Ovarian markers and irregular menses among women with type 1 diabetes in the Epidemiology of Diabetes Interventions and Complications study

OBJECTIVE

Women with type 1 diabetes have increased risk of infertility compared to women without diabetes even after adjustment for irregular menses, but aetiologies are incompletely understood. Our aim was to examine the prevalence of abnormalities in ovarian markers consistent with polycystic ovary syndrome in women with type 1 diabetes and associations with irregular menses and diabetes-specific variables.

DESIGN, PATIENTS AND MEASUREMENTS

We conducted a secondary analysis of women in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC), a randomized trial and observational follow-up of intensive insulin therapy for type 1 diabetes. We included women with anti-Müllerian hormone (AMH) measurements among women not using oral contraceptives (n = 187). Initial AMH and testosterone measures were performed between EDIC years 1 and 4. History of irregular menses was assessed annually.

RESULTS

The median age of women was 35 (interquartile ratio 29, 40) years; 133 (35%) had elevated AMH and 62 (17%) reported irregular menses. Twelve per cent of women had relative elevations in total testosterone. In multivariable models, lower insulin dosages were associated with higher AMH concentrations (P = .0027), but not diabetes duration, glycemic control, body mass index or irregular menses. Neither irregular menses nor diabetes-specific variables were associated with testosterone concentrations.

CONCLUSIONS

Among women with type 1 diabetes in their thirties, abnormalities in ovarian markers are common and not associated with irregular menses and thus may partially account for decreased fecundity in women with type 1 diabetes.

Measurements of Multiparticle Correlations in d+Au Collisions at 200, 62.4, 39, and 19.6 GeV and p+Au Collisions at 200 GeV and Implications for Collective Behavior

Recently, multiparticle-correlation measurements of relativistic p/d/^{3}He+Au, p+Pb, and even p+p collisions show surprising collective signatures. Here, we present beam-energy-scan measurements of two-, four-, and six-particle angular correlations in d+Au collisions at sqrt[s_{NN}]=200, 62.4, 39, and 19.6 GeV. We also present measurements of two- and four-particle angular correlations in p+Au collisions at sqrt[s_{NN}]=200  GeV. We find the four-particle cumulant to be real valued for d+Au collisions at all four energies. We also find that the four-particle cumulant in p+Au has the opposite sign as that in d+Au. Further, we find that the six-particle cumulant agrees with the four-particle cumulant in d+Au collisions at 200 GeV, indicating that nonflow effects are subdominant. These observations provide strong evidence that the correlations originate from the initial geometric configuration, which is then translated into the momentum distribution for all particles, commonly referred to as collectivity.

Beam-Energy Dependence of Directed Flow of Λ, Λ[over ¯], K^{±}, K_{s}^{0}, and ϕ in Au+Au Collisions

Rapidity-odd directed-flow measurements at midrapidity are presented for Λ, Λ[over ¯], K^{±}, K_{s}^{0}, and ϕ at sqrt[s_{NN}]=7.7, 11.5, 14.5, 19.6, 27, 39, 62.4, and 200 GeV in Au+Au collisions recorded by the Solenoidal Tracker detector at the Relativistic Heavy Ion Collider. These measurements greatly expand the scope of data available to constrain models with differing prescriptions for the equation of state of quantum chromodynamics. Results show good sensitivity for testing a picture where flow is assumed to be imposed before hadron formation and the observed particles are assumed to form via coalescence of constituent quarks. The pattern of departure from a coalescence-inspired sum rule can be a valuable new tool for probing the collision dynamics.

Nuclear Dependence of the Transverse-Single-Spin Asymmetry for Forward Neutron Production in Polarized p+A Collisions at sqrt[s_{NN}]=200 GeV

During 2015, the Relativistic Heavy Ion Collider (RHIC) provided collisions of transversely polarized protons with Au and Al nuclei for the first time, enabling the exploration of transverse-single-spin asymmetries with heavy nuclei. Large single-spin asymmetries in very forward neutron production have been previously observed in transversely polarized p+p collisions at RHIC, and the existing theoretical framework that was successful in describing the single-spin asymmetry in p+p collisions predicts only a moderate atomic-mass-number (A) dependence. In contrast, the asymmetries observed at RHIC in p+A collisions showed a surprisingly strong A dependence in inclusive forward neutron production. The observed asymmetry in p+Al collisions is much smaller, while the asymmetry in p+Au collisions is a factor of 3 larger in absolute value and of opposite sign. The interplay of different neutron production mechanisms is discussed as a possible explanation of the observed A dependence.

Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA

We present possible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next decade, with the intention of providing information to the astronomy community to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals, and study the capability of the network to determine the sky location of the source. We report our findings for gravitational-wave transients, with particular focus on gravitational-wave signals from the inspiral of binary neutron star systems, which are the most promising targets for multi-messenger astronomy. The ability to localize the sources of the detected signals depends on the geographical distribution of the detectors and their relative sensitivity, and [Formula: see text] credible regions can be as large as thousands of square degrees when only two sensitive detectors are operational. Determining the sky position of a significant fraction of detected signals to areas of 5-[Formula: see text] requires at least three detectors of sensitivity within a factor of [Formula: see text] of each other and with a broad frequency bandwidth. When all detectors, including KAGRA and the third LIGO detector in India, reach design sensitivity, a significant fraction of gravitational-wave signals will be localized to a few square degrees by gravitational-wave observations alone.

A parallel input composite transimpedance amplifier

A new approach to high performance current to voltage preamplifier design is presented. The design using multiple operational amplifiers (op-amps) has a parasitic capacitance compensation network and a composite amplifier topology for fast, precision, and low noise performance. The input stage consisting of a parallel linked JFET op-amps and a high-speed bipolar junction transistor (BJT) gain stage driving the output in the composite amplifier topology, cooperating with the capacitance compensation feedback network, ensures wide bandwidth stability in the presence of input capacitance above 40 nF. The design is ideal for any two-probe measurement, including high impedance transport and scanning tunneling microscopy measurements.

Spin-Orbit Coupling and Interband Transitions in the Optical Conductivity of Sr_{2}RhO_{4}

The prototypical correlated metal Sr_{2}RhO_{4} was studied using optical and photoemission spectroscopy. At low energies and temperatures, the optical data reveal a complex, multicomponent response that on the surface points to an unconventional metallic state in this material. Via a comparison with photoemission, the anomalous optical response may be attributed to an unexpectedly strong interband transition near 180 meV between spin-orbit coupled bands that are nearly parallel along ΓX. This spin-orbit coupling effect is shown to occur in a number of related metallic ruthenates and explains the previously puzzling optical properties reported for these materials.

The Use of Clinician-Performed Ultrasonography to Determine the Treatment Method for Suspected Paediatric Appendicitis

Objective

To investigate whether the clinician-performed ultrasonography based on the specific criteria for paediatric appendicitis could decrease the negative appendectomy rate without treatment failure.

Methods

The study was a retrospective review of paediatric patients with suspected appendicitis who presented at the emergency department of a teaching hospital over a period of 18 months. The clinicians performed the ultrasound and decided whether the patients with suspected appendicitis should be referred to surgery or managed conservatively. The determinative ultrasound criteria were the presence of periappendiceal fat infiltration and/or an obstructing appendicolith.

Results

The 166 paediatric patients with suspected appendicitis underwent ultrasonography performed by clinicians on weekdays; forty (24.1%) cases with an obstructing appendicolith and/or periappendiceal fat infiltration were treated surgically, and none had a pathologically negative appendectomy, which was significantly lower than the number in the computed tomography scan group (10.4%, 11/106) on weeknights or weekends. The remaining 126 (75.8%) patients without obstructing appendicolith or periappendiceal fat infiltration were treated conservatively, regardless of their appendiceal diameter, and no patients experienced a treatment failure.

Conclusions

The clinician-performed ultrasonography bases on the strict use of above specific ultrasound criteria to determine treatment strategies for suspected paediatric appendicitis can reduce the negative appendectomies without treatment failure. (Hong Kong j.emerg.med. 2015;22:31-40)

How do Fetal Grafts of the Suprachiasmatic Nucleus Communicate with the Host Brain?

Fetal grafts containing the hypothalamic suprachiasmatic nucleus (SCN), the site of an endogenous circadian pacemaker, can reinstate behavioral rhythms in lesioned recipients but the precise routes of communication between the graft and the host brain remain unknown. Grafts containing the SCN may convey temporal information to the host brain via neural efferents, diffusible factors, or a combination of both. We examined graft-host connections in anterior hypothalamic homografts (hamster-to hamster) and heterografts (rat-to hamster) implanted in the third ventricle by: (a) applying the carbocyanine dye, dil, directly onto homo- and heterografts in fixed tissue sections; and (b) using a donor-specific neurofilament (NF) antibody to immuno-cytochemically visualize heterograft efferents. Dil applied onto either homografts or heterografts labeled relatively few graft efferents which could be followed only short distances into the host brain. In contrast, NF-labeled heterograft efferents were both more numerous and extended for longer distances into the host brain than anticipated on the basis of dil tract tracing. The results suggest that anterior hypothalamic grafts implanted in the third ventricle provide substantial input to the adjacent host hypothalamus although it is not known whether these projections arise from SCN cells or from other extra-SCN hypothalamic tissue within these grafts. Nor is it known whether these projections are functional. To determine if neural efferents are required for the restoration of rhythmicity after grafting, we have encapsulated fetal anterior hypothalamus in a permselective polymer which prevents neurite outgrowth but allows diffusible signals to reach the host brain. Polymer-encapsulated grafts of fetal anterior hypothalamus from wild-type hamster fetuses have been implanted into the third ventricle of heterozygote tau mutant, SCN-lesioned hamsters. Because the free-running period of tau mutant hamsters is significantly shorter than that of wild-type hamsters, restored rhythms when they occur can be unambiguously attributed to the presence of donor tissue. Encapsulated grafts that survive contain neuropeptide cell markers characteristic of the intact SCN, but the survival rate of encapsulated neural tissue is low. Nevertheless, if we find that even a few encapsulated grafts restore donor-specific rhythms, this would suggest that diffusible signals emitted from SCN grafts may be sufficient to support circadian function. It may be that the SCN in the intact animal communicates with the rest of the brain by redundant signals, either efferent fibers or diffusible signals. Alternatively, different circadian rhythms may be mediated by distinct output signals from the SCN.

Time to resolution: A prospective evaluation from the Society for Fetal Urology hydronephrosis registry

INTRODUCTION

The resolution rate of prenatal urinary tract dilation (UTD) has been documented in several retrospective studies. The present study analyzed prospective observational registry data, with the aim of determining time to resolution among patients prenatally identified with mild postnatal UTD.

MATERIALS AND METHODS

A total of 248 subjects, from four centers, were prospectively enrolled from 2008 to 2015. Exclusion criteria included other anomalies (n = 69), fewer than two ultrasounds, and/or <3 months follow-up (n = 26). Resolution was defined as Outcome A (SFU 0) and Outcome B (SFU 0/1). Fisher's exact test, Mann-Whitney U or Kruskal-Wallis test and Kaplan-Meier were used for analysis.

RESULTS/DISCUSSION

The median follow-up for 179 (n = 137 males) subjects was 15 months (IQR 7-24), range 0-56 months. VCUG was performed in 100 (57%) and VUR identified in 15 (15%). There was no association with reflux and resolution (P = 0.72). For resolution assessment (n = 153), lower grades were likely to resolve and demonstrated a higher rate in the Outcome B classification. Time to resolution also favored lower grades, with the majority resolving within 2 years (Figure). Surgical intervention was performed in 14 (8%). It is interesting to note that regardless of grade of UTD, there was no difference in frequency of US or the time that RUS was first performed. Practitioners performed the first RUS of life within a narrow window ranging from 0.27 RUS/month for Grade 1 UTD to 0.30 RUS/month for Grade 4 UTD. It was speculated that this practice pattern occurrence likely reflected the deficiency in knowledge by primary care providers, and identified a potential opportunity for education. The SFU registry substantiates that the vast majority of patients will demonstrate transient UTD and most cases that do not resolve will improve within 2 years of life. This data could be used to further an evidenced-based approach towards the evaluation and management of prenatal UTD, as outlined in the multidisciplinary consensus statement for prenatal urinary tract dilation.

CONCLUSIONS

This prospective registry confirms that the majority of prenatal UTD is transient, resolution occurs within the first 3 years of life, and most patients will not need intervention. Redefining SFU 1 as normal increased the resolution rate. A large proportion of patients were not evaluated with a VCUG, therefore impact of VUR could not be determined.

Perfectionism is related with academic stress in medical student

Objective

Especially medical students set high academic standard, and try hard to achieve because they are requested to studying medicine perfectly. Multidimensional perfectionism scale (MPS) is used to measure perfectionism in medical student. The purpose of the present study was to investigate the relationships between stress and various factors including perfectionism.

Methods

We enrolled 159 medical students from University of Ulsan college of Medicine. We used the Medical Stress scale (MSS), the Multidimensional Perfectionism Scale(MPS), the patient health questionnaire-9(PHQ-9), the academic motivation scale (AMS), the insomnia severity scale(ISS), and The revised neo personality inventory.

Result

To analyze data, we used Pearson's correlation and logistic regression analysis. In the first step- Pearson's correlation analysis, a motivation, PHQ-9, ISI, perfectionism and neuroticism traits of NEO-PI significantly correlated with stress level (P < 0.001). In the second step, logistic regression analysis indicated that students who feel high level of academic stress (MSS score ≥ 28) are also related to a motivation, insomnia, perfectionism and neuroticism traits of NEO-PI (R2 = 0.389, P < 0.05).

Conclusion

Student who tend to be perfect feel more academic stress. The high level of stress related to insomnia and a motivation in medical student. Moreover, personality trait also can influences their psychological stress level.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Electron Number-Based Phase Diagram of Pr_{1-x}LaCe_{x}CuO_{4-δ} and Possible Absence of Disparity between Electron- and Hole-Doped Cuprate Phase Diagrams

We performed annealing and angle resolved photoemission spectroscopy studies on electron-doped cuprate Pr_{1-x}LaCe_{x}CuO_{4-δ} (PLCCO). It is found that the optimal annealing condition is dependent on the Ce content x. The electron number (n) is estimated from the experimentally obtained Fermi surface volume for x=0.10, 0.15 and 0.18 samples. It clearly shows a significant and annealing dependent deviation from the nominal x. In addition, we observe that the pseudo-gap at hot spots is also closely correlated with n; the pseudogap gradually closes as n increases. We established a new phase diagram of PLCCO as a function of n. Different from the x-based one, the new phase diagram shows similar antiferromagnetic and superconducting phases to those of hole doped ones. Our results raise a possibility for absence of disparity between the phase diagrams of electron- and hole-doped cuprates.

Abstract P3-07-01: Selinexor, a selective inhibitor of nuclear export, demonstrates efficacy in preclinical models of triple negative breast cancer

Background: Approximately 15% of all breast cancers are categorized as triple negative (TNBC) for which the only chemotherapy is known to be effective, yet often fails to achieve remission. Nuclear exporter XPO1 (Exportin1 or CRM1) is a promising target for cancer therapy that mediates the transport of multiple tumor suppressors and cell cycle regulators that have been known to be relevant predictors in the mechanism and severity of TNBC. Given the pressing need for novel therapies for this disease, we sought to determine the antitumor effects of selinexor, a novel inhibitor of nuclear export, on triple negative breast cancers in vitro and in vivo as well as to address its mechanism of action.

Methods: 26 breast cancer cell lines of different breast cancer subtypes were treated with selinexor in vitro. Using cell proliferation assays the half maximal inhibitory concentration (IC50) was calculated using isobologram curves after 3 days of treatment; sensitivity was defined as IC50 &lt;1000nM. We then assessed mechanistic effects on apoptosis and cell proliferation using flow cytometry analysis with annexin V and propidium iodide and using western blot analysis we also studied its effects on markers of inhibition of apoptosis. In vivo efficacy was studied as single agent and in combination with standard chemotherapy agents in TNBC patient derived xenografts (PDXs) with varying levels of sensitivity to chemotherapy as well as with varying statuses of TP53 and PIK3CA, and gene expression subtypes.

Results: Selinexor demonstrated growth inhibition in all fourteen TNBC cell lines tested; TNBC cell lines were more sensitive to selinexor (median IC50 44nM, range 11 - 550nM), compared to ER+ cells lines (median IC50 of 13000 nM, range of 40nM - &gt; 1000 nM; P=0.017). Treatment with selinexor decreased expression levels of XPO1, as well as survivin and XIAP, and induced apoptosis. In multiple TNBC cell lines selinexor was synergistic with paclitaxel, carboplatin, eribulin and doxorubicin in vitro (median combination index 0.6, range 0.5-0.8). Selinexor as a single agent reduced tumor growth in vivo in 4 of 5 different TNBC PDX models with a median tumor growth inhibition ratio score (T/C) of 48% (range 34-59%) and demonstrated greater antitumor efficacy in combination with paclitaxel or eribulin with an average T/C score of 27% and 12% respectively.

Conclusions: Selinexor is a promising therapeutic agent for triple negative breast cancer and it has potential as a combination agent with standard chemotherapy.

Citation Format: Paez Arango N, Evans KW, Zhao M, Yuca E, Scott SM, Janku F, Ueno NT, Tripathy D, Kim C, Naing A, Funda M-B. Selinexor, a selective inhibitor of nuclear export, demonstrates efficacy in preclinical models of triple negative breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-07-01.