, and Functional Brain Defects following Prenatal Radiation Exposure

    Science.gov (United States)

    Verreet, Tine; Quintens, Roel; Baatout, Sarah; Benotmane, Mohammed A.

    2016-01-01

    Ionizing radiation is omnipresent. We are continuously exposed to natural (e.g., radon and cosmic) and man-made radiation sources, including those from industry but especially from the medical sector. The increasing use of medical radiation modalities, in particular those employing low-dose radiation such as CT scans, raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques. One of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother, of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors. In the following years, animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits. However, the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established. This review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered. PMID:27382490

  19. Modifiable factors in the management of glaucoma: a systematic review of current evidence.

    Science.gov (United States)

    Hecht, Idan; Achiron, Asaf; Man, Vitaly; Burgansky-Eliash, Zvia

    2017-04-01

    Primary open angle glaucoma is a chronic optic neuropathy affecting millions of people worldwide and represents a major public health issue. Environmental factors, behaviors, and diet are intimately related to patient health and may play a role in the pathogenesis and progression of glaucoma. This study aims to review the literature, focusing on the last three years, regarding modifiable lifestyle interventions in the management of primary open angle glaucoma. Electronic databases were searched for studies published between January 2013 and July 2016 on the topic of lifestyle interventions in primary open angle glaucoma. Sleeping with the head elevated and avoiding the worst eye-dependent side during sleep may slightly lower intraocular pressure and reduce visual field loss. Some food supplements and moderate aerobic exercise may also reduce intraocular pressure up to 2.0 and 3.0 mmHg, respectively. Frequency of coffee intake may be associated with disease progression. Potential negative effects are associated with weight-lifting and yoga exercises. Certain lifestyle habits could influence glaucoma progression, yet no specific interventions are currently supported by robust evidence. Awareness of the possible influences of certain habits should help guide clinical advice and is important to help patients avoid adverse outcomes and take an active role in the management of their disease.

  20. Clinical utility of trabectedin for the treatment of ovarian cancer: current evidence

    Directory of Open Access Journals (Sweden)

    Mascilini F

    2014-07-01

    Full Text Available Floriana Mascilini,* Giulia Amadio,* Maria Grazia Di Stefano, Manuela Ludovisi, Alessia Di Legge, Carmine Conte, Rosa De Vincenzo, Caterina Ricci, Valeria Masciullo, Vanda Salutari, Giovanni Scambia, Gabriella FerrandinaGynecologic Oncology Unit, Department of Oncology, Catholic University of Rome, Italy  *These authors contributed equally to this work Abstract: Among the pharmaceutical options available for treatment of ovarian cancer, attention has been increasingly focused on trabectedin (ET-743, a drug which displays a unique mechanism of action and has been shown to be active in several human malignancies. Currently, single agent trabectedin is approved for treatment of patients with advanced soft tissue sarcoma after failure of anthracyclines and ifosfamide, and in association with pegylated liposomal doxorubicin for treatment of patients with relapsed partially platinum-sensitive ovarian cancer. This review aims at summarizing the available evidence about the clinical role of trabectedin in the management of patients with epithelial ovarian cancer. Novel perspectives coming from a better understanding of trabectedin mechanisms of action and definition of patients subgroups likely susceptible to benefit of trabectedin treatment are also presented. Keywords: ET-743, ovarian cancer, clinical trials

  1. Antibiotics versus appendectomy in the management of acute appendicitis: a review of the current evidence

    Science.gov (United States)

    Fitzmaurice, Gerard J.; McWilliams, Billy; Hurreiz, Hisham; Epanomeritakis, Emanuel

    2011-01-01

    Background Acute appendicitis remains the most common cause of the acute abdomen in young adults, and the mainstay of treatment in most centres is an appendectomy. However, treatment for other intra-abdominal inflammatory processes, such as diverticulitis, consists initially of conservative management with antibiotics. The aim of this study was to determine the role of antibiotics in the management of acute appendicitis and to assess if appendectomy remains the gold standard of care. Methods A literature search using MEDLINE and the Cochrane Library identified studies published between 1999 and 2009, and we reviewed all relevant articles. The articles were critiqued using the Public Health Resource Unit (2006) appraisal tools. Results Our search yielded 41 papers, and we identified a total of 13 papers within the criteria specified. All of these papers, while posing pertinent questions and demonstrating the role of antibiotics as a bridge to surgery, failed to adequately justify their findings that antibiotics could be used as a definitive treatment of acute appendicitis. Conclusion Appendectomy remains the gold standard of treatment for acute appendicitis based on the current evidence. PMID:21651835

  2. The Role of Adiponectin in Cancer: A Review of Current Evidence

    Science.gov (United States)

    Dalamaga, Maria; Diakopoulos, Kalliope N.

    2012-01-01

    Excess body weight is associated not only with an increased risk of type 2 diabetes and cardiovascular disease (CVD) but also with various types of malignancies. Adiponectin, the most abundant protein secreted by adipose tissue, exhibits insulin-sensitizing, antiinflammatory, antiatherogenic, proapoptotic, and antiproliferative properties. Circulating adiponectin levels, which are determined predominantly by genetic factors, diet, physical activity, and abdominal adiposity, are decreased in patients with diabetes, CVD, and several obesity-associated cancers. Also, adiponectin levels are inversely associated with the risk of developing diabetes, CVD, and several malignancies later in life. Many cancer cell lines express adiponectin receptors, and adiponectin in vitro limits cell proliferation and induces apoptosis. Recent in vitro studies demonstrate the antiangiogenic and tumor growth-limiting properties of adiponectin. Studies in both animals and humans have investigated adiponectin and adiponectin receptor regulation and expression in several cancers. Current evidence supports a role of adiponectin as a novel risk factor and potential diagnostic and prognostic biomarker in cancer. In addition, either adiponectin per se or medications that increase adiponectin levels or up-regulate signaling pathways downstream of adiponectin may prove to be useful anticancer agents. This review presents the role of adiponectin in carcinogenesis and cancer progression and examines the pathophysiological mechanisms that underlie the association between adiponectin and malignancy in the context of a dysfunctional adipose tissue in obesity. Understanding of these mechanisms may be important for the development of preventive and therapeutic strategies against obesity-associated malignancies. PMID:22547160

  3. Percutaneous patent foramen ovale occlusion: current evidence and evolving clinical practice.

    Science.gov (United States)

    Leong, Ming Chern; Uebing, Anselm; Gatzoulis, Michael A

    2013-11-15

    Patent foramen ovale (PFO) has long been implicated with cryptogenic stroke, migraine and decompression illness. PFO is common and its implicated pathologies cause devastating neurological sequelae; and hence have drawn the attention of medical practitioners across disciplines. The pathogenesis is hypothesized to be caused by micro-emboli or neuro-hormones which would otherwise being filtered by the lungs, astraying into the systemic circulation via the atrial communication especially during Valsalva maneuver. Treatment options have been proposed; among others are medical therapy, PFO closure or both. While medical therapy as secondary prevention is being adopted by most centers in the world, PFO closure is performed in selected patients only. The reason being is that most studies linking PFO to these pathologies are observational in nature. And these associations do not equate to a firm cause and effect relationship. For causal relationship to be established, good quality prospective data is required. Recently, there has been emergence of new prospective trials which improve the understanding of PFO closure in these pathologies. This article reviews the associations between PFO and the three main implicated pathologies as well as the evidence for PFO closure in the current era.

  4. Evidence for improvement of critical current by Ag in YBaCuO-Ag thick films

    Science.gov (United States)

    Dwir, B.; Kellett, B.; Mieville, L.; Pavuna, D.

    1991-04-01

    The evidence is reported for enhancement of critical current density J(c) in YBa2Cu3O(7-delta) thick films with the addition of Ag, which is correlated with improvements in structural properties. An improvement of 50 percent in J(c) (up to about 500 A/sq cm at T = 4.2 K) was obtained in films made from YBCO + 60 wt pct Ag powder, fabricated by the spin-on technique on (100) SrTiO3, which is correlated with improvements in structure. The resulting films are 10 microns thick, uniform, partially textured, and show good adherence. The critical temperature Tc is improved by the addition of Ag, and a reduction in the density of microcracks and in the amount of secondary phases in the sintered films was observed. Normal-state resistivity is reduced by almost three orders of magnitude, making these films potentially useful for electronic applications in interconnects and novel hybrid circuits.

  5. Evidence for improvement of critical current by Ag in YBaCuO-Ag thick films

    Energy Technology Data Exchange (ETDEWEB)

    Dwir, B.; Kellett, B.; Mieville, L.; Pavuna, D. (Institute of Micro- and Opto-electronics, Department of Physics, Swiss Federal Institute of Technology, CH-1015 Lausanne, Switzerland (CH))

    1991-04-15

    The evidence is reported for enhancement of critical current density {ital J}{sub {ital c}} in YBa{sub 2}Cu{sub 3}O{sub 7{minus}{delta}} thick films with the addition of Ag, which is correlated with improvements in structural properties. An improvement of 50% in {ital J}{sub {ital c}} (up to {similar to}500 A/cm{sup 2} at {ital T}=4.2 K) was obtained in films made from YBCO+60wt % Ag powder, fabricated by the spin-on technique on (100) SrTiO{sub 3}, which is correlated with improvements in structure. The resulting films are 10 {mu}m thick, uniform, partially textured, and show good adherence. The critical temperature {ital T}{sub {ital c}} is improved by the addition of Ag, and a reduction in the density of microcracks and in the amount of secondary phases in the sintered films was observed. Normal-state resistivity is reduced by almost three orders of magnitude, making these films potentially useful for electronic applications in interconnects and novel hybrid circuits.

  6. Current Situation and Suggestions for Development of Recycling Agriculture in Lingwu Municipality%灵武市循环农业发展现状及建议

    Institute of Scientific and Technical Information of China (English)

    张仲军; 杨金贵; 俞宏彪

    2015-01-01

    The combination of agriculture with animal husbandry as well as planting with livestock raising is a kind of recy-cling agriculture. Based on an investigation on the current situation of the combination of agriculture with animal husbandry as well as planting with livestock raising in Lingwu Municipality, an exploration is made on the development of recycling a-griculture, organic agriculture and the new ways for supporting animal husbandry with agriculture and promoting agriculture with animal husbandry.%农牧种养结合是循环农业的一种形式,通过对灵武市农牧种养结合现状调研,探索发展循环农业、有机农业、以"农养牧,以牧促农"的新路子.

  7. 耕地保护生态补偿现状及政策建议%Current Situation and Policy Suggestion of Ecological Compensation for Cultivated Land Protection

    Institute of Scientific and Technical Information of China (English)

    李林; 李海燕

    2015-01-01

    On the basis of exploration of the present situation of cultivated land protection of ecological compensation in China,the necessity to establish the ecological compensation of cultivated land protection was analyzed,and relevant policy suggestions to perfect the ecological compensation for farmland protection in China were finally put forward.%在剖析我国耕地保护生态补偿现状的基础上,分析建立耕地保护生态补偿的必要性,最后提出完善我国耕地保护生态补偿的相关政策建议。

  8. Current Status of Food Safety System in China and Suggestions%我国食品安全体系现状及建议

    Institute of Scientific and Technical Information of China (English)

    段云

    2011-01-01

    从食品安全战略、食品安全组织、食品安全法律法规、我国食品安全领域存在的问题和建议等方面综述我国食品安全体系。%Food safety plays important role in our life.Recently,there occur several incidents in food safety,which was noticed by our government.This paper mainly reviewed the food safety strategies,organizations,laws and regulations,problems and suggestions for the problems.

  9. Donor human milk for preterm infants: current evidence and research directions.

    Science.gov (United States)

    Arslanoglu, Sertac; Corpeleijn, Willemijn; Moro, Guido; Braegger, Christian; Campoy, Cristina; Colomb, Virginie; Decsi, Tamas; Domellöf, Magnus; Fewtrell, Mary; Hojsak, Iva; Mihatsch, Walter; Mølgaard, Christian; Shamir, Raanan; Turck, Dominique; van Goudoever, Johannes

    2013-10-01

    The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants. The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions for future research directions. Protection against necrotizing enterocolitis is the major clinical benefit deriving from the use of DHM when compared with formula. Limited data also suggest unfortified DHM to be associated with improved feeding tolerance and with reduced cardiovascular risk factors during adolescence. Presence of a human milk bank (HMB) does not decrease breast-feeding rates at discharge, but decreases the use of formula during the first weeks of life. This commentary emphasizes that fresh own mother's milk (OMM) is the first choice in preterm infant feeding and strong efforts should be made to promote lactation. When OMM is not available, DHM is the recommended alternative. When neither OMM nor DHM is available, preterm formula should be used. DHM should be provided from an established HMB, which follows specific safety guidelines. Storage and processing of human milk reduces some biological components, which may diminish its health benefits. From a nutritional point of view, DHM, like HM, does not meet the requirements of preterm infants, necessitating a specific fortification regimen to optimize growth. Future research should focus on the improvement of milk processing in HMB, particularly of heat treatment; on the optimization of HM fortification; and on further evaluation of the potential clinical benefits of processed and fortified DHM.

  10. 中国天然橡胶产业现状及其发展建议%Current Situation of Chinese Natural Rubber Industry and Development Suggestions

    Institute of Scientific and Technical Information of China (English)

    祁栋灵; 王秀全; 张志扬; 黄月球

    2013-01-01

    This paper analyzes general situation of development in Chinese natural rubber industry, the industrial status and role of Chinese natural rubber industry, as well as establish production impetus of Chinese rubber science & technology to rubber production, and putting forward some suggestions on how to improve Chinese natural rubber industry.%从我国天然橡胶产业发展概况、产业的地位和作用,以及我国橡胶科技对植胶生产的推动作用等方面对中国天然橡胶产业发展现状进行了综述,并提出了促进我国天然橡胶产业发展提升的建议.

  11. Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence-based Recommendations

    Science.gov (United States)

    Silverman, Eric C.; Sporer, Karl A.; Lemieux, Justin M.; Brown, John F.; Koenig, Kristi L.; Gausche-Hill, Marianne; Rudnick, Eric M.; Salvucci, Angelo A.; Gilbert, Greg H.

    2017-01-01

    Introduction We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. Methods We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations. We analyzed the type and route of medication administered, number of additional rescue doses permitted, and requirements for glucose testing prior to medication. The treatment for eclampsia and seizures in pediatric patients were analyzed separately. Results Protocols across EMS Agencies in California varied widely. We identified multiple drugs, dosages, routes of administration, re-dosing instructions, and requirement for blood glucose testing prior to medication delivery. Blood glucose testing prior to benzodiazepine administration is required by 61% (20/33) of agencies for adult patients and 76% (25/33) for pediatric patients. All agencies have protocols for giving intramuscular benzodiazepines and 76% (25/33) have protocols for intranasal benzodiazepines. Intramuscular midazolam dosages ranged from 2 to 10 mg per single adult dose, 2 to 8 mg per single pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intranasal midazolam dosages ranged from 2 to 10 mg per single adult or pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intravenous/intrasosseous midazolam dosages ranged from 1 to 6 mg per single adult dose, 1 to 5 mg per single pediatric dose, and 0.05 to 0.1 mg/kg as a weight-based dose. Eclampsia is specifically addressed by 85% (28/33) of agencies. Forty-two percent (14/33) have a protocol for administering magnesium sulfate, with intravenous dosages ranging from 2 to 6 mg, and 58% (19/33) allow benzodiazepines to be administered

  12. Current evidence for the role of complement in the pathogenesis of Shiga toxin haemolytic uraemic syndrome.

    Science.gov (United States)

    Keir, Lindsay S; Saleem, Moin A

    2014-10-01

    Shiga toxin-associated haemolytic uraemic syndrome (Stx HUS) is the leading cause of paediatric acute kidney injury. This toxin-mediated disease carries a significant morbidity and mortality but has no direct treatments. Rare familial atypical HUS (aHUS) is now understood to result from over-activation of the alternative complement pathway causing glomerular endothelial damage. By understanding the pathogenic mechanisms of this disease, the monoclonal antibody eculizumab, which blocks the final common pathway of complement, is now being used to treat aHUS. For this reason, clinicians and scientists are studying the role of the alternative complement pathway in Stx HUS with the aim of targeting treatment in a similar way. There is some evidence suggesting that complement plays a role in the pathogenesis of Stx HUS, but other mechanisms may also be important. Clinically, modulating the complement system using plasma exchange provides no proven benefit in Stx HUS, and the use of eculizumab has provided conflicting results. Understanding the local effect of Stx on the glomerulus, in particular regulation of the complement and coagulation systems, may lead to advances in defining the precise pathogenesis of this disease. Then, targeted treatment strategies could be devised and clinical trials undertaken.

  13. Cellulite treatment: evidence and ethics, brief history, and emphasis on current practices including liposuction

    Science.gov (United States)

    de Riese, Cornelia

    2005-04-01

    According to Taber's Cyclopedic Medical Dictionary "cellulite" is defined as: "a non-technical term for subcutaneous deposits of fat, especially in the buttocks, legs, and thighs." These deposits result in puckered, dimply skin and they are a cause for major aesthetic concerns in affected patients. The etiology of this condition is still unclear. Female predilection is witnessed in clinical practice as it is reported in the literature. It remains a subject for further studies whether it is a structural problem of connective tissue or as suggested probably related to hormonal causes. Magnetic resonance imaging may provide some answers to these questions. Not knowing what is causing this nuisance makes it almost impossible to treat. No wonder that there is little scientific validation to support any of the many treatments that are advertised on the Internet or in women's magazines. This review focuses on mechanical and microinvasive interventions that claim to alleviate "cellulite": lipoplasty, liposcultpure, liposuction, subcision, and laser. Among the parameters analyzed are the proposed modes of action of these techniques as well as adverse events and complications that may occur. Of special interest will be the evidence that backs these procedures. Extracting reliable data is hampered by methodical problems with the design of most of the published trials. In essence, at this time there is no "cure" for cellulite. Safe treatment recommendations are related to healthy life style choices that include toning exercises, dietary changes, and weight loss.

  14. Current situation and suggestions for pressure ulcer management in China%我国压疮管理现状与建议

    Institute of Scientific and Technical Information of China (English)

    张洪君; 卢㛃; 刘金莲

    2014-01-01

    Pressure ulcer is a common and important complication in clinical nursing. Its mechanism is complicated. Pressure ulcer widely exists in different departments of hospital and would greatly inlfuence patients. This paper summarized and analyzed the current situation of pressure ulcer management in China. The ideas and methods of pressure ulcer management from abroad had been applied in some medical institutions in China, and were modiifed in order to ift themselves. But due to the diversity of our medical institutions, we still need to formulate a uniifed nursing standard to improve the prevention and treatment management of pressure ulcer in our country.%压疮是临床护理工作中常见的重要并发症,其发生机制复杂,广泛存在于各科室,给患者带来较大影响。本文通过对目前我国压疮管理现状的分析发现,国际压疮护理管理理念和方法已经在我国部分医疗机构得到改进和应用,逐步形成适合我国的压疮防治规范。但是,由于我国各地医疗机构水平参差不齐,为提高全国整体压疮预防与治疗管理水平,还须制订统一的全国压疮护理标准。

  15. Review of Evidence Suggesting That the Fascia Network Could Be the Anatomical Basis for Acupoints and Meridians in the Human Body

    Directory of Open Access Journals (Sweden)

    Yu Bai

    2011-01-01

    Full Text Available The anatomical basis for the concept of meridians in traditional Chinese medicine (TCM has not been resolved. This paper reviews the evidence supporting a relationship between acupuncture points/meridians and fascia. The reviewed evidence supports the view that the human body's fascia network may be the physical substrate represented by the meridians of TCM. Specifically, this hypothesis is supported by anatomical observations of body scan data demonstrating that the fascia network resembles the theoretical meridian system in salient ways, as well as physiological, histological, and clinical observations. This view represents a theoretical basis and means for applying modern biomedical research to examining TCM principles and therapies, and it favors a holistic approach to diagnosis and treatment.

  16. Promotion of sexual education by nurses in Macau-current state and suggestions%澳门护士推行性教育现状与建议

    Institute of Scientific and Technical Information of China (English)

    余惠莺; 黄翠萍; 李雪屏

    2015-01-01

    In the recent decade,the Macau Government,community associations and schools have been making concerted efforts to initiate sexual education.Nursing professionals in Macau,being the largest population of frontline health care providers,play an indispensable role in promoting adolescents’sexual health.Nurses in Macau have been promoting sexual education in three aspects,namely (1)nursing students initiate sexual education pro-jects under supervisors’guidance,(2)nurses in schools promote sexual health to school students on a regular ba-sis,(3)apart from launching relevant promotion activities in communities,professional associations of nurses also provide consultative services on physiological and sexual knowledge to adolescents in collaboration with the Govern-ment.Moreover,by organizing academic symposia,the associations initiate discussions on relevant topics and offer suggestions to the Government to consummate the relevant policies.In terms of the role in sexual health promotion, in addition to offering disease assessment,examination and nursing care,and arranging sexual health promotion ac-tivities in communities and schools,nursing professionals are suggested to also take up the responsibilities from the leadership aspect by monitoring and enhancing the quality and safety of the relevant services.Furthermore,from the research aspect,nursing professionals may initiate relevant researches and capitalize on the research findings to ele-vate service quality.%近十年,澳门政府、民间机构、学校共同合作开展性教育,澳门的护理人员作为前线健康服务提供者中最大的群体,在青少年的性健康上担当着不可或缺的角色。澳门护士从三个层次推行性教育,一是澳门护士学生在导师带领下开展性教育项目;二是澳门学校护士在学校定期推广性健康,对学生进行性教育;三是护士专业团体除到小区进行有关推广外,还会与政府合作为青少年提供生

  17. Current situation and Suggestions About Overseas Investment of Suzhou enterprises%苏州企业境外投资现状及发展建议

    Institute of Scientific and Technical Information of China (English)

    姚晴霞

    2013-01-01

    Suzhou in attracting foreign investment has made remarkable achievements,but with respect to overseas investment,it is still in the initial stage.Suzhou enterprises’overseas investment has dominant force private enterprises,investment diversification and expanding . The main difficulty faced by overseas investment is not familiar with the investment policy and legal environment ,government support policies unsound,the lack of international management talent and financing difficulties,and finally put forward suggestion.%苏州在吸引国际资本方面取得了令人瞩目的成绩,但苏州的境外投资相对于利用外资来说,还处于起步阶段。苏州企业境外投资呈现民营企业是投资主导力量、境外投资方式多元化和投资规模不断扩大的特点。企业开展境外投资面临的困难和问题是企业对境外投资政策和法律环境的不熟悉、政府境外投资支持政策和服务体系不健全、国际化经营人才缺乏和融资难四个方面,最后针对性地提出促进苏州企业境外投资的建议。

  18. 我国玉米品种权保护现状及建设%Current Situation and Suggestions on the Protection of Maize Variety Rights in China

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    In order to strengthen the protection of maize new variety rightsm ,standardize seed market ,ensure food security ,the protection present situation of maize variety rights in China was discussed ,the existing prob-lems were analysed such as the too long period of the review ,the delay of economic transformation of author-ized varieties ,the seriousness of infringing upon variety rights and the difficulty of safeguarding the variety rights ,the improvement suggestions of maize variety rights in China were put forward .The protection strategy of variety rightsm were proposed ,including building up the system of approv combining between approbation and protection ,standardizing the trading platform of variety rightsm ,strengthen the peralties for infringement , encouraging the cooperation between school and enterprise ,speeding up the pace of achievement transformation%  为了加强玉米新品种权的保护,规范种子市场,确保粮食安全,阐述了我国玉米品种权保护的现状,分析了玉米品种权存在审查周期过长、授权品种经济转化滞后、侵权严重和维权艰难等问题,提出了应建立品种审定和保护相结合的体制、规范的品种权交易平台、加大对侵权的惩处力度、鼓励院企业作加速成果转化步伐等品种权保护策略。

  19. Evolution of an Evidence Collaboration: From Initial Goals to Current Initiatives.

    Science.gov (United States)

    Giambra, Barbara K; Clark, Eloise; Busch, Melida D; Gerhardt, Wendy Engstrom

    2015-01-01

    Best practices based on evidence are needed by every clinician to provide safe, effective, patient-centered care. Determining best practice for a given situation can be difficult. Ideally, the clinician understands how to critically appraise the relevant research, and integrates high-quality research with interdisciplinary clinical expertise and patient and family values and preferences to choose best care for an individual or family. At our organization, we are taking the integration of research, clinical expertise, and patient/family preferences and values to the next level by aligning the evidence work of multiple functional areas and disciplines to improve the safety and effectiveness of clinical practice. The Evidence Collaboration, an interdisciplinary community of practice, has evolved to meet the challenges of helping novices and experts of all disciplines identify, critically appraise, synthesize, and disseminate evidence to inform best practices for patients and families, staff, and institutional processes. By creating a common language for evidence work, resources such as the Let Evidence Guide Every New Decision system, and templates for dissemination, the Evidence Collaboration has moved the organizational culture toward one that encourages the use of evidence in all decisions. Our progress continues as we strive to include patients and families in the decisions about best practices based on evidence.

  20. Weak evidence suggests higher risk for bracket bonding failure with self-etch primer compared to conventional acid etch over 12 months.

    Science.gov (United States)

    Elkhadem, Ahmed; Orabi, Noha

    2013-01-01

    Medline, Embase, Cochrane Oral Health Group's Trials Register and the Cochrane Central Register of Controlled Trials (CENTRAL). Unpublished data were sought by searching ClinicalTrials.gov, the National Research Register and Pro-Quest Dissertation Abstracts and Thesis database. There were no language restrictions. Randomised and controlled clinical trials (including split mouth) directly comparing self-etch and acid-etch primers including patients with full-arch, fixed and bonded orthodontic appliances (not banded) with follow-up periods of at least 12 months were included. Two authors abstracted data independently, with disagreements being resolved by a third. The Cochrane Risk of Bias tool was used to assess study quality. A random effects meta-analysis was undertaken. Eleven studies were included in the qualitative summary with five studies contributing to a meta-analysis. These five studies (n =3444 brackets, 1721 acid-etch, 1723 self-etch) had relatively low statistical and clinical heterogeneity. Meta-analysis demonstrated a tendency for a higher risk of failure (odds ratio 1.35; 95% CI, 0.99-1.83; P 5 0.06) with self-etch primers. The use of self-etch techniques was also associated with a small but statistically significant time saving (weighted mean difference 23.2 seconds per bracket; 95% CI, 20.7-25.8; P \\0.001). There was insufficient evidence to assess the effect of bonding modality on demineralisation rates. There is weak evidence indicating higher odds of failure with self-etch primer than acid-etch over 12 months in orthodontic patients, and there is strong evidence that a self-etch primer is likely to result in modest time savings (eight minutes for full bonding) compared with acid-etch.

  1. School Social Work in the United States: Current Evidence and Future Directions

    Directory of Open Access Journals (Sweden)

    Stone, Susan

    2015-02-01

    Full Text Available This paper surveys the historical and school institutional factors that shape current workforce, programmatic, and practice trends related to school social work in America. A key strand developed throughout is that the field of practice appears to be at a crossroads. It is suggested that this field of practice may be enhanced by placing the central focus on schools as organisations and school-community relations as key targets of intervention.Este artículo examina los factores históricos e institucionales que perfilan al personal docente, las tendencias en las programaciones y las prácticas que se desarrollan en la actualidad en el ámbito del trabajo social en la escuela en los Estados Unidos de América. Un aspecto clave derivado de este examen es que la profesión parece estar en una encrucijada. Se sugiere como alternativa a esta situación, centrar la atención y los objetivos fundamentales de intervención en las escuelas como organizaciones, y en las relaciones que se generan entre las escuelas y la comunidad.

  2. Biologic therapy with or without topical treatment in psoriasis: what does the current evidence say?

    Science.gov (United States)

    Jensen, J Daniel; Delcambre, Macey Renault; Nguyen, Gloria; Sami, Naveed

    2014-10-01

    Biologic therapy represents a relatively new class of drugs which have revolutionized the treatment of psoriasis and are used with increasing frequency in order to control this chronic, systemic inflammatory disease. However, it is unclear what role there is for combination therapy of biologics with traditional topical agents. The purpose of this article is to assess the literature on the role of topical agents as adjuvants to biological treatments in the treatment of psoriasis and identify areas for further research. A MEDLINE search was performed in order to identify English-language publications from 1996 to 2014 examining combination biologic therapy with topical medications in the treatment of psoriasis. Data from these clinical studies are summarized and the outcomes are discussed. In general, the addition of adjuvant topical therapy to systemic biologic therapy allowed for a reduction in dosage and side effects of both agents, maintenance of initial response to biologics, treatment of recalcitrant lesions in partial responders, and potential acceleration of response to biologic therapies. The current data, though limited, suggest that using topical therapies as adjunct treatment to biologics is a well tolerated and effective means of controlling psoriasis and improving quality of life for patients. However, the treating physician should remain attentive to signs of adverse events and seek opportunities to reduce the dose or treatment frequency during chronic use.

  3. Is Parkinson’s Disease Truly a Prion-Like Disorder? An Appraisal of Current Evidence

    Directory of Open Access Journals (Sweden)

    Aneesha Chauhan

    2015-01-01

    Full Text Available Parkinson’s disease (PD is the world’s second most common neurodegenerative disease and most common movement disorder. Characterised by a loss of dopaminergic neurons and the development of intraneuronal inclusions known as Lewy bodies, it has classically been thought of as a cell-autonomous disease. However, in 2008, two groups reported the startling observation of Lewy bodies within embryonic neuronal grafts transplanted into PD patients little more than a decade previously, suggesting that PD pathology can be propagated to neighbouring cells and calling basic assumptions of our understanding of the disease into question. Subsequent research has largely served to confirm this interpretation, pointing towards a prion-like intercellular transfer of misfolded α-synuclein, the main component of Lewy bodies, as central to PD. This shift in thinking offers a revolutionary approach to PD treatment, potentially enabling a transition from purely symptomatic therapy to direct targeting of the pathology that drives disease progression. In this short review, we appraise current experimental support for PD as a prion-like disease, whilst highlighting areas of controversy or inconsistency which must be resolved. We also offer a brief discussion of the therapeutic implications of these discoveries.

  4. Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices.

    Science.gov (United States)

    Neufeld, E J; Solimeno, L; Quon, D; Walsh, C; Seremetis, S; Cooper, D; Iyer, N N; Hoxer, C S; Giangrande, P

    2017-07-27

    While there is substantial literature addressing the principles of general management of haemophilia, literature on perioperative management of haemostasis is scarce. The aim of this study was to better understand perioperative management among congenital haemophilia B patients (without inhibitors) and to gain insights into real-world surgical practices. A systematic literature review, with an emphasis on haemophilia B, was conducted using EMBASE(®) , Medline(®) and the Cochrane Library. Studies from 1974 to June 2015 were accessed, and 132 studies were eligible for the full-study review. An international expert panel with five haematologists and one surgeon reviewed the resulting literature and provided further insights. The literature review revealed that documented experience in the perioperative management of bleeding risk in haemophilia B patients is relatively scarce. Therefore, the review was amended to provide a comprehensive overview of the perioperative management for haemophilia A and B patients; the expert panel applied a particular focus to haemophilia B. Several gaps were identified in the literature including the lack of consensus on defining surgery in terms of bleeding risk, optimal factor levels during surgery and lack of robust evidence on surgical outcomes. The ensuing discussions with the expert panel provided validation of some of the results from the systematic literature review and proposed future directions for perioperative management. Suggestions included collaboration with haemophilia treatment centres (HTCs) to collect real-world data on perioperative management, establishing the need for optimal factor level monitoring practice, and the appropriate adoption of extended half-life products in clinical settings. © 2017 John Wiley & Sons Ltd.

  5. Current scientific evidence for integrated community case management (iCCM in Africa: Findings from the iCCM Evidence Symposium

    Directory of Open Access Journals (Sweden)

    Theresa Diaz

    2014-11-01

    Full Text Available In March 2014, over 400 individuals from 35 countries in sub-Saharan Africa and 59 international partner organizations gathered in Accra, Ghana for an integrated Community Case Management (iCCM Evidence Review Symposium. The objective was 2-fold: first, to review the current state of the art of iCCM implementation and second, to assist African countries to integrate lessons learned and best practices presented during the symposium into their programmes. Based on the findings from the symposium this supplement includes a comprehensive set of articles that provide the latest evidence for improving iCCM programs and ways to better monitor and evaluate such programs

  6. Towards Evidence-Based Initial Teacher Education in Singapore: A Review of Current Literature

    Science.gov (United States)

    Low, Ee-Ling; Hui, Chenri; Taylor, Peter G.; Ng, Pak Tee

    2012-01-01

    Initial teacher education (ITE) in Singapore is shifting towards evidence-based practice. Despite a clear policy orientation, ITE in Singapore has not yet produced the evidence base that it is anticipating. This paper presents an analytical review of previous research into ITE in Singapore and makes comparisons to the larger international context.…

  7. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries

    DEFF Research Database (Denmark)

    Twetman, Svante; Dhar, Vineet

    2015-01-01

    and Evaluation) system. RESULTS: There was moderate and limited quality of evidence in support of fluoride toothpaste and fluoride varnish for ECC prevention, while the evidence for fluoride tablets/drops was insufficient. The support for the use of silver diamine fluoride, xylitol, chlorhexidine varnish...

  8. Current state of evidence-based practice education for undergraduate nursing students in Taiwan: A questionnaire study.

    Science.gov (United States)

    Hung, Hsiao-Ying; Huang, Yu-Fang; Tsai, Jing-Jane; Chang, Ying-Ju

    2015-12-01

    Evidence-based practice (EBP) has been emphasized as the core competency of undergraduate nursing students and must be cultivated before graduation. However, there is limited information of EBP education for undergraduate nursing students in Taiwan. The purpose of this study was to investigate the current state of EBP education for undergraduate nursing students in Taiwan. A self-developed questionnaire, validated by experienced educators, was designed to explore curriculum design, teaching resources, qualification of teachers, and barriers regarding EBP education. A total of 21 nursing schools and colleges participated. The chair of each recommended a faculty member involved in teaching EBP as the school's representative to fill out the questionnaire. Among the 21 nursing schools and colleges, 18 (85.7%) had implemented EBP education in the curriculum. Among these schools, 22.2% conducted an independent EBP course, 50% incorporated EBP concepts into other courses, and the remainder offered both kinds of EBP courses. Multiple strategies were incorporated to teach the EBP. Less than 35% of the schools had designed or adopted standardized teaching materials and evaluated students' learning outcomes. Although 55.6% of the schools reimbursed faculty for participation in EBP training, 39% of their faculty members who taught EBP did not receive any EBP training. Shortage of qualified faculty and limited opportunity to involve students in evidence-based applications were reported as major obstacles to teaching EBP. EBP education has already gained the attention of nursing schools in Taiwan. However, lack of comprehensive EBP training among teachers and the difficulty of teaching clinical application of EBP require special consideration. In order to promote EBP education in undergraduate nursing curriculums, we suggest that nursing schools reinforce and support faculty to participate in formal EBP training. Also needed is a systematic curriculum design with multiple

  9. Observational evidence for remote forcing of the west India coastal current

    Digital Repository Service at National Institute of Oceanography (India)

    Shetye, S.R.; Suresh, I.; Shankar, D.; Sundar, D.; Jayakumar, S.; Mehra, P.; Desai, R.G.P.; Pednekar, P.S.

    remote and local forcing in observations. Using field measurements (current, sea level, and wind) for a month during March-April 2003 off Goa in the near-coast regime of the West India Coastal Current (WICC), we show that the current was driven by local...

  10. Dietary supplementation in patients with alcoholic liver disease:a review on current evidence

    Institute of Scientific and Technical Information of China (English)

    Zeinab Ghorbani; Masoomeh Hajizadeh; Azita Hekmatdoost

    2016-01-01

    BACKGROUND: Alcoholic liver disease (ALD) is one of the main causes of liver disease worldwide. Although the patho-genesis of ALD has not yet been well elucidated, the oxidative metabolites of ethanol such as acetaldehyde and reactive oxy-gen species play a pivotal role in the clinical and pathological spectrum of the disease. This review summarizes the existing evidences on dietary supplements considered to have antioxi-dant, and/or anti-inlfammatory properties, and their role in the management of ALD and the proposed mechanisms. DATA SOURCES: The present study reviewed all studies pub-lished in PubMed, ScienceDirect and Scopus, from 1959 to 2015, indicating the role of different dietary supplementation in attenuation of many pathophysiological processes involved in development and progression of ALD. Full-texts of citations were used except for those that were published in languages other than English. RESULTS: Signiifcant progress has been made to understand the key events and molecular players for the onset and pro-gression of ALD from both experimental and clinical studies;however, there is no successful treatment currently available. The present review discussed the role of a variety of dietary supplements (e.g. vitamin A, carotenoids, vitamins B3, C and E, in addition to antioxidants and anti-inlfammatory agents) in treating ALD. It has been shown that supplementation with some carotenoids, vitamin B3, vitamin C, silymarin, curcumin, probiotics, zinc, S-adenosylmethionine and garlic may have potential beneifcial effects in animal models of ALD; however, the number of clinical studies is very limited. In addition, sup-plementation should be accompanied with alcohol cessation. CONCLUSIONS: Since oxidative stress and inlfammation are involved in the pathogenesis of ALD, dietary supplements that can modulate these pathologies could be useful in the treat-ment of ALD. In addition to alcohol cessation, these supple-ments have shown beneifcial effects on animal

  11. Role of VEGF, Nitric Oxide, and Sympathetic Neurotransmitters in the Pathogenesis of Tendinopathy: A Review of the Current Evidences.

    Science.gov (United States)

    Vasta, Sebastiano; Di Martino, Alberto; Zampogna, Biagio; Torre, Guglielmo; Papalia, Rocco; Denaro, Vincenzo

    2016-01-01

    Chronic tendinopathy is a painful common condition affecting athletes as well as the general population undergoing to tendon overuse. Although its huge prevalence, little is known about tendinopathy pathogenesis, and even cloudier is its treatment. Traditionally, tendinopathy has been defined as a lack of tendon ability to overcome stressing stimuli with appropriate adaptive changes. Histologic studies have demonstrated the absence of inflammatory infiltrates, as a consequence conventional antinflammatory drugs have shown little or no effectiveness in treating tendinopathies. New strategies should be therefore identified to address chronic tendon disorders. Angiofibroblastic changes have been highlighted as the main feature of tendinopathy, and vascular endothelial growth factor (VEGF) has been demonstrated as one of the key molecules involved in vascular hyperplasia. More recently, attention has been focused on new peptides such as Substance P, nitric oxide, and calcitonin gene-related peptide (CGRP). Those new findings support the idea of a nerve-mediated disregulation of tendon metabolism. Each of those molecules could be a target for new treatment options. This study aimed to systematically review the current available clinical and basic science in order to summarize the latest evidences on the pathophysiology and its effect on treatment of chronic tendinopathy, and to spread suggestions for future research on its treatment.

  12. Role of VEGF, Nitric Oxide and sympathetic neurotransmitters in the pathogenesis of tendinopathy: a review of the current evidences

    Directory of Open Access Journals (Sweden)

    Sebastiano Vasta

    2016-08-01

    Full Text Available Chronic tendinopathy is a painful common condition affecting athletes as well as the general population undergoing to tendon overuse. Although its huge prevalence, little is known about tendinopathy pathogenesis, and even cloudier is its treatment.Traditionally, tendinopathy has been defined as a lack of tendon ability to overcome stressing stimuli with appropriate adaptive changes. Histologic studies have demonstrated the absence of inflammatory infiltrates, as a consequence conventional antinflammatory drugs have shown little or no effectiveness in treating tendinopathies. New strategies should be therefore identified to address chronic tendon disorders. Angiofibroblastic changes have been highlighted as the main feature of tendinopathy, and vascular endothelial growth factor (VEGF has been demonstrated as one of the key molecules involved in vascular hyperplasia. More recently, attention has been focused on new peptides such as Substance P, nitric oxide and calcitonin gene-related peptide. Those new findings support the idea of a nerve-mediated disregulation of tendon metabolism. Each of those molecules could be a target for new treatment options. This study aimed to systematically review the current available clinical and basic science in order to summarize the latest evidences on the pathophysiology and its effect on treatment of chronic tendinopathy, and to spread suggestions for future research on its treatment.

  13. Difference of Sodium Currents between Pediatric and Adult Human Atrial Myocytes: Evidence for Developmental Changes of Sodium Channels

    Directory of Open Access Journals (Sweden)

    Benzhi Cai, Xiaoqin Mu, Dongmei Gong, Shulin Jiang, Jianping Li, Qingxin Meng, Yunlong Bai, Yanju Liu, Xinyue Wang, Xueying Tan, Baofeng Yang, Yanjie Lu

    2011-01-01

    Full Text Available Voltage-gated calcium currents and potassium currents were shown to undergo developmental changes in postnatal human and animal cardiomocytes. However, so far, there is no evidence whether sodium currents also presented the developmental changes in postnatal human atrial cells. The aim of this study was to observe age-related changes of sodium currents between pediatric and adult atrial myocytes. Human atrial myocytes were acutely isolated and the whole-cell patch clamp technique was used to record sodium currents isolated from pediatric and adult atrial cardiomocytes. The peak amplitude of sodium currents recorded in adult atrial cells was significantly larger than that in pediatric atrial myocytes. However, there was no significant difference of the activation voltage for peak sodium currents between two kinds of atrial myocytes. The time constants for the activation and inactivation of sodium currents were smaller in adult atria than pediatric atria. The further study revealed that the voltage-dependent inactivation of sodium currents were more slow in adult atrial cardiomyocytes than pediatric atrial cells. A significant difference was also observed in the recovery process of sodium channel from inactivation. In summary, a few significant differences were demonstrated in sodium currents characteristics between pediatric and adult atrial myocytes, which indicates that sodium currents in human atria also undergo developmental changes.

  14. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  15. How current are leading evidence-based medical textbooks? An analytic survey of four online textbooks.

    Science.gov (United States)

    Jeffery, Rebecca; Navarro, Tamara; Lokker, Cynthia; Haynes, R Brian; Wilczynski, Nancy L; Farjou, George

    2012-12-10

    The consistency of treatment recommendations of evidence-based medical textbooks with more recently published evidence has not been investigated to date. Inconsistencies could affect the quality of medical care. To determine the frequency with which topics in leading online evidence-based medical textbooks report treatment recommendations consistent with more recently published research evidence. Summarized treatment recommendations in 200 clinical topics (ie, disease states) covered in four evidence-based textbooks--UpToDate, Physicians' Information Education Resource (PIER), DynaMed, and Best Practice--were compared with articles identified in an evidence rating service (McMaster Premium Literature Service, PLUS) since the date of the most recent topic updates in each textbook. Textbook treatment recommendations were compared with article results to determine if the articles provided different, new conclusions. From these findings, the proportion of topics which potentially require updating in each textbook was calculated. 478 clinical topics were assessed for inclusion to find 200 topics that were addressed by all four textbooks. The proportion of topics for which there was 1 or more recently published articles found in PLUS with evidence that differed from the textbooks' treatment recommendations was 23% (95% CI 17-29%) for DynaMed, 52% (95% CI 45-59%) for UpToDate, 55% (95% CI 48-61%) for PIER, and 60% (95% CI 53-66%) for Best Practice (χ(2) (3)=65.3, P<.001). The time since the last update for each textbook averaged from 170 days (range 131-209) for DynaMed, to 488 days (range 423-554) for PIER (P<.001 across all textbooks). In online evidence-based textbooks, the proportion of topics with potentially outdated treatment recommendations varies substantially.

  16. Evidence-based practice in Occupational Health Psychology. Current status and further developments

    Directory of Open Access Journals (Sweden)

    Maricutoiu, Laurentiu P.

    2012-04-01

    Full Text Available The present paper discusses the status of evidence-based practice in Occupational Health Psychology (OHP. After several searches on large online databases, we have found that OHP papers that discuss interventions are less than 10% of the overall literature. Furthermore, quantitative reviews research that reports interventions on major OHP topics are generally absent. In the last part of the paper, we formulate some reccomendations for increasing the number of papers relevant for evidence-based practice in OHP.

  17. Anomalous low-frequency noise in synthetic antiferromagnets: possible evidence of current-induced domain-wall motion

    NARCIS (Netherlands)

    Herranz, D.; Guerrero, R.; Villar, R.; Aliev, F.G.; Swaving, A.C.; Duine, R.A.; Van Haesendonck, C.; Vavra, I.

    2009-01-01

    We investigate current-driven magnetization dynamics in synthetic [Fe/Cr]10 multilayer antiferromagnets by using low-frequency voltage noise measurements. We observe suppression of the noise above a critical current density of about 2×105 A/cm2. Theoretical estimates suggest that this effect may be

  18. Low-Level Evidence Suggests that Perceived Ability to Evaluate and Trust Online Health Information is Associated with Low Health Literacy

    Directory of Open Access Journals (Sweden)

    Lindsay Alcock

    2016-04-01

    Full Text Available Objective – To review, based on research evidence, the correlation between low health literacy and four outcomes of interest: (1 the ability to evaluate online health information based on (2 perceived reliability and accuracy, (3 trust in the Internet as an information source, and (4 the application of established evaluation criteria. Design – Systematic review and narrative synthesis. Setting –MEDLINE, PsycInfo, Web of Science, CINAHL, and Communication and Mass-media Complete as well as articles discovered through the snowball method. Subjects – 38 studies identified through a systematic literature search. Methods – An exhaustive list of potential articles was gathered through searching five online databases and Google Scholar, and hand searching of references. Inclusion and exclusion criteria were applied in a two-phase screening process in which two researchers participated to address reliability. Data, including study characteristics and metadata, predictors, assessment methods, and outcomes, were extracted from relevant studies, and then synthesized narratively. Main Results – Following duplication removal 13,632 records were retrieved, 254 of which were identified for full-text assessment. Thirty-eight studies met the eligibility criteria. All studies were non-experimental and therefore graded as a low level of evidence; 35 were cross-sectional designs, 1 a focus group, and 2 were observational studies. Studies varied widely in population definition and sample size and were published between 2001 and 2013, primarily in North America. Overall, a positive association was identified between health literacy and outcomes related to the ability to evaluate or trust Internet health information, while findings were inconsistent related to perceived quality of information and the application of evaluative criteria. Four studies examined the impact of health literacy levels on one or more of the outcomes of interest. The most prevalent

  19. A Novel Wide-Area Backup Protection Based on Fault Component Current Distribution and Improved Evidence Theory

    Directory of Open Access Journals (Sweden)

    Zhe Zhang

    2014-01-01

    Full Text Available In order to solve the problems of the existing wide-area backup protection (WABP algorithms, the paper proposes a novel WABP algorithm based on the distribution characteristics of fault component current and improved Dempster/Shafer (D-S evidence theory. When a fault occurs, slave substations transmit to master station the amplitudes of fault component currents of transmission lines which are the closest to fault element. Then master substation identifies suspicious faulty lines according to the distribution characteristics of fault component current. After that, the master substation will identify the actual faulty line with improved D-S evidence theory based on the action states of traditional protections and direction components of these suspicious faulty lines. The simulation examples based on IEEE 10-generator-39-bus system show that the proposed WABP algorithm has an excellent performance. The algorithm has low requirement of sampling synchronization, small wide-area communication flow, and high fault tolerance.

  20. Managing caries: the need to close the gap between the evidence base and current practice.

    Science.gov (United States)

    Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

    2015-11-13

    Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

  1. Interaction of pyroclastic density currents with human settlements: Evidence from ancient Pompeii

    Science.gov (United States)

    Gurioli, Lucia; Pareschi, M. Teresa; Zanella, Elena; Lanza, Roberto; Deluca, Enrico; Bisson, Marina

    2005-06-01

    Integrating field observations and rock-magnetic measurements, we report how a turbulent pyroclastic density current interacted with and moved through an urban area. The data are from the most energetic, turbulent pyroclastic density current of the A.D. 79 eruption of Vesuvius, Italy, which partially destroyed the Roman city of Pompeii. Our results show that the urban fabric was able to divide the lower portion of the current into several streams that followed the city walls and the intracity roads. Vortices, revealed by upstream particle orientations and decreases in deposit temperature, formed downflow of obstacles or inside cavities. Although these perturbations affected only the lower part of the current and were localized, they could represent, in certain cases, cooler zones within which chances of human survival are increased. Our integrated field data for pyroclastic density current temperature and flow direction, collected for the first time across an urban environment, enable verification of coupled thermodynamic numerical models and their hazard simulation abilities.

  2. Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.

    Science.gov (United States)

    Gerdesmeyer, Ludger; Mittermayr, Rainer; Fuerst, Martin; Al Muderis, Munjed; Thiele, Richard; Saxena, Amol; Gollwitzer, Hans

    2015-12-01

    Chronic Achilles tendinopathy has been described as the most common overuse injury in sports medicine. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. After failed conservative therapy, invasive treatment may be considered. Extracorporeal shock wave therapy (ESWT) has been successfully used in soft-tissue pathologies like lateral epicondylitis, plantar fasciitis, tendinopathy of the shoulder and also in bone and skin disorders. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is still lacking. In plantar fasciitis as well as in calcific shoulder tendinopathy shock wave therapy is recently the best evaluated treatment option. This article analysis the evidence based literature of ESWT in chronic Achilles tendinopathy. Recently published data have shown the efficacy of focused and radial extracorporeal shock wave therapy. Copyright © 2015 IJS Publishing Group Limited. All rights reserved.

  3. CURRENT EVIDENCE REGARDING THE EFFICACY OF PROPHYLACTIC ANTIBIOTICS IN THE MANAGEMENT OF FACIAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Anilkumar

    2016-03-01

    Full Text Available Fractures of the facial region are commonly treated by surgeons operating in the head and neck. Antibiotic prophylaxis is used by these surgeons to decrease the rate of infections, however the role of prophylactic antibiotics remains controversial. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery and third molar surgeries. Unfortunately there is little evidence regarding the efficacy of prophylactic antibiotics in the management of facial fractures. In numerous cases no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. The aim of this paper is to present the available evidence regarding the efficacy of prophylactic antibiotics in the management of facial fractures.

  4. Evidence of at least two evolutionary lineages in Melipona subnitida (Apidae, Meliponini) suggested by mtDNA variability and geometric morphometrics of forewings

    Science.gov (United States)

    Bonatti, Vanessa; Simões, Zilá Luz Paulino; Franco, Fernando Faria; Francoy, Tiago Mauricio

    2014-01-01

    Melipona subnitida, a tropical stingless bee, is an endemic species of the Brazilian northeast and exhibits great potential for honey and pollen production in addition to its role as one of the main pollinators of the Caatinga biome. To understand the genetic structure and better assist in the conservation of this species, we characterized the population variability of M. subnitida using geometric morphometrics of the forewing and cytochrome c oxidase I gene fragment sequencing. We collected workers from six localities in the northernmost distribution. Both methodologies indicated that the variability among the sampled populations is related both to the environment in which samples were collected and the geographical distance between the sampling sites, indicating that differentiation among the populations is due to the existence of at least evolutionary lineages. Molecular clock data suggest that this differentiation may have begun in the middle Pleistocene, approximately 396 kya. The conservation of all evolutionary lineages is important since they can present differential resistance to environmental changes, as resistance to drought and diseases.

  5. Suggestive evidence of a multi-cytokine resistin pathway in humans and its role on cardiovascular events in high-risk individuals

    Science.gov (United States)

    Menzaghi, Claudia; Marucci, Antonella; Antonucci, Alessandra; De Bonis, Concetta; Ortega Moreno, Lorena; Salvemini, Lucia; Copetti, Massimiliano; Trischitta, Vincenzo; Di Paola, Rosa

    2017-01-01

    In cells and tissues resistin affects IL-1β, IL-6, IL-8, IL-12 and TNF-α expression, thus suggesting the existence of a multi-cytokine “resistin pathway”. We investigated whether such pathway does exist in humans and, if so, if it is associated with cardiovascular risk factors and with major adverse cardiovascular events (MACE). Serum cytokines were measured in 280 healthy subjects from the Gargano Study 2 (GS2) whose BMI, waist circumference, HOMAIR, triglycerides, HDL-cholesterol, systolic and diastolic blood pressure data were available and in 353 patients with type 2 diabetes and coronary artery disease from the Gargano Heart Study (GHS)-prospective design (follow-up 5.4 ± 2.5 years; 71 MACE). In GS2, cytokines mRNA levels in white blood cells were also measured. In GS2, resistin mRNA was correlated with all cytokines expression (all p eRPS) and serum (sRPS) resistin pathway scores (excluding IL-12) were each other correlated (p < 0.001) and both associated with cardiovascular risk factors (all p < 0.01). In GHS, sRPS was independently associated with MACE (HR = 1.44, 95% CI = 1.10–1.90). Our data indicate the existence of a resistin pathway, which is associated with cardiovascular risk factors and which strongly and independently predicts MACE. PMID:28290549

  6. Is Current Account of Turkey Sustainable ? Evidence from Nonlinear Unit Root Tests

    Directory of Open Access Journals (Sweden)

    Serkan Taştan

    2015-09-01

    Full Text Available In this paper, current account sustainability of Turkey is analyzed in a nonlinear framework. Various nonlinear unit root tests have been used to test for structural break, sign and size nonlinearity. We have tested structural break and size nonlinearity separately and structural break-sign and size-sign nonlinearities simultaneously. Only considering the size nonlinearity, we have found that the current account of Turkey is sustainable. Thus, the size nonlinearity, in other words the speed of reversion to equilibrium, is essential for the current account sustainability of Turkey. We have also found that the speed of adjustment towards equilibrium is symmetric, while considering size and sign nonlinearities simultaneously.

  7. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  8. Type 2 Endoleaks Post-EVAR: Current Evidence for Rupture Risk, Intervention and Outcomes of Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Raymond, E-mail: rchung@doctors.org.uk; Morgan, Robert A., E-mail: Robert.Morgan@stgeorges.nhs.uk [St. George’s Healthcare NHS Trust, Radiology, Ground Floor, St. James Wing (United Kingdom)

    2015-06-15

    Type 2 endoleaks (EL2) are the most commonly encountered endoleaks following EVAR. Despite two decades of experience, there remains considerable variation in the management of EL2 with controversies ranging from if to treat, when to treat and how to treat. Here, we summarise the available evidence, describe the treatment techniques available and offer guidelines for management.

  9. Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

    Science.gov (United States)

    Gowers, Simon; Bryant-Waugh, Rachel

    2004-01-01

    Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

  10. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries

    DEFF Research Database (Denmark)

    Twetman, Svante; Dhar, Vineet

    2015-01-01

    PURPOSE: The purpose of this paper was to systematically review the quality of evidence related to self-applied and professionally applied fluorides, antimicrobial agents, fissure sealants, temporary restorations, and restorative care for the prevention and management of early childhood caries (E...

  11. A review of current evidence for the causal impact of attentional bias on fear and anxiety

    NARCIS (Netherlands)

    van Bockstaele, B.; Verschuere, B.; Tibboel, H.; de Houwer, J.; Crombez, G.; Koster, E.H.W.

    2014-01-01

    Prominent cognitive theories postulate that an attentional bias toward threatening information contributes to the etiology, maintenance, or exacerbation of fear and anxiety. In this review, we investigate to what extent these causal claims are supported by sound empirical evidence. Although differen

  12. Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

    Science.gov (United States)

    Gowers, Simon; Bryant-Waugh, Rachel

    2004-01-01

    Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

  13. Evidence Suggesting That Francisella tularensis O-Antigen Capsule Contains a Lipid A-Like Molecule That Is Structurally Distinct from the More Abundant Free Lipid A.

    Directory of Open Access Journals (Sweden)

    Jason H Barker

    Full Text Available Francisella tularensis, the Gram-negative bacterium that causes tularemia, produces a high molecular weight capsule that is immunologically distinct from Francisella lipopolysaccharide but contains the same O-antigen tetrasaccharide. To pursue the possibility that the capsule of Francisella live vaccine strain (LVS has a structurally unique lipid anchor, we have metabolically labeled Francisella with [14C]acetate to facilitate highly sensitive compositional analysis of capsule-associated lipids. Capsule was purified by two independent methods and yielded similar results. Autoradiographic and immunologic analysis confirmed that this purified material was largely devoid of low molecular weight LPS and of the copious amounts of free lipid A that the Francisellae accumulate. Chemical hydrolysis yielded [14C]-labeled free fatty acids characteristic of Francisella lipid A but with a different molar ratio of 3-OH C18:0 to 3-OH C16:0 and different composition of non-hydroxylated fatty acids (mainly C14:0 rather than C16:0 than that of free Francisella lipid A. Mild acid hydrolysis to induce selective cleavage of KDO-lipid A linkage yielded a [14C]-labeled product that partitioned during Bligh/Dyer extraction and migrated during thin-layer chromatography like lipid A. These findings suggest that the O-antigen capsule of Francisella contains a covalently linked and structurally distinct lipid A species. The presence of a discrete lipid A-like molecule associated with capsule raises the possibility that Francisella selectively exploits lipid A structural heterogeneity to regulate synthesis, transport, and stable bacterial surface association of the O-antigen capsular layer.

  14. Reproducibility of current classifications of endometrial endometrioid glandular proliferations : further evidence supporting a simplified classification

    NARCIS (Netherlands)

    Ordi, Jaume; Bergeron, Christine; Hardisson, David; McCluggage, W. Glenn; Hollema, Harry; Felix, Ana; Soslow, Robert A.; Oliva, Esther; Tavassoli, Fattaneh A.; Alvarado-Cabrero, Isabel; Wells, Michael; Nogales, Francisco F.

    2014-01-01

    AimsTo compare the reproducibility of the current (2003) World Health Organization (WHO), endometrial intraepithelial neoplasia (EIN) and European Working Group (EWG) classifications of endometrial endometrioid proliferations. Methods and resultsNine expert gynaecological pathologists from Europe an

  15. Evidence suggesting phosphodiesterase-3B regulation of NPY/AgRP gene expression in mHypoE-46 hypothalamic neurons.

    Science.gov (United States)

    Anamthathmakula, Prashanth; Sahu, Maitrayee; Sahu, Abhiram

    2015-09-14

    Hypothalamic neurons expressing neuropeptide Y (NPY) and agouti related-protein (AgRP) are critical regulators of feeding behavior and body weight, and transduce the action of many peripheral signals including leptin and insulin. However, intracellular signaling molecules involved in regulating NPY/AgRP neuronal activity are incompletely understood. Since phosphodiesterase-3B (PDE3B) mediates the hypothalamic action of leptin and insulin on feeding, and is expressed in NPY/AgRP neurons, PDE3B could play a significant role in regulating NPY/AgRP neuronal activity. To investigate the direct regulation of NPY/AgRP neuronal activity by PDE3B, we examined the effects of gain-of-function or reduced function of PDE3B on NPY/AgRP gene expression in a clonal hypothalamic neuronal cell line, mHypoE-46, which endogenously express NPY, AgRP and PDE3B. Overexpression of PDE3B in mHypoE-46 cells with transfection of pcDNA-3.1-PDE3B expression plasmid significantly decreased NPY and AgRP mRNA levels and p-CREB levels as compared to the control plasmid. For the PDE3B knockdown study, mHypoE-46 cells transfected with lentiviral PDE3BshRNAmir plasmid or non-silencing lentiviral shRNAmir control plasmid were selected with puromycin, and stably transfected cells were grown in culture for 48h. Results showed that PDE3BshRNAmir mediated knockdown of PDE3B mRNA and protein levels (∼60-70%) caused an increase in both NPY and AgRP gene expression and in p-CREB levels. Together, these results demonstrate a reciprocal change in NPY and AgRP gene expression following overexpression and knockdown of PDE3B, and suggest a significant role for PDE3B in the regulation of NPY/AgRP gene expression in mHypoE-46 hypothalamic neurons.

  16. Lack of genomic evidence of AI-2 receptors suggests a non-quorum sensing role for luxS in most bacteria

    Directory of Open Access Journals (Sweden)

    Duffy Brion

    2008-09-01

    Full Text Available Abstract Background Great excitement accompanied discoveries over the last decade in several Gram-negative and Gram-positive bacteria of the LuxS protein, which catalyzes production of the AI-2 autoinducer molecule for a second quorum sensing system (QS-2. Since the luxS gene was found to be widespread among the most diverse bacterial taxa, it was hypothesized that AI-2 may constitute the basis of a universal microbial language, a kind of bacterial Esperanto. Many of the studies published in this field have drawn a direct correlation between the occurrence of the luxS gene in a given organism and the presence and functionality of a QS-2 therein. However, rarely hathe existence of potential AI-2 receptors been examined. This is important, since it is now well recognized that LuxS also holds a central role as a metabolic enzyme in the activated methyl cycle which is responsible for the generation of S-adenosyl-L-methionine, the major methyl donor in the cell. Results In order to assess whether the role of LuxS in these bacteria is indeed related to AI-2 mediated quorum sensing we analyzed genomic databases searching for established AI-2 receptors (i.e., LuxPQ-receptor of Vibrio harveyi and Lsr ABC-transporter of Salmonella typhimurium and other presumed QS-related proteins and compared the outcome with published results about the role of QS-2 in these organisms. An unequivocal AI-2 related behavior was restricted primarily to organisms bearing known AI-2 receptor genes, while phenotypes of luxS mutant bacteria lacking these genes could often be explained simply by assuming deficiencies in sulfur metabolism. Conclusion Genomic analysis shows that while LuxPQ is restricted to Vibrionales, the Lsr-receptor complex is mainly present in pathogenic bacteria associated with endotherms. This suggests that QS-2 may play an important role in interactions with animal hosts. In most other species, however, the role of LuxS appears to be limited to metabolism

  17. Web 2.0 for health promotion: reviewing the current evidence.

    Science.gov (United States)

    Chou, Wen-ying Sylvia; Prestin, Abby; Lyons, Claire; Wen, Kuang-yi

    2013-01-01

    As Web 2.0 and social media make the communication landscape increasingly participatory, empirical evidence is needed regarding their impact on and utility for health promotion. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched 4 medical and social science databases for literature (2004-present) on the intersection of Web 2.0 and health. A total of 514 unique publications matched our criteria. We classified references as commentaries and reviews (n = 267), descriptive studies (n = 213), and pilot intervention studies (n = 34). The scarcity of empirical evidence points to the need for more interventions with participatory and user-generated features. Innovative study designs and measurement methods are needed to understand the communication landscape and to critically assess intervention effectiveness. To address health disparities, interventions must consider accessibility for vulnerable populations.

  18. Current evidence supporting fertility and pregnancy among young survivors of breast cancer.

    Science.gov (United States)

    Meneses, Karen; Holland, Aimee Chism

    2014-01-01

    Approximately 6% of invasive breast cancer is diagnosed in women younger than age 40 of age childbearing potential. Cancer-directed therapies can cause hormonal and anatomical changes that negatively affect the reproductive potential of young survivors of breast cancer. Recent national guidelines on fertility preservation are widely available. However, gaps in care exist in the interdisciplinary evidence-based management of young survivors of breast cancer with fertility and parenting concerns after cancer treatment.

  19. B-vitamins and bone in health and disease: the current evidence.

    Science.gov (United States)

    Clarke, M; Ward, M; Strain, J J; Hoey, L; Dickey, W; McNulty, H

    2014-05-01

    Osteoporosis, a metabolic skeletal disease characterised by decreased bone mass and increased fracture risk, is a growing public health problem. Among the various risk factors for osteoporosis, calcium and vitamin D have well-established protective roles, but it is likely that other nutritional factors are also implicated. This review will explore the emerging evidence supporting a role for certain B-vitamins, homocysteine and the 677 C → T polymorphism in the gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase, in bone health and disease. The evidence, however, is not entirely consistent and as yet no clear mechanism has been defined to explain the potential link between B-vitamins and bone health. Coeliac disease, a common condition of malabsorption, induced by gluten ingestion in genetically susceptible individuals, is associated with an increased risk both of osteoporosis and inadequate B-vitamin status. Given the growing body of evidence linking low bone mineral density and/or increased fracture risk with low B-vitamin status and elevated homocysteine, optimal B-vitamin status may play an important protective role against osteoporosis in coeliac disease; to date, no trial has addressed this possible link.

  20. Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

    Directory of Open Access Journals (Sweden)

    Kilian Kreutzer

    2014-01-01

    Full Text Available Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.

  1. How to prevent burnout in cardiologists? A review of the current evidence, gaps, and future directions.

    Science.gov (United States)

    Panagioti, Maria; Geraghty, Keith; Johnson, Judith

    2017-07-04

    Burnout is rising in all physicians, and cardiologists are not an exemption. Cardiology is a very popular specialty among medical students as it is associated with outstanding training standards and high prestige and income. In this review, we critically summarize the evidence on consequences, causes, and evidence-based interventions for burnout with a view toward recommending the best strategies for promoting wellness in cardiologists. Only a handful of studies have examined burnout specifically in cardiologists. Evidence therefore was mainly extrapolated by larger studies in all physicians and other physician specialties. Burnout in cardiologists has serious negative personal and professional consequences and is associated with suboptimal healthcare outcomes for patients. Burnout in cardiologists is primarily driven by professional and healthcare system demands and inefficiencies such as excessive workload and role complexity, training and certification demands, inefficient compensation models and lack of resources, computerization, and loss of autonomy. Moreover, loss of connectedness with patients, difficulties in balancing work and personal life and overvaluing compulsiveness and perfectionism in medical practice further increase the risk for burnout. Burnout among cardiologists may be best mitigated by organizational strategies complemented by individual stress reduction and reflection techniques under the resilience-based approach. Large-scale strategies are needed to mitigate burnout and promote physician wellness as a shared responsibility of healthcare systems and individuals and be committed in creating a new culture in medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Evidence for neutral-current diffractive neutral pion production from hydrogen in neutrino interactions on hydrocarbon

    CERN Document Server

    Wolcott, J; Altinok, O; Bercellie, A; Betancourt, M; Bodek, A; Bravar, A; Budd, H; Cai, T; Carneiro, M F; Chvojka, J; Devan, J; Dytman, S A; Diaz, G A; Eberly, B; Endress, E; Felix, J; Fields, L; Galindo, R; Gallagher, H; Golan, T; Gran, R; Harris, D A; Higuera, A; Hurtado, K; Kiveni, M; Kleykamp, J; Kordosky, M; Le, T; Maher, E; Manly, S; Mann, W A; Marshall, C M; Caicedo, D A Martinez; McFarland, K S; McGivern, C L; McGowan, A M; Messerly, B; Miller, J; Mislivec, A; Morfin, J G; Mousseau, J; Naples, D; Nelson, J K; Norrick, A; Nuruzzaman,; Paolone, V; Park, J; Patrick, C E; Perdue, G N; Rakotondravohitra, L; Ramirez, M A; Ray, H; Ren, L; Rimal, D; Rodrigues, P A; Ruterbories, D; Schellman, H; Schmitz, D W; Salinas, C J Solano; Sanchez, S F; Tagg, N; Tice, B G; Valencia, E; Walton, T; Wospakrik, M; Zhang, D

    2016-01-01

    The MINERvA experiment observes an excess of events containing electromagnetic showers relative to the expectation from Monte Carlo simulations in neutral-current neutrino interactions with mean beam energy of 4.5 GeV on a hydrocarbon target. The excess is characterized and found to be consistent with neutral-current neutral pion production with a broad energy distribution peaking at 7 GeV and a total cross section of 0.26 +- 0.02 (stat) +- 0.08 (sys) x 10^{-39} cm^{2}. The angular distribution, electromagnetic shower energy, and spatial distribution of the energy depositions of the excess are consistent with expectations from neutrino neutral-current diffractive neutral pion production from hydrogen in the hydrocarbon target. These data comprise the first direct experimental observation and constraint for a reaction that poses an important background process in neutrino oscillation experiments searching for muon neutrino to electron neutrino oscillations.

  3. The promise of ketamine for treatment-resistant depression: current evidence and future directions

    Science.gov (United States)

    DeWilde, Kaitlin E.; Levitch, Cara F.; Murrough, James W.; Mathew, Sanjay J.; Iosifescu, Dan V.

    2014-01-01

    Major depressive disorder (MDD) is one of the most disabling diseases worldwide and is a significant public health threat. Current treatments for MDD primarily consist of monoamine-targeting agents and have limited efficacy. However, the glutamate neurotransmitter system has recently come into focus as a promising alternative for novel antidepressant treatments. We review the current data on the glutamate NMDA receptor antagonist ketamine, which has been shown in clinical trials to act as a rapid antidepressant in MDD. We also examine ketamine efficacy on dimensions of psychopathology, including anhedonia, cognition, and suicidality, consistent with the NIMH Research Domain Criteria (RDoC) initiative. Other aspects of ketamine reviewed in this paper include safety and efficacy, different administration methods, and the risks of misuse of ketamine outside of medical settings. Finally, we conclude with a discussion of other glutamatergic agents other than ketamine currently being tested as novel antidepressants. PMID:25649308

  4. Rip current evidence by hydrodynamic simulations, bathymetric surveys and UAV observation

    Science.gov (United States)

    Benassai, Guido; Aucelli, Pietro; Budillon, Giorgio; De Stefano, Massimo; Di Luccio, Diana; Di Paola, Gianluigi; Montella, Raffaele; Mucerino, Luigi; Sica, Mario; Pennetta, Micla

    2017-09-01

    The prediction of the formation, spacing and location of rip currents is a scientific challenge that can be achieved by means of different complementary methods. In this paper the analysis of numerical and experimental data, including RPAS (remotely piloted aircraft systems) observations, allowed us to detect the presence of rip currents and rip channels at the mouth of Sele River, in the Gulf of Salerno, southern Italy. The dataset used to analyze these phenomena consisted of two different bathymetric surveys, a detailed sediment analysis and a set of high-resolution wave numerical simulations, completed with Google EarthTM images and RPAS observations. The grain size trend analysis and the numerical simulations allowed us to identify the rip current occurrence, forced by topographically constrained channels incised on the seabed, which were compared with observations.

  5. Conventional and/or laparoscopic rectal cancer surgery: what is the current evidence?

    Directory of Open Access Journals (Sweden)

    Mik Michal

    2016-09-01

    Full Text Available Despite many years of experience with laparoscopic procedures in rectal cancer, the superiority of minimally invasive approaches has been questioned especially in recent years. This article is a short review of the current knowledge about laparoscopic approaches in comparison to conventional modalities in patients with rectal cancer. To present the current state of the knowledge, we focused on reports that were published in the last few years and compared them to multicenter trials and meta-analyses published last year. Our analysis mainly applied to the primary end-points of these trials. We also included expert opinions that have been published in the last several months.

  6. Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

    NARCIS (Netherlands)

    Schirmer, Stephan H.; Baumhaekel, Magnus; Neuberger, Hans-Ruprecht; Hohnloser, Stefan H.; van Gelder, Isabelle C.; Lip, Gregory Y. H.; Boehm, Michael

    2010-01-01

    Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need

  7. Evidence for two separate heliospheric current sheets of cylindrical shape during MID-2012

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y.-M. [Space Science Division, Naval Research Laboratory, Washington, DC 20375 (United States); Young, P. R. [College of Science, George Mason University, Fairfax, VA 22030 (United States); Muglach, K., E-mail: yi.wang@nrl.navy.mil, E-mail: pyoung@ssd5.nrl.navy.mil, E-mail: karin.muglach@nasa.gov [Code 674, NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States)

    2014-01-01

    During the reversal of the Sun's polar fields at sunspot maximum, outward extrapolations of magnetograph measurements often predict the presence of two or more current sheets extending into the interplanetary medium, instead of the single heliospheric current sheet (HCS) that forms the basis of the standard 'ballerina skirt' picture. By comparing potential-field source-surface models of the coronal streamer belt with white-light coronagraph observations, we deduce that the HCS was split into two distinct structures with circular cross sections during mid-2012. These cylindrical current sheets were centered near the heliographic equator and separated in longitude by roughly 180°; a corresponding four-sector polarity pattern was observed at Earth. Each cylinder enclosed a negative-polarity coronal hole that was identifiable in extreme ultraviolet images and gave rise to a high-speed stream. The two current sheet systems are shown to be a result of the dominance of the Sun's nonaxisymmetric quadrupole component, as the axial dipole field was undergoing its reversal during solar cycle 24.

  8. Evidence for Two Separate Heliospheric Current Sheets of Cylindrical Shape During Mid-2012

    Science.gov (United States)

    Wang, Y.-M.; Young, P. R.; Muglach, K.

    2014-01-01

    During the reversal of the Sun's polar fields at sunspot maximum, outward extrapolations of magnetograph measurements often predict the presence of two or more current sheets extending into the interplanetary medium, instead of the single heliospheric current sheet (HCS) that forms the basis of the standard "ballerina skirt" picture. By comparing potential-field source-surface models of the coronal streamer belt with white-light coronagraph observations, we deduce that the HCS was split into two distinct structures with circular cross sections during mid-2012. These cylindrical current sheets were centered near the heliographic equator and separated in longitude by roughly 180° a corresponding four-sector polarity pattern was observed at Earth. Each cylinder enclosed a negative-polarity coronal hole that was identifiable in extreme ultraviolet images and gave rise to a high-speed stream. The two current sheet systems are shown to be a result of the dominance of the Sun's nonaxisymmetric quadrupole component, as the axial dipole field was undergoing its reversal during solar cycle 24.

  9. Is C-50 a superaromat? Evidence from electronic structure and ring current calculations

    NARCIS (Netherlands)

    Matias, Ana Sanz; Havenith, Remco W. A.; Alcami, Manuel; Ceulemans, Arnout

    2016-01-01

    The fullerene-50 is a 'magic number' cage according to the 2(N + 1)(2) rule. For the three lowest isomers of C-50 with trigonal and pentagonal symmetries, we calculate the sphericity index, the spherical parentage of the occupied p-orbitals, and the current density in an applied magnetic field. The

  10. Dietary prevention of allergic disease in children : Are current recommendations really based on good evidence?

    NARCIS (Netherlands)

    Brand, Paul L. P.; Vlieg-Boerstra, Berber J.; Dubois, Anthony E. J. .

    2007-01-01

    We provide a critical appraisal of the literature on the effects of dietary prevention of atopic disease in children. In our view, currently available studies suffer from lack of blinding which is a major problem if the primary end point is subjective (Such as the diagnosis of eczema). In addition,

  11. Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

    NARCIS (Netherlands)

    Schirmer, Stephan H.; Baumhaekel, Magnus; Neuberger, Hans-Ruprecht; Hohnloser, Stefan H.; van Gelder, Isabelle C.; Lip, Gregory Y. H.; Boehm, Michael

    2010-01-01

    Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need

  12. Mindfulness-Based Cognitive Therapy: Further Issues in Current Evidence and Future Research

    Science.gov (United States)

    Williams, J. Mark G.; Russell, Ian; Russell, Daphne

    2008-01-01

    The authors respond to the article by H. F. Coelho, P. H. Canter, and E. Ernst (2007), which reviewed the current status of mindfulness-based cognitive therapy (MBCT). First, they clarify the randomization procedures in the 2 main MBCT trials. Second, they report posttreatment and follow-up data to show that trial participants allocated to…

  13. Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence

    OpenAIRE

    Nafiseh Shokri Mashhadi; Reza Ghiasvand; Gholamreza Askari; Mitra Hariri; Leila Darvishi; Mohammad Reza Mofid

    2013-01-01

    Background: Ginger (Zingiber officinale Rosc.) belongs to the family Zingiberaceae. The health-promoting perspective of ginger is attributed to its rich phytochemistry. This study aimed to review the current evidence on ginger effects as an anti-inflammatory and anti-oxidative. Methods: We searched MEDLINE for related publications using “ginger” and “anti-oxidative” and “ginger” and “anti-inflammatory” as keywords. This search had considered Papers that had been published between 2000 and 201...

  14. Current evidence on whether perinatal risk factors influence coeliac disease is circumstantial.

    Science.gov (United States)

    Mårild, Karl; Ludvigsson, Jonas F; Størdal, Ketil

    2016-04-01

    Coeliac disease is triggered by an interplay of environmental and genetic factors and is one of the most prevalent autoimmune diseases in children, occurring in about 1% of Europeans. Over the last few decades, there has been a growing interest in the role of the perinatal environment in coeliac disease and this review discusses the growing body of literature on coeliac disease and perinatal risk factors. There is still only circumstantial evidence that the perinatal environment influences coeliac disease development. Large-scale cohort studies and emerging scientific concepts, such as epigenetics, may help us establish the role of these environmental factors. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Regional heterogeneity in consumption due to current income shocks: New evidence from the Permanent Income Hypothesis

    DEFF Research Database (Denmark)

    Mitze, Timo

    In the light of new theoretical and empirical work on the Permanent Income Hypothesis we tackle earlier findings for German data, which reject its validity given a large fraction of liquidity constrained consumers. Starting from a standard short run approach we do not find evidence for excess...... borrow from the literature on Poolability tests and search for macro regional clusters with similar adjustment paths. The findings show that for the sample of West German states between 1970 and 2006 both for short and long run parameters the assumption of poolability of the data cannot be rejected...

  16. Current Evidence on the Socket-Shield Technique: A Systematic Review.

    Science.gov (United States)

    Gharpure, Amit Srikant; Bhatavadekar, Neel B

    2016-11-29

    The recently popularised socket shield technique involves intentional retention of a thin buccal section of the remnant root at the time of immediate implant placement to preserve the buccal crestal bone from resorption. The objective of this systematic review was to assess the literature available on the socket-shield technique and weigh its biological plausibility and long-term clinical prognosis. A Systematic Search was performed in PubMed-Medline, Embase, Web of Knowledge, Google Scholar and Cochrane Central for clinical/ animal studies up to May 2016 without restrictions of language, duration, and follow-up. The literature search revealed that 15 out of 16 articles available were case reports and series, with 12 out of 16 having less than 12 months duration. Animal histological evidence demonstrated the formation of PDL and/or cementum on the implant surfaces in contact with/ in proximity to the socket-shield. Some clinical reports indicated stable results at 12 months; however, a few studies also reported infection and resorption of the socket-shield and bone loss. It would be difficult to predict the long -term success of this technique until high-quality evidence becomes available. Given some negative results, clinicians are recommended to use this technique with caution.

  17. Fasting therapy for treating and preventing disease - current state of evidence.

    Science.gov (United States)

    Michalsen, Andreas; Li, Chenying

    2013-01-01

    Periods of deliberate fasting with restriction of solid food intake are practiced worldwide, mostly based on traditional, cultural or religious reasons. There is large empirical and observational evidence that medically supervised modified fasting (fasting cure, 200-500 kcal nutritional intake per day) with periods of 7-21 days is efficacious in the treatment of rheumatic diseases, chronic pain syndromes, hypertension, and metabolic syndrome. The beneficial effects of fasting followed by vegetarian diet in rheumatoid arthritis are confirmed by randomized controlled trials. Further beneficial effects of fasting are supported by observational data and abundant evidence from experimental research which found caloric restriction and intermittent fasting being associated with deceleration or prevention of most chronic degenerative and chronic inflammatory diseases. Intermittent fasting may also be useful as an accompanying treatment during chemotherapy of cancer. A further beneficial effect of fasting relates to improvements in sustainable lifestyle modification and adoption of a healthy diet, possibly mediated by fasting-induced mood enhancement. Various identified mechanisms of fasting point to its potential health-promoting effects, e.g., fasting-induced neuroendocrine activation and hormetic stress response, increased production of neurotrophic factors, reduced mitochondrial oxidative stress, general decrease of signals associated with aging, and promotion of autophagy. Fasting therapy might contribute to the prevention and treatment of chronic diseases and should be further evaluated in controlled clinical trials and observational studies.

  18. Central retinal vein occlusion: A review of current Evidence-based treatment options

    Directory of Open Access Journals (Sweden)

    Amy Patel

    2016-01-01

    Full Text Available A central retinal vein occlusion (CRVO can induce an ischemic and hypoxic state with resulting sequelae of macular edema and neovascularization. Many treatment options have been studied. Our review aims to investigate the safety and efficacy of the multiple treatment options of CRVO. A PubMed and Cochrane literature search was performed. Well-controlled randomized clinical trials that demonstrated strong level 1 evidence-based on the rating scale developed by the British Centre for Evidence-Based Medicine were included. Seven clinical trials met inclusion criteria to be included in this review. These included studies that investigated the safety and efficacy of retinal photocoagulation (1 study, intravitreal steroid treatment (2 studies, and antivascular endothelial growth factor treatment (4 studies for the treatment of CRVO. In addition, studies evaluating surgical treatment options for CRVO were also included. Many treatment modalities have been demonstrated to be safe and efficacious in the treatment of CRVO. These treatment options offer therapeutic benefits for patients and clinically superior visual acuity and perhaps the quality of life after suffering from a CRVO.

  19. Epigenetics of Posttraumatic Stress Disorder: Current Evidence, Challenges, and Future Directions.

    Science.gov (United States)

    Zannas, Anthony S; Provençal, Nadine; Binder, Elisabeth B

    2015-09-01

    Posttraumatic stress disorder (PTSD) is a stress-related psychiatric disorder that is thought to emerge from complex interactions among traumatic events and multiple genetic factors. Epigenetic regulation lies at the heart of these interactions and mediates the lasting effects of the environment on gene regulation. An increasing body of evidence in human subjects with PTSD supports a role for epigenetic regulation of distinct genes and pathways in the pathogenesis of PTSD. The role of epigenetic regulation is further supported by studies examining fear conditioning in rodent models. Although this line of research offers an exciting outlook for future epigenetic research in PTSD, important limitations include the tissue specificity of epigenetic modifications, the phenomenologic definition of the disorder, and the challenge of translating molecular evidence across species. These limitations call for studies that combine data from postmortem human brain tissue and animal models, assess longitudinal epigenetic changes in living subjects, and examine dimensional phenotypes in addition to diagnoses. Moreover, examining the environmental, genetic, and epigenetic factors that promote resilience to trauma may lead to important advances in the field. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Low-grade inflammation, diet composition and health: current research evidence and its translation.

    Science.gov (United States)

    Minihane, Anne M; Vinoy, Sophie; Russell, Wendy R; Baka, Athanasia; Roche, Helen M; Tuohy, Kieran M; Teeling, Jessica L; Blaak, Ellen E; Fenech, Michael; Vauzour, David; McArdle, Harry J; Kremer, Bas H A; Sterkman, Luc; Vafeiadou, Katerina; Benedetti, Massimo Massi; Williams, Christine M; Calder, Philip C

    2015-10-14

    The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear. An unresolved inflammatory response is likely to be involved from the early stages of disease development. The present position paper is the most recent in a series produced by the International Life Sciences Institute's European Branch (ILSI Europe). It is co-authored by the speakers from a 2013 workshop led by the Obesity and Diabetes Task Force entitled 'Low-grade inflammation, a high-grade challenge: biomarkers and modulation by dietary strategies'. The latest research in the areas of acute and chronic inflammation and cardiometabolic, gut and cognitive health is presented along with the cellular and molecular mechanisms underlying inflammation-health/disease associations. The evidence relating diet composition and early-life nutrition to inflammatory status is reviewed. Human epidemiological and intervention data are thus far heavily reliant on the measurement of inflammatory markers in the circulation, and in particular cytokines in the fasting state, which are recognised as an insensitive and highly variable index of tissue inflammation. Potential novel kinetic and integrated approaches to capture inflammatory status in humans are discussed. Such approaches are likely to provide a more discriminating means of quantifying inflammation-health/disease associations, and the ability of diet to positively modulate inflammation and provide the much needed evidence to develop research portfolios that will inform new product development and associated health claims.

  1. Do current clinical trials meet society's needs?: a critical review of recent evidence.

    Science.gov (United States)

    Pocock, Stuart J; Gersh, Bernard J

    2014-10-14

    This paper describes some important controversies regarding the current state of clinical trials research in cardiology. Topics covered include the inadequacy of trial research on medical devices, problems with industry-sponsored trials, the lack of head-to-head trials of new effective treatments, the need for wiser handling of drug safety issues, the credibility (or lack thereof) of trial reports in medical journals, problems with globalization of trials, the role of personalized (stratified) medicine in trials, the need for new trials of old drugs, the need for trials of treatment withdrawal, the importance of pragmatic trials of treatment strategies, and the limitations of observational comparative effectiveness studies. All issues are illustrated by recent topical trials in cardiology. Overall, we explore the extent to which clinical trials, as currently practiced, are successful in meeting society's expectations.

  2. Natural history of intraductal papillary mucinous neoplasms (IPMN): current evidence and implications for management.

    Science.gov (United States)

    Bassi, Claudio; Sarr, Michael G; Lillemoe, Keith D; Reber, Howard A

    2008-04-01

    Intraductal papillary mucinous neoplasms (IPMNs) show varying degrees of dysplasia throughout the neoplasm that can range from adenoma to invasive carcinoma, with dysplastic changes of borderline neoplasms and carcinoma in situ in between. An understanding of the natural history, and especially the required time to transform into either carcinoma in situ or an invasive adenocarcinoma, is critically important for management policy. This topic serves as the rationale for the present analysis. At the beginning of February 2007, using the key word "IPMN" in PubMed, we initially selected 119 publications using the principal criteria as defined by the WHO classification. We identified 20 appropriate original reports and one consensus paper. Neither randomized control trials (RCT) or systematic reviews of RCTs (level 1 evidence) nor cohort studies or reviews of cohort studies (level 2 evidence) have been published. Only one report fit the criteria for level 3 evidence (case control study). Nineteen papers satisfied criteria for level 4 (cases series) and two for level 5 (expert opinion publication). After additional review and analysis, we considered only six reports to be "cornerstone papers" of merit for the final review. Clues to the natural history of IPMNs can be gained by using several methods to examine the articles: (a) to verify different prognoses between main and side branch duct subtypes; (b) to compare the average age of patients with benign vs. malignant IPMNs; (c) to summarize the findings of nonoperative, observational studies based on follow up by clinical, biochemical, and imaging techniques without operative resection; (d) to determine the prognostic importance of the status of the resection margin; and (e) to follow patients clinically after surgical resection. Although important aspects of the natural history of IPMN are still unknown, the following conclusions can be drawn: (1) Branch-duct IPMNs are less aggressive than main-duct IPMNs. (2

  3. A fractal model for nuclear organization: current evidence and biological implications.

    Science.gov (United States)

    Bancaud, Aurélien; Lavelle, Christophe; Huet, Sébastien; Ellenberg, Jan

    2012-10-01

    Chromatin is a multiscale structure on which transcription, replication, recombination and repair of the genome occur. To fully understand any of these processes at the molecular level under physiological conditions, a clear picture of the polymorphic and dynamic organization of chromatin in the eukaryotic nucleus is required. Recent studies indicate that a fractal model of chromatin architecture is consistent with both the reaction-diffusion properties of chromatin interacting proteins and with structural data on chromatin interminglement. In this study, we provide a critical overview of the experimental evidence that support a fractal organization of chromatin. On this basis, we discuss the functional implications of a fractal chromatin model for biological processes and propose future experiments to probe chromatin organization further that should allow to strongly support or invalidate the fractal hypothesis.

  4. The interactions of anticancer agents with tea catechins: current evidence from preclinical studies.

    Science.gov (United States)

    Shang, Weihu; Lu, Weidong; Han, Mei; Qiao, Jinping

    2014-01-01

    Tea catechins exhibit a broad range of pharmacological activities that impart beneficial effects on human health. Epigallocatechin-3-gallate (EGCG), one of the major tea catechins, has been widely associated with cancer prevention and treatment. In addition, tea catechins in combination with anticancer drugs are being evaluated as a new cancer treatment strategy. However, the interactions of anticancer drugs with tea catechins are largely unknown. Accumulated data indicate significant interactions between anticancer drugs and tea catechins, such as synergistic tumor inhibition or antagonist activity. Therefore, it is critical to understand comprehensively the effects of tea catechins on anticancer drugs. Focusing on evidence from preclinical studies, this paper will review the interactions between anticancer drugs and tea catechins, including pharmacodynamics and pharmacokinetics effects. We hope that by detailing the interactions between anticancer drugs and tea catechins, more attention will be directed to this important therapeutic combination in the future.

  5. Regional heterogeneity in consumption due to current income shocks: New evidence from the Permanent Income Hypothesis

    DEFF Research Database (Denmark)

    Mitze, Timo

    In the light of new theoretical and empirical work on the Permanent Income Hypothesis we tackle earlier findings for German data, which reject its validity given a large fraction of liquidity constrained consumers. Starting from a standard short run approach we do not find evidence for excess...... interpret this specification as a solution to a consumer’s optimization problem with habit persistence. Different from earlier findings changes of income growth measuring the excess sensitivity of consumption with respect to income changes and thus the degree of liquidity constrained households turn....... However, we find a clear distinction in the short run path of the East German states since 1991 (which nevertheless converge to the same long run co-integration as the Western counter...

  6. Riboflavin status, MTHFR genotype and blood pressure: current evidence and implications for personalised nutrition.

    Science.gov (United States)

    McAuley, E; McNulty, H; Hughes, C; Strain, J J; Ward, M

    2016-08-01

    Clinical deficiency of the B-vitamin riboflavin (vitamin B2) is largely confined to developing countries; however accumulating evidence indicates that suboptimal riboflavin status is a widespread problem across the developed world. Few international data are available on riboflavin status as measured by the functional biomarker, erythrocyte glutathione reductase activation coefficient, considered to be the gold standard index. One important role of riboflavin in the form of flavin dinucleotide is as a co-factor for the folate-metabolising enzyme methylenetetrahydrofolate reductase (MTHFR). Homozygosity for the common C677T polymorphism in MTHFR, affecting over 10 % of the UK and Irish populations and up to 32 % of other populations worldwide, has been associated with an increased risk of CVD, and more recently with hypertension. This review will explore available studies reporting riboflavin status worldwide, the interaction of riboflavin with the MTHFR C677T polymorphism and the potential role of riboflavin in personalised nutrition. Evidence is accumulating for a novel role of riboflavin as an important modulator of blood pressure (BP) specifically in individuals with the MTHFR 677TT genotype, with results from a number of recent randomised controlled trials demonstrating that riboflavin supplementation can significantly reduce systolic BP by 5-13 mmHg in these genetically at risk adults. Studies are however required to investigate the BP-lowering effect of riboflavin in different populations and in response to doses higher than 1·6 mg/d. Furthermore, work focusing on the translation of this research to health professionals and patients is also required.

  7. Electrostatic Solitary Waves in the Solar Wind: Evidence for Instability at Solar Wind Current Sheets

    Science.gov (United States)

    Malaspina, David M.; Newman, David L.; Wilson, Lynn Bruce; Goetz, Keith; Kellogg, Paul J.; Kerstin, Kris

    2013-01-01

    A strong spatial association between bipolar electrostatic solitary waves (ESWs) and magnetic current sheets (CSs) in the solar wind is reported here for the first time. This association requires that the plasma instabilities (e.g., Buneman, electron two stream) which generate ESWs are preferentially localized to solar wind CSs. Distributions of CS properties (including shear angle, thickness, solar wind speed, and vector magnetic field change) are examined for differences between CSs associated with ESWs and randomly chosen CSs. Possible mechanisms for producing ESW-generating instabilities at solar wind CSs are considered, including magnetic reconnection.

  8. CANCER IMMUNOLOGY AND IMMUNOTHERAPY – UNDERSTANDING AND ADAPTATION THE CURRENT EVIDENCE TO OPTIMIZE PATIENT THERAPY OUTCOMES.

    Directory of Open Access Journals (Sweden)

    Orlin Savov

    2015-11-01

    Full Text Available The aim of this publication includes the try to act as intermediary to the readers, which should be able to understand: - The description of the cancer immunotherapy mechanisms in the context of current therapy decisions for the treatment of cancer - The including criteria for those patients with cancer who could be appropriate candidates for immunotherapy - And to optimize patient outcomes by using best practices to manage the adverse events associated with immunotherapy treatment More than 15 promising immunotherapy approaches being tested in clinical trials with appropriate patients and colleagues for enrollment and peer-to-peer education purposes, respectively.

  9. Endovascular Treatment For Acute Anterior Circulation Ischemic Stroke - New Evidence And Current Status

    Directory of Open Access Journals (Sweden)

    KA Salam

    2016-07-01

    Full Text Available Endovascular mechanical treatment can remove large proximal clots rapidly and result in higher rates of reperfusion than IV rt-PA alone. Three initial trials of endovascular therapies in 2013 did not show a benefit for thrombectomy over IV rt-PA. But in 2015, 5 trials from around the world, namely MR CLEAN, EXTEND-IA, ESCAPE, SWIFT-PRIME, and REVASCAT, advanced the scope of endovascular therapy for acute ischemic stroke. We review these trials and discuss how they have shaped the current status of endovascular therapy in acute ischaemic stroke.

  10. Structured exercise interventions for type 2 diabetes mellitus: Strength of current evidence

    Directory of Open Access Journals (Sweden)

    Mohammed Ejas Hussain

    2011-07-01

    Full Text Available Exercise, along with medical nutrition therapy and pharmacological interventions, is an important component in the clinical management of type 2 diabetes mellitus (T2D. Current clinical guidelines on type 2 diabetes provide no detailed information on the modalities of effective exercise intervention in the treatment of type 2 diabetes. Both endurance and resistance types of exercise seem to be equally effective in improving metabolic control in patients with type 2 diabetes. Determining the best method of providing exercise is clinically relevant to this population. This paper reviews the epidemiology of diabetes and problems of physical function associated with type 2 diabetes and discuss the benefits of exercise therapy on the parameters of glycemic control and function in type 2 diabetes patients, with special reference to Asian Indians. Based on the currently available literature, it is concluded that type 2 diabetes patients should be encouraged to participate in specifically designed exercise intervention programs. Attention should be paid to the avoidance of cardiovascular and musculoskeletal deconditioning. More clinical research is warranted to establish the efficacy of different dosages of exercise intervention in a holistic approach for type 2 diabetes subpopulations within different stages of the disease and various levels of co-morbidity.

  11. Sublingual immunotherapy in allergic asthma: Current evidence and needs to meet

    Directory of Open Access Journals (Sweden)

    Incorvaia Cristoforo

    2010-01-01

    Full Text Available Allergen-specific immunotherapy is aimed at modifying the natural history of allergy by inducing tolerance to the causative allergen. In its traditional, subcutaneous form, immunotherapy has complete evidence of efficacy in allergic asthma. However, subcutaneous immunotherapy (SCIT has a major flaw in side effects, and especially in possible anaphylactic reactions, and this prompted the search for safer ways of administration of allergen extracts. Sublingual immunotherapy (SLIT has met such need while maintaining a clinical efficacy comparable to SCIT. In fact, the safety profile, as outlined by a systematic revision of the available literature, was substantially free from serious systemic reactions. A number of meta-analyses clearly showed that SLIT is effective in allergic rhinitis by significantly reducing the clinical symptoms and the use of anti-allergic drugs, while the efficacy in allergic asthma is still debated, with some meta-analyses showing clear effectiveness but other giving contrasting results. Besides the efficacy on symptoms, the preventive activity and the cost-effectiveness are important outcomes of SLIT in asthma. The needs to meet include more data on efficacy in house dust mite asthma, optimal techniques of administration and, as previously done with SCIT, introduction of adjuvants able to enhance the immunologic response and use of recombinant allergens.

  12. Urbanization and non-communicable disease in Southeast Asia: a review of current evidence.

    Science.gov (United States)

    Angkurawaranon, C; Jiraporncharoen, W; Chenthanakij, B; Doyle, P; Nitsch, D

    2014-10-01

    Non-communicable diseases (NCDs) have been highlighted as a major public health issue in the Southeast (SE) Asian region. One of the major socio-environmental factors that are considered to be associated with such a rise in NCDs is urbanization. Urbanization is associated with behavioural changes such as eating an unhealthy diet, and a decrease in physical activities, which may result in associated obesity. The SE Asian region also has a substantive burden of infectious disease such as HIV and malaria, which may modify associations between urbanization and development of NCDs. A systematic review was conducted until April 2013. Using four databases: EMBASE, PubMed, GlobalHealth and DigitalJournal, the systematic review pools existing evidence on urban-rural gradients in NCD prevalence/incidence. The study found that in SE Asia, urban exposure was positively associated with coronary heart disease, diabetes and respiratory diseases in children. Urban exposure was negatively associated with rheumatic heart diseases. The stages of economic development may also modify the association between urbanization and NCDs such as diabetes. There was pronounced heterogeneity between associations. It is recommended that future studies examine the major constituents of NCDs separately and also focus on the interplay between lifestyle and infectious risk factors for NCDs. Prospective studies are needed to understand the diverse causal pathways between urbanization and NCDs in SE Asia.

  13. [Non-celiac gluten sensitivity: a critical review of current evidence].

    Science.gov (United States)

    Molina-Infante, Javier; Santolaria, Santos; Montoro, Miguel; Esteve, María; Fernández-Bañares, Fernando

    2014-01-01

    Non-celiac gluten sensitivity (NCGS) is an emerging disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food in non-celiac patients. Its prevalence has been estimated to be six to ten-times higher than that of celiac disease (CD). A gluten-free diet is the most widely recommended therapy, but the causative agent remains unknown and there are no consensus diagnostic criteria. Recent studies on NCGS have included patients with possibly overlooked minor CD and diarrhea-predominant irritable bowel syndrome without self-reported gluten intolerance, but showing a response to a gluten-free diet. Furthermore, FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) have recently been postulated as the culprit component for NCGS in wheat, instead of gluten. This review updates evidence on the pathophysiology of NCGS and the efficacy of different dietary interventions in its treatment, stressing the need for proper screening for CD before a diagnosis of NCGS is made. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  14. Current Evidence of Chinese Herbal Constituents with Effects on NMDA Receptor Blockade

    Directory of Open Access Journals (Sweden)

    David T. Yew

    2013-08-01

    Full Text Available NMDA receptor (NMDA-R is an important molecular entity governing a wide range of functions in the central nervous system. For example, the NMDA-R is involved in memory and cognition, and impairment of both (as in Alzheimer’s Disease is attributed to NMDA-mediated neurotoxicity. With greater understanding of the NMDA-R structure, antagonists with varying degrees of binding-site and subtype selectivity have been developed and put into clinical use. Discovery of target-specific Chinese herbs have also been made in parallel. This article provides an overview of the known active sites on the NMDA-R, followed by a discussion of the relevant herbs and their constituents. Experimental evidence supporting the inhibitory role of the herbal compounds on the NMDA-R is highlighted. For some of the compounds, potential research directions are also proposed to further elucidate the underlying mechanisms of the herbs. It is envisaged that future investigations based on the present data will allow more clinically relevant herbs to be identified.

  15. B-Vitamins and Bone Health–A Review of the Current Evidence

    Science.gov (United States)

    Dai, Zhaoli; Koh, Woon-Puay

    2015-01-01

    Because of ongoing global ageing, there is a rapid worldwide increase in incidence of osteoporotic fractures and the resultant morbidity and mortality associated with these fractures are expected to create a substantial economic burden. Dietary modification is one effective approach for prevention of osteoporosis in the general population. Recently, B vitamins have been investigated for their possible roles in bone health in human studies. In this review, we provide different lines of evidence and potential mechanisms of individual B vitamin in influencing bone structure, bone quality, bone mass and fracture risk from published peer-reviewed articles. These data support a possible protective role of B vitamins, particularly, B2, B6, folate and B12, in bone health. However, results from the clinical trials have not been promising in supporting the efficacy of B vitamin supplementation in fracture reduction. Future research should continue to investigate the underlying mechanistic pathways and consider interventional studies using dietary regimens with vitamin B enriched foods to avoid potential adverse effects of high-dose vitamin B supplementation. In addition, observational and interventional studies conducted in Asia are limited and thus require more attention due to a steep rise of osteoporosis and hip fracture incidence projected in this part of the world. PMID:25961321

  16. B-vitamins and bone health--a review of the current evidence.

    Science.gov (United States)

    Dai, Zhaoli; Koh, Woon-Puay

    2015-05-07

    Because of ongoing global ageing, there is a rapid worldwide increase in incidence of osteoporotic fractures and the resultant morbidity and mortality associated with these fractures are expected to create a substantial economic burden. Dietary modification is one effective approach for prevention of osteoporosis in the general population. Recently, B vitamins have been investigated for their possible roles in bone health in human studies. In this review, we provide different lines of evidence and potential mechanisms of individual B vitamin in influencing bone structure, bone quality, bone mass and fracture risk from published peer-reviewed articles. These data support a possible protective role of B vitamins, particularly, B2, B6, folate and B12, in bone health. However, results from the clinical trials have not been promising in supporting the efficacy of B vitamin supplementation in fracture reduction. Future research should continue to investigate the underlying mechanistic pathways and consider interventional studies using dietary regimens with vitamin B enriched foods to avoid potential adverse effects of high-dose vitamin B supplementation. In addition, observational and interventional studies conducted in Asia are limited and thus require more attention due to a steep rise of osteoporosis and hip fracture incidence projected in this part of the world.

  17. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence

    Directory of Open Access Journals (Sweden)

    Patricia Feliciano Pereira

    2014-01-01

    Full Text Available OBJECTIVE: The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. SOURCES: Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes. DATA SYNTHESIS: The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. CONCLUSION: Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes.

  18. WD40-repeat proteins in plant cell wall formation: current evidence and research prospects

    Directory of Open Access Journals (Sweden)

    Gea eGuerriero

    2015-12-01

    Full Text Available The metabolic complexity of living organisms relies on supramolecular protein structures which ensure vital processes, such as signal transduction, transcription, translation and cell wall synthesis. In eukaryotes WD40-repeat (WDR proteins often function as molecular hubs mediating supramolecular interactions. WDR proteins may display a variety of interacting partners and participate in the assembly of complexes involved in distinct cellular functions. In plants, the formation of lignocellulosic biomass involves extensive synthesis of cell wall polysaccharides, a process that requires the assembly of large transmembrane enzyme complexes, intensive vesicle trafficking, interactions with the cytoskeleton, and coordinated gene expression. Because of their function as supramolecular hubs, WDR proteins could participate in each or any of these steps, although to date only few WDR proteins have been linked to the cell wall by experimental evidence. Nevertheless, several potential cell wall-related WDR proteins were recently identified using in silico aproaches, such as analyses of co-expression, interactome and conserved gene neighbourhood. Notably, some WDR genes are frequently genomic neighbours of genes coding for GT2-family polysaccharide synthases in eukaryotes, and this WDR-GT2 collinear microsynteny is detected in diverse taxa. In angiosperms, two WDR genes are collinear to cellulose synthase genes, CESAs, whereas in ascomycetous fungi several WDR genes are adjacent to chitin synthase genes, chs. In this Perspective we summarize and discuss experimental and in silico studies on the possible involvement of WDR proteins in plant cell wall formation. The prospects of biotechnological engineering for enhanced biomass production are discussed.

  19. Current perspectives on therapeutic ultrasound in the management of chronic wounds: a review of evidence

    Directory of Open Access Journals (Sweden)

    Conner-Kerr T

    2017-07-01

    Full Text Available Teresa Conner-Kerr,1 Mary Ellen Oesterle2 1College of Health Sciences & Professions, 2Department of Physical Therapy, University of North Georgia, Dahlonega, GA, USA Abstract: Although therapeutic ultrasound has been in existence since the 1930s, questions remain as to its effectiveness in promoting tissue healing in various injured tissues. These tissues include soft tissues such as skin, tendons, ligaments, bursae, joint capsules and muscles. Limited evidence exists to support a role for therapeutic ultrasound in closed, soft tissue lesions. However, an evolving literature provides support for the role of therapeutic ultrasound in the treatment of chronic wounds, acute injuries such as fractures and split thickness graft donor sites as well as in the modulation of wound-related pain. Modern technology that uses low-frequency (kilohertz, long wave ultrasound appears promising compared to older, higher frequency ultrasound (megahertz devices. These newer devices appear to have positive effects on healing rates in various wound types, pain levels and the modulation of proinflammatory cytokines. Keywords: low-frequency ultrasound, non-contact ultrasound, KHz, acoustic, healing, cavitation

  20. Evidence-based medicine in bovine, equine and canine reproduction: quality of current literature.

    Science.gov (United States)

    Simoneit, C; Heuwieser, W; Arlt, S

    2011-10-01

    The objective was to evaluate deficits and differences of published literature on reproduction in cattle, horses, and dogs. A literature search was conducted in the databases Medline and Veterinary Science. Approximately five times more articles on clinical bovine reproduction (n = 25 910) were found compared to canine (n = 5 015) and equine (n = 5 090) reproduction. For the evaluation of the literature, a checklist was used. A subset of 600 articles published between 1999 and 2008 was randomly selected. After applying exclusion criteria, a total of 268 trials (86 for cattle, 99 for horses, and 83 for dogs) were evaluated and used for further analysis. For the field of canine and equine reproduction, there were fewer clinical trials with a control group compared to bovine reproduction (cattle 66%, horses 41%, and dogs 41%). For all three species investigated, few publications were identified (4%) with the highest level of evidence, i.e., controlled, randomized, and blinded trials, or meta-analyses. In cattle 33% of the publications were graded adequate to draw sound conclusions; however, only 7 and 11% were graded adequate in dogs and horses, respectively. Therefore, the veterinarian should always assess the quality of information before implementing results into practice to provide best available care for the animals. In conclusion, improvement of the quality of well-designed, conducted and reported clinical trails in animal reproduction is required.

  1. Appraisal of biochemical classes of radioprotectors: evidence, current status and guidelines for future development.

    Science.gov (United States)

    Mishra, Krishnanand; Alsbeih, Ghazi

    2017-10-01

    The search for efficient radioprotective agents to protect from radiation-induced toxicity, due to planned or accidental radiation exposure, is still ongoing worldwide. Despite decades of research and development of widely different biochemical classes of natural and derivative compounds, a safe and effective radioprotector is largely unmet. In this comprehensive review, we evaluated the evidence for the radioprotective performance of classical thiols, vitamins, minerals, dietary antioxidants, phytochemicals, botanical and bacterial preparations, DNA-binding agents, cytokines, and chelators including adaptogens. Where radioprotection was demonstrated, the compounds have shown moderate dose modifying factors ranging from 1.1 to 2.7. To date, only few compounds found way to clinic with limited margin of dose prescription due to side effects. Most of these compounds (amifostine, filgratism, pegfilgrastim, sargramostim, palifermin, recombinant salmonella flagellin, Prussian blue, potassium iodide) act primarily via scavenging of free radicals, modulation of oxidative stress, signal transduction, cell proliferation or enhance radionuclide elimination. However, the gain in radioprotection remains hampered with low margin of tolerance. Future development of more effective radioprotectors requires an appropriate nontoxic compound, a model system and biomarkers of radiation exposure. These are important to test the effectiveness of radioprotection on physiological tissues during radiotherapy and field application in cases of nuclear eventualities.

  2. Hyponatremia in the neurocritical care patient: An approach based on current evidence.

    Science.gov (United States)

    Manzanares, W; Aramendi, I; Langlois, P L; Biestro, A

    2015-05-01

    In the neurocritical care setting, hyponatremia is the commonest electrolyte disorder, which is associated with significant morbimortality. Cerebral salt wasting and syndrome of inappropriate antidiuretic hormone have been classically described as the 2 most frequent entities responsible of hyponatremia in neurocritical care patients. Nevertheless, to distinguish between both syndromes is usually difficult and useless as volume status is difficult to be determined, underlying pathophysiological mechanisms are still not fully understood, fluid restriction is usually contraindicated in these patients, and the first option in the therapeutic strategy is always the same: 3% hypertonic saline solution. Therefore, we definitively agree with the current concept of "cerebral salt wasting", which means that whatever is the etiology of hyponatremia, initially in neurocritical care patients the treatment will be the same: hypertonic saline solution. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  3. The flow structure of pyroclastic density currents: evidence from particle models and large-scale experiments

    Science.gov (United States)

    Dellino, Pierfrancesco; Büttner, Ralf; Dioguardi, Fabio; Doronzo, Domenico Maria; La Volpe, Luigi; Mele, Daniela; Sonder, Ingo; Sulpizio, Roberto; Zimanowski, Bernd

    2010-05-01

    Pyroclastic flows are ground hugging, hot, gas-particle flows. They represent the most hazardous events of explosive volcanism, one striking example being the famous historical eruption of Pompeii (AD 79) at Vesuvius. Much of our knowledge on the mechanics of pyroclastic flows comes from theoretical models and numerical simulations. Valuable data are also stored in the geological record of past eruptions, i.e. the particles contained in pyroclastic deposits, but they are rarely used for quantifying the destructive potential of pyroclastic flows. In this paper, by means of experiments, we validate a model that is based on data from pyroclastic deposits. It allows the reconstruction of the current's fluid-dynamic behaviour. We show that our model results in likely values of dynamic pressure and particle volumetric concentration, and allows quantifying the hazard potential of pyroclastic flows.

  4. Current thinking in qualitative research: evidence-based practice, moral philosophies, and political struggle.

    Science.gov (United States)

    Papadimitriou, Christina; Magasi, Susan; Frank, Gelya

    2012-01-01

    In this introduction to the special issue on current thinking in qualitative research and occupational therapy and science, the authors focus on the importance of rigorous qualitative research to inform occupational therapy practice. The authors chosen for this special issue reflect a "second generation of qualitative researchers" who are critical, theoretically sophisticated, methodologically productive, and politically relevant to show that working with disabled clients is political work. Three themes emerged across the articles included in this special issue: (1) recognizing and addressing social justice issues; (2) learning from clients' experiences; and (3) critically reframing occupational therapy's role. These themes can inform occupational therapy practice, research, and education to reflect a more client-centered and politically engaging approach. Copyright 2012, SLACK Incorporated.

  5. Intravenous immunoglobulin for the treatment of Alzheimer's disease: current evidence and considerations

    Directory of Open Access Journals (Sweden)

    Schindowski C

    2014-09-01

    Full Text Available Christina Schindowski,1,* Jürgen Zimmermann,2,* Katharina Schindowski3  1Vivantes Klinikum am Urban Hospital, Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Berlin, Germany; 2Thermofisher Scientific, Langenselbold, Germany; 3Institute of Applied Biotechnology, Faculty for Biotechnology, Biberach University of Applied Sciences, Biberach/Riss, Germany *These authors contributed equally to this work Abstract: Alzheimer's disease (AD is a devastating neurodegenerative form of dementia with increasing incidence rates in most countries. AD is characterized by amyloid plaques and neurofibrillary tangles in the brains of AD individuals accompanied by global neuronal loss. The peptide amyloid-β (Aβ aggregates to amyloid plaques in AD brains. As a result, many therapeutic approaches target Aβ. Human plasma and the plasma product intravenous immunoglobulin (IVIG contain naturally-occurring anti-Aβ antibodies (Nabs-Aβ that appear to reduce risks of developing AD. IVIG sequesters Aβ and thus interferes with AD progression. This study reviews the role of different Aβ species, Nabs-Aβ, preclinical data, and clinical studies of IVIG as potential AD treatments. The focus of this study is the outcomes of a recent Gammaglobulin Alzheimer's Partnership Phase III trial that did not reach primary endpoints, as well as efforts to compare IVIG with current anti-Aβ monoclonals such as bapineuzumab, solanezumab, and BIIB037. Moreover, this study critically examines current market and ethical consequences of potential off-label uses of IVIG, limits in IVIG supply, and subsequent challenges. Keywords: IVIG, amyloid-beta, Nabs-Aβ, Gammagard®, efficacy, target, market

  6. Active surveillance for prostate cancer: current evidence and contemporary state of practice.

    Science.gov (United States)

    Tosoian, Jeffrey J; Carter, H Ballentine; Lepor, Abbey; Loeb, Stacy

    2016-04-01

    Prostate cancer remains one of the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment seem to improve survival in men with unfavourable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favourable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate-cancer-specific mortality are exceedingly low in the intermediate term (5-10 years). Such outcomes seem to be closely associated with programme-specific criteria for selection, monitoring, and intervention, suggesting that AS--like other management strategies--could be individualized based on the level of risk acceptable to patients in light of their personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis.

  7. Radiation as an immunological adjuvant: current evidence on dose and fractionation

    Directory of Open Access Journals (Sweden)

    Sandra eDemaria

    2012-10-01

    Full Text Available Ionizing radiation to a cancer site has the ability to convert the irradiated tumor in an immunogenic hub. However, radiation is a complex modifier of the tumor microenvironment and, by itself, is seldom sufficient to induce a therapeutically significant anti-tumor immune response, since it can also activate immune suppressive pathways. While several combinations of local radiation and immunotherapy have been shown in pre-clinical models to induce powerful anti-tumor immunity, the optimal strategy to achieve this effect remains to be defined. When used in vivo, radiation effects on tumors depend on the dose per fraction applied, the number of fractions used, and the total dose. Moreover, the interplay of these three variables is contingent upon the tumor setting studied, both in preclinical and clinical applications. To enable repair of the collateral damage to the normal tissue, radiation is usually given in multiple fractions, usually of 2 Gy. Generally, the use of larger fractions is limited to sterotactic applications, whereby optimal immobilization reduces inter and intra-fraction movement and permits a very conformal delivery of dose to the target, with optimal exclusion of normal tissue. Translation of the partnership of radiation and immunotherapy to the clinic requires a careful consideration of the radiation regimens used. To date, little is known on whether different dose/fractionation regimens have a specific impact on the anti-tumor immune response. Most experiments combining the two modalities were conducted with single fractions of radiotherapy. However, there is at least some evidence that when combined with some specific immunotherapy approaches, the ability of radiation to promote anti-tumor immunity is dependent on the dose and fractionation employed. We critically review the available in vitro and in vivo data on this subject and discuss the potential impact of fractionation on the ability of radiation to synergize with

  8. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence.

    Science.gov (United States)

    Pereira, Patrícia Feliciano; Alfenas, Rita de Cássia G; Araújo, Raquel Maria A

    2014-01-01

    The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes). The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Analysis of consumption behaviour concerning current income and lags consumption: Empirical evidence from Pakistan

    Directory of Open Access Journals (Sweden)

    Abdul Qayyum Khan

    2014-10-01

    Full Text Available As in other economies, consumption expenditure is the largest component of the Gross Domestic Product (GDP of Pakistan economy. The figure has been estimated around 80 percent of the GDP and demonstrates that historically, Pakistan’s economic growth is characterized as consumption-led growth. The present paper aims to explore the relationship between income and consumption using annual time series data for the period: 1975 to 2012 in Pakistan. For empirical investigation the linear regression model and the method of Least Squares is used as analytical techniques. Empirical results support the existence of a significant positive relationship between income and consumption. The finding suggests that long term committed planning is indispensable to enhance the productive capacity of the economy, employment opportunities and reduce poverty levels more effectively.

  10. Biological Activities and Bioavailability of Mangosteen Xanthones: A Critical Review of the Current Evidence

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    Mark L. Failla

    2013-08-01

    Full Text Available Mangosteen (Garcinia mangostana L. is a tropical tree native to Southeast Asia that produces a fruit whose pericarp contains a family of tricyclic isoprenylated polyphenols referred to as xanthones. Numerous in vitro studies have shown that these xanthones possess anti-oxidant, anti-proliferative, pro-apoptotic, anti-inflammatory and anti-carcinogenic activities. Aggressive marketing of such health promoting benefits has resulted in mangosteen’s classification as a “superfruit”. This has led to sales of mangosteen containing beverages in USA alone exceeding $200 million in 2008 despite very limited animal and human studies. This review will (a critically address recent reports of in vivo studies on the bioavailability and metabolism of mangosteen xanthones, (b update the in vitro and in vivo data on anti-cancer and anti-inflammatory activities of mangosteen xanthones, and (c suggest needed areas of inquiry regarding the absorption, metabolism and efficacy of mangosteen xanthones.

  11. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Directory of Open Access Journals (Sweden)

    Trefoux Bourdet A

    2015-03-01

    Full Text Available Alice Trefoux Bourdet, Dominique Luton, Martin Koskas Department of Obstetrics and Gynecology, Bichat University Hospital, Paris Diderot University, Paris, France Abstract: Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA, an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s. Keywords: uterine fibroids, medical treatment, selective progesterone receptor modulator, ulipristal acetate, surgery

  12. Ayurveda and botanical drugs for epilepsy: Current evidence and future prospects.

    Science.gov (United States)

    Sriranjini, Sitaram Jaideep; Sandhya, Kumar; Mamta, Vernekar Sanjeeva

    2015-11-01

    The understanding of epilepsy has progressed since its earliest impression as a disease associated with paranormal and superstitious beliefs. Landmark advances have been made in deciphering the pathophysiological substrates involved in the disease process, and treatment advances have contributed significantly to ameliorating the seizures. However, disease-modifying agents are yet to be discovered. Ayurveda is a system of medicine that stresses a holistic approach to disease, and treatment is focused on disease modification and symptom management. Herbs form the core of Ayurveda medicine; though many of them have been studied for their anticonvulsant activity, very few actually mention the reference of these herbs in Ayurveda literature. Other therapeutic interventions used in Ayurveda are relatively unexplored, and future research will need to focus on this. The current manuscript briefly discusses the understanding of epilepsy as per Ayurveda and reviews herbs that have been studied for their anticonvulsant activity mentioned in Ayurveda literature. This article is part of a Special Issue entitled "Botanicals for Epilepsy".

  13. Anti-angiogenesis in hepatocellular carcinoma treatment: Current evidence and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Martin-Walter Welker; Joerg Trojan

    2011-01-01

    Hepatocellular carcinoma (HCC) is among the most common cancer diseases worldwide. Arterial hypervascularisation is an essential step for HCC tumorigenesis and can be targeted by transarterial chemoembolization (TACE). This interventional method is the standard treatment for patients with intermediate stage HCC, but is also applied as "bridging" therapy for patients awaiting liver transplantation in many centers worldwide. Usually the devascularization effect induced by TACE is transient, consequently resulting in repeated cycles of TACE every 4-8 wk. Despite documented survival benefits, TACE can also induce the up-regulation of proangiogenic and growth factors, which might contribute to accelerated progression in patients with incomplete response. In 2007, sorafenib, a multi-tyrosine kinase and angiogenesis inhibitor, was approved as the first systemic treatment for advanced stage HCC. Other active targeted compounds, either inhibitors of angiogenesis and/or growth factors, are currently being investigated in numerous clinical trials. To overcome revascularisation or tumor progression under TACE treatment it seems therefore attractive to combine TACE with systemic targeted agents, which might theoretically block the effects of proangiogenic and growth factors. Over the last 12 mo, several retrospective or prospective cohort studies combining TACE and sorafenib have been published. Nevertheless, robust results of the efficacy and tolerability of such combination strategies as proven by randomized, controlled trials are awaited in the next two years.

  14. Targeting the Glutamatergic System to Treat Pathological Gambling: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Mauro Pettorruso

    2014-01-01

    Full Text Available Pathological gambling or gambling disorder has been defined by the DSM-5 as a behavioral addiction. To date, its pathophysiology is not completely understood and there is no FDA-approved treatment for gambling disorders. Glutamate is the principal excitatory neurotransmitter in the nervous system and it has been recently involved in the pathophysiology of addictive behaviors. In this paper, we review the current literature on a class of drugs that act as modulating glutamate system in PG. A total of 19 studies have been included, according to inclusion and exclusion criteria. Clinical trial and case series using glutamatergic drugs (N-acetylcysteine, memantine, amantadine, topiramate, acamprosate, baclofen, gabapentin, pregabalin, and modafinil will be presented to elucidate the effectiveness on gambling behaviors and on the related clinical dimensions (craving, withdrawal, and cognitive symptoms in PG patients. The results have been discussed to gain more insight in the pathophysiology and treatment of PG. In conclusion, manipulation of glutamatergic neurotransmission appears to be promising in developing improved therapeutic agents for the treatment of gambling disorders. Further studies are required. Finally, we propose future directions and challenges in this research area.

  15. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Science.gov (United States)

    Natesan, Suganthini Krishnan; Chandrasekar, Pranatharthi H

    2016-01-01

    The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA) and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ) seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA) for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. PMID:27994475

  16. Factors Influencing Adult Physical Health after Controlling for Current Health Conditions: Evidence from a British Cohort

    Science.gov (United States)

    Cheng, Helen; Furnham, Adrian

    2013-01-01

    This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth), cognitive ability (at age 11 yrs), personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs), after taking account of current health conditions (number of illness). Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness) were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health). Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed. PMID:23826090

  17. Clinical significance of nutritional status in patients with atrial fibrillation: An overview of current evidence.

    Science.gov (United States)

    Anaszewicz, Marzena; Budzyński, Jacek

    2017-05-01

    Obesity is a well-known atherosclerosis risk factor; however, its role and the importance of undernutrition in atrial fibrillation (AF) pathogenesis are still not well understood. The aim of this study was to present the current state of knowledge on this issue in different groups of patients. Systematic review of papers published between 1980 and 2016. The literature shows contradicting views regarding the impact of nutritional status on the risk, course, and complications of AF. On the one hand, it has been revealed that overweight, obesity, and high birth mass increase the risk of AF, and that their reduction is linked to an improved course of AF and reduced all-cause and cardiovascular mortality. On the other hand, a so-called obesity paradox has been found, which shows lower all-cause mortality in overweight patients with AF compared to those of normal weight or who are underweight. It has also been shown, although based on a small number of studies, that the relationship between nutritional status and risk of AF and its complication may be U-shaped, which means that not only patients with obesity, but also individuals with underweight, cachexia, and low birth weight may have an increased risk and poor outcome of AF. The relationship between patients' nutritional status and the course of AF has become clearer but it requires further studies examining the importance of weight reduction on AF course. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  18. Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

    Directory of Open Access Journals (Sweden)

    Helen Cheng

    Full Text Available This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth, cognitive ability (at age 11 yrs, personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs, after taking account of current health conditions (number of illness. Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health. Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed.

  19. Is Africa’s current growth reducing inequality? Evidence from some selected african countries

    Directory of Open Access Journals (Sweden)

    Alege P.O.

    2015-06-01

    Full Text Available Is Africa’s current growth reducing inequality? What are the implications of growth on output performances in Africa? Does the effect of Africa’s growth on sectorial output have any implication for inequality in Africa? The study investigates the effect of shocks on a set of macroeconomic variables on inequality (measured by life expectancy and the implication of this on sectors that are perceived to provide economic empowerment in form of employment for people living in the African countries in our sample. Studies already find that growth in many African countries has not been accompanied with significant improvement in employment. Therefore inequality is subject to a counter cyclical trend in production levels when export destination countries experience a recession. The study also provides insight on the effect of growth on sectorial output for three major sectors in the African economy with the intent of analyzing the impact of growth on sectorial development. The method used in this study is Panel Vector Autoregressive (PVAR estimation and the obvious advantage of this method lies in the fact that it allows us to capture both static and dynamic interdependencies and to treat the links across units in an unrestricted fashion. Data is obtained from World Bank (WDI Statistics for the period 1985 to 2012 (28 years for 10 African Countries. Our main findings confirm strong negative relationship between GDP growth and life expectancy and also for GDP and the services and manufacturing sector considering the full sample.

  20. PRESCRIBING OF ANTIHYPERTENSIVE AGENTS IN PUBLIC PRIMARY CARE CLINICS – IS IT IN ACCORDANCE WITH CURRENT EVIDENCE?

    Directory of Open Access Journals (Sweden)

    SAJARI J

    2010-01-01

    Full Text Available Background: Large population surveys in Malaysia have consistently shown minimal improvement of blood pressure control rates over the last 10 years. Poor adherence to antihypertensive medication has been recognized as a major reason for poor control of hypertension. This study aimed to describe the prescribing pattern of antihypertensive agents in 2 public primary care clinics and assess its appropriateness in relation to current evidence and guidelines. Methods: A cross-sectional survey to describe the prescribing pattern of antihypertensive agents was carried out in 2 publicprimary care clinics in Selangor from May to June 2009. Hypertensive patients on pharmacological treatment for ≥1 year who attended the clinics within the study period of 7 weeks were selected. Appropriate use of antihypertensive agents was defined based on current evidence and the recommendations by the Malaysian Clinical Practice Guidelines (CPG on the Management of Hypertension, 2008. Data were obtained from patients’ medical records and were analysed using the SPSS software version 16.0. Results: A total of 400 hypertensive patients on treatment were included. Mean age was 59.5 years (SD ±10.9, range 28 to91 years, of which 52.8% were females and 47.2% were males. With regards to pharmacotherapy, 45.7% were on monotherapy,43.3% were on 2 agents and 11.0% were on ≥3 agents. Target blood pressure of <140/90mmHg was achieved in 51.4% of patients on monotherapy, and 33.2% of patients on combination of ≥2 agents. The commonest monotherapy agents being prescribed were β-blockers (atenolol or propranolol, followed by the short-acting calcium channel blocker (nifedipine. The commonest combination of 2-drug therapy prescribed was β-blockers and short-acting calcium channel blocker. Conclusion: This study shows that the prescribing pattern of antihypertensive agents in the 2 primary care clinics was not in accordance with current evidence and guidelines.

  1. Observational evidence of seasonality in the timing of loop current eddy separation

    Science.gov (United States)

    Hall, Cody A.; Leben, Robert R.

    2016-12-01

    Observational datasets, reports and analyses over the time period from 1978 through 1992 are reviewed to derive pre-altimetry Loop Current (LC) eddy separation dates. The reanalysis identified 20 separation events in the 15-year record. Separation dates are estimated to be accurate to approximately ± 1.5 months and sufficient to detect statistically significant LC eddy separation seasonality, which was not the case for previously published records because of the misidentification of separation events and their timing. The reanalysis indicates that previously reported LC eddy separation dates, determined for the time period before the advent of continuous altimetric monitoring in the early 1990s, are inaccurate because of extensive reliance on satellite sea surface temperature (SST) imagery. Automated LC tracking techniques are used to derive LC eddy separation dates in three different altimetry-based sea surface height (SSH) datasets over the time period from 1993 through 2012. A total of 28-30 LC eddy separation events were identified in the 20-year record. Variations in the number and dates of eddy separation events are attributed to the different mean sea surfaces and objective-analysis smoothing procedures used to produce the SSH datasets. Significance tests on various altimetry and pre-altimetry/altimetry combined date lists consistently show that the seasonal distribution of separation events is not uniform at the 95% confidence level. Randomization tests further show that the seasonal peak in LC eddy separation events in August and September is highly unlikely to have occurred by chance. The other seasonal peak in February and March is less significant, but possibly indicates two seasons of enhanced probability of eddy separation centered near the spring and fall equinoxes. This is further quantified by objectively dividing the seasonal distribution into two seasons using circular statistical techniques and a k-means clustering algorithm. The estimated

  2. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Directory of Open Access Journals (Sweden)

    Natesan SK

    2016-12-01

    Full Text Available Suganthini Krishnan Natesan,1,2 Pranatharthi H Chandrasekar1 1Division of Infectious Diseases, Department of Internal Medicine, Wayne State University, 2John D Dingell VA Medical Center, Detroit, MI, USA Abstract: The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. Keywords: isavuconazole, aspergillosis, mucormycosis, efficacy, antifungal therapy, novel azole, tolerability, drug interactions

  3. Extended Lymphadenectomy and "Mesopancreas" Excision during Pancreatoduodenectomy for Cancer; is it worth it? Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Elissaios Kontis

    2016-03-01

    Full Text Available Pancreatic cancer is a malignancy with overall poor prognosis. Surgery is the only treatment modality, which could provide cure. Therefore every effort possible should be made for pancreatectomy to achieve R0 resection. However, even after R0 resection, the survival outcomes are still far behind from other solid intrabdominal tumors. Extended lymphadenectomy and “mesopancreas” excision are the two main factors where focus has been given, in order to improve the outcomes of pancreatectomy for pancreatic head cancer. We present an up to date comprehensive review of the current evidence on the topics of extended lymphadenectomy and “mesopancreas” excision during pancreatoduodenectomy for cancer.

  4. The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review

    Science.gov (United States)

    Mimura, C; Griffiths, P

    2003-01-01

    The effectiveness of current approaches to workplace stress management for nurses was assessed through a systematic review. Seven randomised controlled trials and three prospective cohort studies assessing the effectiveness of a stress management programmes were identified and reviewed. The quality of research identified was weak. There is more evidence for the effectiveness of programmes based on providing personal support than environmental management to reduce stressors. However, since the number and quality of studies is low, the question as to which, if any, approach is more effective cannot be answered definitively. Further research is required before clear recommendations for the use of particular interventions for nursing work related stress can be made. PMID:12499451

  5. NASA's Current Evidence and Hypothesis for the Visual Impairment and Intracranial Pressure Risk

    Science.gov (United States)

    Otto, Christian A.; Norsk, Peter; Oubre, Cherie M.; Pass, Anastas F.; Tarver, William

    2012-01-01

    While 40 years of human spaceflight exploration has reported visual decrement to a certain extent in a subgroup of astronauts, recent data suggests that there is indeed a subset of crewmembers that experience refraction changes (hyperoptic shift), cotton wool spot formation, choroidal fold development, papilledema, optic nerve sheath distention and/or posterior globe flattening with varying degrees of severity and permanence. Pre and postflight ocular measures have identified a potential risk of permanent visual changes as a result of microgravity exposure, which has been defined as the Visual Impairment and Intracranial Pressure risk (VIIP). The combination of symptoms are referred to as the VIIP syndrome. It is thought that the ocular structural and optic nerve changes are caused by events precipitated by the cephalad fluid shift crewmembers experience during long-duration spaceflight. Three important systems, ocular, cardiovascular, and central nervous, seem to be involved in the development of symptoms, but the etiology is still under speculation. It is believed that some crewmembers are more susceptible to these changes due to genetic/anatomical predisposition or lifestyle (fitness) related factors. Future research will focus on determining the etiology of the VIIP syndrome and development of mechanisms to mitigate the spaceflight risk.

  6. Can Vitex Agnus castus Be Used for the Treatment of Mastalgia? What Is the Current Evidence?

    Directory of Open Access Journals (Sweden)

    A. R. Carmichael

    2008-01-01

    Full Text Available There have been many treatments suggested for the management of mastalgia; one of these is the fruit extract of Vitex Agnus castus L. commonly known as Agnus castus, an extract of a deciduous shrub native to Mediterranean Europe and Central Asia. It is postulated that A. castus suppresses the stress-induced latent hyperprolactinemia which is a release of supra-physiological levels of prolactin in some patients in response to stressful stimuli. It is postulated that A. castus could be effective in the treatment of cyclical mastalgia by inhibiting the release of excess prolactin by blocking Dopamine-2 receptor type on pituitary. The adverse events following A. castus treatment are mild and reversible. The aim of this review is assess the efficacy of A. castus in the treatment of mastalgia. Data from randomized and non-randomized studies regarding the efficacy and safety of A. castus is reviewed in a systematic fashion. It is concluded that A. castus can be considered as an efficient alternative phytotherapeutic agent in the treatment of mastalgia.

  7. Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence.

    Science.gov (United States)

    Mark-Christensen, Troels; Troelsen, Anders; Kallemose, Thomas; Barfod, Kristoffer Weisskirchner

    2016-06-01

    The optimal treatment for acute Achilles tendon rupture (ATR) is continuously debated. Recent studies have proposed that the choice of either operative or non-operative treatment may not be as important as rehabilitation, suggesting that functional rehabilitation should be preferred over traditional immobilization. The purpose of this meta-analysis of randomized controlled trials (RCTs) was to compare functional rehabilitation to immobilization in the treatment of ATR. This meta-analysis was conducted using the databases: PubMed, EMBASE, Rehabilitation and Sports Medicine Source, AMED, CINAHL, Cochrane Library and PEDro using the search terms: "Achilles tendon," "rupture," "mobilization" and "immobilization". Seven RCTs involving 427 participants were eligible for inclusion, with a total of 211 participants treated with functional rehabilitation and 216 treated with immobilization. Re-rupture rate, other complications, strength, range of motion, duration of sick leave, return to sport and patient satisfaction were examined. There were no statistically significant differences between groups. A trend favoring functional rehabilitation was seen regarding the examined outcomes. Functional rehabilitation after acute Achilles tendon rupture does not increase the rate of re-rupture or other complications. A trend toward earlier return to work and sport, and increased patient satisfaction was found when functional rehabilitation was used. The present literature is of low-to-average quality, and the basic constructs of the examined treatment and study protocols vary considerably. Larger, randomized controlled trials using validated outcome measures are needed to confirm the findings. II.

  8. Glazed clay pottery and lead exposure in Mexico: Current experimental evidence.

    Science.gov (United States)

    Diaz-Ruiz, Araceli; Tristán-López, Luis Antonio; Medrano-Gómez, Karen Itzel; Torres-Domínguez, Juan Alejandro; Ríos, Camilo; Montes, Sergio

    2017-11-01

    Lead exposure remains a significant environmental problem; lead is neurotoxic, especially in developing humans. In Mexico, lead in human blood is still a concern. Historically, much of the lead exposure is attributed to the use of handcrafted clay pottery for cooking, storing and serving food. However, experimental cause-and-effect demonstration is lacking. The present study explores this issue with a prospective experimental approach. We used handcrafted clay containers to prepare and store lemonade, which was supplied as drinking water to pregnant rats throughout the gestational period. We found that clay pots, jars, and mugs leached on average 200 µg/l lead, and exposure to the lemonade resulted in 2.5 µg/dl of lead in the pregnant rats' blood. Neonates also showed increased lead content in the hippocampus and cerebellum. Caspase-3 activity was found to be statistically increased in the hippocampus in prenatally exposed neonates, suggesting increased apoptosis in that brain region. Glazed ceramics are still an important source of lead exposure in Mexico, and our results confirm that pregnancy is a vulnerable period for brain development.

  9. The Current Status of Nurse-Administered Propofol Sedation in Endoscopy: An Evidence-Based Practice Nurse Fellowship Project.

    Science.gov (United States)

    Rivera, Beth

    2015-01-01

    The Society for Gastroenterology Nurses and Associates (SGNA) launched a nurse fellowship program in 2011 to promote evidence-based practice. Each accepted applicant was challenged to select a relevant topic, explore the current research, and translate this information to daily practice. The author, an SGNA Fellow, selected the topic, nurse-administered propofol sedation, that has been a prevailing subject in endoscopy for many years. A significant amount of literature has been written on the drug's safety and efficacy. This article explores a brief history of the practice and the future of this controversial drug for procedural sedation. A review of current literature is explored with an emphasis on the past 5 years as well as a discussion on regulatory limitations that have been placed on the practice of non-anesthesiologist-administered propofol sedation.

  10. Cytidine 5′-Diphosphocholine (Citicoline) in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives

    Science.gov (United States)

    Roberti, Gloria; Tanga, Lucia; Michelessi, Manuele; Quaranta, Luciano; Parisi, Vincenzo; Manni, Gianluca; Oddone, Francesco

    2015-01-01

    Cytidine 5′-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson’s disease and Alzheimer’s disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma. PMID:26633368

  11. Cytidine 5′-Diphosphocholine (Citicoline in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Gloria Roberti

    2015-11-01

    Full Text Available Cytidine 5′-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson’s disease and Alzheimer’s disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma.

  12. Sofosbuvir for the treatment of chronic hepatitis C: between current evidence and future perspectives

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    Degasperi E

    2014-04-01

    Full Text Available Elisabetta Degasperi, Alessio AghemoDivision of Gastroenterology and Hepatology, AM and M Migliavacca Center, Fondazione IRCCS Ca' Granda Maggiore Hospital, University of Milan, Milan, ItalyAbstract: In recent years, clinical research in the field of new treatments for chronic hepatitis C (HCV has been devoted to developing regimens based on direct-acting antivirals (DAAs, with the goal of increasing treatment efficacy and improving tolerability and safety. This can be achieved by Peginterferon (PegIFN-free anti-HCV regimens, as PegIFN is responsible for many side effects and limits treatment access due to contraindications in some patient categories. Sofosbuvir (SOF is the first compound to enter the market with IFN-free combination regimens; it belongs to the nucleotide inhibitors of viral polymerase NS5B and acts as a chain terminator during the HCV replication process, exhibiting pan-genotypic antiviral activity with a high barrier to resistance. Clinical trials in HCV genotype 2/3 patients have demonstrated optimal efficacy in HCV-2, where the combination SOF/ribavirin (Rbv for 12 weeks resulted in >90% sustained virological response (SVR rates, while HCV-3 patients with advanced liver fibrosis and previous failure to PegIFN plus Rbv therapy still require individualized and optimized treatment strategies. Historically difficult-to-treat genotypes HCV-1, -4–6 can benefit from reduced duration of PegIFN plus SOF and Rbv, while IFN-free regimens in these patients will be based on SOF in combination with other DAA classes. Due to an optimal tolerability and safety profile with no significant drug-to-drug interactions, SOF is currently undergoing clinical trials in the setting of pre- and post-liver transplantation and HIV-coinfected patients, with the objective to address the until now unmet need for safe and efficient treatment in these populations. This article provides an overview of SOF features and the main clinical trials, discussing

  13. Infections and urolithiasis: current clinical evidence in prophylaxis and antibiotic therapy.

    Science.gov (United States)

    Zanetti, Giampaolo; Paparella, Stefano; Trinchieri, Alberto; Prezioso, Domenico; Rocco, Francesco; Naber, Kurt G

    2008-03-01

    Urinary tract infections and urosepsis are complications which can precede or follow a kidney stone treatment. Often the stones themselves are the source of infection, whether they are infection stones or not. Systemic infections are difficult to foresee, and neither a pre-operative negative urine culture nor an antibiotic prophylaxis avoid infectious complications for certain. The primary predictive risk factors of urosepsis are: patient conditions, urinary tract infection or a history of recurrent infections, characteristics of the stone, and anatomy of the urinary tract. Infection stones are still a matter of debate, concerning both the aetiology of the disease and its treatment. Positive cultures are not only found with struvite stones, but also with apatite and calcium oxalate stones. Currently, a long-term antibiotic therapy is advised in patients affected by infection stones. Antibiotic therapy should prevent not only septic complications but also recurrence or re-growth of stones after treatment. Different antibiotic modalities are recommended, sometimes together with urease inhibitors. Mid-stream urine culture is the easiest available pre-treatment parameter notwithstanding its poor predictive value. In case of suspected or proven urinary infection, an appropriate antibiotic therapy should always be administered prior to surgical procedure. There is, however, controversy regarding the antibiotic use, its role, expediency, and duration of prophylaxis in relation to the various surgical procedures, and the way infectious complications are considered and classified. When antibiotic prophylaxis is considered, its duration should be clearly established prior to surgery; duration may vary depending on the type of surgery or the type of antibiotic. Furthermore, prophylaxis should be administered only for a limited amount of time. In infection stones, in immuno-compromised patients or in patients with anatomical anomalies or diabetes, the risk of post

  14. Is vitamin D deficiency associated with heart failure? A review of current evidence.

    Science.gov (United States)

    Agarwal, Megha; Phan, Anita; Willix, Robert; Barber, Mickey; Schwarz, Ernst R

    2011-01-01

    An estimated 1 billion people worldwide have deficient or insufficient levels of vitamin D. Even more alarming is the association of vitamin D deficiency with many types of diseases, particularly heart failure (HF). Hypovitaminosis D has been observed to be highly prevalent in the HF community with rates varying from approximately 80% to 95%. Higher rates of deficiency have been linked to winter months, in patients with protracted decompensated HF, darker skin pigmentation, and higher New York Heart Association (NYHA) classes. In fact, some data suggest vitamin D deficiency may even be an independent predictor of mortality in patients with HF. Traditionally obtained through UV exposure and activated in the liver and then the kidneys, vitamin D is classified as a vitamin but functions as a steroid hormone. The hormone acts through the vitamin D receptor (VDR), which is expressed in vascular smooth muscle cells, renal juxtaglomerular cells, and most interestingly, cardiac myocytes. Studies have shown that the association between vitamin D deficiency and HF often manifests in the structural components of cardiac myocytes and/or through alterations of the neurohormonal cascade. In addition, vitamin D may also act rapidly through intracellular nongenomic receptors that alter cardiac contractility. Unfortunately, prospective vitamin D supplementation trials show mixed results. In rat models, successful correction of deficiency was associated with reductions in ventricular hypertrophy. In humans, however, echocardiographic dimensions did not change significantly. These results bring into questions whether vitamin D is a risk factor for HF, a marker of HF disease severity, or has a true pathologic role. This article provides a thorough review of vitamin D deficiency etiology, prevalence, and possible pathophysiologic role in HF. Furthermore, we carefully review prospective trials on vitamin D therapy in HF. We believe more trials on vitamin D therapy in HF need to be

  15. Clinical potential of methylphenidate in the treatment of cocaine addiction: a review of the current evidence

    Directory of Open Access Journals (Sweden)

    Dürsteler KM

    2015-06-01

    open-label studies, the results of randomized controlled trials have been disappointing so far and do not corroborate the use of MPH as a substitute for cocaine dependence in patients without attention deficit hyperactivity disorder. Conclusion: Clinical studies evaluating MPH substitution for cocaine dependence have provided inconsistent findings. However, the negative findings may be explained by specific study characteristics, among them dosing, duration of treatment, or sample size. This needs to be considered when discussing the potential of MPH as replacement therapy for cocaine dependence. Finally, based on the results, we suggest possible directions for future research. Keywords: agonist replacement, dependence, substitution

  16. Physical Exercise for the Treatment of Neuropsychiatric Disturbances in Alzheimer's Dementia: Possible Mechanisms, Current Evidence and Future Directions.

    Science.gov (United States)

    Matura, Silke; Carvalho, André F; Alves, Gilberto S; Pantel, Johannes

    2016-01-01

    Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric or non-cognitive symptoms are common and often distressing features of Alzheimer's Dementia. BPSD significantly increase patient suffering, early institutionalization and caregiver's burden. The clinical management of BPSD is dominated by a pharmacological approach, although these medications often come with serious adverse side-effects. There are only few nonpharmacological treatment strategies for BPSD. A substantial amount of intervention studies that have investigated non-pharmacological treatment options for BPSD have focused on physical exercise. Although these studies are very heterogeneous in terms of type and severity of dementia, as well as type and duration of the exercise intervention, the overall picture shows a positive effect of physical exercise in alleviating BPSD. There is evidence that numerous mechanisms contribute to the positive effect of physical exercise on BPSD. No attempt has been undertaken so far to give an overview of the existing knowledge regarding these mechanisms. Therefore, the current review aims to integrate the existing evidence on psychological and neurobiological mechanisms that contribute to the beneficial effects of physical exercise in ameliorating BPSD in Alzheimer's dementia. A discussion of psychological mechanisms such as improved sleep and stress reduction will be followed by a discussion of neurobiological mechanisms including the exercise induced change in neurotransmitter concentrations, increased synthesis of neurotrophins and immune activation. The review closes with recommendations for future research to overcome the shortcomings of existing studies and broaden the current knowledge on the positive effects of physical exercise on BPSD.

  17. Probiotics as a novel treatment for non-alcoholic Fatty liver disease; a systematic review on the current evidences.

    Science.gov (United States)

    Kelishadi, Roya; Farajian, Sanam; Mirlohi, Maryam

    2013-04-01

    Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, with 5-10% of liver having extra fat. Increase in its prevalence in all age groups is linked with obesity and Type II diabetes. The treatment of NAFLD remains controversial. A growing body of evidence suggests a relation between overgrowth of gut microbiota with NAFLD and non-alcoholic steatohepatitis (NASH). The objective of this review is to provide an overview on experimental and clinical studies assessing all positive and negative effects of probiotics. We made a critical appraisal on various types of documents published from 1999 to March 2012 in journals, electronic books, seminars, and symposium contexts including Medline, PubMed, and Cochrane Central Register of Controlled Trials databases. We used the key words: "non-alcoholic fatty liver disease, probiotics, non-alcoholic steatohepatitis, liver disease, and fatty liver". Probiotics, as biological factors, control the gut microbiota and result in its progression. It is in this sense that they are suggestive of a new and a natural way of promoting liver function. Correspondingly, limited evidence suggests that probiotics could be considered as a new way of treatment for NAFLD. Various experimental studies and clinical trials revealed promising effects of probiotics in improving NAFLD; however given the limited experience in this field, generalization of probiotics as treatment of NAFLD needs substantiation through more trials with a larger sample sizes and with longer-term follow up.

  18. Applying 'Technology Assessment' and 'Evidence Based Medicine' theory to interventional radiology. Part 1: Suggestions for the phased evaluation of new procedures

    Energy Technology Data Exchange (ETDEWEB)

    Malone, Dermot E.; Maceneaney, Peter M

    2000-12-01

    AIM: To compare and contrast interventional radiology (IR) clinical and research practices with the technology assessment and evidence-based medicine (EBM) paradigms and make suggestions for the phased evaluation of new IR procedures. MATERIALS AND METHODS: Course literature of the Association of University Radiologists' 'Basic Technology Assessment for Radiologists' course and the McMaster University Health Information Research Unit's 'How to Teach Evidence-Based Medicine 1999' course were used to identify major publications in each discipline. A computer search was performed to seek other relevant literature. A model of traditional development of IR procedures was developed. Suggestions for the phased evaluation of IR procedures were derived. RESULTS: As in diagnostic radiology, several levels of progressively stronger IR study design can be described and related to EBM 'levels of evidence'. These range from case reports and case series through case-control and cohort studies to randomized controlled trials (RCTs). The major weakness in the existing IR literature is the predominance of small, uncontrolled, case series. Randomized controlled trials are likely to provide the best possible evidence of effectiveness. They are expensive and randomization is sometimes unethical or impractical. Case-control and cohort studies have been under-utilized. Evidence-based medicine indices of benefit and harm have not yet been applied in IR and may have clinical advantages over traditional statistical methods. A literature search (10 years) using MeSH terms 'radiology, interventional' and 'efficacy' yielded 30 papers. Combining 'radiology, interventional' and 'evidence-based medicine' yielded no papers. Comparative searches substituting the term 'diagnostic imaging' for 'radiology, interventional' yielded 4883 and 62 papers, respectively. CONCLUSION: Principles of technology

  19. 广西河湖水域岸线管理现状分析及建议%Current status analysis and suggestions for administration of river-lake shoreline and water area in Guangxi

    Institute of Scientific and Technical Information of China (English)

    王晓妮

    2013-01-01

    An introduction was made on the current status of river-lake shoreline and water area administration in Guangxi. The author analyzed the major problems and put forward suggestions for strengthening administration.%  介绍了广西河湖水域岸线管理现状,分析现阶段管理中存在的主要问题,并提出加强河湖水域及岸线管理的建议措施。

  20. Hypnosis, suggestion, and suggestibility: an integrative model.

    Science.gov (United States)

    Lynn, Steven Jay; Laurence, Jean-Roch; Kirsch, Irving

    2015-01-01

    This article elucidates an integrative model of hypnosis that integrates social, cultural, cognitive, and neurophysiological variables at play both in and out of hypnosis and considers their dynamic interaction as determinants of the multifaceted experience of hypnosis. The roles of these variables are examined in the induction and suggestion stages of hypnosis, including how they are related to the experience of involuntariness, one of the hallmarks of hypnosis. It is suggested that studies of the modification of hypnotic suggestibility; cognitive flexibility; response sets and expectancies; the default-mode network; and the search for the neurophysiological correlates of hypnosis, more broadly, in conjunction with research on social psychological variables, hold much promise to further understanding of hypnosis.

  1. Current hormonal contraceptive use predicts female extra-pair and dyadic sexual behavior: evidence based on Czech National Survey data.

    Science.gov (United States)

    Klapilová, Kateřina; Cobey, Kelly D; Wells, Timothy; Roberts, S Craig; Weiss, Petr; Havlíček, Jan

    2014-01-10

    Data from 1155 Czech women (493 using oral contraception, 662 non-users), obtained from the Czech National Survey of Sexual Behavior, were used to investigate evolutionary-based hypotheses concerning the predictive value of current oral contraceptive (OC) use on extra-pair and dyadic (in-pair) sexual behavior of coupled women. Specifically, the aim was to determine whether current OC use was associated with lower extra-pair and higher in-pair sexual interest and behavior, because OC use suppresses cyclical shifts in mating psychology that occur in normally cycling women. Zero-inflated Poisson (ZIP) regression and negative binomial models were used to test associations between OC use and these sexual measures, controlling for other relevant predictors (e.g., age, parity, in-pair sexual satisfaction, relationship length). The overall incidence of having had an extra-pair partner or one-night stand in the previous year was not related to current OC use (the majority of the sample had not). However, among the women who had engaged in extra-pair sexual behavior, OC users had fewer one-night stands than non-users, and tended to have fewer partners, than non-users. OC users also had more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. These results suggest that suppression of fertility through OC use may alter important aspects of female sexual behavior, with potential implications for relationship functioning and stability.

  2. Current Hormonal Contraceptive Use Predicts Female Extra-Pair and Dyadic Sexual Behavior: Evidence Based on Czech National Survey Data

    Directory of Open Access Journals (Sweden)

    Kateřina Klapilová

    2014-01-01

    Full Text Available Data from 1155 Czech women (493 using oral contraception, 662 non-users, obtained from the Czech National Survey of Sexual Behavior, were used to investigate evolutionary-based hypotheses concerning the predictive value of current oral contraceptive (OC use on extra-pair and dyadic (in-pair sexual behavior of coupled women. Specifically, the aim was to determine whether current OC use was associated with lower extra-pair and higher in-pair sexual interest and behavior, because OC use suppresses cyclical shifts in mating psychology that occur in normally cycling women. Zero-inflated Poisson (ZIP regression and negative binomial models were used to test associations between OC use and these sexual measures, controlling for other relevant predictors (e.g., age, parity, in-pair sexual satisfaction, relationship length. The overall incidence of having had an extra-pair partner or one-night stand in the previous year was not related to current OC use (the majority of the sample had not. However, among the women who had engaged in extra-pair sexual behavior, OC users had fewer one-night stands than non-users, and tended to have fewer partners, than non-users. OC users also had more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. These results suggest that suppression of fertility through OC use may alter important aspects of female sexual behavior, with potential implications for relationship functioning and stability.

  3. Maternal nutritional status, C(1) metabolism and offspring DNA methylation: a review of current evidence in human subjects.

    Science.gov (United States)

    Dominguez-Salas, Paula; Cox, Sharon E; Prentice, Andrew M; Hennig, Branwen J; Moore, Sophie E

    2012-02-01

    Evidence is growing for the long-term effects of environmental factors during early-life on later disease susceptibility. It is believed that epigenetic mechanisms (changes in gene function not mediated by DNA sequence alteration), particularly DNA methylation, play a role in these processes. This paper reviews the current state of knowledge of the involvement of C1 metabolism and methyl donors and cofactors in maternal diet-induced DNA methylation changes in utero as an epigenetic mechanism. Methyl groups for DNA methylation are mostly derived from the diet and supplied through C1 metabolism by way of choline, betaine, methionine or folate, with involvement of riboflavin and vitamins B6 and B12 as cofactors. Mouse models have shown that epigenetic features, for example DNA methylation, can be altered by periconceptional nutritional interventions such as folate supplementation, thereby changing offspring phenotype. Evidence of early nutrient-induced epigenetic change in human subjects is scant, but it is known that during pregnancy C1 metabolism has to cope with high fetal demands for folate and choline needed for neural tube closure and normal development. Retrospective studies investigating the effect of famine or season during pregnancy indicate that variation in early environmental exposure in utero leads to differences in DNA methylation of offspring. This may affect gene expression in the offspring. Further research is needed to examine the real impact of maternal nutrient availability on DNA methylation in the developing fetus.

  4. Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies

    Science.gov (United States)

    2017-01-01

    Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion. PMID:28168195

  5. [Undesired awareness phenomena during general anesthesia: Evidence-based state of knowledge, current discussions and strategies for prevention and management].

    Science.gov (United States)

    Bischoff, P; Rundshagen, I; Schneider, G

    2015-10-01

    Patient awareness during general anesthesia and the later recall of what happened during surgery can be experienced by patients as horrifying events that leave lasting mental trauma in the form of posttraumatic stress syndrome (PTSS). Awareness is related to a temporary insufficient depth of anesthesia. This phenomenon has been discussed for more than 20 years. According to randomized controlled studies, in the absence of risk factors awareness phenomena occur in 1-2 per 1000 operations involving general anesthesia (0.1-0.2%) and are classified as occasionally occurring critical events. An astonishing twist occurred elicited by the recent data from the 5th National Audit Project from Great Britain (NAP5) published in the British Journal of Anaesthesia and in Anaesthesia. The NAP5 evaluated patient reports of accidental awareness during general anesthesia (AAGA) in a multicenter manner in more than 2.7 million cases and indicated incidences of awareness of only 1:19,600, a frequency 20 times less than previously reported. These results gave rise to some controversy. It seems likely that, due to the absence of structured interviews, the NAP5 data only demonstrated the tip of the iceberg and may have vastly underestimated the real incidence of intraoperative awareness. The present overview summarizes the current knowledge about awareness. Furthermore, it addresses the question whether the awareness problem has been overestimated by evidence-based criteria or underestimated by the results of the NAP5. The responsibility for sufficient anesthesia in the clinical routine requires knowledge of awareness risks and potential sequelae. A formal recommendation from the German Society of Anesthesia and Intensive Care Medicine (DGAI) concerning awareness is not yet available; however, the recognition of evidence-based strategies in the management of anesthesia may minimize the occurrence of awareness and its sequelae.

  6. The Outcomes of Minimally Invasive versus Open Posterior Approach Spinal Fusion in Treatment of Lumbar Spondylolisthesis: The Current Evidence from Prospective Comparative Studies

    Science.gov (United States)

    Wu, Ai-Min; Chen, Chun-Hui; Shen, Zhi-Hao; Feng, Zhen-Hua; Weng, Wan-Qing; Li, Shu-Min; Chi, Yong-Long; Yin, Li-Hui

    2017-01-01

    Purpose. To investigate the evidence of minimally invasive (MI) versus open (OP) posterior lumbar fusion in treatment of lumbar spondylolisthesis from current prospective literatures. Methods. The electronic literature database of Pubmed, Embase, and Cochrane library was searched at April 2016. The data of operative time, estimated blood loss and length of hospital stay, visual analog scale (VAS) of both lower back pain and leg pain, Oswestry disability index (ODI), SF-36 PCS (physical component scores) and SF-36 MCS (mental component scores), complications, fusion rate, and secondary surgery were extracted and analyzed by STATA 12.0 software. Results. Five nonrandom prospective comparative studies were included in this meta-analysis. The meta-analysis showed that the MI group had a significantly longer operative time than OP group, less blood loss, and shorter hospital stay. No significant difference was found in back pain, leg pain, ODI, SF-36 PCS, SF-36 MCS, complications, fusion rate, and secondary surgery between MI and OP groups. Conclusion. The prospective evidence suggested that MI posterior fusion for spondylolisthesis had less EBL and hospital stay than OP fusion; however it took more operative time. Both MI and OP fusion had similar results in pain and functional outcomes, complication, fusion rate, and secondary surgery. PMID:28154826

  7. The Outcomes of Minimally Invasive versus Open Posterior Approach Spinal Fusion in Treatment of Lumbar Spondylolisthesis: The Current Evidence from Prospective Comparative Studies

    Directory of Open Access Journals (Sweden)

    Ai-Min Wu

    2017-01-01

    Full Text Available Purpose. To investigate the evidence of minimally invasive (MI versus open (OP posterior lumbar fusion in treatment of lumbar spondylolisthesis from current prospective literatures. Methods. The electronic literature database of Pubmed, Embase, and Cochrane library was searched at April 2016. The data of operative time, estimated blood loss and length of hospital stay, visual analog scale (VAS of both lower back pain and leg pain, Oswestry disability index (ODI, SF-36 PCS (physical component scores and SF-36 MCS (mental component scores, complications, fusion rate, and secondary surgery were extracted and analyzed by STATA 12.0 software. Results. Five nonrandom prospective comparative studies were included in this meta-analysis. The meta-analysis showed that the MI group had a significantly longer operative time than OP group, less blood loss, and shorter hospital stay. No significant difference was found in back pain, leg pain, ODI, SF-36 PCS, SF-36 MCS, complications, fusion rate, and secondary surgery between MI and OP groups. Conclusion. The prospective evidence suggested that MI posterior fusion for spondylolisthesis had less EBL and hospital stay than OP fusion; however it took more operative time. Both MI and OP fusion had similar results in pain and functional outcomes, complication, fusion rate, and secondary surgery.

  8. Current data of targeted therapies for the treatment of triple-negative advanced breast cancer: empiricism or evidence-based?

    Science.gov (United States)

    Petrelli, Fausto; Cabiddu, Mary; Ghilardi, Mara; Barni, Sandro

    2009-10-01

    Approximately 10 - 15% of breast carcinomas (BCs) are known to be 'triple-negative (TN) receptor' (i.e., not expressing ER or PR and not exhibiting overexpression and/or gene amplification of HER2-neu). Triple-negative BCs comprise approximately 85% of all basal-type tumours. Classically, basal-like BCs have been characterised by low expression of ER, PR, and HER2 neu and high expression of CK5, CK14, caveolin-1, CAIX, p63, and EGFR (HER1), which reflects the mammary gland basal/myoepithelial cell component. Although there is no standard first-line chemotherapy regimen for metastatic TN BCs, anthracycline- and taxane-containing regimens are acceptable treatments. A large number of agents, including DNA-damaging agents, EGFR inhibitors, antiangiogenic agents and novel taxane formulations are currently being tested in clinical trials for first-line and pretreated patients. Limited experiences with platinum salts, poly(ADP-ribose) polymerase (PARP) inhibitors, cetuximab, bevacizumab and ixabepilone have been published in recent years and will be reported. Novel immunohistochemistry analysis for identification of basal like/TN phenotype are awaited to correctly select this population. The clinical trials investigating new agents have to be designed for a specific (and possibly large) subset of patients with BC. In the future, a gene array platform with greater sensitivity for distinguishing the various BC subtypes, as well as having the power to predict the molecular biology of the disease, will be an indispensible tool for treatment selection. Currently, treatment of TN BC is more empirical than evidence-based. The cornerstone of treatment is chemotherapy, but in the near future, novel target agents will emerge as possible partners.

  9. Current clinical evidence on the effect of general anesthesia on neurodevelopment in children: an updated systematic review with meta-regression.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available BACKGROUND: Several epidemiological studies have been conducted to address the later effect of anesthesia on neurodevelopment in children. However, the results are still inconclusive. METHODS: We here conducted a systematic review and meta-analysis to summarize the currently available clinical and epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children by searching PubMed, EMBASE, and Web of Science database (from January-1 2000 to February-1, 2013. The evaluation of neurodevelopment includes language and learning disabilities, cognition, behavioral development, and academic performance. Both retrospective and prospective studies were included. Data were abstracted from seven eligible studies. We estimated the synthesized hazard ratios (HR and 95% confidence interval (CI according to inter-study heterogeneity. RESULTS: The pooled HR for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.25 (95% CI, 1.13-1.38, P<0.001; random-effects model in children undergoing the first anesthesia before the age of 4-year. Then we analyzed the factors for this association using meta-regression method. It showed that it was the number of times of exposure (HR = 1.75, 95% CI 1.31-2.33; P<0.001 rather than the time at exposure before 4-year (HR = 1.08, 95% CI 0.87-1.34 for the effect of per 1-year early exposure; P = 0.47 is a risk factor for neurodevelopmental impairment. CONCLUSION: The current clinical evidence suggests modestly elevated risk of adverse neurodevelopmental outcomes in children who were exposed to anesthesia/surgery during early childhood, especially for those with multiple times of exposure. Due to limitation of retrospective studies, prospective investigations are needed to determine whether anesthesia/surgery is causative.

  10. Anti EGFR therapy in the treatment of non-metastatic head and neck squamous cell carcinoma: The current evidence

    Directory of Open Access Journals (Sweden)

    Rony Benson

    2016-09-01

    Full Text Available Head and neck squamous cell carcinoma (HNSCC accounts for a large oncologic burden in the developing countries. In patients with locally advanced head and neck cancer multimodality treatment is warranted. Radiation therapy with concurrent chemotherapy has long been considered the standard for patients with disease involving the oropharynx, larynx and hypopharynx. However, addition of chemotherapy to radiotherapy increases treatment related toxicity by many folds and compliance rates decrease. In this context a systemic therapy, which when used concurrent with radiation with favorable toxicity profile is of great importance for improving disease control in locally advanced HNSCC. Anti-epithelial growth factor receptor targeted therapy emerged as a potential treatment option. In recent years many trials were conducted to find the optimum treatment option with the combination of these targeted agents. The initial trials showed excellent results with minimal morbidity and led to great enthusiasm across the globe to incorporate these regimens as a standard of care. However, subsequently many trials failed to maintain such results and now there is little agreement to the initial results achieved with these drugs. Based on the current evidence we cannot recommend the replacement of cisplatin with targeted therapy in concurrent setting. It may be considered in patients with altered renal parameters, hypersensitivity or intolerance to cisplatin. The addition of targeted therapy in addition to chemotherapy in the concurrent setting can’t also be recommended as the benefit is doubtful and is associated with a significant increase in toxicity.

  11. 我国新修订GMP认证的现状、困境及对策研究%Research on current situation,difficulties and specific suggestions of certification of the new version of GMP

    Institute of Scientific and Technical Information of China (English)

    颜建周; 邵蓉

    2014-01-01

    This paper analyzed the current situation of GMP certification,concluding the difficulties and problems in certification process in terms of certification concepts,costs,financial sources and related mechanisms,providing specific suggestions on the basis of representative provinces such as Shandong. Suggested that we should change the enterprises′ negative attitude toward GMP certifica-tion,accelerate certification process;broaden financial sources to relieve the fund pressure of enterprises;set up full-time GMP inspec-tors pool to improve the efficiency of certification;perfect market withdrawal mechanism to eliminate the worries of enterprises.%本文在分析我国新修订GMP认证工作现状的基础上,从认证理念、认证成本、融资渠道和认证配套机制等方面总结了当前新修订GMP认证中遇到的困境。以此为依据,结合山东等典型省份的实践经验提出转变企业消极对待新修订GMP认证的观念,加快认证进度;开拓融资渠道,缓解企业认证资金压力;设置专职的GMP检查员队伍,提高认证效率;健全市场退出机制,消除拟退出企业后顾之忧等推进我国新修订GMP认证工作的政策建议。

  12. 大学英语ESP教学现状及发展建议%On the Current Teaching Condition of ESP Learning in the College English and Developing Suggestions

    Institute of Scientific and Technical Information of China (English)

    李然; 谢威

    2014-01-01

    改革开放使我国对外交流活动越来越丰富,与世界各国的频繁接触,使得各行各业急需许多既懂专业又懂英语的毕业生。因此专门用途英语ESP(English for specific purpose)成为了近年来研究的热点。本文论述了在高等院校进行英语ESP教学的现状以及相关的发展建议。%China’s reform and opening enriches its foreign exchange activities, and contacts with other countries frequently, resulting in all kinds of graduates who need to know professional knowledge and English knowledge. This makes ESP (English for specific purposes) a research highlight in recent years. This article talks about the current teaching condition of ESP learning in the college English and its developing suggestions.

  13. Theories of Suggestion.

    Science.gov (United States)

    Brown, W

    1928-02-01

    The word "suggestion" has been used in educational, scientific and medical literature in slightly different senses. In psychological medicine the use of suggestion has developed out of the earlier use of hypnotic influence.Charcot defined hypnosis as an artificial hysteria, Bernheim as an artificially increased suggestibility. The two definitions need to be combined to give an adequate account of hypnosis. Moreover, due allowance should be made for the factors of dissociation and of rapport in hypnotic phenomena.The relationships between dissociation, suggestibility, and hypnotizability.Theories of suggestion propounded by Pierre Janet, Freud, McDougall, Pawlow and others. Ernest Jones's theory of the nature of auto-suggestion. Janet explains suggestion in terms of ideo-motor action in which the suggested idea, because of the inactivity of competing ideas, produces its maximum effect. Freud explains rapport in terms of the sex instinct "inhibited in its aim" (transference) and brings in his distinction of "ego" and "ego-ideal" (or "super-ego") to supplement the theory. Jones explains auto-suggestion in terms of narcissism. McDougall explains hypnotic suggestion in terms of the instinct of self-abasement. But different instincts may supply the driving power to produce suggestion-effects in different circumstances. Such instincts as those of self-preservation (fear) and gregariousness may play their part. Auto-suggestion as a therapeutic factor is badly named. It supplements, but does not supplant the will, and makes complete volition possible.

  14. Does deforestation promote or inhibit malaria transmission in the Amazon? A systematic literature review and critical appraisal of current evidence.

    Science.gov (United States)

    Tucker Lima, Joanna M; Vittor, Amy; Rifai, Sami; Valle, Denis

    2017-06-05

    Considerable interest in the relationship between biodiversity and disease has recently captured the attention of the research community, with important public policy implications. In particular, malaria in the Amazon region is often cited as an example of how forest conservation can improve public health outcomes. However, despite a growing body of literature and an increased understanding of the relationship between malaria and land use / land cover change (LULC) in Amazonia, contradictions have emerged. While some studies report that deforestation increases malaria risk, others claim the opposite. Assessing malaria risk requires examination of dynamic processes among three main components: (i) the environment (i.e. LULC and landscape transformations), (ii) vector biology (e.g. mosquito species distributions, vector activity and life cycle, plasmodium infection rates), and (iii) human populations (e.g. forest-related activity, host susceptibility, movement patterns). In this paper, we conduct a systematic literature review on malaria risk and deforestation in the Amazon focusing on these three components. We explore key features that are likely to generate these contrasting results using the reviewed articles and our own data from Brazil and Peru, and conclude with suggestions for productive avenues in future research.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  15. Does deforestation promote or inhibit malaria transmission in the Amazon? A systematic literature review and critical appraisal of current evidence

    Science.gov (United States)

    Tucker Lima, Joanna M.; Vittor, Amy; Rifai, Sami

    2017-01-01

    Considerable interest in the relationship between biodiversity and disease has recently captured the attention of the research community, with important public policy implications. In particular, malaria in the Amazon region is often cited as an example of how forest conservation can improve public health outcomes. However, despite a growing body of literature and an increased understanding of the relationship between malaria and land use / land cover change (LULC) in Amazonia, contradictions have emerged. While some studies report that deforestation increases malaria risk, others claim the opposite. Assessing malaria risk requires examination of dynamic processes among three main components: (i) the environment (i.e. LULC and landscape transformations), (ii) vector biology (e.g. mosquito species distributions, vector activity and life cycle, plasmodium infection rates), and (iii) human populations (e.g. forest-related activity, host susceptibility, movement patterns). In this paper, we conduct a systematic literature review on malaria risk and deforestation in the Amazon focusing on these three components. We explore key features that are likely to generate these contrasting results using the reviewed articles and our own data from Brazil and Peru, and conclude with suggestions for productive avenues in future research. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. PMID:28438914

  16. Evidence Suggesting that the Buccal and Zygomatic Branches of the Facial Nerve May Contain Parasympathetic Secretomotor Fibers to the Parotid Gland by Means of Communications from the Auriculotemporal Nerve.

    Science.gov (United States)

    Tansatit, Tanvaa; Apinuntrum, Prawit; Phetudom, Thavorn

    2015-12-01

    , supplying the branches of the parotid duct within the loop of the two main divisions of the parotid gland. A single cutaneous zygomatic branch arising from the auriculotemporal nerve in some specimens, the intraparotid communications with the zygomatic and the buccal trunks of the facial nerve, the retromandibular communications with the superficial temporal-maxillary periarterial plexuses, and the periductal autonomic plexus between the loop of the two main facial divisions lead to the suggestion that these communications of the auriculotemporal nerve convey the secretomotor to the zygomatic and buccal branches of the facial nerve. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  17. Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence

    Directory of Open Access Journals (Sweden)

    Farin Soleimani

    2013-12-01

    Full Text Available Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory, contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and

  18. The suggestion of "barefoot doctors" training model to the current rural health talent fostering%"赤脚医生"培养模式对当前农村医疗卫生人才培养的启示

    Institute of Scientific and Technical Information of China (English)

    孟庆书; 杨佳; 王晓燕; 吕兆丰

    2010-01-01

    "赤脚医生"是对我国农村人民公社时期"半农半医"医疗卫生人员的特定称谓,他们的工作在当时的中国社会为保障农民健康发挥了重要的作用.本文回顾了"赤脚医生"从产生到衰亡期间的教育发展历程,阐述了当时"赤脚医生"的教育培养模式,并从中汲取可资借鉴的经验;同时,本着"以史为鉴"的态度,针对当前乡村医生队伍中存在的业务素质偏低、人才流动明显等问题,提出了改变选拔方式、改进课程设置、加强中医药知识能力培训等建议.%"Barefoot doctors" is a specific title of "the half-time farm and half-time medical" sanitation personnel in the period of rural people' s communes. Their work had played an active role in the protection of the farmers health at the time in Chinese society. This article reviewed the "barefoot doctors"history of educational development from generation to recession and expounded the cultivated model of "barefoot doctors" and selected the best experience, adopted a "reflect on the past" attitude, put forward countermeasures and suggestions like changing the selection methods, improved the course setting and strengthened the cultivation of Chinese medicine for the current problems of village doctors with less capability and a significant loss of talents.

  19. Current Status of Doping in Japan Based on Japan Anti-Doping Disciplinary Panels of the Japan Anti-Doping Agency (JADA): A Suggestion on Anti-Doping Activities by Pharmacists in Japan.

    Science.gov (United States)

    Imanishi, Takashi; Kawabata, Takayoshi; Takayama, Akira

    2017-01-01

     In 2009, the Japan Anti-Doping Agency (JADA) established the "Sports Pharmacist Accreditation Program" to prevent doping in sports. Since then, anti-doping activities in Japan have been attracting attention. In this study, we investigated research about the current status of doping from 2007 to 2014 in Japan to make anti-doping activities more concrete, and we also discussed future anti-doping activities by pharmacists. In Japan, bodybuilding was the sporting event with the highest number and rate of doping from 2007 to 2014. Many of the positive doping cases were detected for class S1 (anabolic agents), S5 (diuretics and masking agents), and S6 (stimulants). Within class S1, supplements were the main cause of positive doping. Within class S5, medicines prescribed by medical doctors were the main cause of positive doping. Within class S6, non-prescription medicines (e.g., OTC) were the main cause of positive doping. When we looked at the global statistics on doping, many of the positive doping cases were detected for class S1. On comparing the Japanese statistics with the global statistics, the rate of positive doping caused by class S1 was significantly lower, but that caused by classes S5 and S6 was significantly higher in Japan than in the world. In conclusion, pharmacists in Japan should pay attention to class S1, S5, and S6 prohibited substances and to the sport events of bodybuilding. Based on this study, sports pharmacists as well as common pharmacists should suggest new anti-doping activities to prevent doping in the future.

  20. Suggested safeguards an

    African Journals Online (AJOL)

    MJM Venter

    ... COORDINATION. (FACILITATION OR CASE MANAGEMENT) IN SOUTH AFRICA ... SUGGESTED SAFEGUARDS AND LIMITATIONS FOR EFFECTIVE AND .... professional practice.27 They have to assess the situation; educate the parents.

  1. Manufacturer's Suggested Retail Prices

    NARCIS (Netherlands)

    Rosenkranz, S.

    2003-01-01

    Based on arguments of the `reference- dependent' theory of consumer choice we assume that a retailer's discount of a manufacturer's suggested retail price changes consumers' demand. We can show that the producer benefits from suggesting a retail price. If consumers are additionally sufficiently `los

  2. Environmental Factors Affecting Growth and Occurrence of Testicular Cancer in Childhood: An Overview of the Current Epidemiological Evidence

    Science.gov (United States)

    Giannandrea, Fabrizio; Fargnoli, Stefania

    2017-01-01

    Testicular cancer (TC) is the most frequently occurring malignancy among adolescents and young men aged 15–34 years. Although incidence of TC has been growing over the past 40 years in several western countries, the explanations for this increase still remain uncertain. It has been postulated that early life exposure to numerous occupational and environmental estrogenic chemicals, such as endocrine-disrupting chemicals (EDCs), may play a contributing role in the etiology of TC, but the subject is still open to additional investigation. Recently, it has also been suggested that prenatal and postnatal environmental exposures associated with child growth and development might also be involved in TC progression. This review of current epidemiological studies (2000–2015) aims to identify environmental factors associated with TC, with a particular focus on infancy and childhood factors that could constitute a risk for disease development. It may also contribute towards recognizing gaps in knowledge and recent research requirements for TC, and to point out possible interactions between child growth and development in relation to prenatal and postnatal environmental exposures. PMID:28067779

  3. "Use of Current Best Evidence": Promises and Illusions, Limitations and Contradictions in the Triangle of Research, Policy and Practice

    Science.gov (United States)

    Lassnigg, Lorenz

    2012-01-01

    This paper explores the methodological and epistemological implications of the relationships between R&D, policy and practice. The proposals towards "evidence-based policy and practice" are analysed with respect to this triangle from three angles: (1) meaning; (2) production; and (3) use of evidence. A comprehensive model of the…

  4. Genetic analysis of streptomycin-resistant (Sm(R)) strains of Erwinia amylovora suggests that dissemination of two genotypes is responsible for the current distribution of Sm(R) E. amylovora in Michigan.

    Science.gov (United States)

    McGhee, Gayle C; Guasco, Jesse; Bellomo, Lisa M; Blumer-Schuette, Sara E; Shane, William W; Irish-Brown, Amy; Sundin, George W

    2011-02-01

    Streptomycin-resistant (Sm(R)) strains of the fire blight pathogen Erwinia amylovora were first isolated in southwest Michigan in 1991. Since that time, resistant strains have progressed northward to other apple-producing regions in the state. A total of 98.7% of Sm(R) strains isolated between 2003 and 2009 in Michigan harbored the strA-strB genes on transposon Tn5393. strA and strB encode phosphotransferase enzymes that modify streptomycin to a nonbactericidal form. Mutational resistance to streptomycin, caused by a point mutation-mediated target-site alteration of the ribosomal S12 protein, occurred in 1.3% of E. amylovora strains from Michigan. Tn5393 was originally introduced to E. amylovora on the plasmid pEa34; thus, the first Sm(R) strains isolated contained both pEa34 and the ubiquitous nonconjugative plasmid pEA29. More recently, we have observed Sm(R) strains in which Tn5393 is present on pEA29, suggesting that the transposon has moved via transposition from pEa34 to pEA29. Almost all of the strains containing Tn5393 on pEA29 had lost pEa34. Of 210 pEA29::Tn5393 plasmids examined, the transposon was inserted at either nucleotide position 1,515 or 17,527. Both of these positions were in noncoding regions of pEA29. Comparative sequencing of the housekeeping genes groEL and potentially variable sequences on pEA29 was done in an attempt to genetically distinguish Sm(R) strains from streptomycin-sensitive (Sm(S)) strains isolated in Michigan. Only 1 nucleotide difference within the total 2,660 bp sequenced from each strain was observed in 2 of 29 strains; multiple sequence differences were observed between the Michigan strains and E. amylovora control strains isolated in the western United States or from Rubus spp. Alterations in virulence observable using an immature pear fruit assay were detected in three of eight Sm(R) strains examined. Our current genetic data indicate that only two Sm(R) strain genotypes (strains containing pEA29::Tn5393 with Tn5393

  5. Research Suggestions for Students

    Science.gov (United States)

    Holland, John L.

    1974-01-01

    Describes how to perform accurate research. Also includes suggestions for specific research projects under such headings as: (1) types; (2) environments; (3) interactions; (4) classification; (5) hexagonal model; and (6) differentiation. (HMV)

  6. Open to Suggestion.

    Science.gov (United States)

    Journal of Reading, 1984

    1984-01-01

    Contributors offer suggestions concerning parents as reading stimulators, book discussions, a test bank for the secondary school/college reading lab, standardized reading tests, television reading, plagiarism, vocabulary development, and book reports. (FL)

  7. Open To Suggestion.

    Science.gov (United States)

    Journal of Reading, 1988

    1988-01-01

    Suggests class activities in three short articles including: (1) "Students Evaluate Reading," by Lenore Sandel; (2) "Solving Verbal Analogies," by Edward J. Dwyer; and (3) "Becoming Testwise," by Dean Schoen. (RS)

  8. Current Evidence of Gait Modification with Real-time Biofeedback to Alter Kinetic, Temporospatial, and Function-Related Outcomes: A Review

    Directory of Open Access Journals (Sweden)

    Oladipo Eddo

    2017-07-01

    Full Text Available Background: Gait retraining using real-time biofeedback (RTB may have positive outcomes in decreasing knee adduction moment (KAM in healthy individuals and has shown equal likelihood in patients with knee osteoarthritis (OA. Currently, there is no consensus regarding the most effective gait modification strategy, mode of biofeedback or treatment dosage. Objective: The purpose of this review was: i to assess if gait retraining interventions using RTB are valuable to reduce KAM, pain, and improve function in individuals with knee osteoarthritis, ii to evaluate the effectiveness of different gait modifications and modes of RTB in reducing KAM in healthy individuals, and iii to assess the impact of gait retraining interventions with RTB on other variables that may affect clinical outcomes. Methods: Seven electronic databases were searched using five search terms. Studies that utilized any form of gait retraining with RTB to improve one or a combination of the following measures were included: KAM, knee pain, and function. Twelve studies met the inclusion criteria, evaluating eleven distinctive gait modifications and three modes of RTB. Results: All but one study showed positive outcomes. Self-selected and multi-parameter gait modifications showed the greatest reductions in KAM with visual and haptic RTB being more effective than auditory. Conclusions: Current evidence suggests that gait modification using RTB can Positively alter KAM in asymptomatic and symptomatic participants. However, the existing literature is limited and of low quality, with the optimal combination strategies remaining unclear (gait and biofeedback mode. Future studies should employ randomized controlled study designs to compare the effects of different gait modification strategies and biofeedback modes on individuals with knee OA.

  9. Current evidence on the relationship between CYP1B1 polymorphisms and lung cancer risk: a meta-analysis.

    Science.gov (United States)

    Xu, Wenhuan; Zhou, Yunhai; Hang, Xiaosheng; Shen, Di

    2012-03-01

    The association between single-nucleotide polymorphisms (SNPs) of the CYP1B1 gene and lung cancer risk is still ambiguous. In this meta analysis, we assessed 10 case-control studies included 7,067 cases and 9,374 controls of the association between CYP1B1 SNPs of Leu432Val (rs1056836, 432C>G), Asn453Ser (rs1800440, 453A>G), Ala119Ser (rs1056827, 119G>T), Arg48Gly (rs10012, 48C>G) and the risk of lung cancer. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of association between the polymorphism and lung cancer risk under codominant model, dominant model and additive model respectively. Although there were limitations, this meta analysis indicated that individuals with 432GG genotype had a 39.7% higher risk of having lung cancer than those with the 432CC genotype, and individuals with the 432G allele had a 26.3% increased risk as well. An increased risk of lung cancer of 2.13 fold was observed in individuals with 119TT genotype. For Arg48Gly, individuals with 48GG genotype had a significantly increased risk of lung cancer compared with individuals with 48CC (OR 3.859; 95% CI 2.536-5.87). Elevated risk of lung cancer were observed in dominant model (OR 2.115; 95% CI 1.653-2.705) as well. The risk of lung cancer was elevated as the frequency of G allele increased in additive model (P = 0.000). For individuals with the polymorphism at codon 453, no evidence of such association was observed. Furthermore, a possible association between the CYP1B1 polymorphism at codon 432 and the lung cancer could be detected in individuals of Caucasian origin, while a negative association was suggested in Asians and African-Americans. An increased lung cancer risk was also found in women with polymorphism at codon 453. These results are supportive for the hypothesis that the CYP1B1 432GG, 119TT and 48GG genotypes are low-penetrance risk factors for developing lung cancer, and further studies are needed to validate these associations.

  10. Review of current evidence available for guiding optimal Enoxaparin prophylactic dosing strategies in obese patients-Actual Weight-based vs Fixed.

    Science.gov (United States)

    He, Zikai; Morrissey, Hana; Ball, Patrick

    2017-05-01

    The current debate over the optimal Enoxaparin prophylactic dosing strategies in obese patients centre around whether it should be based on the actual weight of the patient (i.e. weight-based), or at an artificially fixed amount, as it is the case in Australia (40mg daily). The vast majority of the evidence available today is laboratory-based, measuring serum Antifactor-Xa activities as a marker for physiological response. The aim of the parent study is to compare the clinical outcomes for obese patients who received fixed doses of enoxaparin compared to those who received weight-based doses within the licensed dosage recommendations. This review was conducted to examine whether a gap in knowledge exists in relation to dosing obese patients with enoxaparin as VTE prophylaxis after hospital admission to aid in development of the parent study concept. Databases such as Medline, EBSCOhost, ProQuest were interrogated using combinations of words such as "enoxaparin", AND "dosing strategy", AND "obese/obesity" AND "prophylaxis". Only eleven out of 14 primary studies which were considered to be sufficiently similar in methodology and anticipated outcomes were reviewed and analysed. Pooled data from the eleven studies suggested that weight-based or higher-than-fixed dosing had a 36.2% higher success rate than fixed dosing, and was more likely to achieve the desired serum Anti-Xa activity levels (52.2% and 16% respectively). The rate of failure to achieve this is significantly lower in the weight-based groups (13.3%) than in fixed-dose groups (18.5%). These eleven studies reviewed included 601 patients in total. There is insufficient evidence to support or negate the current enoxaparin health outcomes in obese and very obese patients due to the lack of post-discharge follow-up from hospitals. Further research is required to compare long-term outcomes after fixed and weight-based dosing of enoxaparin. The optimal dose of enoxaparin per kilogram of body weight for prophylaxis

  11. No evidence for spontaneous orbital currents in numerical studies of three-band models for the CuO planes of high temperature superconductors.

    Science.gov (United States)

    Greiter, Martin; Thomale, Ronny

    2007-07-13

    We have numerically evaluated the current-current correlations for three-band models of the CuO planes in high-T(c) superconductors at hole doping x = 1/8. The results show no evidence for the orbital current patterns proposed by Varma. If such patterns exist, the associated energy is estimated to be smaller than 5 meV per link even if [formula: see text]. Assuming that the three-band models are adequate, quantum critical fluctuations of such patterns hence cannot be responsible for phenomena occurring at significantly higher energies, such as superconductivity or the anomalous properties of the strange metal phase.

  12. Attitudes to Suggestions

    Institute of Scientific and Technical Information of China (English)

    PETER; JOHNSON

    2007-01-01

    As an Australian expat teaching English in China for over four years, I often encourage my students to not only learn the English language but also try to understand Western culture. This includes the fact that Westerners frequently initiate proactive suggestions on any aspects of soci-

  13. Delirium in Hospitalized Patients: Implications of Current Evidence on Clinical Practice and Future Avenues for Research—A Systematic Evidence Review

    Science.gov (United States)

    Khan, Babar A.; Zawahiri, Mohammed; Campbell, Noll L.; Fox, George C.; Weinstein, Eric J.; Nazir, Arif; Farber, Mark O.; Buckley, John D.; MacLullich, Alasdair; (UK), MRCP; Boustani, Malaz A.

    2013-01-01

    BACKGROUND Despite the significant burden of delirium among hospitalized adults, critical appraisal of systematic data on delirium diagnosis, pathophysiology, treatment, prevention, and outcomes is lacking. PURPOSE To provide evidence-based recommendations for delirium care to practitioners, and identify gaps in delirium research. DATA SOURCES Medline, PubMed, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) information systems fromJanuary 1966 to April 2011. STUDY SELECTION All published systematic evidence reviews (SERs) on delirium were evaluated. DATA EXTRACTION Three reviewers independently extracted the data regarding delirium risk factors, diagnosis, prevention, treatment, and outcomes, and critically appraised each SER as good, fair, or poor using the United States Preventive Services Task Force criteria. DATA SYNTHESIS Twenty-two SERs graded as good or fair provided the data. Age, cognitive impairment, depression, anticholinergic drugs, and lorazepam use were associated with an increased risk for developing delirium. The Confusion Assessment Method (CAM) is reliable for delirium diagnosis outside of the intensive care unit. Multicomponent nonpharmacological interventions are effective in reducing delirium incidence in elderly medical patients. Low-dose haloperidol has similar efficacy as atypical antipsychotics for treating delirium. Delirium is associated with poor outcomes independent of age, severity of illness, or dementia. CONCLUSION Delirium is an acute, preventable medical condition with short- and long-term negative effects on a patient’s cognitive and functional states. PMID:22684893

  14. Suggestions for Teaching Practice

    Institute of Scientific and Technical Information of China (English)

    ZHAN Na-na

    2013-01-01

    Teacher development and teaching practice(TP) have caught the eyes of researchers at home and abroad for many years. Many western scholars hold that reflective teaching is an efficient way to promote teacher development, but traditional TP is prevailing in China. Based on the merits and demerits of traditional TP and reflective TP, the author hopes to provide some suggestions for the people involved to promote the development of teacher education.

  15. Effects of extracellular potassium on ventricular automaticity and evidence for a pacemaker current in mammalian ventricular myocardium.

    Science.gov (United States)

    Katzung, B G; Morgenstern, J A

    1977-01-01

    Automaticity was induced in isolated guinea pig and cat papillary muscles by application of depolarizing constant current pulses. Increasing extracellular potassium from 1 to 15 mM caused a shift of pacemaker-like activity to less negative diastolic potentials and a decrease in maximum phase 4 slope. Membrane resistance, estimated from the relation of applied current to maximum diastolic potential, decreased when extracellular potassium was increased. Voltage clamps of cat papillary muscle demonstrated that action potentials activate a time-dependent outward current which has a reversal potential of -79.1 mV (+/- 0.99 SE, n = 20) at an extracellular potassium concentration of 5 mM. The reversal potential of this current varies with extracellular K+ with a slope of 50-60 mV per 10-fold concentration change. The current is activated by voltage clamps or action potential plateaus in the range of -30 to +30 mV. It has a time constant of deactivation which increases from approximately 100 to over 400 msec as clamp potential is increased from -90 to -60 mV. It is proposed that this current is equivalent to Ix1 demonstrated in other cardiac tissues and is responsible, in combination with inward currents, for automaticity in ventricular fibers.

  16. Direct Experimental Evidence for Current-Transfer Mode Operation of Nested Tungsten Wire Arrays at 16 19 MA

    Science.gov (United States)

    Cuneo, M. E.; Sinars, D. B.; Bliss, D. E.; Waisman, E. M.; Porter, J. L.; Stygar, W. A.; Lebedev, S. V.; Chittenden, J. P.; Sarkisov, G. S.; Afeyan, B. B.

    2005-06-01

    Nested tungsten wire arrays (20-mm on 12-mm diam.) are shown for the first time to operate in a current-transfer mode at 16 19 MA, even for azimuthal interwire gaps of 0.2 mm that are the smallest typically used for any array experiment. After current transfer, the inner wire array shows discrete wire ablation and implosion characteristics identical to that of a single array, such as axially nonuniform ablation, delayed acceleration, and trailing mass and current. The presence of trailing mass from the outer and the inner arrays may play a role in determining nested array performance.

  17. Osteoradionecrosis in cancer patients : the evidence base for treatment-dependent frequency, current management strategies, and future studies

    NARCIS (Netherlands)

    Peterson, Douglas E.; Doerr, Wolfgang; Hovan, Allan; Pinto, Andres; Saunders, Debbie; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    The purpose of this study is to review the evidence base from 1990 to 2008 to (1) clarify the impact of cancer therapies on prevalence of osteoradionecrosis (ORN) in head and neck cancer patients, and to (2) evaluate management strategies and their consequences on quality of life and cost of care.

  18. Osteoradionecrosis in cancer patients : the evidence base for treatment-dependent frequency, current management strategies, and future studies

    NARCIS (Netherlands)

    Peterson, Douglas E.; Doerr, Wolfgang; Hovan, Allan; Pinto, Andres; Saunders, Debbie; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    2010-01-01

    The purpose of this study is to review the evidence base from 1990 to 2008 to (1) clarify the impact of cancer therapies on prevalence of osteoradionecrosis (ORN) in head and neck cancer patients, and to (2) evaluate management strategies and their consequences on quality of life and cost of care. A

  19. Manejo da asma aguda em adultos na sala de emergência: evidências atuais Management of acute asthma in adults in the emergency room: current evidence

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Roth Dalcin

    2009-01-01

    Full Text Available Asma é uma doença com uma alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver um aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda se constituem em uma emergência médica muito comum. As evidências têm demonstrado que o manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revisão, enfocaremos a avaliação e o tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. Serão consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento, avaliação das complicações, decisão sobre onde se realizará o tratamento adicional e orientações por ocasião da alta da emergência. Espera-se que estas recomendações contribuam para que o médico clínico tome as decisões apropriadas durante o manejo da asma aguda na sala de emergência.Asthma is a disease with high prevalence in our country and worldwide. Although new therapeutic approaches have been developed recently, there seems to be a global increase in morbidity and mortality from asthma. In many institutions, asthma exacerbation is still a common medical emergency. Clinical evidence demonstrates that management of acute asthma in the emergency room entails crucial decisions that could determine the clinical outcome. In this review, the authors focus on assessment and treatment of patients with acute asthma and outline an appropriate management strategy. Diagnosis, severity assessment, treatment, complications, decision about where additional treatment will take place and orientations on discharge from the emergency will be considered. It is expected that these recommendations will help physicians to make the appropriate decisions about care of acute asthma in the emergency

  20. Evolution and variation of the Tsushima warm current during the late Quaternary: Evidence from planktonic foraminifera, oxygen and carbon isotopes

    Institute of Scientific and Technical Information of China (English)

    LI TieGang; SUN RongTao; ZHANG DeYu; LIU ZhenXia; LI Qing; JIANG Bo

    2007-01-01

    The evolution and variation history of the Tsushima warm current during the late Quaternary was reconstructed based on the quantitative census data of planktonic foraminiferal fauna, together with oxygen and carbon isotope records of mixed layer dweller G ruber and thermocline dweller N. dutertrei in piston core CSH1 and core DGKS9603 collected separately from the Tsushima warm current and the Kuroshio dominated area. The result showed that the Tsushima warm current vanished in the Iowstand period during 40-24 cai ka BP, while the Kuroshio still flowed across the Okinawa Trough, arousing strong upwelling in the northern Trough. Meanwhile, the influence of freshwater greatly increased in the northern Okinawa Trough, as the broad East China Sea continental shelf emerged. The freshwater reached its maximum during the last glacial maximum (LGM), when the upwelling obviously weakened for the lowest sea-level and the depression of the Kuroshio. The modern Tsushima warm current began its development since 16 cai ka BP, and the impact of the Kuroshio increased in the middle and northern Okinawa Trough synchronously during the deglaciation and gradually evolved as the main water source of the Tsushima current. The modern Tsushima current finally formed at about 8.5 cai ka BP,since then the circulation structure has been relatively stable. The water of the modern Tsushima current primarily came from the Kuroshio axis. A short-term wiggle of the current occurred at about 3 cai ka BP, probably for the influences from the enhancement of the winter monsoon and the depression of the Kuroshio. The cold water masses greatly strengthened during the wiggle.

  1. Breast cancer screening in the era of density notification legislation: summary of 2014 Massachusetts experience and suggestion of an evidence-based management algorithm by multi-disciplinary expert panel.

    Science.gov (United States)

    Freer, Phoebe E; Slanetz, Priscilla J; Haas, Jennifer S; Tung, Nadine M; Hughes, Kevin S; Armstrong, Katrina; Semine, A Alan; Troyan, Susan L; Birdwell, Robyn L

    2015-09-01

    Stemming from breast density notification legislation in Massachusetts effective 2015, we sought to develop a collaborative evidence-based approach to density notification that could be used by practitioners across the state. Our goal was to develop an evidence-based consensus management algorithm to help patients and health care providers follow best practices to implement a coordinated, evidence-based, cost-effective, sustainable practice and to standardize care in recommendations for supplemental screening. We formed the Massachusetts Breast Risk Education and Assessment Task Force (MA-BREAST) a multi-institutional, multi-disciplinary panel of expert radiologists, surgeons, primary care physicians, and oncologists to develop a collaborative approach to density notification legislation. Using evidence-based data from the Institute for Clinical and Economic Review, the Cochrane review, National Comprehensive Cancer Network guidelines, American Cancer Society recommendations, and American College of Radiology appropriateness criteria, the group collaboratively developed an evidence-based best-practices algorithm. The expert consensus algorithm uses breast density as one element in the risk stratification to determine the need for supplemental screening. Women with dense breasts and otherwise low risk (20% lifetime) should consider supplemental screening MRI in addition to routine mammography regardless of breast density. We report the development of the multi-disciplinary collaborative approach to density notification. We propose a risk stratification algorithm to assess personal level of risk to determine the need for supplemental screening for an individual woman.

  2. Evolution and variation of the Tsushima warm current during the late Quaternary: Evidence from planktonic foraminifera, oxygen and carbon isotopes

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The evolution and variation history of the Tsushima warm current during the late Quaternary was reconstructed based on the quantitative census data of planktonic foraminiferal fauna, together with oxygen and carbon isotope records of mixed layer dweller G. ruber and thermocline dweller N. dutertrei in piston core CSH1 and core DGKS9603 collected separately from the Tsushima warm current and the Kuroshio dominated area. The result showed that the Tsushima warm current vanished in the lowstand period during 40―24 cal ka BP, while the Kuroshio still flowed across the Okinawa Trough, arousing strong upwelling in the northern Trough. Meanwhile, the influence of freshwater greatly increased in the northern Okinawa Trough, as the broad East China Sea continental shelf emerged. The freshwater reached its maximum during the last glacial maximum (LGM), when the upwelling obviously weakened for the lowest sea-level and the depression of the Kuroshio. The modern Tsushima warm current began its development since 16 cal ka BP, and the impact of the Kuroshio increased in the middle and north- ern Okinawa Trough synchronously during the deglaciation and gradually evolved as the main water source of the Tsushima current. The modern Tsushima current finally formed at about 8.5 cal ka BP, since then the circulation structure has been relatively stable. The water of the modern Tsushima cur- rent primarily came from the Kuroshio axis. A short-term wiggle of the current occurred at about 3 cal ka BP, probably for the influences from the enhancement of the winter monsoon and the depression of the Kuroshio. The cold water masses greatly strengthened during the wiggle.

  3. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    Science.gov (United States)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.

    2007-01-01

    were not significantly different between groups. Patients with Chagas heart disease have increased cardiac repolarization abnormalities, especially by advanced ECG. Moreover, as a group, they have decreased uncorrected JT and QT interval durations and increased filtered QRS interval durations (versus age/gender-matched controls), all suggesting a potential loss of cardiac sodium channel function that might be mediated, in part, by cardiac autonomic damage. Overall findings support Brugada et al's recent hypothesis that the pathway leading to sudden death may often be similar in Chagas' disease and Brugada syndrome i.e., damage to the sodium channel (infectious/immunologic/autonomic in Chagas' genetic in Brugada) with consequent loss of sodium currents may facilitate a phase II-reentry based arrhythmic substrate for ventricular fibrillation in both conditions. In general, JT interval-related results have been underreported in the Chagas literature.

  4. Testing for causality between the foreign direct investment, current account deficit, GDP and total credit: Evidence from G7

    Directory of Open Access Journals (Sweden)

    Akbas Yusuf Ekrem

    2013-01-01

    Full Text Available In this study, countries were analyzed between 1990 and 2011 in order to determine whether a causal relationship exists among current account deficit, GDP, foreign direct investment, and total credits of G7. Analysis took into account the cross-sectional dependence and was applied to test the causality among the variables form the panel. Firstly, panel unit root tests were used for determining stationary of variables. As a result of the panel unit root tests, it was found that GDP and foreign direct investment have a stationary structure and that total credits and current account deficit contain unit root. In order to see whether there is a long-term relationship among the variables or not, the panel co-integration test was used. As a result of the test, it was concluded that there is a co-integration relationship among the series. The possibility of a causal relationship was analyzed among the variables using the causality test developed by Elena Ivona Dumitrescu and Christophe Hurlin (2012. Results of the analysis showed a unidirectional causal relationship from current account deficit and foreign direct investment to GDP. Bidirectional causality was found between current account deficit and total credits. Finally, a unidirectional relationship was found from foreign direct investment to current account deficit and total credits.

  5. Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research.

    Science.gov (United States)

    Yakoob, Mohammad Yawar; Lo, Clifford W

    2017-10-01

    An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.

  6. The current status of evidence for and against postnatal oogenesis in mammals: a case of ovarian optimism versus pessimism?

    Science.gov (United States)

    Tilly, Jonathan L; Niikura, Yuichi; Rueda, Bo R

    2009-01-01

    Whether or not oogenesis continues in the ovaries of mammalian females during postnatal life was heavily debated from the late 1800s through the mid-1900s. However, in 1951 Lord Solomon Zuckerman published what many consider to be a landmark paper summarizing his personal views of data existing at the time for and against the possibility of postnatal oogenesis. In Zuckerman's opinion, none of the evidence he considered was inconsistent with Waldeyer's initial proposal in 1870 that female mammals cease production of oocytes at or shortly after birth. This conclusion rapidly became dogma, and remained essentially unchallenged until just recently, despite the fact that Zuckerman did not offer a single experiment proving that adult female mammals are incapable of oogenesis. Instead, 20 years later he reemphasized that his conclusion was based solely on an absence of data he felt would be inconsistent with the idea of a nonrenewable oocyte pool provided at birth. However, in the immortal words of Carl Sagan, an "absence of evidence is not evidence of absence." Indeed, building on the efforts of a few scientists who continued to question this dogma after Zuckerman's treatise in 1951, we reported several data sets in 2004 that were very much inconsistent with the widely held belief that germ cell production in female mammals ceases at birth. Perhaps not surprisingly, given the magnitude of the paradigm shift being proposed, this work reignited a vigorous debate that first began more than a century ago. Our purpose here is to review the experimental evidence offered in recent studies arguing support for and against the possibility that adult mammalian females replenish their oocyte reserve. "Never discourage anyone who continually makes progress, no matter how slow."-Plato (427-347 BC).

  7. Thrombolytic treatment in the oldest-old patient with acute ischemic stroke: an update on current evidence

    Directory of Open Access Journals (Sweden)

    Fabiola Maioli

    2013-09-01

    Full Text Available The incidence of ischemic stroke rises exponentially with age, with a steep increase in the age interval between 75 and 85 years. Thrombolytic therapy restores cerebral blood flow in patients with acute ischemic stroke of any etiology by using drugs that dissolve blood clots. Infusion for 1 h of alteplase at the dose of 0.9 mg/kg within 3 h of the start of the symptoms is associated to a 30% increase in the likelihood of gaining a favorable outcome with respect to placebo. There is strong evidence that selected patients with ischemic stroke may benefit from intravenous thrombolysis when treated within 3 h. The aim of the study was to evaluate available evidence for the efficacy and safety of thrombolytic therapy in patients with ischemic stroke aged 80 years and over. Compared to younger stroke patients treated with thrombolytic therapy, those aged 80 years and over have higher acute mortality due to symptomatic intracranial hemorrhage. However, functional outcome at six months is significantly better for over-80-year-olds than younger patients. There is a need for screening tools that take into account pre-stroke functional and cognitive status that are able to identify those over-80-year-old patients with ischemic stroke who can most benefit from thrombolytic treatment. Available evidence supports further recruitment of oldest-old patients into ongoing trials of thrombolysis.

  8. Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

    Science.gov (United States)

    Damman, Kevin; Tang, W H Wilson; Felker, G Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J V

    2014-03-11

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients with (severe) renal dysfunction. The benefit of these evidence-based therapies in this high-risk patient group is largely unknown. This paper reviews data from randomized clinical trials in systolic heart failure and the interactions between baseline renal dysfunction and the effect of randomized treatment. It highlights that most evidence-based therapies show consistent outcome benefit in patients with moderate renal insufficiency (stage 3 CKD), whereas there are very scarce data on patients with severe (stage 4 to 5 CKD) renal insufficiency. If any, the outcome benefit might be even greater in stage 3 CKD compared with those with relatively preserved renal function. However, prescription of therapies should be individualized with consideration of possible harm and benefit, especially in those with stage 4 to 5 CKD where limited data are available.

  9. Evidence of the Current Collector Effect: Study of the SOFC Cathode Material Ca3Co4O9+d

    NARCIS (Netherlands)

    Rolle, A.; Thoréton, V.; Rozier, P.; Capoen, E.; Mentré, O.; Boukamp, B.A.; Daviero-Minaud, S.

    2012-01-01

    In the study of the performance of solid oxide fuel cell (SOFC) electrodes, the possible influence of the applied current collector is often not mentioned or recognized. In this article, as part of an optimization study of the potentially attractive Ca3Co4O9+δ cathode material (Ca349), special atten

  10. Current evidence for a role of GLP-1 in Roux-en-Y gastric bypass-induced remission of type 2 diabetes

    DEFF Research Database (Denmark)

    Rhee, Nicolai Alexander; Vilsbøll, T; Knop, F K

    2012-01-01

    Weight-reducing surgical procedures such as Roux-en-Y gastric bypass (RYGB) have proven efficient as means of decreasing excess body weight. Furthermore, some studies report that up to 80% of patients with type 2 diabetes mellitus (T2DM) undergoing RYGB experience complete remission of their T2DM......-induced remission of T2DM are lacking. This article critically evaluates the current evidence for a role of GLP-1 in RYGB-induced remission of T2DM....

  11. Guiyang modern logistics industry and regional economic coordinated development of the Current Situation and Suggestions%贵阳市现代物流业与区域经济协调发展现状及对策建议

    Institute of Scientific and Technical Information of China (English)

    曾方俊

    2012-01-01

    根据现代物流业与区域经济协调发展的重要性和内在机理,对贵阳市现代物流业与区域经济发展现状进行调研,针对存在的问题,提出了相关对策建议。%According to the importance of the modem logistics industry and the coordinated development of regional economy and the internal mechanism of Guiyang City, the modem logistics industry and regional economic development research, development and put forward relevant suggestions for possible problems.

  12. The health systems' priority setting criteria for selecting health technologies: A systematic review of the current evidence

    Science.gov (United States)

    Mobinizadeh, Mohammadreza; Raeissi, Pouran; Nasiripour, Amir Ashkan; Olyaeemanesh, Alireza; Tabibi, Seyed Jamaleddin

    2016-01-01

    Background: In the recent years, using health technologies to diagnose and treat diseases has had a considerable and accelerated growth. The proper use of these technologies may considerably help in the diagnosis and treatment of different diseases. On the other hand, unlimited and unrestricted entry of these technologies may result in induced demand by service providers. The aim of this study was to determine the appropriate criteria used in health technologies priority-setting models in the world. Methods: Using MESH and free text, we sought and retrieved the relevant articles from the most appropriate medical databases (the Cochrane Library, PubMed and Scopus) through three separate search strategies up to March 2015. The inclusion criteria were as follows: 1) Studies with specific criteria; 2) Articles written in English; 3) Those articles conducted in compliance with priority setting of health technologies. Data were analyzed qualitatively using a thematic synthesis technique. Results: After screening the retrieved papers via PRISMA framework, from the 7,012 papers, 40 studies were included in the final phase. Criteria for selecting health technologies (in pre assessment and in the assessment phase) were categorized into six main themes: 1) Health outcomes; 2) Disease and target population; 3) Technology alternatives; 4) Economic aspects; 5) Evidence; 6) and other factors. "Health effects/benefits" had the maximum frequency in health outcomes (8 studies); "disease severity" had the maximum frequency in disease and target population (12 studies); "the number of alternatives" had the maximum frequency in alternatives (2 studies); "cost-effectiveness" had the maximum frequency in economic aspects (15 studies); "quality of evidence" had the maximum frequency in evidence (4 studies); and "issues concerning the health system" had the maximum frequency in other factors (10 studies). Conclusion: The results revealed an increase in the number of studies on health

  13. Incidental moderate mitral regurgitation in patients undergoing aortic valve replacement for aortic stenosis: review of guidelines and current evidence.

    Science.gov (United States)

    Ramakrishna, Harish; Kohl, Benjamin A; Jassar, Arminder S; Augoustides, John G T

    2014-04-01

    Recent evidence has shown that moderate mitral regurgitation is common and clinically relevant in patients presenting for surgical and transcatheter aortic valve replacement for aortic stenosis. Prospective multicenter clinical trials are now indicated to resolve the clinical equipoise about whether or not mitral valve intervention also is indicated at the time of aortic valve intervention. Advances in three-dimensional transesophageal echocardiography, transcatheter mitral interventions, and surgical aortic valve replacement, including the advent of sutureless valves, likely will expand the therapeutic possibilities for moderate mitral regurgitation in the setting of aortic valve interventions for severe aortic stenosis.

  14. 转基因主粮商业化对现行法律的挑战与对策分析%Challenges of Commercialization of Genetically Modified Staple Foods to Current Laws and Suggestions

    Institute of Scientific and Technical Information of China (English)

    付文佚

    2014-01-01

    The commercialization of genetically modified (GM)staple foods is a critical issue concerning the national economy and people’s livelihood.Today debates are focusing on whether or not to commercialize GMsta-ple foods,and seldom on the huge drawbacks of current law facing with commercialization.After a comprehen-sively analysis current rules on GM crops and foods,huge drawbacks are found in ideas,measures,procedures and remedies in legal system.Reasons for legislation dilemma are due to GMprocess,hard to distinction between GMand non GMproducts,also huge interests’conflicts exist in staple food.Before pushing commercialization of GMstaple foods,legislation must change,including guiding ideas and principles being modified,special law and new measures being regulated,with more information transparency and public engagement,increasing punishment and identifying the tort liability etc.In conclusion,current laws are not sufficient for the commercialization of GM staple foods.If decisions are rashly made,huge and irreversible damage may result.%转基因主粮的商业化是涉及国计民生的重大问题,舆论上对其是否商业化争论不休,少有研究涉及当前法律在商业化情形下存在的巨大不足。现行的转基因法律、法规和规章在法律理念、法律制度、法律程序和法律救济方面等存在诸多问题。转基因作为生产过程,在区分困难的客观特性和主粮问题上根本利益的严重冲突导致转基因立法的举步维艰。转基因主粮商业化决策之前,必须先进行法律的整体更新和完善,包括转变立法理念,确定法律原则,通过专门立法、革新法律制度,完善信息公开、增加公众参与,加重违法成本、明确侵权责任等。总之,我国目前现尚不具备转基因主粮商业化的法律环境,贸然推行商业化,将带来严重危害后果。

  15. Women empowerment and the current use of long acting and permanent contraceptive: Evidence from 2010 Malawi Demographic and Health Survey.

    Science.gov (United States)

    Palamuleni, M E; Adebowale, A S

    2014-09-01

    Both contraceptive use and fertility rates are high fertility in Malawi. Status of women remains low and is believed to affect reproductive health decisions including use of Long Acting and Permanent Contraceptives Method (LAPCM). This study seeks to examine the relationship between women empowerment and LAPCM. A measure of women's empowerment is derived from the women's responses to questions on the number of household decisions in which the respondent participates, employment status, type of earnings, women's control over cash earnings and level of education. The study is based on a sub sample of 5,948 married women from the 2010 Malawi Demographic and Health Survey. Data was analysed using descriptive statistics, Chi-square and multinomial logistic regression models (α=5%). The prevalence of current use of LAPCM was 20.0% and increases with increasing empowerment level (pempowerment score of women who are currently using LAPCM were 38.53±6.2 years and 6.80±2.9 respectively. Urban women (22.2%) were more currently using LAPCM than rural women (19.4%) pWomen who belong to Seven Day Adventists/Baptist were 1.51(C.I=1.058-2.153; p=0.023) more likely and Muslims were 0.58(C.I=0.410-0.809; p=0.001) less likely to currently use LAPCM than Catholic women. Being in the richest wealth quintile (OR=1.91; C.I=1.362-2.665; pwomen who have access to FP programmes on media and increases consistently with increasing women empowerment level even when other potential confounding variables were used as control. In Malawi, LAPCM is still underutilized and more than half of the women are not adequately empowered. Women empowerment, wealth quintile and access to FP programmes are key factors influencing the use of LAPCM. Programmes that address these determinants are urgently needed in Malawi.

  16. Acceptance and Commitment Therapy versus Traditional Cognitive Behavioral Therapy: A Systematic Review and Meta-analysis of Current Empirical Evidence

    OpenAIRE

    2012-01-01

    Controversy remains about the empirical status of acceptance and commitment therapy (ACT) and its presumably different characteristics relative to traditional cognitive behavioral therapy (CBT). The current study aims to shed some light in this respect by conducting a systematic review and meta-analysis of the studies that have empirically compared ACT versus CBT. Sixteen studies comparing differential outcomes (N= 954) of ACT versus CBT in diverse problems were identified following several s...

  17. Runout distance and dynamic pressure of pyroclastic density currents: Evidence from 18 May 1980 blast surge of Mount St. Helens

    Science.gov (United States)

    Gardner, J. E.; Andrews, B. J.

    2016-12-01

    Pyroclastic density currents (flows and surges) are one of the most deadly hazards associated with volcanic eruptions. Understanding what controls how far such currents will travel, and how their dynamic pressure evolves, could help mitigate their hazards. The distance a ground hugging, pyroclastic density current travels is partly limited by when it reverses buoyancy and lifts off into the atmosphere. The 1980 blast surge of Mount St. Helens offers an example of a current seen to lift off. Before lofting, it had traveled up to 20 km and leveled more than 600 km3 of thick forest (the blowdown zone). The outer edge of the devastated area - where burned trees that were left standing (the singe zone) - is where the surge is thought to have lifted off. We recently examined deposits in the outer parts of the blowdown and in the singe zone at 32 sites. The important finding is that the laterally moving surge travelled into the singe zone, and hence the change in tree damage does not mark the run out distance of the ground hugging surge. Eyewitness accounts and impacts on trees and vehicles reveal that the surge consisted of a fast, dilute "overcurrent" and a slower "undercurrent", where most of the mass (and heat) was retained. Reasonable estimates for flow density and velocity show that dynamic pressure of the surge (i.e., its ability to topple trees) peaked near the base of the overcurrent. We propose that when the overcurrent began to lift off, the height of peak dynamic pressure rose above the trees and stopped toppling them. The slower undercurrent continued forward, burning trees but it lacked the dynamic pressure needed to topple them. Grain-size variations argue that it slowed from 30 m/s when it entered the singe zone to 3 m/s at the far end. Buoyancy reversal and liftoff are thus not preserved in the deposits where the surge lofted upwards.

  18. The Indicator Amino Acid Oxidation Method with the Use of l-[1-13C]Leucine Suggests a Higher than Currently Recommended Protein Requirement in Children with Phenylketonuria.

    Science.gov (United States)

    Turki, Abrar; Ueda, Keiko; Cheng, Barbara; Giezen, Alette; Salvarinova, Ramona; Stockler-Ipsiroglu, Sylvia; Elango, Rajavel

    2017-02-01

    Phenylketonuria is characterized by mutations in the Phe hydroxylase gene that leads to the accumulation of Phe in plasma and the brain. The standard of care for phenylketonuria is nutritional management with dietary restriction of Phe and the provision of sufficient protein and energy for growth and health maintenance. The protein requirement in children with phenylketonuria is empirically determined based upon phenylketonuria nutritional guidelines that are adjusted individually in response to biochemical markers and growth. We determined dietary protein requirements in children with phenylketonuria with the use of the indicator amino acid oxidation (IAAO) technique, with l-[1-(13)C]Leu as the indicator amino acid. Four children (2 males; 2 females) aged 9-18 y with phenylketonuria [mild hyperphenylalanemia (mHPA); 6-10 mg/dL (360-600 μmol/L)] were recruited to participate in ≥7 separate test protein intakes (range: 0.2-3.2 g ⋅ kg(-1) ⋅ d(-1)) with the IAAO protocol with the use of l-[1-(13)C]Leu followed by the collection of breath and urine samples over 8 h. The diets were isocaloric and provided energy at 1.7 times the resting energy expenditure. Protein was provided as a crystalline amino acid mixture based on an egg protein pattern, except Phe and Leu, which were maintained at a constant across intakes. Protein requirement was determined with the use of a 2-phase linear-regression crossover analysis of the rate of l-[1-(13)C]Leu tracer oxidation. The mean protein requirement was determined to be 1.85 g ⋅ kg(-1) ⋅ d(-1) (R(2) = 0.66; 95% CI: 1.37, 2.33). This result is substantially higher than the 2014 phenylketonuria recommendations (1.14-1.33 g ⋅ kg(-1) ⋅ d(-1); based on 120-140% above the current RDA for age). To our knowledge, this is the first study to directly define a quantitative requirement for protein intake in children with mHPA and indicates that current protein recommendations in children with phenylketonuria may be insufficient

  19. Sleep and Children with Cerebral Palsy: A Review of Current Evidence and Environmental Non-Pharmacological Interventions

    Directory of Open Access Journals (Sweden)

    Risha Dutt

    2015-02-01

    Full Text Available Between 23%–46% of children with cerebral palsy experience sleep problems. Many of the sensory-motor and cognitive features of cerebral palsy (such as immobility, pain, and seizures act as predisposing factors for sleep problems in this population. This paper presents the background related to the etiology and consequences of sleep problems in children with cerebral palsy. The relationship between pain and sleep is emphasized, as the risk of pain is highly prevalent in children with cerebral palsy. The review concludes with a discussion of the evidence-base for environmental non-pharmacological interventions based on light, temperature, sound and bedding to promote sleep for children with cerebral palsy.

  20. When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy.

    Science.gov (United States)

    Yuan, Kristy; Kim, Anthony S

    2016-04-01

    For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major bleeding as warfarin that offsets reductions in stroke risk. Dual antiplatelet therapy is recommended for endovascular cerebrovascular stenting procedures, although the optimal duration of therapy is not well established. Short-term dual antiplatelet therapy when initiated acutely after minor stroke/TIA, particularly in Asian populations or for intracranial atherosclerosis, holds promise though studies to evaluate this approach more generally are ongoing. New antiplatelet agents and additional data on the pharmacogenetics of clopidogrel metabolism have the potential to help to individualize these recommendations moving forward.

  1. Are immune checkpoint blockade monoclonal antibodies active against CNS metastases from NSCLC?-current evidence and future perspectives.

    Science.gov (United States)

    O'Kane, Grainne M; Leighl, Natasha B

    2016-12-01

    Brain metastases occur in approximately half of patients with non-small cell lung cancer (NSCLC) and are associated with a poor prognosis and an inferior quality of life. Historically systemic therapy has had a limited role in CNS disease with a reliance placed on local treatments. The emergence of targeted therapies and immune checkpoint inhibitors (ICIs) in recent years has dramatically changed the treatment landscape of NSCLC. Programmed cell death-1 (PD-1) inhibitors have demonstrated efficacy in three randomized trials and now represent standard second line therapy after platinum failure. Trials have largely excluded patients with symptomatic or untreated CNS disease as the brain has been considered an 'immune-privileged' organ. We review the evidence and future prospects of ICIs in treating brain metastases in NSCLC.

  2. 流通产业数据统计的现状、问题及改进建议%Current Situation and Problems of Statistics in Distribution Industry and Suggestions for Improvement

    Institute of Scientific and Technical Information of China (English)

    张昊

    2014-01-01

    流通领域的数据统计对于产业自身发展和宏观经济预测都具有极其重要的价值。目前,我国流通统计指标体系已经基本形成,但其数据内容、来源及发布方式等仍有改进的必要。应当以接轨国际标准的行业分类为基础,在“大流通”视野中确定流通产业的行业范围,进而建立由共性指标、个性指标构成的有机统一的指标体系。同时,有必要梳理、协调政府及相关机构目前发布的数据内容,通过“云技术”实现统筹与整合。并且,要明晰数据的来源渠道、采集方式,将重复矛盾转变为差异互补。在这一过程中,应当充分挖掘经济普查数据的利用价值,发挥非官方机构的补充作用,使流通统计更加全面、透明,为问题导向的分析研究提供更好的支撑。%Statistics in distribution area is of great importance both for the development of industry and macroeconomic forecasts. Currently,the statistical indicator system has been basically formed,but improvement is still needed for its data contents,sources and publication methods. According to international standards,the industry scope of‘enlarged distribution system’should be determined,and based on industry classification,an organically consolidated indicator system which includes both common and special indicators should be built. Meanwhile,it is necessary to rearrange and coordinate the contents of the data currently published by government and related organizations,and an integration could be achieved by using the"cloud tech". The source and collection method of data should also be made clear,so as to change the situation of data publication from repeated or contradictory into differentiated and complementary. In this process,the value of economic census data should be cherished and the NGOs can also play a supplementary role,so that the statistics can be made more comprehensive and transparent,thus providing

  3. Current Situation, Problem and Suggestion in the Tractor Driver-training in Anhui Province%安徽省拖拉机驾驶培训的现状·问题与建议

    Institute of Scientific and Technical Information of China (English)

    管志俊

    2016-01-01

    The existing common problem in the process of driver-training such as the training and check, the training hours-setting, the teaching material, the practical machinery, the policy support and others and its causes were analyzed through the analysis of the historical review and cur-rent status in Anhui tractor driver-training and then the recommendation was put forward. The tractor driver-training should be one kind of public service activity. The R&D and management of teaching material and coach equipment should be strengthened. The process of training and ac-creditation should be reformed, and the management of software should be promoted, the subsidies for tractor-purchasing should be optimized, so that the tractor driver-training would be more scientific, reasonable and efficient.%通过对安徽省拖拉机驾驶培训的历史回顾和现状的梳理,分析在培训考证流程、学时设置、教材建设、实习机具、政策支持等方面存在的共性问题及成因,进而提出相关建议,要求回归拖拉机驾驶培训的公益性,加强教材教法建设和教练机具的研发和管理,改革和完善现有的培训办证流程,推广软件化管理,优化购机补贴政策,促使今后的拖拉机驾驶培训工作更加科学、合理和高效。

  4. Seascape genomics provides evidence for thermal adaptation and current-mediated population structure in American lobster (Homarus americanus).

    Science.gov (United States)

    Benestan, Laura; Quinn, Brady K; Maaroufi, Halim; Laporte, Martin; Clark, Fraser K; Greenwood, Spencer J; Rochette, Rémy; Bernatchez, Louis

    2016-10-01

    Investigating how environmental features shape the genetic structure of populations is crucial for understanding how they are potentially adapted to their habitats, as well as for sound management. In this study, we assessed the relative importance of spatial distribution, ocean currents and sea surface temperature (SST) on patterns of putatively neutral and adaptive genetic variation among American lobster from 19 locations using population differentiation (PD) approaches combined with environmental association (EA) analyses. First, PD approaches (using bayescan, arlequin and outflank) found 28 outlier SNPs putatively under divergent selection and 9770 neutral SNPs in common. Redundancy analysis revealed that spatial distribution, ocean current-mediated larval connectivity and SST explained 31.7% of the neutral genetic differentiation, with ocean currents driving the majority of this relationship (21.0%). After removing the influence of spatial distribution, no SST were significant for putatively neutral genetic variation whereas minimum annual SST still had a significant impact and explained 8.1% of the putatively adaptive genetic variation. Second, EA analyses (using Pearson correlation tests, bayescenv and lfmm) jointly identified seven SNPs as candidates for thermal adaptation. Covariation at these SNPs was assessed with a spatial multivariate analysis that highlighted a significant temperature association, after accounting for the influence of spatial distribution. Among the 505 candidate SNPs detected by at least one of the three approaches, we discovered three polymorphisms located in genes previously shown to play a role in thermal adaptation. Our results have implications for the management of the American lobster and provide a foundation on which to predict how this species will cope with climate change.

  5. Evidence for a role of transporter-mediated currents in the depletion of brain serotonin induced by serotonin transporter substrates.

    Science.gov (United States)

    Baumann, Michael H; Bulling, Simon; Benaderet, Tova S; Saha, Kusumika; Ayestas, Mario A; Partilla, John S; Ali, Syed F; Stockner, Thomas; Rothman, Richard B; Sandtner, Walter; Sitte, Harald H

    2014-05-01

    Serotonin (5-HT) transporter (SERT) substrates like fenfluramine and 3,4-methylenedioxymethamphetamine cause long-term depletion of brain 5-HT, while certain other substrates do not. The 5-HT deficits produced by SERT substrates are dependent upon transporter proteins, but the exact mechanisms responsible are unclear. Here, we compared the pharmacology of several SERT substrates: fenfluramine, d-fenfluramine, 1-(m-chlorophenyl)piperazine (mCPP) and 1-(m-trifluoromethylphenyl)piperainze (TFMPP), to establish relationships between acute drug mechanisms and the propensity for long-term 5-HT depletions. In vivo microdialysis was carried out in rat nucleus accumbens to examine acute 5-HT release and long-term depletion in the same subjects. In vitro assays were performed to measure efflux of [(3)H]5-HT in rat brain synaptosomes and transporter-mediated ionic currents in SERT-expressing Xenopus oocytes. When administered repeatedly to rats (6 mg/kg, i.p., four doses), all drugs produce large sustained elevations in extracellular 5-HT (>5-fold) with minimal effects on dopamine. Importantly, 2 weeks after dosing, only rats exposed to fenfluramine and d-fenfluramine display depletion of brain 5-HT. All test drugs evoke fluoxetine-sensitive efflux of [(3)H]5-HT from synaptosomes, but d-fenfluramine and its bioactive metabolite d-norfenfluramine induce significantly greater SERT-mediated currents than phenylpiperazines. Our data confirm that drug-induced 5-HT release probably does not mediate 5-HT depletion. However, the magnitude of transporter-mediated inward current may be a critical factor in the cascade of events leading to 5-HT deficits. This hypothesis warrants further study, especially given the growing popularity of designer drugs that target SERT.

  6. Evidence for a current sheet forming in the wake of a Coronal Mass Ejection from multi-viewpoint coronagraph observations

    OpenAIRE

    Patsourakos, S.; Vourlidas, A.

    2010-01-01

    Ray-like features observed by coronagraphs in the wake of Coronal Mass Ejections (CMEs) are sometimes interpreted as the white light counterparts of current sheets (CSs) produced by the eruption. The 3D geometry of these ray-like features is largely unknown and its knowledge should clarify their association to the CS and place constraints on CME physics and coronal conditions. With this study we test these important implications for the first time. An example of such a post-CME ray was observ...

  7. Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence.

    Science.gov (United States)

    Yoshinaga, Keiichiro; Tamaki, Nagara

    2015-08-01

    Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.

  8. 基于SWOT模型的四川创新团队发展现状分析及建议%Analysis on Current Status of Innovation Team Development in Sichuan Province Based on SWOT Model and Suggestions

    Institute of Scientific and Technical Information of China (English)

    景晓卫; 李晓; 雷波

    2015-01-01

    加强四川创新团队建设是提升科技支撑产业发展、促进农业产业提档升级的有效方式.文章采用SWOT模型分析了四川创新团队在科研力量、优势产业和管理方式等方面的优势,以及在科技协作、经费投入等方面的劣势.提出了通过加强组织领导和管理创新、突出成果转化应用和大力培育新型职业农民等促进四川创新团队健康、持续发展的建议.%Strengthening the construction of innovation team is the effective way of promoting the development of scientific supporting industry and accelerating the upgrade of agricultural industry. In this article, innovation team of Sichuan Province was analyzed by SWOT model, which has advantages in scientific research force, superior industry and management mode, and has main obstacles in cooperative mode and fund input. Suggestions to promote healthy and sustainable development of innovation team in Sichuan Province were put forward, i.e., strengthening the organization leadership and management innovation, laying stress on transformation and application of achievements, and cultivating new type of professional farmers.

  9. 供电营业网点建设现状分析及建议%Analysis on the Current Situation of Power Supply Outlets Construction and Its Suggestions

    Institute of Scientific and Technical Information of China (English)

    杜雅飞

    2015-01-01

    本文通过深入研究"大营销"体系建成以来营业网点在管理标准、网点布局、软硬件设施及人员配备等方面存在的问题,按照"大营销"体系建设中"城乡一体化"的发展要求,结合近年来"城市十分钟缴费圈"、"农村村村布点"等多元化缴费渠道和代收网点的建设标准,给供电营业网点建设提出参考建议.%In this paper, through the deep research of the existing problems in management standard, site layout, hardware and software facilities, staffing accouterment and other aspects of the business outlets after the "big marketing" system construction, according to the development requirements of "urban-rural integration" in the "big marketing" system construction, combined with the construction standard of "ten-minute capture expends circle of cities", "outlets in every village" and other diversified payment channels and outlets, the suggestions of power supply outlets construction are put forward.

  10. Evidence of the Relationship between the Emerging Magnetic Fields, Electric Currents, and Solar Flares Observed on May 10, 2012

    CERN Document Server

    Livshits, M A; Myshyakov, I I; Rudenko, G V

    2016-01-01

    We have analyzed multi-wavelength observations and magnetic-field data for the solar flare of May 10, 2012 (04:18 UT) and have detected a sign inversion of the signal in the line-of-sight magnetic measurements in the umbra of a small spot. This effect is associated, at least partly, with the emergence of a new magnetic field. Almost at the same time, a burst of hard X-rays was recorded, and a wave in the vacuum ultraviolet (EUV) range (a "sunquake") was generated due to the impact of the disturbance in the energy release range on the photosphere. At the beginning of the event, a sigmoid flare was recorded, but it did not spread, as it usually does, along the polarity inversion (neutral) line. SDO/HMI full-vector measurements were used to extrapolate the AR 11476 magnetic field to the corona, and the distribution of vertical currents $j_z$ in the photosphere was obtained. The distribution of currents in the active region shows that the relationship between them and the occurrence of flares is very intricate. W...

  11. Evidence for non-conservative current-induced forces in the breaking of Au and Pt atomic chains

    Directory of Open Access Journals (Sweden)

    Carlos Sabater

    2015-12-01

    Full Text Available This experimental work aims at probing current-induced forces at the atomic scale. Specifically it addresses predictions in recent work regarding the appearance of run-away modes as a result of a combined effect of the non-conservative wind force and a ‘Berry force’. The systems we consider here are atomic chains of Au and Pt atoms, for which we investigate the distribution of break down voltage values. We observe two distinct modes of breaking for Au atomic chains. The breaking at high voltage appears to behave as expected for regular break down by thermal excitation due to Joule heating. However, there is a low-voltage breaking mode that has characteristics expected for the mechanism of current-induced forces. Although a full comparison would require more detailed information on the individual atomic configurations, the systems we consider are very similar to those considered in recent model calculations and the comparison between experiment and theory is very encouraging for the interpretation we propose.

  12. Evidence for non-conservative current-induced forces in the breaking of Au and Pt atomic chains.

    Science.gov (United States)

    Sabater, Carlos; Untiedt, Carlos; van Ruitenbeek, Jan M

    2015-01-01

    This experimental work aims at probing current-induced forces at the atomic scale. Specifically it addresses predictions in recent work regarding the appearance of run-away modes as a result of a combined effect of the non-conservative wind force and a 'Berry force'. The systems we consider here are atomic chains of Au and Pt atoms, for which we investigate the distribution of break down voltage values. We observe two distinct modes of breaking for Au atomic chains. The breaking at high voltage appears to behave as expected for regular break down by thermal excitation due to Joule heating. However, there is a low-voltage breaking mode that has characteristics expected for the mechanism of current-induced forces. Although a full comparison would require more detailed information on the individual atomic configurations, the systems we consider are very similar to those considered in recent model calculations and the comparison between experiment and theory is very encouraging for the interpretation we propose.

  13. Current Evidence to Justify, and the Methodological Considerations for a Randomised Controlled Trial Testing the Hypothesis that Statins Prevent the Malignant Progression of Barrett's Oesophagus

    Institute of Scientific and Technical Information of China (English)

    David Thurtle; Leo Alexandre; Yoon K Loke; Ed Cheong; Andrew Hart

    2014-01-01

    Barrett's oesophagus is the predominant risk factor for oesophageal adenocarcinoma, a cancer whose incidence is increasing and which has a poor prognosis. This article reviews the latest experimental and epidemiological evidence justifying the development of a randomised controlled trial investigating the hypothesis that statins prevent the malignant progression of Barrett's oesophagus, and explores the methodological considerations for such a trial. The experimental evidence suggests anti-carcinogenic properties of statins on oesophageal cancer cell lines, based on the inhibition of the mevalonate pathway and the production of pro-apoptotic proteins. The epidemiological evidence reports inverse associations between statin use and the incidence of oesophageal carcinoma in both general population and Barrett's oesophagus cohorts. Such a randomised controlled trial would be a large multi-centre trial, probably investigating simvastatin, given the wide clinical experience with this drug, relatively low side-effect profile and low ifnancial cost. As with any clinical trial, high adherence is important, which could be increased with therapy, patient, doctor and system-focussed interventions. We would suggest there is now sufifcient evidence to justify a full clinical trial that attempts to prevent this aggressive cancer in a high-risk population.

  14. Current Evidence to Justify, and the Methodological Considerations for a Randomised Controlled Trial Testing the Hypothesis that Statins Prevent the Malignant Progression of Barrett's Oesophagus

    Directory of Open Access Journals (Sweden)

    David Thurtle

    2014-12-01

    Full Text Available Barrett’s oesophagus is the predominant risk factor for oesophageal adenocarcinoma, a cancer whose incidence is increasing and which has a poor prognosis. This article reviews the latest experimental and epidemiological evidence justifying the development of a randomised controlled trial investigating the hypothesis that statins prevent the malignant progression of Barrett’s oesophagus, and explores the methodological considerations for such a trial. The experimental evidence suggests anti-carcinogenic properties of statins on oesophageal cancer cell lines, based on the inhibition of the mevalonate pathway and the production of pro-apoptotic proteins. The epidemiological evidence reports inverse associations between statin use and the incidence of oesophageal carcinoma in both general population and Barrett’s oesophagus cohorts. Such a randomised controlled trial would be a large multi-centre trial, probably investigating simvastatin, given the wide clinical experience with this drug, relatively low side-effect profile and low financial cost. As with any clinical trial, high adherence is important, which could be increased with therapy, patient, doctor and system-focussed interventions. We would suggest there is now sufficient evidence to justify a full clinical trial that attempts to prevent this aggressive cancer in a high-risk population.

  15. 高中生主动体育锻炼现状的调查与建议%Investigation and Suggestion on the current Situation of Active Physical Exercises in high school Students

    Institute of Scientific and Technical Information of China (English)

    刘子毅; 李惟英

    2016-01-01

    为了解高中生课余主动体育锻炼的现状,采用问卷调查和访谈的研究方法,对高中生的体育锻炼时间、频率、态度与所喜爱的项目、体育与健康知识的获取途径等一系列问题进行调查与访谈,从数据的角度分析高中生主动体育锻炼的现状,并对培养高中生主动体育锻炼的习惯给出一些建议,如加强课上体育与健康知识的传授、以及基于微信平台引导学生养成主动体育锻炼的方法等。%To understand the present situation of high school students extracurricular physical exercise initiative, using methods of questionnaires and interview investigation to explore a series of answers on high school students’ physical exercise time, frequency, attitude and favorite items sports and health knowledge acquirement. Analysis of the status quo of active exercise of high school students from the perspective of data. and this paper also gave some suggestions help cultivate the habit of physical exercise, such as strengthening teaching of physical and health knowledge in class, and guide students to develop active physical exercise habits through WeChat platform, etc.

  16. Current Status , Problems and Suggestions on Climate Change Adaptation Actions in Sichuan Province%四川省气候变化适应行动现状、问题和建议研究

    Institute of Scientific and Technical Information of China (English)

    田梅; 冉春红; 李映果; 赵毅峰; 杨光炜

    2016-01-01

    The effective development of local climate change adaptation action is an important guarantee to ensure the imple-mentation of climate change adaptation strategies and objectives.As one of the more serious province which suffering from the ad-verse effects of climate change, Sichuan province is facing the challenge of enhancing the ability of sustainable development and responding the new climate change risk, how to maintain the economic development while establishing a low carbon development model of climate change is a realistic and urgent task for the economic and social development of our province .Based on the brief description of climate change impacts on Sichuan province as well as the Sichuan province's climate change adaptation achieve-ments, the paper further analyzed the problems about the adaptation to climate change , it was found that the policies and work mechanism for adaptation work had not been perfected, the lack of funding was difficult to provide long -term security mecha-nisms, infrastructure construction could not meet the needs of the adaptation, foundation support capacity was relatively weak, etc.Finally, several suggestions were put forward for further strengthening Sichuan province's climate change adaptation actions, such as:Strengthening policies and regulations for climate change adaptation;accelerating the improvement of institutional mecha-nisms for climate change adaptation; Increasing financial investment and financial support; enhancing the construction of the in-frastructure and condition platform to adapt for climate change; strengthening capacity building for climate change adaptation.%作为遭受气候变化不利影响较为严重的省份之一,四川省面临着可持续发展能力提升和应对新增气候变化风险的挑战.文章在简要介绍气候变化对四川省的影响、系统梳理其在适应气候变化中取得成效的基础上,进一步剖析了存在的问题,最后结合四川省省情和气候变

  17. The control of insulin secretion by adipokines: current evidence for adipocyte-beta cell endocrine signalling in metabolic homeostasis.

    Science.gov (United States)

    Cantley, James

    2014-10-01

    Metabolic homeostasis is maintained by the coordinated action of multiple organ systems. Insulin secretion is often enhanced during obesity or insulin resistance to maintain glucose and lipid homeostasis, whereas a loss of insulin secretion is associated with type 2 diabetes. Adipocytes secrete hormones known as adipokines which act on multiple cell types to regulate metabolism. Many adipokines have been shown to influence beta cell function by enhancing or inhibiting insulin release or by influencing beta cell survival. Insulin, in turn, regulates lipolysis and promotes glucose uptake and lipid storage in adipocytes. As adipokine secretion and action is strongly influenced by obesity, this provides a potential route by which beta cell function is coordinated with adiposity, independently of alterations in blood glucose or lipid levels. In this review, I assess the evidence for the direct regulation of beta cell function by the adipokines leptin, adiponectin, extracellular nicotinamide phosphoribosyltransferase, apelin, resistin, retinol binding protein 4, fibroblast growth factor 21, nesfatin-1 and fatty acid binding protein 4. I summarise in vitro and in vivo data and discuss the influence of obesity and diabetes on circulating adipokine concentrations, along with the potential for influencing beta cell function in human physiology. Finally, I highlight future research questions that are likely to yield new insights into the exciting field of insulinotropic adipokines.

  18. Evidence for a higher number of species of Odontotermes (Isoptera than currently known from Peninsular Malaysia from mitochondrial DNA phylogenies.

    Directory of Open Access Journals (Sweden)

    Shawn Cheng

    Full Text Available Termites of the genus Odontotermes are important decomposers in the Old World tropics and are sometimes important pests of crops, timber and trees. The species within the genus often have overlapping size ranges and are difficult to differentiate based on morphology. As a result, the taxonomy of Odontotermes in Peninsular Malaysia has not been adequately worked out. In this study, we examined the phylogeny of 40 samples of Odontotermes from Peninsular Malaysia using two mitochondrial DNA regions, that is, the 16S ribosomal RNA and cytochrome oxidase subunit I genes, to aid in elucidating the number of species in the peninsula. Phylogenies were reconstructed from the individual gene and combined gene data sets using parsimony and likelihood criteria. The phylogenies supported the presence of up to eleven species in Peninsular Malaysia, which were identified as O. escherichi, O. hainanensis, O. javanicus, O. longignathus, O. malaccensis, O. oblongatus, O. paraoblongatus, O. sarawakensis, and three possibly new species. Additionally, some of our taxa are thought to comprise a complex of two or more species. The number of species found in this study using DNA methods was more than the initial nine species thought to occur in Peninsular Malaysia. The support values for the clades and morphology of the soldiers provided further evidence for the existence of eleven or more species. Higher resolution genetic markers such as microsatellites would be required to confirm the presence of cryptic species in some taxa.

  19. Evidence for a higher number of species of Odontotermes (Isoptera) than currently known from Peninsular Malaysia from mitochondrial DNA phylogenies.

    Science.gov (United States)

    Cheng, Shawn; Kirton, Laurence G; Panandam, Jothi M; Siraj, Siti S; Ng, Kevin Kit-Siong; Tan, Soon-Guan

    2011-01-01

    Termites of the genus Odontotermes are important decomposers in the Old World tropics and are sometimes important pests of crops, timber and trees. The species within the genus often have overlapping size ranges and are difficult to differentiate based on morphology. As a result, the taxonomy of Odontotermes in Peninsular Malaysia has not been adequately worked out. In this study, we examined the phylogeny of 40 samples of Odontotermes from Peninsular Malaysia using two mitochondrial DNA regions, that is, the 16S ribosomal RNA and cytochrome oxidase subunit I genes, to aid in elucidating the number of species in the peninsula. Phylogenies were reconstructed from the individual gene and combined gene data sets using parsimony and likelihood criteria. The phylogenies supported the presence of up to eleven species in Peninsular Malaysia, which were identified as O. escherichi, O. hainanensis, O. javanicus, O. longignathus, O. malaccensis, O. oblongatus, O. paraoblongatus, O. sarawakensis, and three possibly new species. Additionally, some of our taxa are thought to comprise a complex of two or more species. The number of species found in this study using DNA methods was more than the initial nine species thought to occur in Peninsular Malaysia. The support values for the clades and morphology of the soldiers provided further evidence for the existence of eleven or more species. Higher resolution genetic markers such as microsatellites would be required to confirm the presence of cryptic species in some taxa.

  20. Strategic spatial planning in the era of crisis: Current trends and evidence from the metropolitan area of Thessaloniki

    Directory of Open Access Journals (Sweden)

    Thoidou Elisavet

    2013-01-01

    Full Text Available Strategic spatial planning has enjoyed widespread implementation since the 1990s, especially in urban and metropolitan areas, having its focus on promoting their competitiveness and sustainability. Nowadays, the effects of economic crisis, together with growing environmental and technological risks, trigger the vulnerability of these areas and stress the need for resilience. This paper examines the role of strategic spatial planning in promoting metropolitan resilience in the era of crisis. It is argued that this type of planning is capable of supporting the adaptation of territorial systems to crisis-induced risks, as is, for instance, the case of planning for climate change. This is further analyzed in light of four of the key aspects of the new strategic spatial planning, namely its principles, content, process, and utilization of resources. The paper draws evidence from the case of Greece and examines the abovementioned aspects of the recently prepared new Regulatory Plan for the Thessaloniki greater area. The first results of this examination show that, provided there is political will which allows for necessary adjustments, the Plan has the potential to incorporate the dimension of resilience. The elaboration and exploitation of the strategic nature of the Plan and of its sustainable development principle constitute key elements of a resilience-oriented approach.

  1. Current evidence for the use of C-MAC videolaryngoscope in adult airway management: a review of the literature.

    Science.gov (United States)

    Xue, Fu-Shan; Li, Hui-Xian; Liu, Ya-Yang; Yang, Gui-Zhen

    2017-01-01

    The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation. In patients with predicted or known difficult airways, C-MAC videolaryngoscope can achieve a better laryngeal view, a higher intubation success rate and a shorter intubation time than direct laryngoscopy. Furthermore, the option to perform direct and video laryngoscopy with the same device makes C-MAC videolaryngoscope exceptionally useful for emergency intubation. In addition, the C-MAC videolaryngoscope is a very good tool for tracheal intubation teaching. However, tracheal intubation with C-MAC videolaryngoscope may occasionally fail and introduction of C-MAC videolaryngoscope in clinical practice must be accompanied by formal training programs in normal and difficult airway managements.

  2. Dietary antioxidants for chronic periodontitis prevention and its treatment: a review on current evidences from animal and human studies

    Directory of Open Access Journals (Sweden)

    Alfonso Varela-López

    2015-09-01

    Full Text Available Objectives: Given the relationship between chronic periodontitis and high levels of oxidative stress, this review aims to clarify what role can played the dietary intake of different antioxidants in maintaining a healthy periodontium and in reducing chronic periodontitis risk, as well as possible use of dietary therapies based on them for this disease treatment. Methods: The database of the National Library of Medicine, Washington, DC (MEDLINE PubMed was used and all the studies in animals and humans are on the subject of interest in English writing online available from inception of the database until May 2015 were collected. Results: Antioxidants analyzed in this regard include vitamin C, vitamin A, carotenoids and some polyphenols, and coenzyme Q; as well as minerals iron, copper and zinc that are constituents of antioxidant enzymes. Still, there is a paucity of studies with few human studies, mostly observational. Among the various antioxidants, vitamin E and polyphenols seem to have more evidence for its beneficial effect, but in general the studies are insufficient to rule out or establish what antioxidants are useful and which are not. Conclusions: Overall, the data presented indicate that dietary antioxidants are beneficial for periodontal health, at least under certain circumstances. However more studies are needed to establish the relationship between chronic periodontitis and each specific antioxidant and to design useful dietary interventions for this disease management.

  3. Occupational status moderates the association between current perceived stress and high blood pressure: evidence from the IPC cohort study.

    Science.gov (United States)

    Wiernik, Emmanuel; Pannier, Bruno; Czernichow, Sébastien; Nabi, Hermann; Hanon, Olivier; Simon, Tabassome; Simon, Jean-Marc; Thomas, Frédérique; Bean, Kathy; Consoli, Silla M; Danchin, Nicolas; Lemogne, Cédric

    2013-03-01

    Although lay beliefs commonly relate high blood pressure (BP) to psychological stress exposure, research findings are conflicting. This study examined the association between current perceived stress and high BP, and explored the potential impact of occupational status on this association. Resting BP was measured in 122 816 adults (84 994 men), aged ≥30 years (mean age±standard deviation: 46.8±9.9 years), without history of cardiovascular and renal disease and not on either psychotropic or antihypertensive drugs. High BP was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg. Perceived stress in the past month was measured with the 4-item perceived stress scale. A total of 33 154 participants (27.0%) had high BP (151±14/90±9 mm Hg). After adjustment for all variables except occupational status, perceived stress was associated with high BP (odds ratio [OR] for a 5-point increase: 1.06; 95% confidence interval [CI]: 1.03-1.09). This association was no longer significant after additional adjustment for occupational status (OR: 1.01; 95% CI: 0.99-1.04). There was a significant interaction (P<0.001) between perceived stress and occupational status in relation to BP: perceived stress was negatively associated with high BP among individuals of high occupational status (OR: 0.91; 95% CI: 0.87-0.96), but positively associated among those of low status (OR: 1.10; 95% CI: 1.03-1.17) or unemployed (OR: 1.13; 95% CI: 1.03-1.24). Sensitivity analyses yielded similar results. The association between current perceived stress and BP depends on occupational status. This interaction may account for previous conflicting results and warrants further studies to explore its underlying mechanisms.

  4. Suggestive evidence for association between L-type voltage-gated calcium channel (CACNA1C) gene haplotypes and bipolar disorder in Latinos: a family-based association study.

    Science.gov (United States)

    Gonzalez, Suzanne; Xu, Chun; Ramirez, Mercedes; Zavala, Juan; Armas, Regina; Contreras, Salvador A; Contreras, Javier; Dassori, Albana; Leach, Robin J; Flores, Deborah; Jerez, Alvaro; Raventós, Henriette; Ontiveros, Alfonso; Nicolini, Humberto; Escamilla, Michael

    2013-03-01

      Through recent genome-wide association studies (GWASs), several groups have reported significant association between variants in the calcium channel, voltage-dependent, L-type, alpha 1C subunit (CACNA1C) and bipolar disorder (BP) in European and European-American cohorts. We performed a family-based association study to determine whether CACNA1C is associated with BP in the Latino population.   This study included 913 individuals from 215 Latino pedigrees recruited from the USA, Mexico, Guatemala, and Costa Rica. The Illumina GoldenGate Genotyping Assay was used to genotype 58 single-nucleotide polymorphisms (SNPs) that spanned a 602.9-kb region encompassing the CACNA1C gene including two SNPs (rs7297582 and rs1006737) previously shown to associate with BP. Individual SNP and haplotype association analyses were performed using Family-Based Association Test (version 2.0.3) and Haploview (version 4.2) software.   An eight-locus haplotype block that included these two markers showed significant association with BP (global marker permuted p = 0.0018) in the Latino population. For individual SNPs, this sample had insufficient power (10%) to detect associations with SNPs with minor effect (odds ratio = 1.15).   Although we were not able to replicate findings of association between individual CACNA1C SNPs rs7297582 and rs1006737 and BP, we were able to replicate the GWAS signal reported for CACNA1C through a haplotype analysis that encompassed these previously reported significant SNPs. These results provide additional evidence that CACNA1C is associated with BP and provides the first evidence that variations in this gene might play a role in the pathogenesis of this disorder in the Latino population. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  5. Suggestive evidence for association between L-type voltage-gated calcium channel (CACNA1C) gene haplotypes and bipolar disorder in Latinos: a family-based association study

    Science.gov (United States)

    Gonzalez, Suzanne; Xu, Chun; Ramirez, Mercedes; Zavala, Juan; Armas, Regina; Contreras, Salvador A; Contreras, Javier; Dassori, Albana; Leach, Robin J; Flores, Deborah; Jerez, Alvaro; Raventós, Henriette; Ontiveros, Alfonso; Nicolini, Humberto; Escamilla, Michael

    2013-01-01

    Objectives Through recent genome-wide association studies (GWAS), several groups have reported significant association between variants in the alpha 1C subunit of the L-type voltage-gated calcium channel (CACNA1C) and bipolar disorder (BP) in European and European-American cohorts. We performed a family-based association study to determine whether CACNA1C is associated with BP in the Latino population. Methods This study consisted of 913 individuals from 215 Latino pedigrees recruited from the United States, Mexico, Guatemala, and Costa Rica. The Illumina GoldenGate Genotyping Assay was used to genotype 58 single-nucleotide polymorphisms (SNPs) that spanned a 602.9 kb region encompassing the CACNA1C gene including two SNPs (rs7297582 and rs1006737) previously shown to associate with BP. Individual SNP and haplotype association analyses were performed using Family-Based Association Test (version 2.0.3) and Haploview (version 4.2) software. Results An eight-locus haplotype block that included these two markers showed significant association with BP (global marker permuted p = 0.0018) in the Latino population. For individual SNPs, this sample had insufficient power (10%) to detect associations with SNPs with minor effect (odds ratio = 1.15). Conclusions Although we were not able to replicate findings of association between individual CACNA1C SNPs rs7297582 and rs1006737 and BP, we were able to replicate the GWAS signal reported for CACNA1C through a haplotype analysis that encompassed these previously reported significant SNPs. These results provide additional evidence that CACNA1C is associated with BP and provides the first evidence that variations in this gene might play a role in the pathogenesis of this disorder in the Latino population. PMID:23437964

  6. Evidence from pharmacology and pathophysiology suggests that chemicals with dissimilar mechanisms of action could be of bigger concern in the toxicological risk assessment of chemical mixtures than chemicals with a similar mechanism of action

    DEFF Research Database (Denmark)

    Hadrup, Niels

    2014-01-01

    mechanisms of action, similar modes of action or with common target organs. In the European Union, efforts are currently being made to subgroup chemicals according to this need. However, it remains to be determined whether this is the best strategy to obtain data for risk assessment. In conditions...... such as cancer or HIV, it is generally recognised that pharmacological combination therapy targeting different mechanisms of action is more effective than a strategy where only one mechanism is targeted. Moreover, in diseases such as acute myocardial infarction and congestive heart failure, several organ systems...

  7. Associations between adults' recalled childhood bullying victimization, current social anxiety, coping, and self-blame: evidence for moderation and indirect effects.

    Science.gov (United States)

    Boulton, Michael J

    2013-01-01

    Prior studies have shown that bullying victimization is common during childhood and may have negative effects over the short term. Evidence is also emerging that childhood bullying victimization in the form of teasing may precipitate social anxiety in adulthood. The present study extended the field by testing for associations between adults' recall of four common subtypes of childhood bullying victimization and their current social anxiety. It also provided the first test of whether coping moderated those associations, if they were indirect effects through self-blame, and if sex differences existed. Data were collected from 582 students aged 23+ years at two universities in the UK. Collectively, and for social exclusion and relational victimization uniquely, the subtypes of bullying victimization did predict social anxiety. Evidence for hypothesized moderation and indirect effects was obtained but these varied by subtype of victimization (but not sex). The theoretical and practical implications of these results were discussed.

  8. The sustainability of current account in the presence of endogenous multiple structural breaks: Evidence from developed and developing countries

    Directory of Open Access Journals (Sweden)

    Dülger Fikret

    2016-01-01

    Full Text Available The purpose of this study is to test for the sustainability of current account in 18 developed and 10 developing countries. The stability of the relationship between export (inflows and import (outflows is assessed using the tests proposed by Mohitosh Kejriwal and Pierre Perron (2010. In particular, the nature of the long-run relationship, when multiple regime shifts are identified endogenously, is analyzed using the residual-based test of the null hypothesis of cointegration with multiple breaks proposed by Kejriwal (2008. The results clearly indicate that, for all countries, (i the stability tests reject the null of coefficient stability of the long-run relationship between exports and imports; (ii the cointegration tests that correspond to the number of breaks selected reject the null of cointegration (weak form of sustainability; and (iii the strong form of sustainability hypothesis is not supported by the data for all countries in most regimes but not for 20 of 28 countries especially in the last regime (the post-2000 era. For eight countries (Canada, New Zealand, Spain, Brazil, Mexico, South Africa, Thailand, and Turkey, the findings may be perceived as a warning to creditors and policymakers unless there are policy distortions or permanent productivity shocks to the domestic economies.

  9. Evidence for the Flavor Changing Neutral Current Decays B to K l+ l- and B to K* l+ l-

    CERN Document Server

    Aubert, Bernard; Gaillard, Jean-Marc; Hicheur, A; Karyotakis, Yu; Lees, J P; Robbe, P; Tisserand, V; Zghiche, A; Palano, A; Pompili, A; Chen, J C; Qi, N D; Rong, G; Wang, P; Zhu, Y S; Eigen, G; Ofte, I; Stugu, B; Abrams, G S; Borgland, A W; Breon, A B; Brown, D N; Button-Shafer, J; Cahn, R N; Charles, E; Gill, M S; Gritsan, A V; Groysman, Y; Jacobsen, R G; Kadel, R W; Kadyk, J; Kerth, L T; Kolomensky, Yu G; Kral, J F; Le Clerc, C; Levi, M E; Lynch, G; Mir, L M; Oddone, P J; Orimoto, T J; Pripstein, M; Roe, N A; Romosan, A; Ronan, Michael T; Shelkov, V G; Telnov, A V; Wenzel, W A; Harrison, T J; Hawkes, C M; Knowles, D J; O'Neale, S W; Penny, R C; Watson, A T; Watson, N K; Deppermann, T; Goetzen, K; Koch, H; Lewandowski, B; Peters, K; Schmücker, H; Steinke, M; Barlow, N R; Bhimji, W; Boyd, J T; Chevalier, N; Clark, P J; Cottingham, W N; MacKay, C; Wilson, F F; Abe, K; Hearty, C; Mattison, T S; McKenna, J A; Thiessen, D; Jolly, S; McKemey, A K; Blinov, V E; Bukin, A D; Buzykaev, A R; Golubev, V B; Ivanchenko, V N; Korol, A A; Kravchenko, E A; Onuchin, A P; Serednyakov, S I; Skovpen, Yu I; Yushkov, A N; Best, D; Chao, M; Kirkby, D; Lankford, A J; Mandelkern, M A; McMahon, S; Stoker, D P; Buchanan, C; Chun, S; Hadavand, H K; Hill, E J; MacFarlane, D B; Paar, H P; Prell, S; Rahatlou, S; Raven, G; Schwanke, U; Sharma, V; Berryhill, J W; Campagnari, C; Dahmes, B; Hart, P A; Kuznetsova, N P; Levy, S L; Long, O; Lu, A; Mazur, M A; Richman, J D; Verkerke, W; Beringer, J; Eisner, A M; Grothe, M; Heusch, C A; Lockman, W S; Pulliam, T; Schalk, T L; Schmitz, R E; Schumm, B A; Seiden, A; Turri, M; Walkowiak, W; Williams, D C; Wilson, M G; Chen, E; Dubois-Felsmann, G P; Dvoretskii, A; Hitlin, D G; Porter, F C; Ryd, A; Samuel, A; Yang, S; Jayatilleke, S M; Mancinelli, G; Meadows, B T; Sokoloff, M D; Barillari, T; Bloom, P; Ford, W T; Nauenberg, U; Olivas, A; Rankin, P; Roy, J; Smith, J G; Van Hoek, W C; Zhang, L; Harton, J L; Hu, T; Krishnamurthy, M; Soffer, A; Toki, W H; Wilson, R J; Zhang, J; Altenburg, D; Brandt, T; Brose, J; Colberg, T; Dickopp, M; Dubitzky, R S; Hauke, A; Maly, E; Müller-Pfefferkorn, R; Otto, S; Schubert, Klaus R; Schwierz, R; Spaan, B; Wilden, L; Bernard, D; Bonneaud, G R; Brochard, F; Cohen-Tanugi, J; Ferrag, S; T'Jampens, S; Thiebaux, C; Vasileiadis, G; Verderi, M; Anjomshoaa, A; Bernet, R; Khan, A; Lavin, D; Muheim, F; Playfer, S; Swain, J E; Tinslay, J; Falbo, M; Borean, C; Bozzi, C; Piemontese, L; Sarti, A; Treadwell, E; Anulli, F; Baldini-Ferroli, R; Calcaterra, A; De Sangro, R; Falciai, D; Finocchiaro, G; Patteri, P; Peruzzi, I M; Piccolo, M; Zallo, A; Bagnasco, S; Buzzo, A; Contri, R; Crosetti, G; Lo Vetere, M; Macri, M; Monge, M R; Passaggio, S; Pastore, F C; Patrignani, C; Robutti, E; Santroni, A; Tosi, S

    2002-01-01

    We present preliminary results from a search for the rare, flavor-changing neutral current decays B to K l+ l- and B to K* l+ l-, where l+ l- is either an e+ e- or mu+ mu- pair. The data sample comprises (84.4 +- 0.9) X 10e6 upsilon(4S) to B B-bar decays (77.8 /fb) collected with the BaBar detector at the PEP-II B factory. For B to K l+ l-, we observe a signal with estimated significance of 4.4 sigma and obtain B(B to K l+ l-) = (0.78 +0.24 -0.20 +0.11 -0.18) X 10e-6 (averaged over l = e and mu). For B to K* l+ l-, we observe an excess of events over background with estimated significance of 2.8 sigma. We obtain B(B to K* l+ l-) = (1.68 +0.68 -0.58 +-0.28) X 10e-6 and the 90% C.L. upper limit B(B to K* l+ l-) < 3.0 X 10e-6.

  10. Trust and management-to-employee communication in Slovenian companies: Some evidence from the current economic crisis

    Directory of Open Access Journals (Sweden)

    Maja Makovec Brenčič

    2011-01-01

    Full Text Available This paper analyzes the importance of trust and management-to-employee communication among top Slovenian employers from the Golden Thread Survey. The paper analyzes the changes and impact of the deteriorating external economic situation on (a company-employee relational trust, and on the (b perceived importance of “trust and long-term relationships with the company in the eyes of the customer” by respondent managers. Furthermore, our analysis also looks at the impact of management-to-employee communication on both trust perspectives. The results show a stable level of company-employee relational trust in the face of the current economic crisis, despite a high level of perceived organizational process changes and a sharp decline in financial performance. On the other hand, the perceived importance of “trust and long-term relationships with the company in the eyes of the customer” has increased substantially as the crisis has deepened, supporting our claim that relationships and the external relationship orientation gain importance in the time of crisis. There is also a strong link between the degree of open and frequent management-to-employee communication, and both perspectives of measured trust among top Slovenian employers.

  11. Switching from neurostimulant therapy to atomoxetine in children and adolescents with attention-deficit hyperactivity disorder : clinical approaches and review of current available evidence.

    Science.gov (United States)

    Prasad, Suyash; Steer, Chris

    2008-01-01

    This review provides practical information on and clinical reasons for switching children and young people with attention-deficit hyperactivity disorder (ADHD) from neurostimulants to atomoxetine, detailing currently available evidence, and switching options. The issue is of particular relevance following recent guidance from the National Institute for Health and Clinical Excellence and European ADHD guidelines endorsing the use of atomoxetine, along with the stimulants methylphenidate and dexamphetamine, in the management of ADHD in children and adolescents in the UK. The selective norepinephrine (noradrenaline) reuptake inhibitor, atomoxetine, is a non-stimulant drug licensed for the treatment of ADHD in children and adolescents, and in adults who have shown a response in childhood. Following the once-daily morning dose, its therapeutic effects extend through the waking hours, into late evening, and in some patients, through to early the next morning. Atomoxetine may be considered for patients who are unresponsive or incompletely responsive to stimulant treatment, have co-morbid conditions (e.g. tics, anxiety, depression), and have sleep disturbances or eating problems, for patients in whom stimulants are poorly tolerated, and for situations where there is potential for drug abuse or diversion. Atomoxetine has been shown to be effective in relapse prevention and there is suggestion that atomoxetine may have a positive effect on global functioning; specifically health-related quality of life, self-esteem, and social and family functioning. According to one study, approximately 50% of non-responders to methylphenidate will respond to atomoxetine therapy and approximately 75% of responders to methylphenidate will also respond to atomoxetine. Atomoxetine may be initiated by a schedule of dose increases and cross-tapering with methylphenidate. A slow titration schedule with divided doses minimizes the impact of adverse events within the first several weeks of

  12. The α-gliadin genes from Brachypodium distachyon L. provide evidence for a significant gap in the current genome assembly.

    Science.gov (United States)

    Chen, G X; Lv, D W; Li, W D; Subburaj, S; Yu, Z T; Wang, Y J; Li, X H; Wang, K; Ye, X G; Ma, Wujun; Yan, Y M

    2014-03-01

    Brachypodium distachyon, is a new model plant for most cereal crops while gliadin is a class of wheat storage proteins related with wheat quality attributes. In the published B. distachyon genome sequence databases, no gliadin gene is found. In the current study, a number of gliadin genes in B. distachyon were isolated, which is contradictory to the results of genome sequencing projects. In our study, the B. distachyon seeds were found to have no gliadin protein expression by gel electrophoresis, reversed-phase high-performance liquid chromatography and Western blotting analysis. However, Southern blotting revealed a presence of more than ten copies of α-gliadin coding genes in B. distachyon. By means of AS-PCR amplification, four novel full-ORF α-gliadin genes, and 26 pseudogenes with at least one stop codon as well as their promoter regions were cloned and sequenced from different Brachypodium accessions. Sequence analysis revealed a few of single-nucleotide polymorphisms among these genes. Most pseudogenes were resulted from a C to T change, leading to the generation of TAG or TAA in-frame stop codon. To compare both the full-ORFs and the pseudogenes among Triticum and Triticum-related species, their structural characteristics were analyzed. Based on the four T cell stimulatory toxic epitopes and two ployglutamine domains, Aegilops, Triticum, and Brachypodium species were found to be more closely related. The phylogenetic analysis further revealed that B. distachyon was more closely related to Aegilops tauschii, Aegilops umbellulata, and the A or D genome of Triticum aestivum. The α-gliadin genes were able to express successfully in E. coli using the functional T7 promoter. The relative and absolute quantification of the transcripts of α-gliadin genes in wheat was much higher than that in B. distachyon. The abundant pseudogenes may affect the transcriptional and/or posttranscriptional level of the α-gliadin in B. distachyon.

  13. The spatial extent of the Deep Western Boundary Current into the Bounty Trough: new evidence from parasound sub-bottom profiling

    Science.gov (United States)

    Horn, Michael; Uenzelmann-Neben, Gabriele

    2016-06-01

    Deep currents such as the Pacific Deep Western Boundary Current (DWBC) are strengthened periodically in Milankovitch cycles. We studied periodic fluctuations in seismic reflection pattern and reflection amplitude in order to detect cycles in the sedimentary layers of Bounty Trough and bounty fan, east of New Zealand. There, the occurrence of the obliquity frequency is caused only by the DWBC. Therefore, it provides direct evidence for the spatial extent of the DWBC. We can confirm the extent of the DWBC west of the outer sill, previously only inferred via erosional features at the outer sill. Further, our data allow an estimation of the extent of the DWBC into the Bounty Trough, limiting the DWBC presence to east of 178.15°E. Using the presented method a larger dataset will allow a chronological and areal mapping of sedimentation processes and hence provide information on glacial/interglacial cycles.

  14. On exploratory factor analysis: a review of recent evidence, an assessment of current practice, and recommendations for future use.

    Science.gov (United States)

    Gaskin, Cadeyrn J; Happell, Brenda

    2014-03-01

    Exploratory factor analysis (hereafter, factor analysis) is a complex statistical method that is integral to many fields of research. Using factor analysis requires researchers to make several decisions, each of which affects the solutions generated. In this paper, we focus on five major decisions that are made in conducting factor analysis: (i) establishing how large the sample needs to be, (ii) choosing between factor analysis and principal components analysis, (iii) determining the number of factors to retain, (iv) selecting a method of data extraction, and (v) deciding upon the methods of factor rotation. The purpose of this paper is threefold: (i) to review the literature with respect to these five decisions, (ii) to assess current practices in nursing research, and (iii) to offer recommendations for future use. The literature reviews illustrate that factor analysis remains a dynamic field of study, with recent research having practical implications for those who use this statistical method. The assessment was conducted on 54 factor analysis (and principal components analysis) solutions presented in the results sections of 28 papers published in the 2012 volumes of the 10 highest ranked nursing journals, based on their 5-year impact factors. The main findings from the assessment were that researchers commonly used (a) participants-to-items ratios for determining sample sizes (used for 43% of solutions), (b) principal components analysis (61%) rather than factor analysis (39%), (c) the eigenvalues greater than one rule and screen tests to decide upon the numbers of factors/components to retain (61% and 46%, respectively), (d) principal components analysis and unweighted least squares as methods of data extraction (61% and 19%, respectively), and (e) the Varimax method of rotation (44%). In general, well-established, but out-dated, heuristics and practices informed decision making with respect to the performance of factor analysis in nursing studies. Based on

  15. Escaping the Adverse Impacts of NSAIDs on Tooth Movement During Orthodontics: Current Evidence Based on a Meta-Analysis.

    Science.gov (United States)

    Fang, Jie; Li, Yifei; Zhang, Keke; Zhao, Zhihe; Mei, Li

    2016-04-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain during orthodontic treatments; however, the possible inhibition of orthodontic tooth movement (OTM) by NSAIDs has been debated. The aim of this study was to evaluate the influence of some commonly used NSAIDs on OTM during orthodontic treatments. A review of the literature identified relevant studies up to August 2014. A meta-analysis was performed following the guidelines of the Cochrane review group and the PRISMA statement. Studies were identified by searching PUBMED, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and the WHO Clinical Trials Registry Platform. Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1.Five studies, including 128 subjects and 3 main NSAIDs (celecoxib, acetaminophen, and aspirin), were included for quantitative synthesis and analysis. Celecoxib did not inhibit OTM except with middle-term use (2-3 weeks) (95% CI [-6.47 to -0.43], P = 0.03). Acetaminophen did not inhibit OTM except with long-term use (>1 month) and low-dose use (∼100 mg/kg per day), (95% CI [-2.96 to -0.78], P = 0.0008; 95%CI [-2.42, -0.46], P = 0.004; respectively). Aspirin was found to inhibit OTM (95%CI [-2.40 to -0.64], P = 0.0008). Our systematic review with meta-analysis suggests that aspirin might inhibit OTM in rat models, whereas the short-term (orthodontic pain would not inhibit OTM. Well-designed human research should be completed before a solid conclusion can be reached.

  16. Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession

    Directory of Open Access Journals (Sweden)

    Tobias Hecker

    2015-11-01

    Full Text Available Background: We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs. Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. Objective: The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Methods: Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. Results: The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. Conclusions: More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this

  17. Adherence to cardiovascular medications in the South Asian population:A systematic review of current evidence and future directions

    Institute of Scientific and Technical Information of China (English)

    Julia M Akeroyd; Winston J Chan; Ayeesha K Kamal; Latha Palaniappan; Salim S Virani

    2015-01-01

    AIM: To review methods of assessing adherence and strategies to improve adherence to cardiovascular disease(CVD) medications,among South Asian CVD patients. METHODS: We conducted a systematic review of English language studies that examined CVD medication adherence in South Asian populations from 1966 to April 1,2015 in SCOPUS and Pub Med. Working in duplicate,we identified 61 studies. After exclusions,26 studies were selected for full text review. Of these,17 studies were included in the final review. We abstracted data on several factors including study design,study population,method of assessing adherence and adherence rate. RESULTS: These studies were conducted in India(n = 11),Pakistan(n = 3),Bangladesh(n = 1),Nepal(n = 1) and Sri Lanka(n = 1). Adherence rates ranged from 32%-95% across studies. Of the 17 total publications included,10 focused on assessing adherence to CVD medications and 7 focused on assessing the impact of interventions on medication adherence. The validated Morisky Medication Adherence Scale(MMAS) was used as the primary method of assessing adherence in five studies. Three studies used validated questionnaires similar to the MMAS,and one study utilized Medication Event Monitoring System caps,with the remainder of the studies utilizing pill count and self-report measures. As expected,studies using non-validated self-report measures described higher rates of adherence than studies using validated scale measurements and pill count. The included intervention studies examined the use of polypill therapy,provider education and patient counseling to improve medication adherence. CONCLUSION: The overall medication adherence rates were low in the region,which suggest a growing need for future interventions to improve adherence.

  18. Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession

    Science.gov (United States)

    Hecker, Tobias; Braitmayer, Lars; van Duijl, Marjolein

    2015-01-01

    Background We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. Objective The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Methods Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. Results The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. Conclusions More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review

  19. Gifted Male Readers: Current Understandings and Suggestions for Future Research

    Science.gov (United States)

    Pagnani, Alexander R.

    2013-01-01

    Research literature concerning gifted male readers relies primarily on more extensive bodies of work regarding gifted males and male readers. Studied as a whole, the two halves portray a worrisome state of affairs for gifted male readers, who lag behind their female counterparts in the same patterns found across the ability spectrum. This literacy…

  20. Current Status and Suggestions of China's Refractories Industry

    Institute of Scientific and Technical Information of China (English)

    XU Dianli

    2009-01-01

    @@ China' s economy has developed rapidly since joined WTO in 2000.Influenced by the rapid development of high temperature industries such as metallurgy,building material,nonferrous metal,etc.,China's refractories industry has its production and sales boomed,benefit enhanced and industrial structure adjusted.

  1. Children's suggestibility research: Things to know before interviewing a child

    Directory of Open Access Journals (Sweden)

    Amelia Courtney Hritz

    2015-01-01

    Full Text Available Children's testimony is often the only evidence of alleged abuse. Thus, the importance of conducting forensic interviews that are free from bias and misleading information is immense, as these could lead to false reports. In the current paper, we review unexpected findings in children's suggestibility that illustrate the difficulty in distinguishing between false and accurate reports. We explore situations in which a younger person's memory account may be more accurate than that of an adult, when a single suggestive interview may be as detrimental as multiple interviews, and when children can make inaccurate reports spontaneously. We conclude with recommendations for interviewers to decrease false reporting by both children and adults.

  2. Molecular clonality relationships in initial carcinomas, ipsilateral breast failures, and distant metastases in patients treated with breast-conserving therapy: evidence suggesting that some distant metastases are derived from ipsilateral breast failures and that metastases can metastasize.

    Science.gov (United States)

    Goldstein, Neal S; Vicini, Frank A; Hunter, Susan; Odish, Eva; Forbes, Suzy; Kestin, Larry L

    2005-07-01

    We studied the clonality relationships in invasive breast carcinomas, ipsilateral breast failures (IBFs), and distant metastases (DMs) using a polymerase chain reaction-loss of heterozygosity (LOH) clonality assay to determine whether IBFs can be the source of DMs. Six cases of initial carcinomas, IBFs, and DMs were identified. Carcinoma DNA was extracted from paraffin blocks and analyzed with 20 markers. In 2 cases, the LOH pattern suggested the DM directly resulted from the IBF. In 2 cases, the initial carcinoma, IBF, and DM were one progressive, genetically unstable process. Separate subclones in the initial carcinoma gave rise to the IBF and DM in 1 case, and the DM derived from a second IBF in 1 case. The relationships of initial carcinomas, IBFs, and DMs are complex. DMs seem to be the direct result of IBFs in some cases. Some carcinomas seem to be composed of subclones with different and unrelated IBF and DM potential.

  3. [Utilization of Multi-Institutional Laboratory Data as an Evidence Database: The Current Status and Future Tasks--Chairmen's Introductory Remarks].

    Science.gov (United States)

    Miyake, Kazunori; Nishibori, Masahiro

    2015-01-01

    The construction of a database that integrates raw laboratory data and diagnostic information with patient backgrounds is an effective tool in the practice of Evidence-Based Laboratory Medicine (EBLM). By exploring this type of database, it is possible to understand the diagnostic characteristics of the tests for a specific patient subgroup or condition. Although several studies have been carried out recently, these databases contain single-hospital data, and are thus limited regarding their external validity. In order to improve the reliability of the evidence, joint multi-institutional research is required. Therefore, the EBLM Committee of the Japanese Society of Clinical Laboratory Medicine arranged the symposium, entitled: "Utilization of multi-institutional laboratory data as an evidence database", which discusses current problems and solutions for the integration of multi-institutional laboratory data. In the symposium, five speakers presented on the following subjects: 1) Standardization of laboratory test coding (JLAC10); 2) The construction of a data warehouse in the hospital; 3) Multi-institutional study on long-term data changes; 4) Multi-institutional study on diagnostic accuracy; and 5) The construction of databases for the practice of EBLM and the need for the standardization/harmonization of laboratory data.

  4. Modulation of the activity of N-methyl-d-aspartate receptors as a novel treatment option for depression: current clinical evidence and therapeutic potential of rapastinel (GLYX-13)

    Science.gov (United States)

    Vasilescu, Andrei-Nicolae; Schweinfurth, Nina; Borgwardt, Stefan; Gass, Peter; Lang, Undine E; Inta, Dragos; Eckart, Sarah

    2017-01-01

    Classical monoaminergic antidepressants show several disadvantages, such as protracted onset of therapeutic action. Conversely, the fast and sustained antidepressant effect of the N-methyl-d-aspartate receptor (NMDAR) antagonist ketamine raises vast interest in understanding the role of the glutamate system in mood disorders. Indeed, numerous data support the existence of glutamatergic dysfunction in major depressive disorder (MDD). Drawback to this short-latency therapy is its side effect profile, especially the psychotomimetic action, which seriously hampers the common and widespread clinical use of ketamine. Therefore, there is a substantial need for alternative glutamatergic antidepressants with milder side effects. In this article, we review evidence that implicates NMDARs in the prospective treatment of MDD with focus on rapastinel (formerly known as GLYX-13), a novel synthetic NMDAR modulator with fast antidepressant effect, which acts by enhancing NMDAR function as opposed to blocking it. We summarize and discuss current clinical and animal studies regarding the therapeutic potential of rapastinel not only in MDD but also in other psychiatric disorders, such as obsessive–compulsive disorder and posttraumatic stress disorder. Additionally, we discuss current data concerning the molecular mechanisms underlying the antidepressant effect of rapastinel, highlighting common aspects as well as differences to ketamine. In 2016, rapastinel received the Breakthrough Therapy designation for the treatment of MDD from the US Food and Drug Administration, representing one of the most promising alternative antidepressants under current investigation.

  5. Non-surgical management of a pediatric “intoed” gait pattern – a systematic review of the current best evidence

    Directory of Open Access Journals (Sweden)

    Uden H

    2012-01-01

    were shown to produce a statistically significant improvement to an intoed gait pattern. Shoe wedges, torqheels, and a leather counter splint were not able to reduce an intoed gait pattern.Conclusion: There is limited evidence to inform the non-surgical management of a pediatric intoed gait pattern. The body of evidence that does exist is small (n = 5 and of varied quality, which means recommendations arising from this evidence base should be interpreted with caution. There is generally weak evidence that suggests that gait plates and orthotic devices with a gait plate extension may assist in the management of a pediatric intoed gait pattern.Keywords: intoeing, toe-in, toeing in, in-toeing

  6. New drugs targeting the cardiac ultra-rapid delayed-rectifier current (I Kur): rationale, pharmacology and evidence for potential therapeutic value.

    Science.gov (United States)

    Ford, John W; Milnes, James T

    2008-08-01

    There is a clear unmet medical need for new pharmacologic therapies for the treatment of atrial fibrillation (AF) with improved efficacy and safety. This article reviews the development of new and novel Kv1.5/ultra-rapid delayed-rectifier current (I Kur) inhibitors and presents evidence that Kv1.5 modulation provides an atrial-selective mechanism for treating AF. Academia and industry have invested heavily in Kv1.5 (>500 scientific publications and >50 patents published since 1993); however, to realize the full value of this therapeutic drug target, clinical efficacy and safety data are required for a selective Kv1.5 modulator. The reward for demonstrating clinical efficacy and safety in a pivotal Phase 3 trial, on regulatory approval, is "first in class" status.

  7. Social work, general practice and evidence-based policy in the collaborative care of older people: current problems and future possibilities.

    Science.gov (United States)

    Kharicha, Kalpa; Levin, Enid; Iliffe, Steve; Davey, Barbara

    2004-03-01

    While collaborative (or joint) working between social services and primary healthcare continues to rise up the policy agenda, current policy is not based on sound evidence of benefit to either patients or the wider community. Both sets of practitioners report benefits for their own work from adopting new arrangements for collaboration. The underlying assumption behind much of this activity is that a greater degree of integration provides benefits to both users and their carers, a perspective that at times obscures the issue of resource availability, especially in the form of practical community services such as district nursing and home help. At the present time there is insufficient evidence to demonstrate that formal arrangements for collaborative working (CW) are better than those forged informally between committed individuals or teams. Furthermore, arrangements for CW have not hitherto been widely evaluated in systematic studies with a comparative design and focus on outcomes for users and carers rather than on processes. In this paper we propose a number of process measures for future evaluation of CW: (1) study populations must be comparable; (2) details of how services are actually delivered must be obtained and colocation should not be assumed to mean collaboration; (3) care packages in areas of comparable resources should be examined; (4) both destinational outcomes and user-defined evaluations of benefit should be considered; (5) possible disadvantages of integrated care also need to be actively considered; (6) evaluations should include an economic analysis. Those implementing new policies in Primary Care Trusts have, at present, little sound evidence to guide them in their innovative work. However, they should take the opportunity to rigorously test the advantages and disadvantages of collaboration.

  8. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  9. Population connectivity and phylogeography of a coastal fish, Atractoscion aequidens (Sciaenidae, across the Benguela Current region: evidence of an ancient vicariant event.

    Directory of Open Access Journals (Sweden)

    Romina Henriques

    Full Text Available Contemporary patterns of genetic diversity and population connectivity within species can be influenced by both historical and contemporary barriers to gene flow. In the marine environment, present day oceanographic features such as currents, fronts and upwelling systems can influence dispersal of eggs/larvae and/juveniles/adults, shaping population substructuring. The Benguela Current system in the southeastern Atlantic is one of the oldest upwelling systems in the world, and provides a unique opportunity to investigate the relative influence of contemporary and historical mechanisms shaping the evolutionary history of warm-temperate fish species. Using the genetic variation in the mitochondrial DNA Control Region and eight nuclear microsatellite DNA loci, we identified the presence of two highly divergent populations in a vagile and warm-temperate fish species, Atractoscion aequidens, across the Benguela region. The geographical distributions of the two populations, on either side of the perennial upwelling cell, suggest a strong correlation between the oceanographic features of the system and the breakdown of gene flow within this species. Genetic divergence (mtDNA φ ST = 0.902, microsatellite F ST = 0.055: probability of genetic homogeneity for either marker = p<0.001, absence of migrants (less than 1% per generation between populations and coalescent estimates of time since most recent common ancestor suggest that the establishment of the main oceanographic features of the system (2 million years ago, particularly the strengthening and position of the perennial upwelling cell, is the most likely mechanism behind the observed isolation. Concordance between mitochondrial and nuclear genetic markers indicates that isolation and divergence of the northern and southern Benguela populations of A. aequidens occurred deep in the past and has continued to the present day. These findings suggest that the Benguela Current system may constitute an

  10. New Evidence Suggests Ocean on Icy Jupiter Moon

    Institute of Scientific and Technical Information of China (English)

    Lisa; Richwine; 鲁见馨

    2000-01-01

    人类是孤独的,遥望夜空,星汉灿烂!然而,茫茫宇宙,只有地球,是一个生机勃勃、各种生命繁衍不息的星球。Jupiter(木星)有一颗卫星,叫Europa(木卫二),其体积与地球相仿。从Galileo spacecraft传回的信息发现:the presence of water in liquid form on Europa。虽然。科学家们尚不明白whether the water was frozen or in liquid form,但是,他们已经展开了想象的双翅: Even though it is buried beneath a thick layer of ice, life forms could draw energy from heat sources below, just asdeep-sea creatures do in the Earth’s oceans. 除了驰骋想象之外,美国国家航空和航天局在“囊中羞涩”之时,仍然决定:to send another spacecraft there!】

  11. Increasing the quantity and quality of searching for current best evidence to answer clinical questions: protocol and intervention design of the MacPLUS FS Factorial Randomized Controlled Trials

    National Research Council Canada - National Science Library

    Agoritsas, Thomas; Iserman, Emma; Hobson, Nicholas; Cohen, Natasha; Cohen, Adam; Roshanov, Pavel S; Perez, Miguel; Cotoi, Chris; Parrish, Rick; Pullenayegum, Eleanor; Wilczynski, Nancy L; Iorio, Alfonso; Haynes, R Brian

    2014-01-01

    .... This trial seeks to test three innovative interventions, among clinicians registered to MacPLUS FS, to increase the quantity and quality of searching for current best evidence to answer clinical questions...

  12. Historical and cultural aspects of the pineal gland: comparison between the theories provided by Spiritism in the 1940s and the current scientific evidence.

    Science.gov (United States)

    Lucchetti, Giancarlo; Daher, Jorge C; Iandoli, Decio; Gonçalves, Juliane P B; Lucchetti, Alessandra L G

    2013-01-01

    Significance has been attached to the pineal gland in numerous different cultures and beliefs. One religion that has advanced the role of the pineal gland is Spiritism. The objective of the present study was to compile information on the pineal gland drawing on the books of Francisco Cândido Xavier written through psychography and to carry out a critical analysis of their scientific bases by comparing against evidence in the current scientific literature. A systematic search using the terms "pineal gland" and "epiphysis" was conducted of 12 works allegedly dictated by the spirit "André Luiz". All information on the pineal having potential correlation with the field of medicine and current studies was included. Specialists in the area were recruited to compile the information and draw parallels with the scientific literature. The themes related to the pineal gland were: mental health, reproductive function, endocrinology, relationship with physical activity, spiritual connection, criticism of the theory that the organ exerts no function, and description of a hormone secreted by the gland (reference alluding to melatonin, isolated 13 years later). The historical background for each theme was outlined, together with the theories present in the Spiritist books and in the relevant scientific literature. The present article provides an analysis of the knowledge the scientific community can acquire from the history of humanity and from science itself. The process of formulating hypotheses and scientific theories can benefit by drawing on the cultural aspects of civilization, taking into account so-called non-traditional reports and theories.

  13. Modulation of the activity of N-methyl-D-aspartate receptors as a novel treatment option for depression: current clinical evidence and therapeutic potential of rapastinel (GLYX-13

    Directory of Open Access Journals (Sweden)

    Vasilescu AN

    2017-03-01

    Full Text Available Andrei-Nicolae Vasilescu,1,* Nina Schweinfurth,2,* Stefan Borgwardt,2,* Peter Gass,1 Undine E Lang,2,* Dragos Inta,1,2,* Sarah Eckart2,* 1Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; 2Department of Psychiatry (Universitäre Psychiatrische Kliniken, University of Basel, Basel, Switzerland *These authors contributed equally to this work Abstract: Classical monoaminergic antidepressants show several disadvantages, such as protracted onset of therapeutic action. Conversely, the fast and sustained antidepressant effect of the N-methyl-d-aspartate receptor (NMDAR antagonist ketamine raises vast interest in understanding the role of the glutamate system in mood disorders. Indeed, numerous data support the existence of glutamatergic dysfunction in major depressive disorder (MDD. Drawback to this short-latency therapy is its side effect profile, especially the psychotomimetic action, which seriously hampers the common and widespread clinical use of ketamine. Therefore, there is a substantial need for alternative glutamatergic antidepressants with milder side effects. In this article, we review evidence that implicates NMDARs in the prospective treatment of MDD with focus on rapastinel (formerly known as GLYX-13, a novel synthetic NMDAR modulator with fast antidepressant effect, which acts by enhancing NMDAR function as opposed to blocking it. We summarize and discuss current clinical and animal studies regarding the therapeutic potential of rapastinel not only in MDD but also in other psychiatric disorders, such as obsessive–compulsive disorder and posttraumatic stress disorder. Additionally, we discuss current data concerning the molecular mechanisms underlying the antidepressant effect of rapastinel, highlighting common aspects as well as differences to ketamine. In 2016, rapastinel received the Breakthrough Therapy designation for the treatment

  14. Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity.

    Science.gov (United States)

    Almoosawi, S; Vingeliene, S; Karagounis, L G; Pot, G K

    2016-11-01

    The importance of the circadian rhythm in regulating human food intake behaviour and metabolism has long been recognised. However, little is known as to how energy intake is distributed over the day in existing populations, and its potential association with obesity. The present review describes global trends in time-of-day of energy intake in the general population based on data from cross-sectional surveys and longitudinal cohorts. Evidence of the association between time-of-day of energy intake and obesity is also summarised. Overall, there were a limited number of cross-sectional surveys and longitudinal cohorts that provided data on time-of-day of energy intake. In the identified studies, a wide variation in time-of-day of energy intake was observed, with patterns of energy distribution varying greatly by country and geographical area. In relation to obesity, eight cross-sectional surveys and two longitudinal cohorts were identified. The association between time-of-day of energy intake and obesity varied widely, with several studies reporting a positive link between evening energy intake and obesity. In conclusion, the current review summarises global trends in time-of-day of energy intake. The large variations across countries and global regions could have important implications to health, emphasising the need to understand the socio-environmental factors guiding such differences in eating patterns. Evidence of the association between time-of-day of energy intake and BMI also varied. Further larger scale collaborations between various countries and regions are needed to sum data from existing surveys and cohorts, and guide our understanding of the role of chrono-nutrition in health.

  15. Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair: International Cartilage Repair Society Recommendations Based on Current Scientific Evidence and Standards of Clinical Care.

    Science.gov (United States)

    Mithoefer, Kai; Saris, Daniel B F; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

    2011-04-01

    To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project.

  16. The importance of associations with saprotrophic non-Rhizoctonia fungi among fully mycoheterotrophic orchids is currently under-estimated: novel evidence from sub-tropical Asia.

    Science.gov (United States)

    Lee, Yung-I; Yang, Chih-Kai; Gebauer, Gerhard

    2015-09-01

    Most fully mycoheterotrophic (MH) orchids investigated to date are mycorrhizal with fungi that simultaneously form ectomycorrhizas with forest trees. Only a few MH orchids are currently known to be mycorrhizal with saprotrophic, mostly wood-decomposing, fungi instead of ectomycorrhizal fungi. This study provides evidence that the importance of associations between MH orchids and saprotrophic non-Rhizoctonia fungi is currently under-estimated. Using microscopic techniques and molecular approaches, mycorrhizal fungi were localized and identified for seven MH orchid species from four genera and two subfamilies, Vanilloideae and Epidendroideae, growing in four humid and warm sub-tropical forests in Taiwan. Carbon and nitrogen stable isotope natural abundances of MH orchids and autotrophic reference plants were used in order to elucidate the nutritional resources utilized by the orchids. Six out of the seven MH orchid species were mycorrhizal with either wood- or litter-decaying saprotrophic fungi. Only one orchid species was associated with ectomycorrhizal fungi. Stable isotope abundance patterns showed significant distinctions between orchids mycorrhizal with the three groups of fungal hosts. Mycoheterotrophic orchids utilizing saprotrophic non-Rhizoctonia fungi as a carbon and nutrient source are clearly more frequent than hitherto assumed. On the basis of this kind of nutrition, orchids can thrive in deeply shaded, light-limiting forest understoreys even without support from ectomycorrhizal fungi. Sub-tropical East Asia appears to be a hotspot for orchids mycorrhizal with saprotrophic non-Rhizoctonia fungi. © The Author 2015. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Optimal Nutrition In Lactating Women And Its Effect On Later Health Of Offspring: A Systematic Review Of Current Evidence And Recommendations (Early Nutrition Project).

    Science.gov (United States)

    de Waard, Marita; Brands, Brigitte; Kouwenhoven, Stefanie M P; Lerma, Joaquim Calvo; Crespo-Escobar, Paula; Koletzko, Berthold; Zalewski, Bartlomiej M; van Goudoever, Johannes B

    2016-04-29

    Background EarlyNutrition ( www.project-earlynutrition.eu ) is an international research consortium investigating the effects of early nutrition on metabolic programming. Objective To summarize current evidence and standards, recommendations, guidelines, and regulations on nutrition or supplements in lactating women with emphasis placed on long-term health effects in offspring, including cardiovascular disease, hypertension, overweight/obesity, metabolic syndrome, diabetes, or glucose intolerance. Methods Medline, Embase, selected databases and websites were searched for documents published between 2010 and 2015. Results Thirteen documents met the inclusion criteria. Effects of maternal long-chain polyunsaturated fatty acid (LC-PUFA) supplementation on overweight/obesity or hypertension in offspring were assessed in 10 studies. One study described the effect of maternal vitamin D supplementation on overweight/obesity, and the remaining 2 studies assessed the effects of maternal probiotic/synbiotic supplementation during lactation on overweight/obesity or metabolic syndrome in their infants. Forty-one documents contained dietary recommendations on various macro- and micronutrients for lactating women, but without consideration of our long-term health outcomes in infants. Conclusion Literature on nutrition of lactating women and its effect on their infants/ later health with respect to metabolic programming outcomes appeared to be scarce, and focused mostly on supplementation of LC-PUFA's. No recent guidelines or recommendations were available, highlighting the significant research gaps regarding this topic.

  18. A study on the effect of free cash flow and profitability current ratio on dividend payout ratio: Evidence from Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Hosein Parsian

    2014-01-01

    Full Text Available Decision making about dividend payout is one of the most important decision that companies should encounter. Identifying factors that influence dividends can help managers in making an appropriate dividend policy. In the other side, companies’ dividend payouts over time and with a stable manner may influence on stock price, future earnings growth and finally investor's evaluation about owners' equity. Hence, investigating the factors influencing dividend payout ratio is of high importance. In this research, we investigate the effects of various factors on dividend payout ratio of Tehran Stock Exchange (TSE listed companies. We use time series regression (panel data in order to test the hypothesis of this study. This study provides empirical evidences by choosing a sample of 102 companies over the time span of 2005-2010. The result shows that independent variables of free cash flow and profitability current ratio have negative and significant impact on dividend payout ratio; whereas, the independent variable of leverage ratio has a positive and significant impact on dividend payout ratio. The other independent ratio such as size of the company, growth opportunities and systematic risk do not have any significant influence on dividend payout ratio.

  19. The correlation between Prorocentrum donghaiense blooms and the Taiwan warm current in the East China Sea - evidence for the "Pelagic Seed Bank" hypothesis.

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    Xinfeng Dai

    Full Text Available During the last two decades, large-scale high biomass algal blooms of the dinoflagellate Prorocentrum donghaiense Lu have occurred frequently in the East China Sea (ECS. The role of increasing nutrient concentrations in driving those blooms is well-established, but the source population that initiates them is poorly understood. We hypothesized that the front of Taiwan Warm Current (TWC may serve as a 'seed bank' that initiates P. donghaiense blooms in the ECS, as the physiochemical conditions in the TWC are suitable for the growth of P. donghaiense. In order to test this hypothesis, two surveys at different spatio-temporal scales were conducted in 2010 and 2011. We found a strong correlation in space and time between the abundance of P. donghaiense and the TWC. The spatial extent of the P. donghaiense bloom coincided with the TWC front in both 2010 and 2011. During the early development of the blooms, P. donghaiense concentration was highest at the TWC front, and then the bloom mass shifted inshore over the course of our 2011 survey. The TWC also moved inshore, albeit after the appearance of P. donghaiense. Overall, these results support our hypothesis that P. donghaiense blooms develop from the population at the TWC front in the ECS, suggesting the role of the ocean current front as a seed bank to dinoflagellate blooms.