Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 par...Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.展开更多
The hepatic sinusoids are lined by a unique population of hepatic sinusoidal endothelial cells (HSEC), which is one of the first hepatic cell populations to come into contact with blood components. However, HSEC are n...The hepatic sinusoids are lined by a unique population of hepatic sinusoidal endothelial cells (HSEC), which is one of the first hepatic cell populations to come into contact with blood components. However, HSEC are not simply barrier cells that restrict the access of blood- borne compounds to the parenchyma. They are func- tionally specialised endothelial cells that have complex roles, including not only receptor-mediated clearance of endotoxin, bacteria and other compounds, but also the regulation of inflammation, leukocyte recruitment and host immune responses to pathogens. Thus understand- ing the differentiation and function of HSEC is critical for the elucidation of liver biology and pathophysiology. This article reviews methods for isolating and studying human hepatic endothelial cell populations using in vitro models. We also discuss the expression and functions of phe- notypic markers, such as the presence of fenestrations and expression of VAP-1, Stabilin-1, L-SIGN, which can be used to identify sinusoidal endothelium and to permit discrimination from vascular and lymphatic endothelial cells.展开更多
We recently reported that targeted deletion of Pannexin 1 in neural precursor cells of the ventricular zone impairs the maintenance of these cells in healthy and stroke-injured brain. Here we frame this exciting new f...We recently reported that targeted deletion of Pannexin 1 in neural precursor cells of the ventricular zone impairs the maintenance of these cells in healthy and stroke-injured brain. Here we frame this exciting new finding in the context of our previous studies on Pannexin 1 in neural precursors as well as the close relationship between Pannexin 1 and purinergic receptors established by other groups. Moreover, we identify important gaps in our understanding of Pannexin 1 in neural precursor cell biology in terms of the underlying molecular mechanisms and functional/behavioural outcomes.展开更多
AIM To compare health-related quality of life(HRQoL),anxiety, depression, and impulsivity scores in patients with and without carcinoid syndrome(CS), and correlated them with serum 5-hydroxyindoleacetic acid(5-HIAA) l...AIM To compare health-related quality of life(HRQoL),anxiety, depression, and impulsivity scores in patients with and without carcinoid syndrome(CS), and correlated them with serum 5-hydroxyindoleacetic acid(5-HIAA) levels.METHODS Patients with advanced gastroenteropancreatic neuroendocrine tumours(GEPNET), with and without CS completed HRQoL QLQ-C30 and QLQ-GI.NET21, Hospital Anxiety and Depression Scale(HADS) and Barratt Impulsivity Scale(BIS) questionnaires. Twosample Wilcoxon test was applied to assess differences in serum 5-HIAA levels, two-sample Mann-Whitney U test for HRQoL and BIS, and proportion test for HADS, between those with and without CS.RESULTS Fifty patients were included; 25 each with and without CS. Median 5-HIAA in patients with and without CS was 367 nmol/L and 86 nmol/L, respectively(P = 0.003). Scores related to endocrine symptoms were significantly higher amongst patients with CS(P = 0.04) and scores for disease-related worries approached significance in the group without CS, but no other statistically-significant differences were reported between patients with and without CS in responses on QLQ-C30 or QLQ-GI.NET21. Fifteen patients(26%) scored ≥ 8/21 on anxiety scale, and 6(12%) scored ≥ 8/21 on depression scale. There was no difference in median 5-HIAA between those scoring < or ≥ 8/21 on anxiety scale(P = 0.53). There were no statistically significant differences between groups in first or second-order factors(BIS) or total sum(P = 0.23).CONCLUSION Excepting endocrine symptoms, there were no significant differences in HRQoL, anxiety, depression or impulsivity between patients with advanced GEPNET, with or without CS. Over one quarter of patients had high anxiety scores, unrelated to peripheral serotonin metabolism.展开更多
Background on the relationship between meditation/yoga practice and its effect on Alzheimer's disease (AD): Dementia refers to a variety of conditions that affect the normal function of the brain, leading to sympt...Background on the relationship between meditation/yoga practice and its effect on Alzheimer's disease (AD): Dementia refers to a variety of conditions that affect the normal function of the brain, leading to symptoms like memory loss, issues with problem solving, difficulty in processing thoughts and disordered language (McKhann et al., 2011).展开更多
The American College of Radiology opened the computed tomography (CT) dose index registry (DIR) for general participation by all facilities in 2011. For each CT examination, data on volume CT dose index (CTDIvol), dos...The American College of Radiology opened the computed tomography (CT) dose index registry (DIR) for general participation by all facilities in 2011. For each CT examination, data on volume CT dose index (CTDIvol), dose-length product (DLP), and, for body examinations, size-specific dose estimate (SSDE) were collected. However, effective dose is not estimated in DIR. The primary objective of this study was to estimate k-factor profile in detail at various scan positions with modified the ImPACT CT patient dosimetry. A tool that easily estimates the k-factor of suitable scan areas is essential for practical dose estimation in the DIR. We evaluated k-factor (effective dose/ DLP) profiles between a medical international radiation dose-five (MIRD-5) phantom positions using aImPACT software. As a result of this study, practicality of the k-factor profile method in clinical use was clarified. We speculate that a flexible k-factor improves the appropriateness of the E in hospital settings.展开更多
Purines have a recognized importance as intercellular messengers.These molecules play an important role in the development and maintenance of the central nervous system(CNS),as well as in its response to pathological ...Purines have a recognized importance as intercellular messengers.These molecules play an important role in the development and maintenance of the central nervous system(CNS),as well as in its response to pathological conditions.Both adenine and guanine-based purines can be released from astrocytes,where they play a relevant role as extracellular signaling molecules.Particularly,the nucleoside guanosine has been proposed as an extracellular molecule展开更多
BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutio...BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutions in the era of neoadjuvant chemoradiation therapy(CRT),the role of selective LLND in patients with enlarged LLN on pre-CRT imaging remains unclear.Some studies have shown improved survival and recurrence outcomes when LLNs show"response"to CRT.However,no management algorithm exists to differentiate treatment for"responders"vs"non-responders".AIM To determine if selective LLND in patients with enlarged LLNs results in improved survival and recurrence outcomes.METHODS A systemic search of Pub Med and Embase databases for studies reporting on patients with synchronous radiologically suspicious LLNM(s-LLNM)in rectal cancer receiving preoperative-CRT was performed.RESULTS Fifteen retrospective,single-centre studies were included.793 patients with sLLNM were evaluated:456 underwent TME while 337 underwent TME with7,LLND post-CRT.In the TME group,local recurrence(LR)rates range from 12.5%to 36%.Five-year disease free survival(DFS)was 42%to 75%.In the TME with LLND group,LR rates were 0%to 6%.Five years DFS was 41.2%to 100%.Radiological response was seen in 58%.Pathologically positive LLN was found in up to 94%of non-responders vs 0%to 20%in responders.Young age,low tumour location and radiological non-response were associated with final positive LLNM and lowered DFS.CONCLUSION LLND is associated with local control in patients with s-LLNM.It can be performed in radiological non-responders given a large majority represent true LLNM.Its role in radiological responders should be considered in selected high risk patients.展开更多
Vibrio parahaemolyticus organisms cause acute gastroenteritis in humans. These bacteria are natural inhabitants of both marine and estuarine ecosystems. In the present study, we investigated the effectiveness of a non...Vibrio parahaemolyticus organisms cause acute gastroenteritis in humans. These bacteria are natural inhabitants of both marine and estuarine ecosystems. In the present study, we investigated the effectiveness of a non-selective enrichment of sediment samples with sodium chloride prior to selective enrichment with alkaline peptone water for a better recovery of V. parahaemolyticus. Sediment samples were collected with or without 1% NaCl from the river Buriganga, located besides Dhaka city and about 400 km away from the Bay of Bengal, and from the estuary of the river Karnaphuli which flows into the Bay of Bengal. Very small number of V. parahaemolyticus (<30 MPN/g) were detected in the sediments of both river and estuary, where NaCl was not added. On the other hand, the number of V. parahaemolyticus increased to more than 40 times (1500 MPN/g) in the river and 32 times (960 MPN/g) in the estuary where NaCl were added. River sediment sample contained the serotype O9:K41 of V. parahaemolyticus and the estuarine sample contained O3:K41 and O3:KUT Our results suggest that a pre-enrichment of environmental samples with 1% NaCl helps V. parahaemolyticus to survive for at least 7 days until they are enriched with alkaline peptone water, for better recovery.展开更多
Objective: To propose approaches to improve nursing handoffs for surgical patients, including standardization. Background: Handoffs, or the transfer of accountability and patient information, can generate potential ri...Objective: To propose approaches to improve nursing handoffs for surgical patients, including standardization. Background: Handoffs, or the transfer of accountability and patient information, can generate potential risks for patient safety. Standardization has been proposed to help improve handoffs. Methods: After observing 333 nursing handoffs in the surgical wards of our institution, we conducted a thematic content analysis, comparing and contrasting the observations. Results: Handoff processes, including the use of support tools, varied among the observations. Common themes in the handoff content suggested possibilities of standardization. About half of the 51 interruptions occurring during the observed handoffs were by healthcare professionals. Conclusions: Standardization to improve handoffs should address both the content and the process. Interruptions were common and should be avoided whenever possible. Future studies should also consider the use of mobile applications to support handoffs and clinical documentation.展开更多
We conducted experiments of oversensing generation of pacemaker (PM) and X-irradiation direction dependency of PM, and examined the oversensing suppression method, using 8 different types of PMs. It was found out from...We conducted experiments of oversensing generation of pacemaker (PM) and X-irradiation direction dependency of PM, and examined the oversensing suppression method, using 8 different types of PMs. It was found out from this experiment that oversensing would occur when some conditions (X-irradiation direction, X-irradiation intensity) are met. Oversensing occurred with the most low irradiation conditions (kV × mA) when PM was irradiated at 90° (vertically to C-MOS;Complementary Metal Oxide Semiconductor). The acuter the angle of irradiation is (α > 90° < α), the higher the irradiation conditions (kV × mA) at which oversensing start to occur. In plain X-ray photography, oversensing was confirmed under the irradiation conditions of (cervical spine, thoracic spine, lateral thoracic spine, rib, shoulder joint, collarbone, humerus, and chest).Once the irradiation angle and irradiation conditions (kV × mA) are available, oversensing is predictable to some extent. Our findings will help to predict oversensing generation of plain X-ray photography and suppress oversensing. Oversensing can be suppressed in most of the radiography by lowering tube current to 100 mA, but a 1.0 mm High-Density Tungsten Sheet must be put on PM in high tube voltage radiography.展开更多
Objectives: The purpose of this study is to identify how to manage oversensing of pacemakers in chest CT. Methods: Four different models of pacemakers were examined to select the pacemaker generating oversensing. To t...Objectives: The purpose of this study is to identify how to manage oversensing of pacemakers in chest CT. Methods: Four different models of pacemakers were examined to select the pacemaker generating oversensing. To the pacemaker with oversensing, intermittent switching X-ray was exposed using ECG-gated CT helical scan system at prospective CTA mode. IVY Model was used to synchronize the ECG. Only during in the alert period that is non-refractory and sensing is available, intermittent switching X-ray (300 msec/sec) was exposed in chest CT. For comparison, the same intermittent switching X-ray (300 msec/sec) was exposed in the refractory period when sensing was not available. Results: Oversensing was detected only in one of the four pacemakers tested. In this pacemaker, oversensing was generated by exposure of the intermittent switching X-ray in the alert (non-refractory) period, but oversensing was not observed in the refractory period. Conclusion: A pacemaker has alert and refractory periods. Oversensing of a pacemaker was found to be inhibited by selective ECG-synchronized exposure in the refractory period. Since all pacemakers have the refractory period, the results of this study can be widely applied to the patients with pacemakers in chest CT, and their chest CT can be operated safely.展开更多
Psychological depression is drawing accumulating attention nowadays, due to the skyrocketing incidence worldwide and the enormous burdens it incurs. Physical exercise has been long recognized for its therapeutic effec...Psychological depression is drawing accumulating attention nowadays, due to the skyrocketing incidence worldwide and the enormous burdens it incurs. Physical exercise has been long recognized for its therapeutic effects on depressive disorders, although knowledge of the underlying mechanisms remains limited. Suppressed hippocampal neurogenesis in adult brains has been regarded, at least partly, contributive to depression, whereas physical exercise that restores neurogenesis accordingly exerts the anti-depressive action. Several recent publications have suggested the potential role of adiponectin, a protein hormone secreted by peripheral mature adipocytes, in mediating physical exercise-triggered enhancement of hippocampal neurogenesis and alleviation of depression. Here, we briefly review these novel findings and discuss the possibility of counteracting depression by modulating adiponectin signaling in the hippocampus with interventions including physical exercise and administration of pharmacological agents.展开更多
Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR)...Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad P.Methods: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with CWU.Results: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT alone.Conclusions: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.展开更多
Orthognathic surgery is frequently accompanied by intermaxillary fixation. Intermaxillary fixation impedes the maintenance of effective oral hygiene and prolonged fixation can result in periodontal disease. A potentia...Orthognathic surgery is frequently accompanied by intermaxillary fixation. Intermaxillary fixation impedes the maintenance of effective oral hygiene and prolonged fixation can result in periodontal disease. A potential shorter term effect is the generation of oral malodour. It is unclear, however, as to how the production of malodorous compounds in the oral cavity is altered post-surgery. Oral air concentration of sulphur containing compounds, short chain organic acids, ammonia, isoprene and acetone were measured using selected ion flow tube-mass spectrometry in a patient who had undergone orthognathic surgery with subsequent intermaxillary fixation. Total sulphide levels rose approximately 5-fold during fixation with metal ties, with smaller increases recorded for the other compounds measured with the exception of isoprene which remained close to baseline levels. Organic acid levels declined markedly once elastic ties had replaced metal ties, with a lesser reduction being observed in sulphide levels, with both declining further after the commencement of a chlorhexidine- containing mouthwash. These data suggest that bacterial generation of a variety of malodorous compounds increases markedly following intermaxillary fixation. This single case also suggests that the use of elastic ties and effective oral hygiene techniques, including the use of chlorhexidine mouthwash, may help ameliorate such post-surgical effects.展开更多
The incidence of Barretts metaplasia (BM) as well as Barrett' s adenocarcinoma (BA) has been increasing in western populations. The prognosis of BA is worse because individuals present at a late stage. Attempts ha...The incidence of Barretts metaplasia (BM) as well as Barrett' s adenocarcinoma (BA) has been increasing in western populations. The prognosis of BA is worse because individuals present at a late stage. Attempts have been made to intervene at early stage using surveillance programmes, although proof of efficacy of endoscopic surveillance is lacking, particularly outside the specialist centres. The management of BM needs to be evidencebased as there is a lack clarity about how best to treat this condition. The role of proton pump inhibitors and antireflux surgery to control reflux symptoms is justified.Whether adequate control of gastroesophageal reflux early in the disease alters the natural history of Barrett' s change once it has developed and or prevents it in patients with gastroesophageal reflux disease but with no Barrett' s change remains unanswered. There is much to be learned about BM. Thus there is great need for carefully designed large randomised controlled trials to address these issues in order to determine how best to manage patients with BM.展开更多
Diseases and disorders of the central nervous system often require significant interventions to restore lost function due to their complexity.Examples of such disorders include Parkinson’s disease,Alzheimer’s diseas...Diseases and disorders of the central nervous system often require significant interventions to restore lost function due to their complexity.Examples of such disorders include Parkinson’s disease,Alzheimer’s disease,multiple sclerosis,traumatic brain injury,and spinal cord injury.These diseases and disorders result from healthy cells being destroyed,which in turn causes dysfunction in the central nervous system.The death of these cells can trigger a cascade of events that affect the rest of the body,causing symptoms展开更多
Enteroaggregative Escherichia coli (EAggEC) strains cause the persistent diarrhea in infants and compromised hosts in developing countries. These strains are currently defined as E. coli that adheres to HEp-2 cells in...Enteroaggregative Escherichia coli (EAggEC) strains cause the persistent diarrhea in infants and compromised hosts in developing countries. These strains are currently defined as E. coli that adheres to HEp-2 cells in an aggregative adherence (AA) pattern. In this study, we compared 4 different rapid methods for the detection of EAggEC using a PCR assay, clump formation test, glass slide adherence assay, and the HEp-2 cell adherence assay. Out of 683 E. coli strains isolated from diarrheal stool samples, we detected 17 aggR and/or clump-positive strains, and identified 2 aggR-positive, clump-negative strains and 2 aggR-negative, clump-positive strains. All the aggR positive and clump positive strains also showed positive results in glass slide adherence and HEp-2 cell adherence assays. From all these results, we suggest the following procedure for the rapid identification of EAggEC strains: first, screen E. coli strains with the clump formation test and subsequently perform the glass slide adherence assay to observe AA for confirmation.展开更多
文摘Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.
文摘The hepatic sinusoids are lined by a unique population of hepatic sinusoidal endothelial cells (HSEC), which is one of the first hepatic cell populations to come into contact with blood components. However, HSEC are not simply barrier cells that restrict the access of blood- borne compounds to the parenchyma. They are func- tionally specialised endothelial cells that have complex roles, including not only receptor-mediated clearance of endotoxin, bacteria and other compounds, but also the regulation of inflammation, leukocyte recruitment and host immune responses to pathogens. Thus understand- ing the differentiation and function of HSEC is critical for the elucidation of liver biology and pathophysiology. This article reviews methods for isolating and studying human hepatic endothelial cell populations using in vitro models. We also discuss the expression and functions of phe- notypic markers, such as the presence of fenestrations and expression of VAP-1, Stabilin-1, L-SIGN, which can be used to identify sinusoidal endothelium and to permit discrimination from vascular and lymphatic endothelial cells.
基金Research in the Swayne lab was supported by operating grants to LAS from the Natural Sciences and Engineering Research Council of Canada(NSERC Discovery Grant)the Canadian Institutes of Health Research(CIHR Grant MOP142215)+5 种基金The Scottish Rite Charitable Foundation of Canada and the University of Victoria Division of Medical Sciencesby infrastructure grants from the Canadian Foundation for Innovation(CFI)the British Columbia Knowledge Development Fund(BCKDF)supported by a Michael Smith Foundation for Health Research and British Columbia Schizophrenia Society Foundation Scholar Awardsupported by a University of Victoria Fellowship Graduate Awardsupported by a Vanier Canada Graduate Scholarship(NSERC)
文摘We recently reported that targeted deletion of Pannexin 1 in neural precursor cells of the ventricular zone impairs the maintenance of these cells in healthy and stroke-injured brain. Here we frame this exciting new finding in the context of our previous studies on Pannexin 1 in neural precursors as well as the close relationship between Pannexin 1 and purinergic receptors established by other groups. Moreover, we identify important gaps in our understanding of Pannexin 1 in neural precursor cell biology in terms of the underlying molecular mechanisms and functional/behavioural outcomes.
文摘AIM To compare health-related quality of life(HRQoL),anxiety, depression, and impulsivity scores in patients with and without carcinoid syndrome(CS), and correlated them with serum 5-hydroxyindoleacetic acid(5-HIAA) levels.METHODS Patients with advanced gastroenteropancreatic neuroendocrine tumours(GEPNET), with and without CS completed HRQoL QLQ-C30 and QLQ-GI.NET21, Hospital Anxiety and Depression Scale(HADS) and Barratt Impulsivity Scale(BIS) questionnaires. Twosample Wilcoxon test was applied to assess differences in serum 5-HIAA levels, two-sample Mann-Whitney U test for HRQoL and BIS, and proportion test for HADS, between those with and without CS.RESULTS Fifty patients were included; 25 each with and without CS. Median 5-HIAA in patients with and without CS was 367 nmol/L and 86 nmol/L, respectively(P = 0.003). Scores related to endocrine symptoms were significantly higher amongst patients with CS(P = 0.04) and scores for disease-related worries approached significance in the group without CS, but no other statistically-significant differences were reported between patients with and without CS in responses on QLQ-C30 or QLQ-GI.NET21. Fifteen patients(26%) scored ≥ 8/21 on anxiety scale, and 6(12%) scored ≥ 8/21 on depression scale. There was no difference in median 5-HIAA between those scoring < or ≥ 8/21 on anxiety scale(P = 0.53). There were no statistically significant differences between groups in first or second-order factors(BIS) or total sum(P = 0.23).CONCLUSION Excepting endocrine symptoms, there were no significant differences in HRQoL, anxiety, depression or impulsivity between patients with advanced GEPNET, with or without CS. Over one quarter of patients had high anxiety scores, unrelated to peripheral serotonin metabolism.
基金provided by the Canada Research Chairs programthe NSERC Discovery Grants program(to SMW)
文摘Background on the relationship between meditation/yoga practice and its effect on Alzheimer's disease (AD): Dementia refers to a variety of conditions that affect the normal function of the brain, leading to symptoms like memory loss, issues with problem solving, difficulty in processing thoughts and disordered language (McKhann et al., 2011).
文摘The American College of Radiology opened the computed tomography (CT) dose index registry (DIR) for general participation by all facilities in 2011. For each CT examination, data on volume CT dose index (CTDIvol), dose-length product (DLP), and, for body examinations, size-specific dose estimate (SSDE) were collected. However, effective dose is not estimated in DIR. The primary objective of this study was to estimate k-factor profile in detail at various scan positions with modified the ImPACT CT patient dosimetry. A tool that easily estimates the k-factor of suitable scan areas is essential for practical dose estimation in the DIR. We evaluated k-factor (effective dose/ DLP) profiles between a medical international radiation dose-five (MIRD-5) phantom positions using aImPACT software. As a result of this study, practicality of the k-factor profile method in clinical use was clarified. We speculate that a flexible k-factor improves the appropriateness of the E in hospital settings.
基金funding from Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq#403120/2012-8,#308723/2013-9,#449436/2014-4)Coordenacao de Aperfeicoamento de Pessoal de Nível Superior(CAPES),Brazil
文摘Purines have a recognized importance as intercellular messengers.These molecules play an important role in the development and maintenance of the central nervous system(CNS),as well as in its response to pathological conditions.Both adenine and guanine-based purines can be released from astrocytes,where they play a relevant role as extracellular signaling molecules.Particularly,the nucleoside guanosine has been proposed as an extracellular molecule
文摘BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutions in the era of neoadjuvant chemoradiation therapy(CRT),the role of selective LLND in patients with enlarged LLN on pre-CRT imaging remains unclear.Some studies have shown improved survival and recurrence outcomes when LLNs show"response"to CRT.However,no management algorithm exists to differentiate treatment for"responders"vs"non-responders".AIM To determine if selective LLND in patients with enlarged LLNs results in improved survival and recurrence outcomes.METHODS A systemic search of Pub Med and Embase databases for studies reporting on patients with synchronous radiologically suspicious LLNM(s-LLNM)in rectal cancer receiving preoperative-CRT was performed.RESULTS Fifteen retrospective,single-centre studies were included.793 patients with sLLNM were evaluated:456 underwent TME while 337 underwent TME with7,LLND post-CRT.In the TME group,local recurrence(LR)rates range from 12.5%to 36%.Five-year disease free survival(DFS)was 42%to 75%.In the TME with LLND group,LR rates were 0%to 6%.Five years DFS was 41.2%to 100%.Radiological response was seen in 58%.Pathologically positive LLN was found in up to 94%of non-responders vs 0%to 20%in responders.Young age,low tumour location and radiological non-response were associated with final positive LLNM and lowered DFS.CONCLUSION LLND is associated with local control in patients with s-LLNM.It can be performed in radiological non-responders given a large majority represent true LLNM.Its role in radiological responders should be considered in selected high risk patients.
文摘Vibrio parahaemolyticus organisms cause acute gastroenteritis in humans. These bacteria are natural inhabitants of both marine and estuarine ecosystems. In the present study, we investigated the effectiveness of a non-selective enrichment of sediment samples with sodium chloride prior to selective enrichment with alkaline peptone water for a better recovery of V. parahaemolyticus. Sediment samples were collected with or without 1% NaCl from the river Buriganga, located besides Dhaka city and about 400 km away from the Bay of Bengal, and from the estuary of the river Karnaphuli which flows into the Bay of Bengal. Very small number of V. parahaemolyticus (<30 MPN/g) were detected in the sediments of both river and estuary, where NaCl was not added. On the other hand, the number of V. parahaemolyticus increased to more than 40 times (1500 MPN/g) in the river and 32 times (960 MPN/g) in the estuary where NaCl were added. River sediment sample contained the serotype O9:K41 of V. parahaemolyticus and the estuarine sample contained O3:K41 and O3:KUT Our results suggest that a pre-enrichment of environmental samples with 1% NaCl helps V. parahaemolyticus to survive for at least 7 days until they are enriched with alkaline peptone water, for better recovery.
文摘Objective: To propose approaches to improve nursing handoffs for surgical patients, including standardization. Background: Handoffs, or the transfer of accountability and patient information, can generate potential risks for patient safety. Standardization has been proposed to help improve handoffs. Methods: After observing 333 nursing handoffs in the surgical wards of our institution, we conducted a thematic content analysis, comparing and contrasting the observations. Results: Handoff processes, including the use of support tools, varied among the observations. Common themes in the handoff content suggested possibilities of standardization. About half of the 51 interruptions occurring during the observed handoffs were by healthcare professionals. Conclusions: Standardization to improve handoffs should address both the content and the process. Interruptions were common and should be avoided whenever possible. Future studies should also consider the use of mobile applications to support handoffs and clinical documentation.
文摘We conducted experiments of oversensing generation of pacemaker (PM) and X-irradiation direction dependency of PM, and examined the oversensing suppression method, using 8 different types of PMs. It was found out from this experiment that oversensing would occur when some conditions (X-irradiation direction, X-irradiation intensity) are met. Oversensing occurred with the most low irradiation conditions (kV × mA) when PM was irradiated at 90° (vertically to C-MOS;Complementary Metal Oxide Semiconductor). The acuter the angle of irradiation is (α > 90° < α), the higher the irradiation conditions (kV × mA) at which oversensing start to occur. In plain X-ray photography, oversensing was confirmed under the irradiation conditions of (cervical spine, thoracic spine, lateral thoracic spine, rib, shoulder joint, collarbone, humerus, and chest).Once the irradiation angle and irradiation conditions (kV × mA) are available, oversensing is predictable to some extent. Our findings will help to predict oversensing generation of plain X-ray photography and suppress oversensing. Oversensing can be suppressed in most of the radiography by lowering tube current to 100 mA, but a 1.0 mm High-Density Tungsten Sheet must be put on PM in high tube voltage radiography.
文摘Objectives: The purpose of this study is to identify how to manage oversensing of pacemakers in chest CT. Methods: Four different models of pacemakers were examined to select the pacemaker generating oversensing. To the pacemaker with oversensing, intermittent switching X-ray was exposed using ECG-gated CT helical scan system at prospective CTA mode. IVY Model was used to synchronize the ECG. Only during in the alert period that is non-refractory and sensing is available, intermittent switching X-ray (300 msec/sec) was exposed in chest CT. For comparison, the same intermittent switching X-ray (300 msec/sec) was exposed in the refractory period when sensing was not available. Results: Oversensing was detected only in one of the four pacemakers tested. In this pacemaker, oversensing was generated by exposure of the intermittent switching X-ray in the alert (non-refractory) period, but oversensing was not observed in the refractory period. Conclusion: A pacemaker has alert and refractory periods. Oversensing of a pacemaker was found to be inhibited by selective ECG-synchronized exposure in the refractory period. Since all pacemakers have the refractory period, the results of this study can be widely applied to the patients with pacemakers in chest CT, and their chest CT can be operated safely.
基金supported by Hong Kong Health and Medical Research FundLeading Talents of Guangdong(2013)+3 种基金Programme of Introducing Talents of Discipline to Universities(B14036)Project of International,as well as Hong Kong,Macao&Taiwan Science and Technology Cooperation Innovation Platform in Universities in Guangdong Province,China(2013gjhz0002)grants to Jinan University Guangdong-Hong Kong-Macao Cooperation and Innovation Center for Tissue Regeneration and RepairState Key Laboratory of Pharmaceutical Biotechnology,Hong Kong SAR,China
文摘Psychological depression is drawing accumulating attention nowadays, due to the skyrocketing incidence worldwide and the enormous burdens it incurs. Physical exercise has been long recognized for its therapeutic effects on depressive disorders, although knowledge of the underlying mechanisms remains limited. Suppressed hippocampal neurogenesis in adult brains has been regarded, at least partly, contributive to depression, whereas physical exercise that restores neurogenesis accordingly exerts the anti-depressive action. Several recent publications have suggested the potential role of adiponectin, a protein hormone secreted by peripheral mature adipocytes, in mediating physical exercise-triggered enhancement of hippocampal neurogenesis and alleviation of depression. Here, we briefly review these novel findings and discuss the possibility of counteracting depression by modulating adiponectin signaling in the hippocampus with interventions including physical exercise and administration of pharmacological agents.
基金supported in part by Varian, Paolo Alto, CA through a structured research agreementsupported by the National Medical Research Council Singapore Clinician-Scientist Award (Grant No. NMRC/CSA/0027/ 2018)the Duke-NUS Oncology Academic Program Proton Research Program
文摘Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad P.Methods: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with CWU.Results: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT alone.Conclusions: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.
文摘Orthognathic surgery is frequently accompanied by intermaxillary fixation. Intermaxillary fixation impedes the maintenance of effective oral hygiene and prolonged fixation can result in periodontal disease. A potential shorter term effect is the generation of oral malodour. It is unclear, however, as to how the production of malodorous compounds in the oral cavity is altered post-surgery. Oral air concentration of sulphur containing compounds, short chain organic acids, ammonia, isoprene and acetone were measured using selected ion flow tube-mass spectrometry in a patient who had undergone orthognathic surgery with subsequent intermaxillary fixation. Total sulphide levels rose approximately 5-fold during fixation with metal ties, with smaller increases recorded for the other compounds measured with the exception of isoprene which remained close to baseline levels. Organic acid levels declined markedly once elastic ties had replaced metal ties, with a lesser reduction being observed in sulphide levels, with both declining further after the commencement of a chlorhexidine- containing mouthwash. These data suggest that bacterial generation of a variety of malodorous compounds increases markedly following intermaxillary fixation. This single case also suggests that the use of elastic ties and effective oral hygiene techniques, including the use of chlorhexidine mouthwash, may help ameliorate such post-surgical effects.
基金the Cancer Research Campaign,Imperial Cancer Research Fund and Medical Research Council.
文摘The incidence of Barretts metaplasia (BM) as well as Barrett' s adenocarcinoma (BA) has been increasing in western populations. The prognosis of BA is worse because individuals present at a late stage. Attempts have been made to intervene at early stage using surveillance programmes, although proof of efficacy of endoscopic surveillance is lacking, particularly outside the specialist centres. The management of BM needs to be evidencebased as there is a lack clarity about how best to treat this condition. The role of proton pump inhibitors and antireflux surgery to control reflux symptoms is justified.Whether adequate control of gastroesophageal reflux early in the disease alters the natural history of Barrett' s change once it has developed and or prevents it in patients with gastroesophageal reflux disease but with no Barrett' s change remains unanswered. There is much to be learned about BM. Thus there is great need for carefully designed large randomised controlled trials to address these issues in order to determine how best to manage patients with BM.
基金supported by grants from the Canada Research Chairs programthe NSERC Engage and Engage Plus program
文摘Diseases and disorders of the central nervous system often require significant interventions to restore lost function due to their complexity.Examples of such disorders include Parkinson’s disease,Alzheimer’s disease,multiple sclerosis,traumatic brain injury,and spinal cord injury.These diseases and disorders result from healthy cells being destroyed,which in turn causes dysfunction in the central nervous system.The death of these cells can trigger a cascade of events that affect the rest of the body,causing symptoms
文摘Enteroaggregative Escherichia coli (EAggEC) strains cause the persistent diarrhea in infants and compromised hosts in developing countries. These strains are currently defined as E. coli that adheres to HEp-2 cells in an aggregative adherence (AA) pattern. In this study, we compared 4 different rapid methods for the detection of EAggEC using a PCR assay, clump formation test, glass slide adherence assay, and the HEp-2 cell adherence assay. Out of 683 E. coli strains isolated from diarrheal stool samples, we detected 17 aggR and/or clump-positive strains, and identified 2 aggR-positive, clump-negative strains and 2 aggR-negative, clump-positive strains. All the aggR positive and clump positive strains also showed positive results in glass slide adherence and HEp-2 cell adherence assays. From all these results, we suggest the following procedure for the rapid identification of EAggEC strains: first, screen E. coli strains with the clump formation test and subsequently perform the glass slide adherence assay to observe AA for confirmation.
