Bioactive compounds in Diospyros mafiensis roots inhibit growth, sporulation and aflatoxin production by Aspergillus flavus and Aspergillus parasiticus

Diospyros mafiensis F. White is a medicinal shrub or small tree (6 m tall) widely distributed in the Zanzibar-Inhambane regional mosaic and traditionally used to treat leprosy, diarrhoea, and skin fungal infections in Tanzania and Mozambique. Our objective was to determine the anti-aflatoxigenic properties of compounds from D. mafiensis root bark against vegetative growth, sporulation and aflatoxin production by Aspergillus flavus and Aspergillus parasiticus. Bioassay-guided extraction, fractionation, and isolation of bioactive compounds using A. parasiticus B62 were employed. The bioactive compounds were elucidated using 1H and 13CNMR and LC-MS. Growth inhibition was determined by measuring the colony diameter of A. flavus AF3357 and A. parasiticus SU-1 ATCC56775. Inhibitory effects on sporulation were estimated using a haemocytometer. Total aflatoxin was quantified by direct competitive enzyme-linked immunosorbent assay (ELISA). Bioactive compounds diosquinone (DQ) and 3-hydroxydiosquinone (3HDQ) were identified. DQ weakly inhibited A. flavus and A. parasiticus vegetative growth (MIC50 > 100 µg/ml) and 3HDQ strongly inhibited A. flavus (MIC50 = 14.9 µg/ml) and A. parasiticus (MIC50 = 39.1 µg/ml). DQ strongly reduced total aflatoxin production by A. flavus from 157 to 36 ng/plate, and by A. parasiticus from 1,145 ng/plate to 45 ng/plate at 100 µg/ml. 3HDQ reduced total aflatoxin production by A. parasiticus from 1,145 to 32 ng/plate; stimulated production by A. flavus from 157 to 872 ng/plate at 12.5 µg/ml but reduced to 45 ng/plate at 100 µg/ml. In summary, DQ and 3HDQ could be used as natural antifungal compounds to prevent mould growth and aflatoxin accumulation in food and feed.

[Neutrophil to lymphocyte ratio in peripheral blood: a novel independent prognostic factor in patients with head and neck squamous cell carcinoma]

Objective: To investigate whether neutrophil to lymphocyte ratio (NLR) in peripheral blood can be an independent prognostic factor in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Clinical data of 97 HNSCC patients who received surgical treatment in our department between January 2008 and January 2012 were analyzed retrospectively. The 97 patients were divided into low NLR group (NLR≤5, n=69) and high NLR group (NLR>5, n=28) according to the NLR in preoperative peripheral blood. The relationships of NLR and clinicopathological features were analyzed. Kaplan-Meier method was used for univariate survival analysis and Cox proportional hazard model for multivariate survival analysis. Results: The clinical stages were significantly different between high NLR group and low NLR group (P<0.05), however, the age, gender, location, lymph node metastasis, smoking and alcohol of the two groups showed no significant differences (P> 0.05 of all). Univariate survival analysis showed that smoking, lymph node metastasis, clinical stage and NLR value were risk factors for 3-year overall survival (OS) rate and relapse-free survival (RFS) rate of HNSCC patients (P<0.05). The OS rate of high NLR and low NLR groups was 42.9% and 91.3%, and the RFS rate was 44.2% and 80.1%, respectively, with a statistically significant difference (P<0.05 for both). Cox multivariate survival analysis showed that clinical stage and NLR were independent factors for prognostic evaluation of HNSCC patients (P<0.05 for both). Conclusions: NLR level is significantly associated with clinical stage of HNSCC. High NLR is an independent prognostic rick factor and plays an important role in prognostic evaluation of HNSCC patients.

The microbial community characteristics of ancient painted sculptures in Maijishan Grottoes, China

In this study, a culture-independent Illumina MiSeq sequencing strategy was applied to investigate the microbial communities colonizing the ancient painted sculptures of the Maijishan Grottoes, a famous World Cultural Heritage site listed by UNESCO in China. Four mixed samples were collected from Cave 4–4 of the Maijishan Grottoes, the so-called Upper Seven Buddha Pavilion, which was built during the Northern Zhou Dynasty (557-581AD). The 16/18S rRNA gene-based sequences revealed a rich bacterial diversity and a relatively low fungal abundance, including the bacterial groups Actinobacteria, Acidobacteria, Bacteroidetes, Cyanobacteria, Chloroflexi, Firmicutes, Proteobacteria and Verrucomicrobia and the fungal groups Ascomycota, Basidiomycota and Chytridiomycota. Among them, the bacteria genera of Pseudonocardia and Rubrobacter and unclassified fungi in the order of Capnodiales were dominant. The relative abundance of Pseudonocardia in the painted layer samples was higher than that in the dust sample, while Cyanobacteria dominated in the dust sample. Many of them have been discovered at other cultural heritage sites and associated with the biodeterioration of cultural relics. The presence and activity of these pioneering microorganisms may lead to an unexpected deterioration of the painted sculptures that are preserved in this heritage site. Thus, proper management strategies and potential risk monitoring should be used in the Maijishan Grottoes to improve the conservation of these precious painted sculptures.

Hypoxia associated biomarkers in lung cancer - an update

The high incidence rates of lung cancer have resulted in multiple progressions in cancer research leading to the development of novel therapeutic strategies. The three main branches of cancer research where improvements are being made are surgery, chemotherapy, and radiotherapy. These research developments have significantly improved the survival rates of cancer patients as most of these therapeutic options target specific molecules involved in cancer progression and metastasis. Experimental research has successfully identified potentially important molecules responsible for cancer progression. Further, the above molecular markers of disease are clinically approved biomolecules of significant prognostic value. The above molecular biomolecules also helped in rapid identification of subgroups of patients who need immediate emergency treatment. Hypoxia is one of such conditions where the human system is deprived of an adequate oxygen supply and requires immediate treatment. Hypoxia markers have been proved to be beneficial in the timely management of cancer. The present review is focused on the latest updates in the area of hypoxia related to markers in the prognosis of lung cancer.

Methamphetamine causes neurotoxicity by promoting polarization of macrophages and inflammatory response

Macrophages, especially their activation state, are closely related to the progression of neurotoxicity. Classically activated macrophages (M1) are proinflammatory effectors, while alternatively activated macrophages (M2) exhibit anti-inflammatory properties. As a powerful addictive psychostimulant drug, coupled with its neurotoxicity, methamphetamine (Meth) abuse may lead to long-lasting abnormalities in the neuronal system. The present study investigated the effect of Meth at subtoxic concentration on macrophage activation state and its underlying toxicity to neuronal cells. PC12 and Murine RAW264.7 cells were coincubated with Meth to test its toxicity. 3-(4,5-Dimethylthiazol)-2,5-diphenyltetrazolium-bromide, enzyme-linked immunosorbent assay, real-time polymerase chain reaction, and Western blot assays were performed to evaluate the toxicity, cytokine secretion, gene, and protein expression. Results showed that cytotoxicity was enhanced on PC12 cells after coculturing with RAW264.7 stimulated with Meth. RAW264.7 macrophages tended to switch to the M1 phenotype, releasing more nitric oxide and proinflammatory cytokines, including tumor necrosis factor α (TNFα), interleukin (IL)-12, and IL-1β, while decreasing the release of anti-inflammatory cytokine IL-10 after treatment with Meth. Meth upregulated the gene expression of IL-6, IL-1β, and TNFα and downregulated the expression of Arg-1, IL-10, and KLF4. Meth could also upregulate the protein expression of IL-1β and TNF α and downregulate the expression of Arg-1 and KLF4. However, the abovementioned effects induced by Meth were abolished by the addition of dopamine receptor D3 antagonist. In conclusion, our study demonstrated that Meth promoted macrophage polarization from M0 to M1 and enhanced inflammatory response, which provided the scientific rationale for the neurotoxicity caused by the chronic use of Meth.

Self-planarized quantum-disks-in-nanowires ultraviolet-B emitters utilizing pendeo-epitaxy

The growth of self-assembled, vertically oriented and uniform nanowires (NWs) has remained a challenge for efficient light-emitting devices. Here, we demonstrate dislocation-free AlGaN NWs with spontaneous coalescence, which are grown by plasma-assisted molecular beam epitaxy on an n-type doped silicon (100) substrate. A high density of NWs (filling factor >95%) was achieved under optimized growth conditions, enabling device fabrication without planarization using ultraviolet (UV)-absorbing polymer materials. UV-B (280-320 nm) light-emitting diodes (LEDs), which emit at ∼303 nm with a narrow full width at half maximum (FWHM) (∼20 nm) of the emission spectrum, are demonstrated using a large active region ("active region/NW length-ratio" ∼50%) embedded with 15 stacks of Al_xGa_1-xN/Al_yGa_1-yN quantum-disks (Qdisks). To improve the carrier injection, a graded layer is introduced at the AlGaN/GaN interfaces on both p- and n-type regions. This work demonstrates a viable approach to easily fabricate ultra-thin, efficient UV optoelectronic devices on low-cost and scalable silicon substrates.

Monolayer-graphene-based perfect absorption structures in the near infrared

Subwavelength perfect optical absorption structures based on monolayer-graphene are analyzed and demonstrated experimentally. The perfect absorption mechanism is a result of critical coupling relating to a guided mode resonance of a low index two-dimensional periodic structure. Peak absorption over 99% at wavelength of 1526.5 nm with full-width at half maximum (FWHM) about 18 nm is demonstrated from a fabricated structure with period of 1230 nm, and the measured results agree well with the simulation results. In addition, the influence of geometrical parameters of the structure and the angular response for oblique incidence are analyzed in detail in the simulation. The demonstrated absorption structure in the presented work has great potential in the design of advanced photo-detectors and modulators.

Two 'Candidatus Liberibacter asiaticus' Strains Recently Found in California Harbor Different Prophages

'Candidatus Liberibacter asiaticus' (CLas), an α-proteobacterium, is associated with citrus Huanglongbing (HLB; yellow shoot disease). In California, two cases of CLas have been detected in Los Angeles County, one in Hacienda Heights in 2012 and the other in San Gabriel in 2015. Although all infected trees were destroyed in compliance with a state mandate, citrus industry stakeholder concerns about HLB in California are high. Little is known about the biology of CLas, particularly the California strains, hindering effective HLB management efforts. In this study, next-generation sequencing technology (Illumina MiSeq) was employed to characterize the California CLas strains. Data sets containing >4 billion (Giga) bp of sequence were generated from each CLas sample. Two prophages (P-HHCA1-2 and P-SGCA5-1) were identified by the MiSeq read mapping technique referenced to two known Florida CLas prophage sequences, SC1 and SC2. P-HHCA1-2 was an SC2-like or Type 2 prophage of 38,989 bp in size. P-SGCA5-1 was an SC1-like or Type 1 prophage of 37,487 bp in size. Phylogenetic analysis revealed that P-HHCA1-2 was part of an Asiatic lineage within the Type 2 prophage group. Similarly, P-SGCA5-1 was part of an Asiatic lineage within Type 1 prophage group. The Asiatic relatedness of both P-HHCA1-2 and P-SGCA5-1 was further presented by single nucleotide polymorphism analysis at terL (encoding prophage terminase) that has been established for CLas strain differentiation. The presence of different prophages suggests that the two California CLas strains could have been introduced from different sources. An alternative explanation is that there was a mixed CLas population containing the two types of prophages, and limited sampling in a geographic region may not accurately depict the true CLas diversity. More accurate pathway analysis may be achieved by including more strains collected from the regions.

[Analysis of clinicopathological features and prognosis of 98 cases of small hepatocellular carcinoma]

Objective: To analyze the clinicopathological features and prognosis of patients with small hepatocellular carcinoma. Methods: The clinicopathological and follow-up data of 98 patients with small hepatocellular carcinoma who underwent R0 resection from January 2009 to December 2013 were analyzed retrospectively. Results: All of the patients were followed up. Their postoperative 1-year, 3-year and 5-year overall survival rates were 99.0%, 91.7%, and 76.3%, respectively. Their postoperative median overall survival (OS) period was 52 months. The postoperative progression-free survival rates were 86.7%, 66.2% and 55.0%, respectively, and the median progression-free survival (PFS) period was 43.5 months. The univariate analysis showed that satellite nodules, liver capsule invasion and postoperative recurrence time were associated with OS (P<0.05), and long-term heavy drinking, satellite nodules and liver capsule invasion with PFS (P<0.05). The multivariate analysis indicated that long-term heavy drinking was an independent factor influencing the progression-free survival period of patients with small hepatocellular carcinoma (P=0.003) and postoperative recurrence time and liver capsule invasion were independent factors affecting their overall survival period (P<0.05). Conclusions: The treatment of small hepatocellular carcinoma still concentrates on the active treatment of surgery. It is beneficial to patients to minimize the resection scope of normal liver under the premise of R0 removal of tumor. Postoperative recurrence time of ≤2 years suggests poor prognosis of small hepatocellular carcinoma. Long-term heavy drinking can accelerate the recurrence of small hepatocellular carcinoma.

[Affected side location and clinical value of horizontal semicircular canal benign paroxysmal positional vertigo]

Objective:To explore the clinical value of rolling test（HRT）, bow and lean test（BLT） and subjective vertigo sensation(SVS) for affected side localization of patients with horizontal semicircular canal benign paroxysmal positional vertigo（HSC-BPPV）.Method:One hundred and thirty-eight patients（94 HSC-Can and 44 HSC-Cup）with HSC-BPPV were enrolled. Patients were tested with HRT and then were asked about SVS, followed by BLT. According to the results of HRT, SVS and BLT, HSC-Can and HSC-Cup were repositioned by Barbecue method and modified Kim method respectively. The detection rate of the affected side of HRT, BLT, SVS and the curative effect were analyzed. Result:In 94 HSC-Can patients and 44 HSC-Cup patients,BN and / or LN were induced by BLT to be 81.91% and 84.09% respectively. HRT induced bilateral asymmetric nystagmus 90.43%, 88.64%, SVS told vertigo symptoms worse side 60.64%,63.64%. There was no significant difference in the detection rate of HRT and BLT(P>0.05)，but have significant difference with SVS(P<0.05). Excluding four patients in whom the comparison among HRT,BLT,SVS were inconclusive，we compared the curative effect of first treatment in 92 HSC-Can patients and 42 HSC-Cup patients. The curative effect of HRT positive only were 66.67% and 60.00% respectively , BLT positive only were 71.43% and 66.67% respectively , HRT and BLT both positive with ipsilateral affected side were 70.37% and 65.50% respectively , HRT and BLT both positive with contralateral affected side were 37.50% and 30.00% respectively. The curative effect of HRT positive only and BLT positive only had no significant difference with that of HRT and BLT both positive with ipsilateral affected side , but they both had significant difference with that of HRT and BLT both positive with contralateral affected side . Conclusion:HRT is the most effective method for detecting affected side of HSC-BPPV, but BLT and SVS also have auxiliary diagnostic value as HSC-BPPV localization method.

[Effects of perioperative transfusion of blood components on the long-term prognosis of hepatocellular carcinoma]

Objective: To investigate the effects of perioperative transfusion of blood components on the long-term prognosis of hepatocellular carcinoma (HCC) patients. Methods: A total of 339 patients with primary HCC who underwent curative hepatectomy between January 2003 and December 2010 at the Cancer Hospital, Chinese Academy of Medical Sciences were enrolled. The clinical data of the patients were retrospectively analyzed. These patients were divided into non-transfusion, fresh frozen plasma (FFP) transfusion only and concentrated red cells (CRC) transfusion groups. Disease-free survival and overall survival were estimated using the Kaplan-Meier method, and Cox regression was performed to identify clinicopathological factors related with survival. Results: Among the 339 patients, the 1-, 3- and 5-year disease-free survival rates were 63.1%, 35.4% and 22.4%, respectively, and the median disease-free survival was 22 months. While the 1-, 3- and 5-year overall survival rates were 90.5%, 69.5% and 56.4%, respectively, and the median overall survival was 72 months. The median disease-free survivals of the non-transfusion (n=181), FFP transfusion only (n=48) and CRC transfusion (n=110) groups were 28, 22 and 12 months, respectively, while the median overall survivals of the three groups were 99, 63 and 40 months respectively. Significant differences in the disease-free and overall survivals were observed among the three groups (both P<0.01). Multivariate Cox regression analyses showed that FFP transfusion only (HR=1.658, P=0.026), CRC transfusion (HR=1.470, P=0.030), serum alpha-fetoprotein>400 μg/L (HR=1.686, P=0.002), albumin<35 g/L (HR=1.782, P=0.047), tumor capsule (HR=0.597, P=0.012), tumor necrosis (HR=1.820, P=0.001) and the TNM stage Ⅲ or above (HR=2.537, P=0.000) were independent predictors of overall survival after hepatectomy. Conclusion: Both perioperative FFP only transfusion and CRC transfusion may have detrimental effect on the long-term prognosis of HCC.

GDF11 does not improve the palmitate induced insulin resistance in C2C12

OBJECTIVE

GDF11 (Growth Differentiation factor 11) has been reported to rejuvenate skeletal muscle, heart and brain in aged mice, and the aged skeletal muscle is closely related to insulin resistance. We wondered whether GDF11 has an effect on skeletal muscle insulin resistance.

MATERIALS AND METHODS

High fat diet induced obese mice with insulin resistance were established in vivo. Palmitate-induced insulin resistance in C2C12 myotubes was established in vitro. The mRNA expression of GDF11, GLUT4, IRS-1 (insulin receptor substrate-1) and PGC-1α (peroxisome proliferator-activated receptor-gamma coactivator 1) were tested by reverse transcriptase-polymerase chain reaction (RT-PCR). The protein level of GDF11 and PGC-1α were detected by Western blot. The glucose uptake was measured by 2NBDG uptake assay.

RESULTS

In high fat diet induced obese mice, both serum level of GDF11 and the expression of GDF11 in skeletal muscle decreased. Similarly, the expression of GDF11 also reduced in palmitate-treated C2C12 myotubes. In vitro, the glucose uptake and the expression of GLUT4, IRS-1 and PGC-1α significantly decreased after palmitate intervention, but GDF11 treatment did not reverse the reduction of glucose uptake and the expression of GLUT4, IRS-1 and PGC-1α in C2C12 myotubes.

CONCLUSIONS

We firstly confirmed that the expression of GDF11 decreased both in the skeletal muscle of obese mice and palmitate-treated myotubes, but supplementation GDF11 does not ameliorate the palmitate-induced insulin resistance in C2C12 myotubes.

The management of open tibial fractures in children

Aims

Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union.

Patients and Methods

A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture. Their mean age was nine years (2 to 16) and the median follow-up was ten months (interquartile range 5 to 18). Management involved IV antibiotics, early debridement and combined treatment of the skeletal and soft-tissue injuries in line with standards proposed by the British Orthopaedic Association.

Results

There were 36 diaphyseal fractures and 25 distal tibial fractures. Of the distal fractures, eight involved the physis. Motor vehicle collisions accounted for two thirds of the injuries and 38 patients (62%) arrived outside of normal working hours. The initial method of stabilisation comprised: casting in nine cases (15%); elastic nailing in 19 (31%); Kirschner (K)-wiring in 13 (21%); intramedullary nailing in one (2%); open reduction and plate fixation in four (7%); and external fixation in 15 (25%). Wound management comprised: primary wound closure in 24 (39%), delayed primary closure in 11 (18%), split skin graft (SSG) in eight (13%), local flap with SSG in 17 (28%) and a free flap in one. A total of 43 fractures (70%) were Gustilo-Anderson grade III. There were four superficial (6.6%) and three (4.9%) deep infections. Two deep infections occurred following open reduction and plate fixation and the third after K-wire fixation of a distal fracture. No patient who underwent primary wound closure developed an infection. All the fractures united, although nine patients required revision of a mono-lateral to circular frame for delayed union (two) or for altered alignment or length (seven). The mean time to union was two weeks longer in diaphyseal fractures than in distal fractures (13 weeks versus 10.8 weeks, p = 0.016). Children aged > 12 years had a significantly longer time to union than those aged < 12 years (16.3 weeks versus 11.4 weeks, p = 0.045). The length of stay in hospital for patients with a Gustilo-Anderson grade IIIB fracture was twice as long as for less severe injuries.

Conclusion

Fractures in children heal better than those in adults. Based on our experience of deep infection we discourage the use of internal fixation with a plate for open tibial fractures in children. We advocate aggressive initial wound debridement in theatre with early definitive combined orthopaedic and plastic surgery in order to obtain skeletal stabilisation and soft-tissue cover. Cite this article: Bone Joint J 2017;99-B:544–53.

Cut-points for associations between vitamin D status and multiple musculoskeletal outcomes in middle-aged women

This was the first study examining optimal vitamin D status for musculoskeletal health in middle-aged women. A 25-hydroxyvitamin D level of at least 29 to 33 nmol/L appears required for optimal musculoskeletal health, but the current cut-off of 50 nmol/L may be warranted.

INTRODUCTION

This study aimed to determine whether cut-points exist for associations between serum 25-hydroxyvitamin D (25OHD) and musculoskeletal health outcomes in middle-aged women, below which greater 25OHD levels are associated with musculoskeletal health benefits and above which no such associations exist.

METHODS

This is a cross-sectional study of 344 women aged 36-57 years. Cut-points for associations of serum 25OHD with lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD), lower limb muscle strength (LMS), timed up and go test (TUG), functional reach test (FRT), lateral reach test (LRT), and step test (ST) were explored using locally weighted regression smoothing and nonlinear least-squares estimation, and associations above and below the identified cut-points were estimated using segmented regression.

RESULTS

The prevalence of low 25OHD was 28 % (<50 nmol/L). Significant cut-points (nmol/L) were identified for FN BMD 31 (95 % confidence interval (CI): 18, 43), LS BMD 31 (17, 45), TUG 30 (24, 36), ST 33 (24, 31), FRT 31 (18, 43), and LMS 29 (8, 49) but not LRT (42 (-8, 93). Below these cut-points, there were beneficial associations between higher 25OHD level and each outcome, while above the cut-points, there were no beneficial associations.

CONCLUSIONS

In middle-aged women, there are thresholds for associations between serum 25OHD concentrations and bone density and most balance measures, suggesting that 25OHD levels of at least 29 to 33 nmol/L are required for optimal musculoskeletal health in this population. The current cut-off of 50 nmol/L may be higher than needed for some outcomes but appears warranted overall.

A review of heavy weight market pigs: status of knowledge and future needs assessment

Marketing weight is an important economic variable that impacts the productivity and profitability of finishing pig production. Marketing weight has been increasing worldwide over the past decades driven by the dilution of fixed production cost over more weight per pig and the improvement of genetic selection of lean-type pigs. This review was aimed to summarize current knowledge and assess the future research needs on producing finishing pigs with marketing weight greater than 130 kg. Based on a thorough literature review, increasing marketing weight affected overall pig growth; in particular, cumulative average daily gain (ADG) decreased by 4.0 g, average daily feed intake (ADFI) increased by 78.1 g, and gain-to-feed ratio (G:F) decreased by 0.011 for every 10 kg increase of marketing weight. Increasing marketing weight by 10 kg increased carcass yield by 0.41% units, backfat by 1.8 mm, longissimus muscle (LM) area by 1.9 cm², carcass length by 2.2 cm, and belly yield by 0.32% units, but decreased percentage of fat-free-lean by 0.78 units and decreased loin, shoulder, and ham yields by 0.13, 0.16, and 0.17% units, respectively. Studies that investigated the effects of marketing weight on pork quality observed decreased pH by 0.02 and 0.01 at 45 min and 24 h postmortem, respectively, and increased a* value by 0.28 per 10 kg marketing weight increase. Heavier market pigs had increased concentrations of saturated fatty acids and intramuscular fat. However, studies reported conflicting results for L* and b* values, drip loss, Warner-Bratzler shear force, and sensory properties of pigs in response to increasing marketing weight. A limited amount of research has been conducted to estimate nutrient requirements for pigs greater than 140 kg. Increased weight and size of heavy pigs can create challenges to farm and packer facilities and equipment. Discussions and recommendations are provided concerning the adjustments for floor and feeder space, barn design, ventilation, disease control, transportation, and carcass processing needed for increasing marketing weight. In conclusion, increasing marketing weight creates both opportunities and challenges to current finishing pig production, and future research is needed to provide nutritional and management guidelines and improve feed efficiency and meat quality of heavy weight market pigs.

Advanced parental age and autism risk in children: a systematic review and meta-analysis

OBJECTIVE

Advanced parental age has raised additional concern as a risk factor of autism. We conducted a meta-analysis of observational studies investigating the association between advanced parental age and risk of autism.

METHOD

PubMed, EMBASE, and Web of Science were searched for reports published up to November 11, 2015. Risk estimates from individual studies were pooled using random-effects models.

RESULTS

Twenty-seven studies were included in the meta-analysis. Compared with the reference points, the lowest parental age category was associated with a reduced risk of autism in the offspring, with adjusted odds ratios (ORs) 0.89 (95% confidence intervals [CIs] 0.75-1.06) and 0.81 (95% CI 0.73-0.89) for mother and father, respectively, and the highest parental age category was associated with an increased risk of autism in the offspring, with adjusted ORs 1.41 (95% CI 1.29-1.55) and 1.55 (95% CI 1.39-1.73) for mother and father respectively. Dose-response meta-analysis indicated that an increase of 10 years in maternal and paternal age was associated with an 18% and 21% higher risk of autism.

CONCLUSION

Advanced parental age was associated with an increased risk of autism in the offspring. More mechanistic studies are needed to further explain this positive association.

[Analysis of the survival of 123 patients with intrahepatic cholangiocarcinoma after surgical resection]

OBJECTIVE

To investigate the prognostic factors for patients with intrahepatic cholangiocarcinoma after surgical resection.

METHODS

The clinicopathological and follow-up data of 123 patients with intrahepatic cholangiocarcinoma who underwent surgical resection in Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and June 2015 were collected and reviewed, and their survival and prognosis were analyzed with the Kaplan-Meier method and Cox regression model.

RESULTS

The median follow-up time was 22 months and median recurrence-free survival time was 8.97 months. The 1-, 2- and 3-year recurrence rates were 58.6%, 68.9% and 76.5%, respectively. Cox multivariate regression analysis showed that preoperative rise in CEA, lymph node metastasis, multiple lesions, extrahepatic invasion, and combination of tumor necrosis were significant adverse prognostic factors affecting the postoperative recurrence-free survival in patients with intrahepatic cholangiocarcinoma after surgical resection (P<0.05 for all). The median overall survival time was 21.17 months, and the 1-, 3- and 5-year overall survival rates were 76.6%, 33.2% and 26.1%, respectively. The Cox multivariate regression analysis showed that preoperative rise in CEA, lymph node metastasis, multiple lesions, and extrahepatic invasion were significant adverse prognostic factors affecting the postoperative overall survival in patients with intrahepatic cholangiocarcinoma after surgical resection(P<0.05 for all).

CONCLUSION

Preoperative rise in CEA, lymph node metastasis, multiple lesions and extrahepatic invasion are significant adverse prognostic factors for patients with intrahepatic cholangiocarcinoma after surgical resection.

Different subtype strains of Akkermansia muciniphila abundantly colonize in southern China

Aim

This study investigates the colonization rate of Akkermansia muciniphila in the gastrointestinal tracts of people living in southern China and applies a modified method for the isolation and subtyping of A. muciniphila strains from faecal samples.

Methods and Results

Fresh faecal samples were collected and bacterial DNA was extracted from these samples for real‐time PCR analysis. Strains were separated using a culture‐dependent sPCR‐directed method and classified using an enterobacterial repetitive intergenic consensus (ERIC‐PCR) DNA fingerprinting method. The colonization rate for the sample population from southern China was 51·74%. We isolated 22 strains from human faeces. The results revealed that all strains were identifiable as A. muciniphila with 99–100% identity to the type‐strain ATCC BAA‐835. ERIC‐PCR resulted in grouping of the DNA fingerprints showed that 12 distinct clusters were distinguished with a delineation level of 100%.

Conclusions

Southern China has a high rate of A. muciniphila colonization and over 12 different subtype strains reside in faecal samples.

Significance and Impact of the Study

Akkermansia muciniphila has a beneficial role in human gastrointestinal tract. These studies provide a better understanding of A. muciniphila and details of its colonization in the human gastrointestinal tract.

Pork fat quality of pigs fed distillers dried grains with solubles with variable oil content and evaluation of iodine value prediction equations

Back, belly, and jowl fat samples of pigs fed control corn-soybean meal-based diets and diets containing 4 sources of distillers dried grains with solubles (DDGS) were used to determine the impact of feeding DDGS with variable oil content on pork fat quality and to evaluate the precision and accuracy of published iodine value (IV) prediction equations. Dietary treatments consisted of 4 corn-soybean meal diets containing 40% DDGS from different sources with 10.7, 5.6, 14.2, or 16.0% ether extract (EE; as-fed) content. Diets did not contain any other supplemental lipid sources. Regardless of fat depot, SFA content (g/100 g fat) of pigs fed 5.6% EE DDGS (35.4) was greater ( < 0.05) than that of pigs fed 14.2 or 16.0% EE DDGS sources (34.4 and 30.2, respectively) and tended to be greater ( < 0.10) than that of pigs fed 10.7% EE DDGS (34.6). Pigs fed 10.7 and 14.2% EE DDGS had greater ( < 0.01) SFA concentration than pigs fed 16.0% EE DDGS. Regardless of fat depot, MUFA content (g/100 g fat) of pigs fed 10.7, 5.6, and 14.2% DDGS sources were similar (43.7, 43.1, and 43.0, respectively) but were greater ( < 0.01) than that of pigs fed 16.0% EE DDGS (40.0). A dietary treatment × fat depot interaction was observed for PUFA ( < 0.05) and IV ( = 0.079). Pigs fed 10.7, 5.6, and 14.2% DDGS sources had reduced ( < 0.01) PUFA concentration and IV compared with pigs fed 16.0% EE DDGS, but the magnitude of responses in PUFA and IV to the variable oil content of DDGS was greater in backfat than in belly and jowl fat. Carcass fat IV data were used to evaluate prediction error (PE) and bias of published carcass fat IV prediction equations. Equations using dietary C18:2 content or IV product as a single predictor resulted in highly variable PE (g/100 g) ranging from 3.43 to 8.36 and bias (g/100 g) ranging from -5.05 to 5.66. Using equations that included additional diet composition information and pig growth performance factors decreased PE (3.27 to 4.73) and bias (-3.37 to 1.73) of prediction for backfat compared with equations only based on the characteristics of dietary lipid, but this improvement was limited in the prediction for belly and jowl fat. Predictions based on percentage of DDGS in diets had the greatest PE (6.66 to 9.19) and bias (5.53 to 8.00).

Energy content and amino acid digestibility of flaxseed expellers fed to growing pigs

This study was conducted to determine the DE and ME as well as the apparent ileal digestibility (AID) and standardized ileal digestibility (SID) of CP and AA in flaxseed expellers fed to growing pigs. In Exp. 1, the DE and ME were determined using 66 crossbred growing pigs (Duroc × Landrace × Yorkshire; 54.2 ± 2.3 kg BW) fed 1 of 11 diets in a completely randomized design. The diets included a corn-soybean meal basal diet and 10 experimental diets containing 29.16% flaxseed expellers supplemented at the expense of corn and soybean meal. In Exp. 2, 11 growing pigs (35.5 ± 3.4 kg), fitted with a T-cannula at the distal ileum, were assigned to 6 × 11 Youden square design with 6 periods and 11 diets. The diets included a N-free diet based on cornstarch and sucrose and 10 test diets containing 40% flaxseed expellers as the sole source of AA. Chromic oxide (0.3%) was used as an indigestible marker. There was considerable variation in the chemical composition among the 10 flaxseed expellers. The CV were greater than 10% for ether extract (EE), NDF, ADF, crude fiber, and Ca and ranged from 7 to 12% for the AA. On a DM basis, the DE and ME ranged from 2,786 to 3,730 and from 2,588 to 3,530 kcal/kg, respectively. The apparent total tract digestibility of GE ranged from 59.91 to 75.83% (mean = 70.92%). Ether extract, GE, and NDF were the best predictors to determine DE and ME. The best prediction equations were DE = -3,231 + (1.58 × GE) - (25.79 × % NDF) ( = 0.90) or DE = 4,189 + (56.78 × % EE) - (30.59 × % NDF) ( = 0.85) and ME = -2,968 + (1.47 × GE) - (24.82 × % NDF) ( = 0.85) or ME = 3,931 + (53.77 × % EE) - (29.31 × % NDF) ( = 0.82), respectively. In Exp. 2, there were significant differences in the AID and SID of CP and all AA with the exception of Phe ( < 0.05). The AID and SID of CP averaged 70.16 and 78.04%, respectively. For the indispensable AA, the AID and SID of Thr were the least, with average values of 70.70 and 76.68%, respectively. The digestibility of Arg and Met were the greatest, averaging over 88 and 91% for AID and SID, respectively. The AID and SID of Lys ranged from 66.10 to 81.82% (mean = 74.14%) and from 70.90 to 85.41% (mean = 78.13%), respectively. These results indicate that there is significant variability in chemical composition, energy content, and the SID and AID of CP and AA among the selected flaxseed expellers. The DE and ME of flaxseed expellers are primarily related to their EE and NDF concentrations.

Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type

AIMS

While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM.

METHODS

We approached adults and families of children with T1DM on insulin pumps in four main New Zealand centres. Participants completed a questionnaire examining pump-related issues they had experienced in the preceding 12 months.

RESULTS

Response rate was 64 % with 174 of 270 eligible people participating in the study. 84 % of subjects reported one or more AEs, with an overall AE incidence of 3.42 per person/year (95 % CI 3.14, 3.73). An event serious enough to require a hospital presentation occurred in 9.8 %, all but one reporting high ketones or diabetic ketoacidosis (DKA). Set/site problems were the AE most commonly reported (by 53 % of respondents), followed by cutaneous complications (43 %) and pump malfunction (38 %). Few predictors of AEs (of any type) were found; however, a negative binomial regression model found that a longer duration of pumping (p = 0.018) and age <18 years (p = 0.043) were both associated with fewer AEs (all types combined).

CONCLUSIONS

Insulin pump-associated AEs are very common. However, few variables are predictive of them with no relationships seen with glycaemic control, socio-economic status, pump manufacturer or infusion set type. Based on these findings, AEs should be anticipated in both adults and children, with anticipatory patient education and training recommended for their successful and safe use.

How climate change and regulations can affect the economics of mycotoxins

In the decades to come, the one factor that will likely have the greatest effect on the economics of the mycotoxin problem is climate change. This article reviews the current state of known science on how the global climate has been changing in recent decades, as well as likely climate change trends in the near future. The article focuses in depth on how climatic variables affect fungal infection and production of specific mycotoxins in food crops, and how near-future climatic changes will shape the prevalence of these mycotoxins in crops in different parts of the world. Because of regulatory limits set on maximum allowable levels of mycotoxins in food and feed, growers will experience economic losses if climatic factors cause certain mycotoxins to become more prevalent. A case study is presented of how maize growers in the United States will experience increased economic losses due to slightly higher aflatoxin levels in maize, even if those levels may still be below regulatory limits. We discuss the overall expected economic impacts of climate change-induced mycotoxin contamination worldwide – not just market-related losses, but also losses to human and animal health and risks to food security. Aflatoxin is the mycotoxin that is most likely to increase under near-future climate scenarios; and thus is likely to pose the greatest amount of economic risk of all the mycotoxins.

[Retrospective study on the efficacy of different chemotherapy regimens concurrently combined with intensity modulated radiation therapyin treatment of Ⅲ-Ⅳa stage nasopharyngeal carcinoma]

Objective:To compare the near and long term efficacy and safety of paclitaxel(TAX) plus cisplatin(DDP) (TP regimen) and DDP plus 5-FU(PF regimen) concurrently combined with IMRT in treatment of patients with advanced NPC.Method: A retrospective analysis on 108 advanced NPC cases from January 2010 to December 2012 was conducted. The patients were divided into TP group(57 cases) and PF group(51 cases) according to therapy regimen. TP group received IMRT combined with TP therapy, and PF group received IMRT combined with PF regimen, two groups were both used 4 cycles of chemotherapy, toxicity reactions during concurrent radiochemotherapy were noted. Two months after treatment, near clinical efficacies of the two groups were determined, and then, a three years followingup was conducted, during which recurrence ratio, metastasis ratio, local control ratio and survival rate were analyzed. Result: Two months after treatment, the total effective ratio of TP group(84.2% vs.76.5%) was higher than PF group,however, the difference was not statistically significant(P>0.05). Gastrointestinal reaction(70.2% vs.66.7%), marrow inhibition(75.4% vs.82.4%), liver function damage(12.3% vs.13.7%), radioactive oral and pharyngeal injury(91.2% vs.98.0%)， hearing damage(15.8% vs.15.7%) in the two groups during chemoradiotherapy had no significant differences(P>0.05). During followingup, the recurrence and metastasis ratio in TP group(33.3% vs.47.1%) was lower than PF group(χ²=2.116,P=0.146). TP group with The local control rate(73.7% vs.68.5%) and survival rate(84.2% vs.78.4%) after three years treatment in TP group were higher than PF group(χ²=0.336,P=0.562；χ²=0.596,P=0.440). Conclusion: IMRT concurrently combined with TP and PF respectively are both effective methods for treatment of advanced NPC. In this study, IMPT plus TP concurrent chemoradiotherapy has a certain superiority in near and long term clinical treatment efficacy and safety.