Comparison of streamlined liner of the pharynx airway (SLIPA ™) and laryngeal mask airway: a systematic review and meta-analysis

We performed a systematic review to compare the efficacy and safety of the streamlined liner of the pharynx airway and laryngeal mask airway used in adults during general anaesthesia. We included 14 studies with studies with 1273 patients in total. There was no evidence of a difference between the two devices in insertion success rate on the first attempt (13 studies, 1143 patients), insertion time (seven studies, 576 patients), ease of insertion (five studies, 466 patients), oropharyngeal leak pressure (eight studies, 771 patients) and the quality of the fibreoptic view of the larynx through the device (three studies, 281 patients). The relative risk (95% CI) of bloodstaining of the device (nine studies, 859 patients) was 2.09 (1.46-3.00) for the streamlined liner of the pharynx airway compared with the laryngeal mask airway. Other adverse events were comparable. Subgroup analysis suggested that the insertion by novice users might be faster and more successful with the streamlined liner of the pharynx airway than the laryngeal mask airway; however, this was from only two studies and 186 patients. The method of size selection of the streamlined liner of the pharynx airway device might also affect the speed of insertion: choosing according to the width of the patient's thyroid cartilage, rather than height, may produce better results.

CpG oligonucleotides and Astragalus polysaccharides are effective adjuvants in cultures of avian bone-marrow-derived dendritic cells

1. The potential use of CpG oligodeoxynucleotides and/or Astragalus polysaccharide (APS) as adjuvants for the culture of chicken bone-marrow-derived dendritic cells (chBM-DCs) was investigated. 2. Chicken dendritic cells (DCs) were isolated and cultured in the presence of recombinant chicken granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin (IL)-4. The chBM-DC displayed typical DC morphology and expressed DC surface markers (MHC-II and CD11c). 3. Cultured chBM-DC showed effective T-cell activation in vitro, based on a mixed lymphocyte response (MLR). Flow cytometry analysis showed an increased proportion of cells expressing CD40 and CD80 in the APS-stimulated culture, compared to the control culture. In the MLR, the APS- and CpG-stimulated chBM-DC could activate T-cells more than control chBM-DC. Real-time PCR assays showed that CpG can activate the TLR21 and an inflammatory response, while APS just reduced the expression of IRF-3. 4. The results demonstrated that in vitro the adjuvant CpG can stimulate chBM-DC to mature by activation of the TLR-signalling pathway, whereas the adjuvant APS stimulates maturation of chBM-DC in vitro to a lesser degree and by another mechanism.

Development of Hypertension Management Mobile Application based on Clinical Practice Guidelines

This study aims to develop and evaluate a mobile application for hypertension management based on Clinical Practice Guidelines. The application was developed according to Web-Roadmap methodology. In planning phase, we defined the tasks and product of each phase, selected clinical practice guidelines and extracted intervention items for hypertension management. In analysis phase, we analysed intervention items and made data dictionary, rules, use-case diagram, hypertension management ontology and tailored recommendations for the application. In design phase, we developed an entity-relations diagram, algorithm, and user interface and coded them in the implementation phase. In evaluation phase, first, the knowledge-base was evaluated for its accuracy by experts and they proposed three more detailed recommendations, which were added to the application. Second, mobile heuristics were evaluated. The evaluators pointed out 33 usability-related problems on mobile heuristics items. Out of these, three problems were solved by reflecting evaluators' comments.

Competition between electron doping and short-range scattering in hydrogenated bilayer graphene on hexagonal boron nitride

We studied the electron doping of bilayer graphene (BLG) on hexagonal boron nitride (h-BN) by dissociative H₂ adsorption.

Measurement of double-polarization asymmetries in the quasielastic (3)He[→](e[→],e(')d) process

We present a precise measurement of double-polarization asymmetries in the ^{3}He[over →](e[over →],e^{'}d) reaction. This particular process is a uniquely sensitive probe of hadron dynamics in ^{3}He and the structure of the underlying electromagnetic currents. The measurements have been performed in and around quasielastic kinematics at Q^{2}=0.25(GeV/c)^{2} for missing momenta up to 270  MeV/c. The asymmetries are in fair agreement with the state-of-the-art calculations in terms of their functional dependencies on p_{m} and ω, but are systematically offset. Beyond the region of the quasielastic peak, the discrepancies become even more pronounced. Thus, our measurements have been able to reveal deficiencies in the most sophisticated calculations of the three-body nuclear system, and indicate that further refinement in the treatment of their two-and/or three-body dynamics is required.

A retrospective study to assess the relative value of peripheral blood, bone marrow aspirate and biopsy morphology, immunohistochemical stains, and flow cytometric analysis in the diagnosis of chronic B cell lymphoproliferative neoplasms

INTRODUCTION

The successful diagnosis of chronic B cell lymphoproliferative neoplasms (B-CLPN) requires the integration of multiple parameters, beginning with clinical information, CBC data, and morphology review. Immunophenotyping is essential and genetic testing may also be necessary. However, the relative value of each specimen or ancillary study in the diagnosis and classification has not been systematically established. We have performed a blinded retrospective review to assess what in our laboratory was the relative value of each specimen type and ancillary study in the diagnostic workup of B-CLPN.

METHODS

A total of 185 cases of PB, BM, spleen and lymph nodes were analyzed for relative value of morphology, IHC, flow cytometry study in the diagnosis of B-CLPN.

RESULTS

'High yield' specimen was identified in most B-CLPN categories, which was highly predictive of the final WHO diagnosis.

CONCLUSION

The goal of this retrospective study was to attempt to assess what was the relative value of morphology, immunophenotype, and molecular/cytogenetic study in various sites in the overall diagnostic process in our institution. We investigated the utility of the 'high yield' specimens in achieving the correct final diagnosis. In our study, some B-CLPNs notably splenic marginal zone lymphoma and hairy cell leukemia variant, required all studies for a 'best fit' type of diagnosis. In other cases, the morphology of a single specimen type was highly predictive of the final diagnosis, although confirmatory studies are recommended for definitive diagnosis.

A 3'-UTR KRAS-variant is associated with cisplatin resistance in patients with recurrent and/or metastatic head and neck squamous cell carcinoma

BACKGROUND

A germline mutation in the 3'-untranslated region of KRAS (rs61764370, KRAS-variant: TG/GG) has previously been associated with altered patient outcome and drug resistance/sensitivity in various cancers. We examined the prognostic and predictive significance of this variant in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).

PATIENTS AND METHODS

We conducted a retrospective study of 103 HNSCCs collected from three completed clinical trials. KRAS-variant genotyping was conducted for these samples and 8 HNSCC cell lines. p16 expression was determined in a subset of 26 oropharynx tumors by immunohistochemistry. Microarray analysis was also utilized to elucidate differentially expressed genes between KRAS-variant and non-variant tumors. Drug sensitivity in cell lines was evaluated to confirm clinical findings.

RESULTS

KRAS-variant status was determined in 95/103 (92%) of the HNSCC tumor samples and the allelic frequency of TG/GG was 32% (30/95). Three of the HNSCC cell lines (3/8) studied had the KRAS-variant. No association between KRAS-variant status and p16 expression was observed in the oropharynx subset (Fisher's exact test, P = 1.0). With respect to patient outcome, patients with the KRAS-variant had poor progression-free survival when treated with cisplatin (log-rank P = 0.002). Conversely, KRAS-variant patients appeared to experience some improvement in disease control when cetuximab was added to their platinum-based regimen (log-rank P = 0.04).

CONCLUSIONS

The TG/GG rs61764370 KRAS-variant is a potential predictive biomarker for poor platinum response in R/M HNSCC patients.

CLINICAL TRIAL REGISTRATION NUMBERS

NCT00503997, NCT00425750, NCT00003809.

Probing the repulsive core of the nucleon-nucleon interaction via the (4)He(e,e'pN) triple-coincidence reaction

We studied simultaneously the (4)He(e,e'p), (4)He(e,e'pp), and (4)He(e,e'pn) reactions at Q(2)=2(GeV/c)(2) and x(B)>1, for an (e,e'p) missing-momentum range of 400 to 830  MeV/c. The knocked-out proton was detected in coincidence with a proton or neutron recoiling almost back to back to the missing momentum, leaving the residual A=2 system at low excitation energy. These data were used to identify two-nucleon short-range correlated pairs and to deduce their isospin structure as a function of missing momentum, in a region where the nucleon-nucleon (NN) force is expected to change from predominantly tensor to repulsive. The abundance of neutron-proton pairs is reduced as the nucleon momentum increases beyond ∼500  MeV/c. The extracted fraction of proton-proton pairs is small and almost independent of the missing momentum. Our data are compared with calculations of two-nucleon momentum distributions in (4)He and discussed in the context of probing the elusive repulsive component of the NN force.

MARCH5-mediated quality control on acetylated Mfn1 facilitates mitochondrial homeostasis and cell survival

Mitochondrial dynamics and quality control have a central role in the maintenance of cellular integrity. Mitochondrial ubiquitin ligase membrane-associated RING-CH (MARCH5) regulates mitochondrial dynamics. Here, we show that mitochondrial adaptation to stress is driven by MARCH5-dependent quality control on acetylated Mfn1. Under mitochondrial stress conditions, levels of Mfn1 were elevated twofold and depletion of Mfn1 sensitized these cells to apoptotic death. Interestingly, overexpression of Mfn1 also promoted cell death in these cells, indicating that a fine tuning of Mfn1 levels is necessary for cell survival. MARCH5 binds Mfn1 and the MARCH5-dependent Mfn1 ubiquitylation was significantly elevated under mitochondrial stress conditions along with an increase in acetylated Mfn1. The acetylation-deficient K491R mutant of Mfn1 showed weak interaction with MARCH5 as well as reduced ubiquitylation. Neither was observed in the acetylation mimetic K491Q mutant. In addition, MARCH5-knockout mouse embryonic fibroblast and MARCH5(H43W)-expressing HeLa cells lacking ubiquitin ligase activity experienced rapid cell death upon mitochondrial stress. Taken together, a fine balance of Mfn1 levels is maintained by MARCH5-mediated quality control on acetylated Mfn1, which is crucial for cell survival under mitochondria stress conditions.

Olea europaea Linn. Fruit Pulp Extract Protects against Carbon Tetrachloride-induced Hepatic Damage in Mice

The present study we investigated the hepatoprotective effects of Olea europaea fruit pulp extract against carbon tetrachloride-induced hepatic damage in experimental mice. Further we explored the antioxidant potential of the extract to substantiate the hepatoprotective properties. Biochemical parameters were analyzed in the serum of experimental mice using respective diagnostic kits. Antioxidant activities were measured following alkyl and hydroxyl radical scavenging assays. Compared with control groups, administration of the extract to carbon tetrachloride-treated mice significantly reduced the elevated serum levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. The carbon tetrachloride-treated morphological changes in hepatocyte architecture were also reversed by extract pretreatment. Further, the carbon tetrachloride-treated increased serum cholesterol levels such as triglyceride and low density/very low-density lipoprotein in the liver were reversed in acute and chronic carbon tetrachloride-treated mice. The extract was also found to significantly increase the serum level of high-density lipoproteins in carbon tetrachloride-treated mice. Furthermore, the extract showed significant in vitro antioxidant actions by scavenging the alkyl and hydroxyl free radicals, substantiating its use in hepatoprotection. The concentration of the extract necessary for 50% inhibition of alkyl and hydroxyl radicals was 72.41 and 52.24 μg/ml, respectively. In conclusion, data from our study suggest that Olea europaea fruit pulp extract could prevent carbon tetrachloride-treated acute and chronic liver degeneration and attenuated the lipid levels elevated by carbon tetrachloride. The hepatoprotective activity exhibited by Olea europaea extract might possibly be through its antioxidant defense mechanisms.

Hepatoprotective Effect of Houttuynia cordata Thunb Extract against Carbon Tetrachloride-induced Hepatic Damage in Mice

Houttuynia cordata Thunb (Saururaceae) is a traditional medicinal herb used to treat several disease symptoms. The present study was focused on the hepatoprotective effects of H. cordata ethyl acetate extract in experimental mice. Further the antioxidant potential of the extract was also evaluated to substantiate its hepatoprotective properties. Carbon tetrachloride-induced hepatic damage in mice was used to measure the serum biochemical parameters. Morphological changes in hepatocyte architecture were studied by haematoxylin and eosin staining. In vitro alkyl and hydroxyl free radical scavenging assays were performed to evaluate the antioxidant effect. Administration of H. cordata extract significantly reduced the elevated serum levels and regulated the altered levels of serum cholesterol in carbon tetrachloride-treated mice (P<0.05). The morphological changes in hepatocyte architecture were also reversed by H. cordata treatment. Further, the extract showed significant antioxidant actions by scavenging the alkyl and hydroxyl free radicals. The concentration of the extract necessary for 50% scavenging of alkyl and hydroxyl radicals was 15.5 and 410 μg/ml, respectively. H. cordata extract exhibited significant hepatoprotective property in carbon tetrachloride-induced hepatotoxicity in mice. The strong antioxidant activities possessed by the extract might be responsible for such actions.

Cross-sectional and dynamic change of serum metabolite profiling for Hepatitis B-related acute-on-chronic liver failure by UPLC/MS

Summary Acute-on-chronic liver failure(ACLF) is an increasingly recognized entity encompassing an acute deterioration of liver function and results in the failure of one or more organs with high short-term mortality. The focus of this study was to discover noninvasive and reliable biomarkers for the diagnosis and prognosis of hepatitis B-related ACLF. Ultra-performance liquid chromatography-mass spectrometry (UPLC/MS) was used to analyse serum metabolites of 28 patients with hepatitis B-related ACLF, 35 patients with Child-Pugh A cirrhosis, 30 patients with chronic hepatitis B and 35 healthy volunteers (HS). Characteristic metabolites were screened, identified and dynamically tracked to investigate their value for diagnosis and prognosis. After comparing serum metabolic profile of hepatitis B-related ACLF and Child-Pugh A cirrhosis, 99 characteristic metabolites were selected, and 38 of them were identified. Dynamic tracking model demonstrated that 17 metabolites were related to prognosis of hepatitis B-related ACLF, and there were also 11 metabolites which improved with treatment in the survival group. The correlations between these characteristic metabolites and the model for end-stage liver disease score were strong. These observations contributed to the investigation of the mechanisms of hepatitis B-related ACLF manifestation and progression on the metabolic level, and they provided information for the identification of biomarkers for the diagnosis and prognosis of hepatitis B-related ACLF.

Phylogenetic distinction of iNOS and IDO function in mesenchymal stem cell-mediated immunosuppression in mammalian species

Mammalian mesenchymal stem cells (MSCs) have been shown to be strongly immunosuppressive in both animal disease models and human clinical trials. We have reported that the key molecule mediating immunosuppression by MSCs is species dependent: indoleamine 2,3-dioxygenase (IDO) in human and inducible nitric oxide synthase (iNOS) in mouse. In the present study, we isolated MSCs from several mammalian species, each of a different genus, and investigated the involvement of IDO and iNOS during MSC-mediated immunosuppression. The characterization of MSCs from different species was by adherence to tissue culture plastic, morphology, specific marker expression, and differentiation potential. On the basis of the inducibility of IDO and iNOS by inflammatory cytokines in MSCs, the tested mammalian species fall into two distinct groups: IDO utilizers and iNOS utilizers. MSCs from monkey, pig, and human employ IDO to suppress immune responses, whereas MSCs from mouse, rat, rabbit, and hamster utilize iNOS. Interestingly, based on the limited number of species tested, the iNOS-utilizing species all belong to the phylogenetic clade, Glires. Although the evolutionary significance of this divergence is not known, we believe that this study provides critical guidance for choosing appropriate animal models for preclinical studies of MSCs.

Measurements of parity-violating asymmetries in electron-deuteron scattering in the nucleon resonance region

We report on parity-violating asymmetries in the nucleon resonance region measured using inclusive inelastic scattering of 5-6 GeV longitudinally polarized electrons off an unpolarized deuterium target. These results are the first parity-violating asymmetry data in the resonance region beyond the Δ(1232). They provide a verification of quark-hadron duality-the equivalence of the quark- and hadron-based pictures of the nucleon-at the (10-15)% level in this electroweak observable, which is dominated by contributions from the nucleon electroweak γZ interference structure functions. In addition, the results provide constraints on nucleon resonance models relevant for calculating background corrections to elastic parity-violating electron scattering measurements.

Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes

Background:

The 2005 and 2010 McDonald criteria utilize magnetic resonance imaging (MRI) to provide evidence of disease dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis (MS) in patients who have clinically isolated syndromes (CIS).

Methods:

Data from 109 CIS patients not satisfying the 2005 criteria at entry into a randomized controlled minocycline trial were analyzed to determine the proportion who would have been diagnosed with MS at screening based on 2010 criteria. The impact of including symptomatic, as well as asymptomatic, MRI lesions to confirm DIT was also explored.

Results:

Thirty percent (33/109) of patients, retrospectively, met the 2010 criteria for a diagnosis of MS at baseline. When both symptomatic and asymptomatic lesions were used to confirm DIT, three additional patients met the 2010 criteria. There was a significant 10.1% increase in the proportion of patients who met the 2010 DIS criteria, compared with the 2005 DIS criteria; however, two patients satisfied the 2005 DIS but not 2010 DIS criteria.

Conclusion:

Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%.

Mitotic and meiotic behavior of rye chromosomes in wheat - Psathyrostachys huashanica amphiploid x triticale progeny

The dynamics of rye chromosomes during mitosis and meiosis was analyzed in a subset comprising 33 F3 lines from the cross of wheat, Psathyrostachys huashanica amphiploid (AABBDDNsNs) and hexaploid triticale (AABBRR), as visualized by genomic in situ hybridization. The results indicated that 31 of the total lines contained 4-14 rye chromosomes. Twenty-eight combinations had more rye chromosomes than the F1 hybrids, suggesting the occurrence of spontaneous quantitative increment. No P. huashanica chromosomes were detected in all of the combinations tested. Mitotic analysis showed that rye chromosomes progressed normally with the wheat counterparts without loss. However, abnormal meiosis was found in almost all lines. Similar progression between wheat and rye genomes appeared from interphase to metaphase I. It was at anaphase I that many rye univalents lagged behind those of wheat, followed by equational division. This resulted in the formation of chromosomal segments and micronuclei at telophase I or II. Micronuclei could also be generated from the immobilized univalents in the periphery of cells. Synapsis and translocations between wheat and rye genomes, chromosome bridges, and unreduced gametes were detected. Therefore, it is proposed that rye chromosome elimination may involve chromatid lagging, fragmentation and micronucleation, or the immobilization of certain univalents during meiosis instead of mitosis in the relatively advanced generations. This mechanism, together with spontaneous incremental increase of rye chromosome number, permitted the generation of various germplasms for wheat improvement.

Distinct long-term neurocognitive outcomes after equipotent sevoflurane or isoflurane anaesthesia in immature rats

BACKGROUND

Many anaesthetics when given to young animals cause cell death and learning deficits that persist until much later in life. Recent attempts to compare the relative safety or toxicity between different agents have not adequately controlled for the relative dose of anaesthetic given, thereby making direct comparisons difficult.

METHODS

Isoflurane or sevoflurane were given at 1 minimum alveolar concentration (MAC) for 4 h to postnatal day 7 (P7) rat pups. Beginning at P75 these animals underwent fear conditioning and at P83 Morris water maze testing to assess working memory, short-term memory and early long-term memory using delays of 1 min, 1 h, and 4 h.

RESULTS

No difference between groups was seen in fear conditioning experiments. Morris water maze learning was equivalent between groups, and no difference was seen in working memory. Sevoflurane-treated animals had a deficit in early long-term memory, and isoflurane-treated animals had a deficit in both short-term and early long-term memory.

CONCLUSIONS

Both isoflurane and sevoflurane delivered at 1 MAC for 4 h to immature rats caused a deficit in long-term memory. Isoflurane also caused a deficit in short-term memory. Isoflurane might be more detrimental than sevoflurane in very young animals.

Estimation of the nares-to-epiglottis distance and the nares-to-vocal cords distance in young children

BACKGROUND

Estimation of the nares-to-epiglottis and nares-to-vocal cords distances would facilitate the selection of properly sized nasopharyngeal airways and appropriate positioning of a fibreoptic bronchoscope in young children. The purposes of this study were to measure the nares-to-epiglottis and nares-to-vocal cords distances and to create an algorithm to predict these distances based on anatomical landmarks and paediatric characteristic data.

METHODS

Two hundred and eleven children, aged 1-10 yr, undergoing elective surgery were investigated. After induction of general anaesthesia, the distances from the nares to the epiglottis/vocal cords were measured using a nasogastric tube. After intubation, the distances from the lateral border of the nose to the ipsilateral mandible angle (nares-to-mandible distance) and the tragus of the ear (nares-to-tragus distance) were measured using a tape measure.

RESULTS

The nares-to-epiglottis and nares-to-vocal cords distances were significantly correlated with the age, weight, height, and external measurements (P<0.001). By stepwise multiple linear regression analysis, formulas were obtained for the nares-to-epiglottis distance (cm)=2.606+0.058×height (cm)+0.231×the nares-to-mandible distance (cm)-0.304 (gender) (r(2)=0.754) and for the nares-to-vocal cords distance (cm)=4.947+0.06×height (cm)+0.228×nares-to-mandible distance (cm)-0.283 (gender) (r(2)=0.803).

CONCLUSIONS

The nares-to-epiglottis and nares-to-vocal cords distances can be predicted using the height and the nares-to-mandible distance in young children.

CLINICAL TRIAL REGISTRATION NUMBER

Clinical Research Information Service KCT0000150.

Visible reconstruction by a circular holographic display from digital holograms recorded under infrared illumination

A circular holographic display that consists of phase-only spatial light modulators is used to reconstruct images in visible light from digital holograms recorded under infrared (10.6 μm) illumination. The reconstruction yields a holographic digital video display of a three-dimensional ghostlike image of an object floating in space where observers can move and rotate around it.

SU-E-T-409: A Comparison of 3D Optical Surface and IR Marker Tracking for Head Motion Compensated Frameless SRS

PURPOSE

Both infrared marker and 3D facial surface tracking were performed simultaneously on both a head phantom and healthy volunteers. Accuracies of the two 6D real-time tracking systems were quantitatively assessed both spatially and temporally. The suitability of 3D facial surface tracking for providing real-time head positioning to guide a robotic head motion compensation stage was investigated.

METHODS

A xyz stage was programmed to move a head phantom to approximately 200 points in 10×10×10 mm³ and 100×100×100 mm³ cubic volumes, respectively. Both 3D surface and IR marker tracking were performed simultaneously on the head phantom to allow direct comparison of spatial accuracy. Sinusoidal motion was performed along all three axis directions and recorded under the same clock cycle. Spatial and temporal accuracies on actual deformable facial surfaces were assessed by simultaneous 3D surface and IR marker tracking on human volunteers. 3D surface tracking both with and without the use of robotic head motion compensation was evaluated.

RESULTS

For 10 samples at each position, the 10 mm cube had RMSE of 0.30 mm and 0.08 mm for the AlignRT and Polaris, respectively. Temporal lag of the AlignRT system was found to be approximately twice the fps time (t_{lag} ∼ 2/fps). The fps value was found to be strongly correlated with region-of-interest (ROI) surface size and could vary from 0.5 - 1.6 fps, leading to a lag time of 1 - 4 s. The Polaris output lagged behind the reference by 0.06 s in all cases.

CONCLUSIONS

Both 3D surface and IR marker devices demonstrate high spatial accuracy for phantom based studies, however, a slight dimensional warping along the SI direction was observed to occur with the AlignRT. The current ROI dependent lag time of the AlignRT could also pose an issue for image guidance techniques requiring quick response times.