Discrepancies between Dihydropyrimidine dehydrogenase phenotyping and genotyping: what are the explanatory factors?

AIM

Dihydropyrimidine dehydrogenase (DPD) deficiency can be detected by phenotyping (measurement of plasma uracil (U), with U≥16μg/L defining a partial deficiency) and/or by genotyping (screening for the four most frequent DPYD variants). We aimed to determine the proportion of discrepancies between phenotypic and genotypic approaches and to identify possible explanatory factors.

METHODS

Data from patients who underwent both phenotyping and genotyping were retrospectively collected. Complementary genetic analyses (genotyping of the variant c.557A>G and DPYD sequencing) were performed for patients with U≥16μg/L without any common variants. The characteristics of patients classified according to the congruence of the phenotyping and genotyping approaches were compared (Kruskal-Wallis test) and determinants of U levels were studied in the whole cohort (linear model).

RESULTS

Among the 712 included patients, phenotyping and genotyping were discordant for 12.5%, with 63 (8.8%) having U≥16μg/L in the absence of a common variant. Complementary genetic investigations marginally reduced the percentage of discrepancies to 12.1%: among the nine additional identified variants, only the c.557A>G variant, carried by three patients, had been previously reported to be associated with DPD deficiency. Liver dysfunction could explain certain discordances, as ASAT, ALP, GGT, and bilirubin levels were significantly elevated, with more frequent liver metastases in patients with U≥16μg/L and the absence of a DPYD variant. The impact of cytolysis was confirmed, as ASAT levels were independently associated with increased U (p<0.001).

CONCLUSION

The frequent discordances between DPD phenotyping and genotyping approaches highlight the need to perform these two approaches to screen for all DPD deficiencies.

Impact of obesity on morbidity and oncologic outcomes after total mesorectal excision for mid and low rectal cancer

BACKGROUND

A recent meta-analysis showed that obesity increased the conversion rate and postoperative morbidity of rectal cancer surgery, but did not influence pathological results. However, this meta-analysis included patients with cancer of the upper rectum and had many biases. The aim of the present retrospective study was to investigate the impact of obesity, defined as a body mass index (BMI) ≥ 30 kg/m², on postoperative morbidity and short- and long-term oncologic outcomes of total mesorectal excision for mid and low rectal cancer in consecutive patients.

METHODS

This study included all eligible patients who were operated on for mid and lower rectal cancer between 1999 and 2018 in our hospital. We compared 90-day postoperative morbidity and mortality, and short- and long-term oncologic outcomes between obese and non-obese patients.

RESULTS

Three hundred and ninety patients [280 males, mean age 65.7 ± 11.3 years, 59 obese individuals (15.1%)] were included. There was no difference in the 90-day mortality rate between obese and non-obese groups (p = 0.068). There was a difference in the overall 90-day morbidity rate between the obese and non-obese groups that disappeared after propensity score matching of the patients. There was no difference in short-term oncological parameters, with a median follow-up of 43 (20-84) months, and there were no significant differences in disease-free and overall survival between obese and non-obese patients (p = 0.42 and p = 0.11, respectively).

CONCLUSIONS

Obesity does not affect the 90-day morbidity rate, or short- and long-term oncologic results in patients operated on for mid and lower rectal cancer.

Envisioning the future of work to safeguard the safety, health, and well-being of the workforce: A perspective from the CDC's National Institute for Occupational Safety and Health

The future of work embodies changes to the workplace, work, and workforce, which require additional occupational safety and health (OSH) stakeholder attention. Examples include workplace developments in organizational design, technological job displacement, and work arrangements; work advances in artificial intelligence, robotics, and technologies; and workforce changes in demographics, economic security, and skills. This paper presents the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health's Future of Work Initiative; suggests an integrated approach to address worker safety, health, and well-being; introduces priority topics and subtopics that confer a framework for upcoming future of work research directions and resultant practical applications; and discusses preliminary next steps. All future of work issues impact one another. Future of work transformations are contingent upon each of the standalone factors discussed in this paper and their combined effects. Occupational safety and health stakeholders are becoming more aware of the significance and necessity of these factors for the workplace, work, and workforce to flourish, merely survive, or disappear altogether as the future evolves. The future of work offers numerous opportunities, while also presenting critical but not clearly understood difficulties, exposures, and hazards. It is the responsibility of OSH researchers and other partners to understand the implications of future of work scenarios to translate effective interventions into practice for employers safeguarding the safety, health, and well-being of their workers.

Reducing ultrafine particulate emission from multiple 3D printers in an office environment using a prototype engineering control

Recent studies have shown that high concentrations of ultrafine particles can be emitted during the 3D printing process. This study characterized the emissions from different filaments using common fused deposition modeling printers. It also assessed the effectiveness of a novel engineering control designed to capture emissions directly at the extruder head. Airborne particle and volatile organic compound concentrations were measured, and particle emission rates were calculated for several different 3D printer and filament combinations. Each printer and filament combination was tested inside a test chamber to measure overall emissions using the same print design for approximately 2 h. Emission rates ranged from 0.71 × 10⁷ to 1400 × 10⁷ particles/min, with particle geometric mean diameters ranging from 45.6 to 62.3 nm. To assess the effectiveness of a custom-designed engineering control, a 1-h print program using a MakerBot Replicator+ with Slate Gray Tough polylactic acid filament was employed. Emission rates and particle counts were evaluated both with and without the extruder head emission control installed. Use of the control showed a 98% reduction in ultrafine particle concentrations from an individual 3D printer evaluated in a test chamber. An assessment of the control in a simulated makerspace with 20 printers operating showed particle counts approached or exceeded 20,000 particles/cm³ without the engineering controls but remained at or below background levels (< 1000 particles/cm³) with the engineering controls in place. This study showed that a low-cost control could be added to existing 3D printers to significantly reduce emissions to the work environment.

Effects of ensiling time on corn silage neutral detergent fiber degradability and relationship between laboratory fiber analyses and in vivo digestibility

Accurate analysis of degradability of silage neutral detergent fiber (NDF) is important for diet formulation and to predict lactational performance of dairy cows. In this study, 5 corn silage hybrids ensiled for 0 (unfermented), 30, 60, 120, and 150 d were used to determine the effects of ensiling time on silage neutral detergent fiber degradability (NDFD) and to assess the relationships between near-infrared reflectance spectroscopy (NIR) NDF-related analyses and in situ NDFD variables. In addition, the relationships between dietary concentration of indigestible NDF, 288-h incubation (iNDF288), or undegraded NDF, 240-h incubation (uNDF240), and in vivo total-tract apparent organic matter and NDF digestibility were studied in total mixed ration samples from 16 experiments with lactating dairy cows. Ensiling time had no effect on silage NDF concentration; however, the ratio of acid detergent fiber ÷ NDF increased, and estimated hemicellulose concentration decreased quadratically with ensiling time. Also, concentration of NDF-bound protein decreased, and that of lignin increased linearly with ensiling time. These changes in silage fiber composition resulted in a linear decrease in in situ effective degradability of silage NDF with increasing ensiling time. The indigestible fraction of NDF and concentration of structural carbohydrates were not affected by ensiling time. Correlations of in situ NDFD variables with laboratory NIR NDFD analyses were weak to moderate. The relationship of corn silage uNDF240 with lignin concentration or 30-h NDFD (all NIR analyses) was remarkably good (R² = 0.73 and 0.88, respectively). The relationship between in situ iNDF288 concentration (but not uNDF240) and in vivo total-tract apparent digestibility of dietary organic matter and NDF was good (R² = 0.72 and 0.80, respectively). In conclusion, in situ degradability of silage NDF linearly decreased from 0 to 150 d ensiling time, primarily caused by a decrease in concentrations of hemicellulose and NDF-bound protein. In situ NDF degradability measurements and common laboratory NIR NDF-related analyses were generally poorly correlated. We found a good relationship between in vivo NDF digestibility and dietary concentration of iNDF288 determined in situ, but the relationship with uNDF240 was poor.

A neutral wind instrument for nano-satellite platforms

Here we describe the first neutral wind sensor developed specifically for use on resource limited nano-satellite platforms. The instrument is a next generation redesign of the ram wind sensor flown on the Communications/Navigation Outage Forecasting System satellite for measurements of neutral velocity, temperature, and composition. Results of subsystem tests in vacuum conditions show low-power operation, promising design, and good resolution of measured parameters over the operational pressure and energy ranges expected in the low Earth orbit environment.

High-pressure structural and vibrational properties of monazite-type BiPO4, LaPO4, CePO4, and PrPO4

Monazite-type BiPO₄, LaPO₄, CePO₄, and PrPO₄ have been studied under high pressure by ab initio simulations and Raman spectroscopy measurements in the pressure range of stability of the monazite structure. A good agreement between experimental and theoretical Raman-active mode frequencies and pressure coefficients has been found which has allowed us to discuss the nature of the Raman-active modes. Besides, calculations have provided us with information on how the crystal structure is modified by pressure. This information has allowed us to determine the equation of state and the isothermal compressibility tensor of the four studied compounds. In addition, the information obtained on the polyhedral compressibility has been used to explain the anisotropic axial compressibility and the bulk compressibility of monazite phosphates. Finally, we have carried out a systematic discussion on the high-pressure behavior of the four studied phosphates in comparison to results of previous studies.

Characterization of linoleic acid (C18:2) concentration in commercial corn silage and grain hybrids

Corn silage and high-moisture corn grain are commonly recognized as risk factors for biohydrogenation-induced milk fat depression and may be due to the high concentration of linoleic acid (C18:2) in corn. Corn silage and corn grain have a low concentration of fatty acids (FA), but due to their high inclusion rate in diets they contribute substantially to unsaturated FA intake. The first objective of this study was to characterize the contribution of individual plant parts to total FA in whole-plant chopped corn. The second objective was to characterize the variation in FA profile in commercial silage and grain hybrids and evaluate the relationship between FA profile and other nutrients. To determine the location of FA in the corn plant, 4 stalks from 4 different commercial hybrids were separated into stalk, husk and shank, leaves, cob, and kernels. On a dry matter basis, 80.5% of total FA were in the kernels, 11.8% in the leaves, 5.1% in the stalk, 1.7% in the cob, and 1.0% in the husk and shank. More than 96% of the oleic acid (C18:1) and 92.5% of the C18:2 was in the kernels, whereas 71.0% of the linolenic acid (C18:3) was in the leaves. Next, the FA composition of fresh whole-plant chopped corn from 124 silage hybrids and grain from 72 grain hybrids was determined over 2 yr from test plots in Pennsylvania. Last, to extend the characterization, FA composition of whole-plant corn silage from 45 hybrids grown in test plots in South Dakota were characterized. In the fresh whole-plant chopped corn from PA test plots, C18:2 as a percentage of total FA averaged from 48.7% in 2013 (percentiles: 10th = 45.2, 90th = 52.2) and 48.0% in 2014 (percentiles: 10th = 44.1, 90th = 49.4). Concentration of C18:2 in corn grain averaged 57.5% in the 2013 (percentiles: 10th = 53.4, 90th = 60.8) and 56.1% in 2014 (percentiles: 10th = 53.5, 90th = 59.4). In the corn silage from South Dakota, the concentration of C18:2 as percentage of total FA averaged 45.4% (percentiles: 10th = 39.4, 90th = 50.2) and C18:2 concentration as a percent of dry matter averaged 1.1% (percentiles: 10th = 0.76, 90th = 1.41). An increase in the concentration of C18:2 was associated with a decrease in C18:3 in fresh whole-plant chopped corn and with a decrease in C18:1 in corn grain. Total FA and C18:2 (as a percentage of dry matter) were positively correlated with starch and negatively correlated with neutral detergent fiber in both fresh whole-plant chopped corn and corn silage samples, whereas no correlation with these traits was observed for C18:2 as a percentage of total FA. In conclusion, FA concentration and profile of corn silage reflects to a great extent the FA composition of kernels and the proportion of grain in the silage. The variation in C18:2 across hybrids provides the opportunity to develop selection programs to decrease C18:2 in corn silage and grain. Selection based on C18:2 concentration as a percent of total FA is preferred as this trait did not correlate with other nutritional properties.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Implementation of a new Cryopad on the diffractometer POLI at MLZ

A new polarized neutron single crystal diffractometer POLI (Polarization Investigator) has been developed at the Maier-Leibnitz Zentrum, Garching, Germany. After reviewing existing devices, spherical neutron polarimetry has been implemented on POLI as a main experimental technique using a third-generation cryogenic polarization analysis device (Cryopad) built in cooperation between RWTH University and Institut Laue-Langevin. In this report we describe the realization and present the performance of the new Cryopad on POLI. Some improvements in the construction as well as details regarding calibrations of Cryopad and its practical use are discussed. The reliable operation of the new Cryopad on POLI is also demonstrated.

Taking stock of the occupational safety and health challenges of nanotechnology: 2000-2015

Engineered nanomaterials significantly entered commerce at the beginning of the 21st century. Concerns about serious potential health effects of nanomaterials were widespread. Now, approximately 15 years later, it is worthwhile to take stock of research and efforts to protect nanomaterial workers from potential risks of adverse health effects. This article provides and examines timelines for major functional areas (toxicology, metrology, exposure assessment, engineering controls and personal protective equipment, risk assessment, risk management, medical surveillance, and epidemiology) to identify significant contributions to worker safety and health. The occupational safety and health field has responded effectively to identify gaps in knowledge and practice, but further research is warranted and is described. There is now a greater, if imperfect, understanding of the mechanisms underlying nanoparticle toxicology, hazards to workers, and appropriate controls for nanomaterials, but unified analytical standards and exposure characterization methods are still lacking. The development of control-banding and similar strategies has compensated for incomplete data on exposure and risk, but it is unknown how widely such approaches are being adopted. Although the importance of epidemiologic studies and medical surveillance is recognized, implementation has been slowed by logistical issues. Responsible development of nanotechnology requires protection of workers at all stages of the technological life cycle. In each of the functional areas assessed, progress has been made, but more is required.

Rapid and fully automated bacterial pathogen detection on a centrifugal-microfluidic LabDisk using highly sensitive nested PCR with integrated sample preparation

Diagnosis of infectious diseases suffers from long turnaround times for gold standard culture-based identification of bacterial pathogens, therefore impeding timely specific antimicrobial treatment based on laboratory evidence. Rapid molecular diagnostics-based technologies enable detection of microorganisms within hours however cumbersome workflows and complex equipment still prevent their widespread use in the routine clinical microbiology setting. We developed a centrifugal-microfluidic "LabDisk" system for rapid and highly-sensitive pathogen detection on a point-of-care analyser. The unit-use LabDisk with pre-stored reagents features fully automated and integrated DNA extraction, consensus multiplex PCR pre-amplification and geometrically-multiplexed species-specific real-time PCR. Processing merely requires loading of the sample and DNA extraction reagents with minimal hands-on time of approximately 5 min. We demonstrate detection of as few as 3 colony-forming-units (cfu) of Staphylococcus warneri, 200 cfu of Streptococcus agalactiae, 5 cfu of Escherichia coli and 2 cfu of Haemophilus influenzae in a 200 μL serum sample. The turnaround time of the complete analysis from "sample-to-result" was 3 h and 45 min. The LabDisk consequently provides an easy-to-use molecular diagnostic platform for rapid and highly-sensitive detection of bacterial pathogens without requiring major hands-on time and complex laboratory instrumentation.

Magnetic chemiluminescent immunoassay for human C-reactive protein on the centrifugal microfluidics platform

Schematic of the LabDisk-based hCRP MCIA. The antibody-coated dynabeads are sequentially transported through the immunoassay buffers by magnetic actuation. Finally the chemiluminescence signal is acquired from a detection cavity.

Center-level variation in infection rates after coronary artery bypass grafting

BACKGROUND

Health-care-acquired infections (HAIs) are a leading cause of morbidity and mortality after cardiac surgery. Prior work has identified several patient-related risk factors associated with HAIs. We hypothesized that rates of HAIs would differ across institutions, in part attributed to differences in case mix.

METHODS AND RESULTS

We analyzed 20 896 patients undergoing isolated coronary artery bypass grafting surgery at 33 medical centers in Michigan between January 1, 2009, and June 30, 2012. Overall HAIs included pneumonia, sepsis/septicemia, and surgical site infections, including deep sternal wound, thoracotomy, and harvest/cannulation site infections. We excluded patients presenting with endocarditis. Predicted rates of HAIs were estimated using multivariable logistic regression. Overall rate of HAI was 5.1% (1071 of 20 896; isolated pneumonia, 3.1% [n=644]; isolated sepsis/septicemia, 0.5% [n=99]; isolated deep sternal wound infection, 0.5% [n=96]; isolated harvest/cannulation site, 0.5% [n=97]; isolated thoracotomy, 0.02% [n=5]; multiple infections, 0.6% [n=130]). HAI subtypes differed across strata of center-level HAI rates. Although predicted risk of HAI differed in absolute terms by 2.8% across centers (3.9-6.7%; min:max), observed rates varied by 18.2% (0.9-19.1%).

CONCLUSIONS

There was a 18.2% difference in observed HAI rates across medical centers among patients undergoing isolated coronary artery bypass grafting surgery. This variability could not be explained by patient case mix. Future work should focus on the impact of other factors (eg, organizational and systems of clinical care) on risk of HAIs.

A high-yielding serum-free, suspension cell culture process to manufacture recombinant adenoviral vectors for gene therapy

We have developed an efficient, reproducible, and scaleable cell culture process for a recombinant adenoviral vector expressing therapeutic transgenes for clinical trials. HEK 293 cells - which support the propagation of E1 deficient adenovirus - were first adapted to serum free media and suspension growth. Subsequent studies focused on the infection, virus production and harvest from suspension culture bioreactors. Future studies are planned to address the kinetics of adenovirus production in HEK 293 as well as in other cell lines.

Magnetic spin structure of pyroxene-type MnGeO(3)

Polycrystalline MnGeO(3) material was synthesized at 1473 K and ambient pressures using ceramic sintering techniques. Under these conditions the pyroxene-type compound crystallizes in the orthorhombic modification with space group Pbca, as determined from the refinement of the neutron diffraction data. The monoclinic modification, space group C 2/c, was also present at a level of 8.8(4) wt% and the magnetic structures for the two polymorphs at low temperatures have been found simultaneously. The monoclinic form orders magnetically below 34 K; the spin structure can be described using k = (0, 0, 0) in the magnetic space group C 2'/c, having an antiferromagnetic spin arrangement within and between the chains of M1 and M2 sites. The orthorhombic phase of MnGeO(3) transforms to a magnetically ordered state with k = (0, 0, 0) and magnetic space group Pb'c'a below 12 K. Spins on M1 sites are aligned along the crystallographic a-axis with a slight non-collinear antiferromagnetic spin arrangement with and between the M1 chains. Spins on M2 sites are also antiferromagnetically coupled; however, one of the three different M1-M2 superexchange pathways within the band of M1 and M2 sites displays a ferromagnetic interaction, while the other two allow antiferromagnetic interaction.

The role of early sensory experience in the prey catching responses of Salamandra salamandra to stationary prey

Two groups of newly metamorphosed Salamandra salamandra (L.) were raised with living and with stationary prey, respectively. One year later, the group which had experience exclusively with stationary prey was significantly better in responding to stationary prey than the group which only had experience with moving prey. This was the case both under light and dark conditions. The experiments show that prey-catching behavior in salamanders can be considerably modified by experience.