Abstract Introduction Preeclampsia (PE) is a leading cause of maternal and neonatal mortality and morbidity worldwide. However, the pathophysiology of this disease is not yet fully understood. MiRNA ...plays an important role in post-transcriptional gene regulation. Recent studies have suggested that dysregulation of miRNAs in placental tissue is involved in the pathogenesis of PE. Therefore, we investigated miRNA profiles in PE placenta to understand the miRNA function in PE pathogenesis. Methods MiRNA profiling was performed in 20 formalin-fixed and paraffin-embedded samples (10 placentas from severe PE and 10 from a control group). We used a hybridization-based microarray with a PNA-probe comprised of 158 miRNAs. Results Thirteen miRNAs (miR-92b, miR-197, miR-342-3p, miR-296-5p, miR-26b, miR-25, miR-296-3p, miR-26a, miR-198, miR-202, miR-191, miR-95, and miR-204) were significantly overexpressed and two miRNAs (miR-21 and miR-223) were underexpressed in PE compared with the control group. Among 15 differentially expressed miRNAs, miR-26b, miR-296-5p, and miR-223 were found to be consistent with results from previous studies. We identified 893 genes that were predicted by at least three of four computational algorithms. Target genes participated in several signaling pathways, adherens junction, focal adhesion, and regulation of the actin cytoskeleton. Conclusions Several miRNAs are found to be dysregulated in placentas of PE patients and they seem to be closely associated with the early pathogenesis of PE. Further study is necessary to develop tools for early detection and management.
BackgroundThe goal of this study was to characterize viral loads and factors affecting viral clearance in persons with severe influenza MethodsThis was a 1-year prospective, observational study ...involving consecutive adults hospitalized with influenza. Nasal and throat swabs were collected at presentation, then daily until 1 week after symptom onset. Real-time reverse-transcriptase polymerase chain reaction to determine viral RNA concentration and virus isolation were performed. Viral RNA concentration was analyzed using multiple linear or logistic regressions or mixed-effect models ResultsOne hundred forty-seven inpatients with influenza A (H3N2) infection were studied (mean age ± standard deviation, 72±16 years). Viral RNA concentration at presentation positively correlated with symptom scores and was significantly higher than that among time-matched outpatients (control subjects). Patients with major comorbidities had high viral RNA concentration even when presenting >2 days after symptom onset (mean ± standard deviation, 5.06±1.85 vs 3.62±2.13 log10 copies/mL; P=.005; β, +0.86 95% confidence interval, +0.03 to +1.68). Viral RNA concentration demonstrated a nonlinear decrease with time; 26% of oseltamivir-treated and 57% of untreated patients had RNA detected at 1 week after symptom onset. Oseltamivir started on or before symptom day 4 was independently associated with an accelerated decrease in viral RNA concentration (mean β standard error, −1.19 0.43 and −0.68 0.33 log10 copies/mL for patients treated on day 1 and days 2–3, respectively; P<.05) and viral RNA clearance at 1 week (odds ratio, 0.10 95% confidence interval, 0.03–0.35 and 0.30 0.10–0.90 for patients treated on day 1–2 and day 3–4, respectively). Conversely, major comorbidities and systemic corticosteroid use for asthma or chronic obstructive pulmonary disease exacerbations were associated with slower viral clearance. Viral RNA clearance was associated with a shorter hospital stay (7.0 vs 13.5 days; P=.001) ConclusionPatients hospitalized with severe influenza have more active and prolonged viral replication. Weakened host defenses slow viral clearance, whereas antivirals started within the first 4 days of illness enhance viral clearance
Although laparoscopic donor hepatectomy is increasingly common, few centers with substantial experience have reported the results of pure laparoscopic donor right hepatectomy (PLDRH). Here, we report ...the experiences of 60 consecutive liver donors undergoing pure laparoscopic donor hepatectomy (PLDH), with most undergoing right hepatectomy. None of the 60 donors who underwent PLDH had intraoperative complications and none required transfusions, reoperation, or conversion to open hepatectomy. Forty‐five donors who underwent PLDRH between November 2015 and December 2016 were compared with 42 who underwent conventional donor right hepatectomy (CDRH) between May 2013 and February 2014. The total operation time was longer (330.7 vs 280.0 minutes; P < .001) and the percentage with multiple bile duct openings was higher (53.3% vs 26.2%; P = .010) in the PLDRH group. However, the length of postoperative hospital stay (8.4 vs 8.2 days; P = .495) and rate of complications (11.9% vs 8.9%; P = .733) and re‐hospitalizations (4.8% vs 4.4%; P = 1.000) were similar in both groups. PLDH, including PLDRH, is feasible when performed by a highly experienced surgeon and transplant team. Further evaluation, including long‐term results, may support these preliminary findings of comparative outcomes for donors undergoing PLDRH and CDRH.
Compared with the open approach, pure laparoscopic donor hepatectomy, primarily right hepatectomy, is a feasible procedure when performed by a highly experienced surgeon and transplantation team.
There are inconsistencies in the literature regarding the prevalence and assessment of chemotherapy-induced peripheral neuropathy (CIPN). This study explored CIPN natural history and its ...characteristics in patients receiving taxane- and platinum-based chemotherapy.
Multi-country multisite prospective longitudinal observational study. Patients were assessed before commencing and three weekly during chemotherapy for up to six cycles, and at 6,9, and 12 months using clinician-based scales (NCI-CTCAE; WHO-CIPN criterion), objective assessments (cotton wool test;10 g monofilament); patient-reported outcome measures (FACT/GOG-Ntx; EORTC-CIPN20), and Nerve Conduction Studies.
In total, 343 patients were recruited in the cohort, providing 2399 observations. There was wide variation in CIPN prevalence rates using different assessments (14.2-53.4%). Prevalence of sensory neuropathy (and associated symptom profile) was also different in each type of chemotherapy, with paclitaxel (up to 63%) and oxaliplatin (up to 71.4%) showing the highest CIPN rates in most assessments and a more complex symptom profile. Peak prevalence was around the 6-month assessment (up to 71.4%). Motor neurotoxicity was common, particularly in the docetaxel subgroup (up to 22.1%; detected by NCI-CTCAE). There were relatively moderately-to-low correlations between scales (r
= 0.15,p < 0.05-r
= 0.48 p < 0.001), suggesting that they measure different neurotoxicity aspects from each other. Cumulative chemotherapy dose was not associated with onset and course of CIPN.
The historical variation reported in CIPN incidence and prevalence is possibly confounded by disagreement between assessment modalities. Clinical practice should consider assessment of motor neuropathy for neurotoxic chemotherapy. Current scales may not be all appropriate to measure CIPN in a valid way, and a combination of scales are needed.
One of the key issues with geological sequestration of carbon dioxide in coal seams is change of permeability caused by carbon dioxide (CO2) injection, and especially any resulting reduction in ...injectivity. Injection causes changes in pressure and effective stress, with further changes caused by coal matrix swelling associated with adsorption of CO2. In this paper we aim to study how the change in effective stress and coal swelling may influence the gas permeability in brown coal using natural coal and reconstituted coal specimens. Tests were conducted at different confining pressures to represent conditions at different depths. Different gas injection pressures were also employed at each confining stress stage. The test results clearly depicted an exponential reduction of coal permeability to CO2 gas when effective stress increases. Based on the experimental results, an empirical correlation to represent the effect of stress on permeability was developed. The results also showed that increase in pore pressure can induce further swelling of the coal specimens, and this can lead to further decrease in permeability which can have important impact on field injectivity. Test results for natural brown coal specimens were compared with results of tests on reconstituted coal specimens made from compaction of coal particles obtained from crushing of blocks of natural coal. Observed permeability behaviour of gas in reconstituted coal was similar to the natural coal specimen permeability trend, when effective stress increases.
Summary
Background
Little is known about factors affecting the quality of life (QoL) of patients with vitiligo, and previous studies have shown conflicting results.
Objectives
To explore the QoL of ...patients with vitiligo and to identify factors affecting QoL.
Methods
A nationwide questionnaire‐based study was conducted with 1123 patients with vitiligo recruited from 21 hospitals in Korea from July 2015 to June 2016. Data were collected using a structured questionnaire for demographic information and the Skindex‐29 instrument. Mild or severely impaired QoL in patients with vitiligo was assessed according to each domain (symptoms, functioning and emotions) of Skindex‐29. Multivariate logistic regression analyses were performed to determine the factors associated with QoL.
Results
Of the enrolled participants, 609 were male and 514 female, with a mean age of 49·8 years (range 20–84). The median duration of disease was 3·0 years (range 0–60). Using multivariate logistic regression modelling, the involvement of visible body parts and a larger affected body surface area were consistently associated with QoL impairment in all three domains of Skindex‐29. Additionally, the QoL of patients aged 20–59 years, who potentially had a more active social life than older patients, was associated with functional impairment. Furthermore, a higher educational background was associated with emotional impairment.
Conclusions
A multitude of factors significantly influence the QoL of patients with vitiligo. A better appreciation of these factors would help the management of these patients.
What's already known about this topic?
Quality of life is highly impaired in patients with vitiligo.
What does this study add?
The involvement of visible body parts and a larger affected body surface area were consistently associated with impaired symptoms, functioning and emotions.
Vitiligo with nonvisible lesions also considerably compromises quality of life; vitiligo should not be regarded as a cosmetic problem.
Patients aged 20–59 years experienced significant functional impairment, and those with a higher educational background had more impairment in their emotions.
Linked Comment: Ezzedine and Eleftheriadou. Br J Dermatol 2018; 178:28–29.
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Abstract
The global energy crisis is increasing the demand for innovative materials with high purity and functionality for the development of clean energy production and storage. The development of ...novel photo- and electrocatalysts significantly depends on synthetic techniques that facilitate the production of tailored advanced nanomaterials. The emerging use of pulsed laser in liquid synthesis has attracted immense interest as an effective synthetic technology with several advantages over conventional chemical and physical synthetic routes, including the fine-tuning of size, composition, surface, and crystalline structures, and defect densities and is associated with the catalytic, electronic, thermal, optical, and mechanical properties of the produced nanomaterials. Herein, we present an overview of the fundamental understanding and importance of the pulsed laser process, namely various roles and mechanisms involved in the production of various types of nanomaterials, such as metal nanoparticles, oxides, non-oxides, and carbon-based materials. We mainly cover the advancement of photo- and electrocatalytic nanomaterials via pulsed laser-assisted technologies with detailed mechanistic insights and structural optimization along with effective catalytic performances in various energy and environmental remediation processes. Finally, the future directions and challenges of pulsed laser techniques are briefly underlined. This review can exert practical guidance for the future design and fabrication of innovative pulsed laser-induced nanomaterials with fascinating properties for advanced catalysis applications.
Background: This meta-analysis aimed to investigate the effect of antioxidant supplements on the primary and secondary prevention of cancer as reported by randomized controlled trials. Methods: We ...searched Medline (PubMed), Excerpta Medica database, and the Cochrane Review in October 2007. Results: Among 3327 articles searched, 31 articles on 22 randomized controlled trials, which included 161 045 total subjects, 88 610 in antioxidant supplement groups and 72 435 in placebo or no-intervention groups, were included in the final analyses. In a fixed-effects meta-analysis of all 22 trials, antioxidant supplements were found to have no preventive effect on cancer relative risk (RR) 0.99; 95% confidence interval (CI) 0.96–1.03). Similar findings were observed in 12 studies on primary prevention trials (RR 1.00; 95% CI 0.97–1.04) and in nine studies on secondary prevention trials (RR 0.97; 95% CI 0.83–1.13). Further, subgroup analyses revealed no preventive effect on cancer according to type of antioxidant, type of cancer, or the methodological quality of the studies. On the other hand, the use of antioxidant supplements significantly increased the risk of bladder cancer (RR 1.52; 95% CI 1.06–2.17) in a subgroup meta-analysis of four trials. Conclusions: The meta-analysis of randomized controlled trials indicated that there is no clinical evidence to support an overall primary and secondary preventive effect of antioxidant supplements on cancer. The effects of antioxidant supplements on human health, particularly in relation to cancer, should not be overemphasized because the use of those might be harmful for some cancer.
Although endoscopic submucosal dissection (ESD) is increasingly utilized to treat early neoplasms of the gastrointestinal tract, its use for duodenal neoplasms is limited by the thin wall and narrow ...lumen of the duodenum. We have reviewed cases where ESD was used to treat sessile, nonampullary duodenal neoplasms. To do this, we retrospectively reviewed the medical records of patients treated with ESD for adenomas of the duodenum from January 2001 to December 2010, assessing the curative outcomes and complication rates. A total of 14 cases were reviewed. Mean patient age was 56.4 years. The mean size of tumors and mean size of the specimens were 17.1 mm and 26.4 mm, respectively. The en bloc resection rate with ESD was 78.6%, and the complete (R0) resection rate was 85.7%. No patient in the study experienced major bleeding. However, second-look endoscopy revealed minor bleeding requiring endoscopic homeostasis in one case (7.1%). Perforations were observed in five cases (35.7%). Two of the five patients with perforation underwent surgery. The ESD methods yielded acceptable curative resection rates for duodenal adenomas, although ESD was associated with a higher rate of perforation. Therefore, duodenal ESD should be performed with care and only in selected patients to avoid serious complications.
Nanoindentation measurements were obtained on eight commercially-produced DP980 dual-phase steels to quantify the hardness of the individual constituents, ferrite and martensite, in each steel. Each ...microstructure was also evaluated to determine grain size, martensite volume fraction (MVF), and retained austenite content. Nanoindentation hardnesses and quantitative microstructural measurements were correlated with tensile properties and performance in hole expansion tests to assess the importance of the individual constituent properties. Hole expansion samples were prepared with both sheared edges produced by mechanical punching, and non-deformed edges produced by electric discharge machining (EDM). Average material hardness based on nanoindentation data correlated directly to Vickers hardness measurements, verifying the capability of the nanoindentation technique to produce data consistent with traditional hardness measurements. Yield strength (YS) correlated directly to ferrite hardness indicating that, for a similar MVF and microstructural morphology, the YS is controlled by the strength of the softer matrix phase (ferrite). Hole expansion ratios (HER) on EDM samples decreased with an increase in both martensite and ferrite hardness, indicating that EDM HER values can be enhanced by softening both constituents. Punched-hole HER values decreased with increasing martensite hardness and martensite-to-ferrite hardness ratio, but were independent of ferrite hardness, indicating that softening the martensite while increasing the ferrite hardness could produce a higher HER.
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