Institutional specific smartphone application as a supplemental tool for an antimicrobial stewardship program in two large community hospitals: acceptance of physicians and pharmacists

PURPOSE

Antimicrobial stewardship programs (ASPs) have been a challenge in less resourceful health care settings. Medical smartphone applications (apps) can be accessible tools to support ASPs under such circumstances. A hospital-specific ASP app was prepared and the acceptance and usability of the study ASP app were evaluated by physicians and pharmacists in 2 community-based academic hospitals.

METHODS

The exploratory survey was conducted 5 months following the implementation of the study ASP app. A questionnaire was developed, and the validity and reliability were analyzed using S-CVI/Ave (scale content validity index/Average) and Cronbach's alpha, respectively. The questionnaire consisted of demographics (3 items), acceptance (9 items), usability (10 items), and barriers (2 items). Descriptive analysis was conducted using a 5-point Likert scale, multiple selections, and free-text responses.

RESULTS

Approximately 38.7% of 75 respondents (response rate, 23.5%) used the app. Most scored 4 or higher, indicating that the study ASP app was easy to install (89.7%), use (79.3%), and apply to clinical settings (69.0%). Frequently used contents were dosing (39.6%), the spectrum of activity (7.1%), and intravenous-to-oral conversion (7.1%). Barriers included limited time (38.2%) and insufficient content (20.6%). Users indicated that the study ASP app helped improve their knowledge on treatment guidelines (72.4%), antibiotic use (62.1%), and adverse reactions (69.0%).

CONCLUSION

The study ASP app was well accepted by physicians and pharmacists and it can be useful to supplement ASPs activities in less resourceful hospitals with a large burden of patient care.

Consumer Trend of Using Ready-to-Use Salted Napa Cabbage at Home: Current Consumer Behaviors, Beliefs, and Opinions about the Main Ingredient of Kimchi

ABSTRACT

Salted napa cabbage is the most important ingredient of kimchi. Currently, people have started to prepare ready-to-use salted napa cabbage at home. This study focused on this trend by investigating consumers' beliefs, opinions, and actual use of the products by conducting a telephone survey (895 female consumers) and face-to-face interviews (n = 514) in 2016 and a telephone survey (n = 200) in 2021. Most respondents (93 and 91% in 2016 and 2021, respectively) answered that convenience was the main reason for using salted napa cabbage. Regarding consumption behavior, 22 and 16% of the respondents in each year used salted napa cabbage after storing it for more than 24 h. In particular, 85 and 91% of consumers stored the product at room temperature, and 60 and 58% used it without washing, which could affect the quality of the food, as microorganisms could multiply during the storage. Inappropriate handling increased by age group, especially in 2021 (P < 0.05). In the query on satisfaction after using the products, 85 and 80% of respondents were satisfied because the product was convenient (54%) and hygienic (17%). Conversely, the respondents who were not satisfied with the products did not like the degree of salting and unhygienic status of the products. The majority (93 and 80%) of consumers preferred buying salted napa cabbage again because of its convenience. Although consumers thought that hygiene and quality were important factors, many respondents (83 and 72%) were not aware of foodborne illnesses associated with kimchi. Nevertheless, consumers intended to pay more for safe, salted napa cabbage (72 and 76%). The results of this study provide useful and credible data for understanding the factors affecting consumers' consumption and general beliefs and opinions on the use of salted napa cabbage, especially for food safety management.

HIGHLIGHTS

Hierarchical Structured Component Analysis for Microbiome Data Using Taxonomy Assignments

The recent advent of high-throughput sequencing technology has enabled us to study the associations between human microbiome and diseases. The DNA sequences of microbiome samples are clustered as operational taxonomic units (OTUs) according to their similarity. The OTU table containing counts of OTUs present in each sample is used to measure correlations between OTUs and disease status and find key microbes for prediction of the disease status. Various statistical methods have been proposed for such microbiome data analysis. However, none of these methods reflects the hierarchy of taxonomy information. In this paper, we propose a hierarchical structural component model for microbiome data (HisCoM-microb) using taxonomy information as well as OTU table data. The proposed HisCoM-microb consists of two layers: one for OTUs and the other for taxa at the higher taxonomy level. Then we calculate simultaneously coefficient estimates of OTUs and taxa of the two layers inserted in the hierarchical model. Through this analysis, we can infer the association between taxa or OTUs and disease status, considering the impact of taxonomic structure on disease status. Both simulation study and real microbiome data analysis show that HisCoM-microb can successfully reveal the relations between each taxon and disease status and identify the key OTUs of the disease at the same time.

Open Innovation Dynamics of Furniture Design and Function: The Difference between IKEA and Nitori

Even though global markets are transferring from offline to online, offline sales are rapidly increasing in two top global furniture firms in Korea and Japan each—IKEA and Nitori. This study aims to answer the following research question: ‘What are the differences and similarities between IKEA and Nitori in the open innovation dynamics of furniture design and function?’ Diverse naturalistic qualitative research methods such as participatory observation, or focus group interviews were used. IKEA is mainly pursuing engineering open innovation strategies, including advanced furniture design with engineering knowledge, fusion with new IT and other technologies for new and innovative furniture function and design, and pursuit of creative design idea frontiers. Nitori is mainly pursuing a strategy towards customer open innovation, which is focused on domestic and regional requirements.

[Cranial suture ultrasound for reducing radiation exposure in diagnosis of craniosynostosis in young children]

Currently, there are no standards for examining patients with suspected craniosynostosis. CT of the brain with 3D skull reconstruction is a common approach to diagnose craniosynostosis in many hospitals. This technique in pediatric patients is associated with a high dose of ionizing radiation and prompts searching for other diagnostic methods.

OBJECTIVE

To generalize an experience of cranial suture ultrasound and compare diagnostic capabilities of various ultrasound devices.

MATERIAL AND METHODS

We retrospectively analyzed data of cranial suture ultrasound in 49 patients under the age of 14 months with a suspected craniosynostosis. All patients underwent expert-class ultrasound. Of these, 10 patients underwent middle-class ultrasound. Age of these patients ranged from 2 to 10 months.

RESULTS

According to ultrasound data, we have found 48 synostotic sutures in 42 patients. There were 2 inaccurate results among these 48 sutures. In both cases, expert-class ultrasound confirmed partial closure of cranial sutures while 3D CT revealed their complete closure. Sensitivity and specificity of technique were 95.8% and 100%, respectively. Both expert- and middle-class ultrasound revealed synostotic sutures in 10 children under 1 year old.

CONCLUSION

Our data have shown that ultrasound of cranial sutures may be a first-line imaging technique. This method has high sensitivity and specificity in pediatric patients. Moreover, middle-class ultrasound devices may be used for diagnosis.

Changes in serum fibronectin levels predict tumor recurrence in patients with early hepatocellular carcinoma after curative treatment

Fibronectin, a matrix glycoprotein aberrantly expressed in various tumor cells, is a known candidate biomarker for the early diagnosis of hepatocellular carcinoma (HCC). In this study, we investigated whether serum fibronectin levels could predict tumor recurrence in patients with early-stage HCC after curative treatment. A total of 83 patients who showed complete response after initial curative treatment were included. The levels of serum fibronectin at baseline and 4–6 weeks after initial treatment were analyzed with regard to their associations with recurrence. Multivariate logistic regression analyses were performed to construct a prognostic nomogram. Baseline fibronectin levels were not significantly correlated with tumor size, number, stage, and serum α-fetoprotein levels. However, decrease in serum fibronectin levels after treatment was significantly associated with reduced HCC recurrence in multivariate logistic regression (odds ratio, 0.009; p < 0.001). Furthermore, a nomogram consisting of gender and changes in serum fibronectin showed a good discriminatory capability for the prediction of HCC recurrence with an area under the receiver-operating curve of 0.87. In conclusion, changes in serum fibronectin levels may be a surrogate indicator for assessment of treatment response in patients with early HCC after curative treatment.

[Intracranial meningiomas in children]

Meningiomas are rare in children and distinguished from the tumors in adults by clinical and biological aspects. Moreover, some histological forms and localizations are even casuistic in adults. There were 178 patients younger 18 years old with brain tumors. All patients underwent surgery at the pediatric department for 5-year period. Meningiomas were diagnosed in 5 cases that accounted for 2.8% of the total number of brain tumors in children. The authors reported children with intracranial meningiomas and discussed certain features of the course of disease in these patients.

gpart: human genome partitioning and visualization of high-density SNP data by identifying haplotype blocks

Summary

For the analysis of high-throughput genomic data produced by next-generation sequencing (NGS) technologies, researchers need to identify linkage disequilibrium (LD) structure in the genome. In this work, we developed an R package gpart which provides clustering algorithms to define LD blocks or analysis units consisting of SNPs. The visualization tool in gpart can display the LD structure and gene positions for up to 20 000 SNPs in one image. The gpart functions facilitate construction of LD blocks and SNP partitions for vast amounts of genome sequencing data within reasonable time and memory limits in personal computing environments.

Availability and implementation

The R package is available at https://bioconductor.org/packages/gpart.

Supplementary information

Supplementary data are available at Bioinformatics online.

MS1-Level Proteome Quantification Platform Allowing Maximally Increased Multiplexity for SILAC and In Vitro Chemical Labeling

Quantitative proteomic platforms based on precursor intensity in mass spectrometry (MS1-level) uniquely support in vivo metabolic labeling with superior quantification accuracy but suffer from limited multiplexity (≤3-plex) and frequent missing quantities. Here we present a new MS1-level quantification platform that allows maximal multiplexing with high quantification accuracy and precision for the given labeling scheme. The platform currently comprises 6-plex in vivo SILAC or in vitro diethylation labeling with a dedicated algorithm and is also expandable to higher multiplexity (e.g., nine-plex for SILAC). For complex samples with broad dynamic ranges such as total cell lysates, our platform performs highly accurately and free of missing quantities. Furthermore, we successfully applied our method to measure protein synthesis rate under heat shock response in human cells by 6-plex pulsed SILAC experiments, demonstrating the unique biological merits of our in vivo platform to disclose translational regulations for cellular response to stress.

[Neuroendoscopic interventions using an Nd-YAG laser for multilevel hydrocephalus: treatment results for 10 patients]

INTRODUCTION

Treatment or multilevel hydrocephalus is a complex problem. Neuroendoscopic interventions, make it possible to combine minimal invasiveness with the possibility of fenestration of several cysts during one procedure and thereby eliminate multi-level occlusion. We present our the experience of using a neodymium YAG laser (Nd-YAG laser) as an additional tool to improve the treatment results of patients with non-communicating hydrocephalus.

MATERIAL AND METHODS

This study included 10 patients aged from 5 months to 8 years who underwent endoscopic interventions with the use of rigid endoscope with frameless navigation. A surgical laser with a radiation wavelength of 1.064 μm was used as the main tool for fenestrating the walls of the cysts.

RESULTS

13 endoscopic laser interventions were performed in 10 patients with multilevel hydrocephalus. In 3 children, the two-stage treatment was chosen in due to the impossibility of simultaneous fenestration of all cysts. The interval between procedures was 1 month in two cases and 11 months in one case. We managed to compensate for cerebrospinal fluid disturbances in each patient, positive dynamics in the condition was noted. The duration of postoperative stay averaged 8 days (from 4 to 13 days). There were no deaths in the study group. All patients were discharged in good condition. Average follow-up duration was 14 months (from 8 to 25 months). During the observation, the condition of the patients remained stable; there was no need for repeated operations.

CONCLUSION

Combined use of bypass operations, endoscopic techniques and neural navigation may improve the results of treatment of patients with multilevel hydrocephalus. Data presented in this article demonstrates the safety and effectiveness of the clinical use of laser radiation as an additional tool for interventions in patients with this condition.

Efficacy and safety of nanoparticle-albumin-bound paclitaxel compared with solvent-based taxanes for metastatic breast cancer: A meta-analysis

The curative effects of nanoparticle albumin-bound (nab)-paclitaxel in the first-line treatment of metastatic breast cancer (MBC) are still controversial, with even more after the removal of marketing approval of indication of bevacizumab. Five electronic databases and the related resources were searched for eligible randomized clinical trials (RCTs) without year and language restrictions to perform a meta-analysis. The studies were comparing the efficacy and safety between nab-paclitaxel chemotherapy versus solvent-based (sb)-taxanes chemotherapy such as sb-paclitaxel and docetaxel. The primary end points were overall response rate (ORR) and disease control rate (DCR). Secondary end points were progression-free survival (PFS), overall survival (OS), adverse events (AEs), and dose discontinuation rate (DDR). Five RCTs (1,554 patients) were finally identified from 1,902 studies. When compared to sb-paclitaxel, nab-paclitaxel showed significant beneficial effects in terms of ORR (OR 2.39, 95% CI 1.69-3.37, p < 0.001), DCR (OR 1.89, 95% CI 1.07-3.35, p = 0.03), and PFS (HR 0.75, 95% CI 0.62-0.90, p = 0.002). Nab-paclitaxel also showed significantly longer OS (HR 0.73, 95% CI 0.54-0.99, p = 0.04) than docetaxel. AEs and DDR were comparable between the two arms. Using nab-paclitaxel could significantly improve efficacy with comparable toxicities in the treatment of MBC.

Antimicrobial Stewardship Programs in Community Health Systems Perceived by Physicians and Pharmacists: A Qualitative Study with Gap Analysis

Antimicrobial stewardship program (ASP) is one of the most important strategies for managing infectious disease treatment and preventing antimicrobial resistance. The successful implementation of ASP in the community health system (CHS) has been challenging. We evaluated perceptions of current ASP, potential setbacks of ASP implementation, and future demands on ASP services among physicians and pharmacists in the CHS. The qualitative research was conducted through in-depth individual interviews and focus group discussions with 11 physicians and 11 pharmacists. In addition, a quantitative gap analysis was conducted to assess the different awareness and demands on services of ASP and preferred antimicrobial-related problems (ARP). In overall, perceptions of ASP varied by profession. The identified setbacks were unorganized institutional leadership, the undefined roles of healthcare professionals, a lack of reimbursement, the hierarchical structure of the health system, and the labor-intensive working environment of pharmacy services. Although demands for ASP improvement were similar among professionals, they had different preferences in prioritizing each service item of ASP/ARP development and the profession responsible for each service. Continuous administrative and financial investments, understanding ASP contents, ASP-specific information technology, and interdisciplinary collaboration with good communication among healthcare professions are needed to continue the progression of ASP.

[Endoscopic treatment of nonsyndromic sagittal craniosynostosis in dizygotic twins. A case report and literature review]

The article presents a rare clinical case of isolated sagittal craniosynostosis in dichorionic diamniotic twins. The review addresses issues of epidemiology, etiology, and pathogenesis of craniosynostosis in this group of patients.

Factors influencing disordered eating behavior based on the theory of triadic influence

PURPOSE

The objective of this study was to identify factors influencing disordered eating behaviors in female college students based on the theory of triadic influence.

DESIGN AND METHOD

The participants in this study were 307 college females in Korea. Data were analyzed using t-tests, correlation coefficients, and multiple regression analyses.

FINDINGS

Multiple regression analysis revealed that objectified body consciousness, social physique anxiety, and sociocultural attitudes toward appearance influenced disordered eating behavior (R²  = 0.33, F = 51.32, P < 0.001).

PRACTICE IMPLICATIONS

This study suggests the development of a nursing program for college females that considers the factors influencing personal, social, and cultural streams will be effective.

Synergistic cranberry juice combinations with natural-borne antimicrobials for the eradication of uropathogenic Escherichia coli biofilm within a short time

Urinary tract infections (UTI), one of the most common diseases in humans, are caused primarily by uropathogenic Escherichia coli (UPEC). Cranberry juice (CB) is a widely known prophylaxis for UTI, but the treatment of CB alone could not effectively eradicate preformed UPEC biofilms. The aim of this study was to develop enforced CB composites within a short time by adding a small quantity of natural borne antimicrobials. UPEC biofilms (initial: 6·0 log CFU per cm² ), formed on silicone coupons in artificial urine medium, were exposed to CB (4-8%), caprylic acid (CAR; 0·025-0·05%) and thymol (TM; 0·025-0·05%) at 37°C for 1 min. Individual treatment of each compound did not show the significant antibacterial effect on UPEC biofilms (P > 0·05). Otherwise, the survivor counts of biofilms were synergistically reduced with CB containing any of the antimicrobials. For example combined treatment with CB (8%) + CAR (0·05%) + TM (0·05%) resulted in a 6 log reduction in UPEC populations in the biofilm (no detectable bacteria remained) with 4·6 log of synergistic bactericidal effect. The confocal laser scanning microscope images indicated that any composites including TM might result in biofilm detachment from the surface. The present method is cost-effective and more acceptable to consumers as it is based on the synergistic interaction of natural borne antimicrobials. The results of this study could be widely applicable in the functional food, medical and healthcare field. SIGNIFICANCE AND IMPACT OF THE STUDY: Anti-biofilm effect of cranberry juice (CB) has been focused mainly on inhibiting biofilm formation of uropathogenic Escherichia coli (UPEC); however, combined treatment with natural borne antimicrobials derived from coconut oil (caprylic acid) and oregano essential oil (thymol) could synergistically enhance its eradicating activity against biofilms. This study developed novel CB composites showing marked anti-biofilm effects (complete eradication of UPEC biofilms within just 1 min).

[Factors of endoscopic third ventriculostomy efficacy in infants with obstructive hydrocephalus under one year of age]

Endoscopic surgery for obstructive hydrocephalus in children is an alternative to shunts. Currently, the efficacy of endoscopic third ventriculostomy (ETV) in infants up to one year of age is increasingly discussed among neurosurgeons. To increase the efficacy of ETV, many surgeons raise the question: what factors may affect the efficacy of this procedure in the younger age group?

OBJECTIVE

To study the factors affecting the efficacy of ETV.

MATERIAL AND METHODS

A total of 88 ETVs were performed in infants under one year of age in our clinic in 2012-2016. Subsequently, 43 (48.9%) children underwent CSF shunting, and one child underwent repeated ETV. The mean time until the appearance of clinical signs of stoma closure was 3.9 months (116 days).

RESULTS

The procedure was most effective in the case of congenital obstructive hydrocephalus (64.5% of successful operations) and also in children over the age of 6 months (63.6% of successful operations). The efficacy in post-hemorrhagic hydrocephalus was 40%. The efficacy in grade 4 intraventricular hemorrhage was lowest and amounted to 25%. The total efficacy of ETV in children under one year of age in our study was 51.1%.

CONCLUSION

In the case of congenital obstructive hydrocephalus, the efficacy of ETV is maximal and amounts to 64.5%. To achieve the highest efficacy of ETV in infants under one year of age, careful selection of patients at the preoperative stage is necessary, with allowance for many factors affecting treatment outcome.

Deuterium-Free, Three-Plexed Peptide Diethylation for Highly Accurate Quantitative Proteomics

The deuterium, a frequently used stable isotope in isotopic labeling for quantitative proteomics, could deteriorate the accuracy and precision of proteome quantification owing to the retention time shift of deuterated peptides from the hydrogenated counterpart. We introduce a novel three-plexed peptide "diethylation" using only ¹³C isotopologues of acetaldehyde and demonstrate that the accuracy and precision of our method in proteome quantification are significantly superior to the conventional deuterium-based dimethylation labeling in both a single-shot and multidimensional LC-MS/MS analysis of the HeLa proteome. Furthermore, in time-resolved profiling of Xenopus laevis early embryogenesis, our 3-plexed diethylation outperformed isobaric labeling approaches in terms of the quantification accuracy or the number of protein identifications, generating more than two times more differentially expressed proteins. Our cost-effective and highly accurate 3-plexed diethylation method could contribute to various types of quantitative proteomics applications in which three of multiplexity would be sufficient.

Nonlinear association between bone mineral density and all-cause mortality: the Dong-gu study

There was a U-shaped association between hip BMD and all-cause mortality, with the lowest mortality in the 90th percentile in males. However, there was an inverse linear relationship in females. In contrast, the association between lumbar spine BMD and mortality was less evident in males, with no association in females.

INTRODUCTION

Bone mineral density (BMD) is reported inversely associated with mortality. Although some previous studies provided evidence for nonlinear associations, these were not adequately assessed in most previous works.

METHODS

We evaluated the nonlinear relationship between BMD and mortality in Asians. Our study involved 8629 participants in the Dong-gu study from 2007 to 2010. Cox proportional hazard regression was used to calculate hazard ratios (HRs) according to BMD categories after adjusting for potential confounders. During a follow-up of 6.7 ± 1.4 years, 712 participants died.

RESULTS

There was a U-shaped association between hip BMD and all-cause mortality, with the lowest mortality in the 90th percentile in males. However, there was an inverse linear relationship in females. In males, compared with the 75th to 95th percentile group, the < 2.5th percentile group had a 3.89 (95% CI 2.41-6.28)-fold higher risk and the 2.5th to 5th percentile group had a 2.51 (95% CI 1.25-5.04)-fold higher risk. The HR was 2.51 (95% CI 1.25, 5.04) in the > 97.5th percentile group. In females, compared with that in the 75th to 95th percentile group, the HR was 2.33 (95% CI 1.24, 4.39) in the < 2.5th percentile group. In contrast, the association between lumbar spine BMD and mortality was less evident in males, with no association in females.

CONCLUSION

In conclusion, this study shows that the association between BMD and mortality varies by gender and that high and low BMD are predictors of all-cause mortality in males.

Molecular-based identification and detection of Salmonella in food production systems: current perspectives

Salmonella remains a prominent cause of foodborne illnesses and can originate from a wide range of food products. Given the continued presence of pathogenic Salmonella in food production systems, there is a consistent need to improve identification and detection methods that can identify this pathogen at all stages in food systems. Methods for subtyping have evolved over the years, and the introduction of whole genome sequencing and advancements in PCR technologies have greatly improved the resolution for differentiating strains within a particular serovar. This, in turn, has led to the continued improvement in Salmonella detection technologies for utilization in food production systems. In this review, the focus will be on recent advancements in these technologies, as well as potential issues associated with the application of these tools in food production. In addition, the recent and emerging research developments on Salmonella detection and identification methodologies and their potential application in food production systems will be discussed.

Nutrition and Clinical Outcomes of Nutrition Support in Multidisciplinary Team for Critically Ill Patients

BACKGROUND

To examine the outcomes of the implementation of a multidisciplinary nutrition support team (NST) that included a pharmacist for critically ill patients in the intensive care unit (ICU).

METHODS

Data were retrospectively collected from electronic medical records and compared between the pre-NST group (n = 73) and post-NST group (n = 75). Patients were included if they received enteral or parenteral nutrition support for at least 72 hours in the ICU of an approximately 900-bed, top-tier university medical center. The percentage of goal kcal, the percentage of goal protein, serum albumin level, total lymphocyte count, C-reactive protein, duration of mechanical ventilation use, hospital length of stay (LOS), ICU LOS, and mortality were evaluated.

RESULTS

There were significant differences in the percentage of goal kcal (66.9% ± 25.9% vs 86.2% ± 27.5%; P < 0.001) and the percentage of goal protein (67.0% ± 29.9% vs 81.7% ± 30.7%; P < 0.05) between the pre-NST and post-NST groups. A higher percentage of goal kcal was associated with a significant decrease in the ICU LOS (P < 0.05) and hospital LOS (P < 0.05). The percentage of goal kcal was associated with mortality rate (odd ratio, 0.977; 95% confidential interval, 0.959-0.996; P = 0.016).

CONCLUSION

Implementation of a multidisciplinary NST service for critically ill patients was associated with higher percentages of goal kcal and goal protein, as well as a shortened duration of mechanical ventilation use. Higher energy supply was associated with a reduced mortality rate.

A cost-effective cell- and matrix-based minimally invasive single-stage chondroregenerative technique developed with validated vertical translation methodology

Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation. Methods and results A technique was developed that allowed chondrogenic primary (uncultured) cells from bone marrow aspirate concentrate, combined with a composite hydrophilic and fibrillar matrix to be applied arthroscopically to a site of a chondral lesion. The construct was tested in vitro and in animal experiments before clinical trials. Clinical trials involved 60 patients in a prospective study. Symptomatic International Cartilage Repair Society grade 3 and 4a lesions were mapped and treated. Pre- and postoperative clinical assessments showed statistically significant improved outcomes; Lysholm Knee Scoring Scale (mean 52.8 to > 76.4; P < 0.05) International Knee Documentation Committee (mean 39 to > 79 P < 0.05) and Knee injury and Osteoarthritis Outcome Score (64.5 to >89.2 P < 0.05). Postoperative magnetic resonance imaging was evaluated morphologically (magnetic resonance observation of cartilage repair tissue, average MOCART score 72) and qualitatively; the regenerate was comparable to native cartilage. Conclusions This technique is effective, affordable, requires no complex tools and delivers a single-stage treatment that is potentially accessible to any centre capable of performing arthroscopic surgery. Good clinical results were found to be sustained at five years of follow-up with a regenerate that appears hyaline like using multiple magnetic resonance measures.

Development and clinical application of an evidence-based pharmaceutical care service algorithm in acute coronary syndrome

WHAT IS KNOWN AND OBJECTIVE

Drug therapies are critical for preventing secondary complications in acute coronary syndrome (ACS). The purpose of this study was to develop and apply a pharmaceutical care service (PCS) algorithm for ACS and confirm that it is applicable through a prospective clinical trial.

METHODS

The ACS-PCS algorithm was developed according to extant evidence-based treatment and pharmaceutical care guidelines. Quality assurance was conducted through two methods: literature comparison and expert panel evaluation. The literature comparison was used to compare the content of the algorithm with the referenced guidelines. Expert evaluations were conducted by nine experts for 75 questionnaire items. A trial was conducted to confirm its effectiveness. Seventy-nine patients were assigned to either the pharmacist-included multidisciplinary team care (MTC) group or the usual care (UC) group. The endpoints of the trial were the prescription rate of two important drugs, readmission, emergency room (ER) visit and mortality.

RESULTS AND DISCUSSION

The main frame of the algorithm was structured with three tasks: medication reconciliation, medication optimization and transition of care. The contents and context of the algorithm were compliant with class I recommendations and the main service items from the evidence-based guidelines. Opinions from the expert panel were mostly positive. There were significant differences in beta-blocker prescription rates in the overall period (P = .013) and ER visits (four cases, 9.76%, P = .016) in the MTC group compared to the UC group, respectively.

WHAT IS NEW AND CONCLUSION

We developed a PCS algorithm for ACS based on the contents of evidence-based drug therapy and the core concept of pharmacist services.

Can persistent organic pollutants distinguish between two opposite metabolic phenotypes in lean Koreans?

AIMS

This study investigated the association of persistent organic pollutants (POPs), an emerging new risk factor for type 2 diabetes and the metabolic syndrome, with the presence of opposite phenotypes of glucose and lipid metabolism among normal-weight Koreans of similar body composition.

METHODS

Fifty subjects, randomly selected from an ongoing community-based cohort study, from two opposite phenotype groups - metabolically unhealthy normal weight (MUHNW) and metabolically healthy normal weight (MHNW) - were matched for waist circumference, visceral fat mass and demographic variables, then compared for serum concentrations of POPs.

RESULTS

Most POPs (10 out of 13 compounds) were present in higher serum concentrations in the MUHNW than in the MHNW. In particular, serum concentrations of all compounds of the organochlorine pesticide class were 2.2 to 4.7 times higher in cases than in controls. Compared with the lowest tertile of summary measures of POPs, Odds ratios (95% confidence interval) for the second and third tertiles were 7.4 (1.9-29.4) and 10.4 (2.6-41.2), respectively. Adjusting for possible confounders did not change the results.

CONCLUSION

Taken altogether, these findings from the present and previous studies suggest that increased serum POP concentrations may play an important role in the development of unhealthy metabolic phenotypes in lean people.

A new haplotype block detection method for dense genome sequencing data based on interval graph modeling of clusters of highly correlated SNPs

Motivation

Linkage disequilibrium (LD) block construction is required for research in population genetics and genetic epidemiology, including specification of sets of single nucleotide polymorphisms (SNPs) for analysis of multi-SNP based association and identification of haplotype blocks in high density sequencing data. Existing methods based on a narrow sense definition do not allow intermediate regions of low LD between strongly associated SNP pairs and tend to split high density SNP data into small blocks having high between-block correlation.

Results

We present Big-LD, a block partition method based on interval graph modeling of LD bins which are clusters of strong pairwise LD SNPs, not necessarily physically consecutive. Big-LD uses an agglomerative approach that starts by identifying small communities of SNPs, i.e. the SNPs in each LD bin region, and proceeds by merging these communities. We determine the number of blocks using a method to find maximum-weight independent set. Big-LD produces larger LD blocks compared to existing methods such as MATILDE, Haploview, MIG ++, or S-MIG ++ and the LD blocks better agree with recombination hotspot locations determined by sperm-typing experiments. The observed average runtime of Big-LD for 13 288 240 non-monomorphic SNPs from 1000 Genomes Project autosome data (286 East Asians) is about 5.83 h, which is a significant improvement over the existing methods.

Availability and implementation

Source code and documentation are available for download at http://github.com/sunnyeesl/BigLD.

Contact

yyoo@snu.ac.kr.

Supplementary information

Supplementary data are available at Bioinformatics online.

Rapid and simple method by combining FTA™ card DNA extraction with two set multiplex PCR for simultaneous detection of non-O157 Shiga toxin-producing Escherichia coli strains and virulence genes in food samples

The aim of this research was to optimize two multiplex polymerase chain reaction (PCR) assays that could simultaneously detect six non-O157 Shiga toxin-producing Escherichia coli (STEC) as well as the three virulence genes. We also investigated the potential of combining the FTA™ card-based DNA extraction with the multiplex PCR assays. Two multiplex PCR assays were optimized using six primer pairs for each non-O157 STEC serogroup and three primer pairs for virulence genes respectively. Each STEC strain specific primer pair only amplified 155, 238, 321, 438, 587 and 750 bp product for O26, O45, O103, O111, O121 and O145 respectively. Three virulence genes were successfully multiplexed: 375 bp for eae, 655 bp for stx1 and 477 bp for stx2. When two multiplex PCR assays were validated with ground beef samples, distinctive bands were also successfully produced. Since the two multiplex PCR examined here can be conducted under the same PCR conditions, the six non-O157 STEC and their virulence genes could be concurrently detected with one run on the thermocycler. In addition, all bands clearly appeared to be amplified by FTA card DNA extraction in the multiplex PCR assay from the ground beef sample, suggesting that an FTA card could be a viable sampling approach for rapid and simple DNA extraction to reduce time and labour and therefore may have practical use for the food industry.

SIGNIFICANCE AND IMPACT OF THE STUDY

Two multiplex polymerase chain reaction (PCR) assays were optimized for discrimination of six non-O157 Shiga toxin-producing Escherichia coli (STEC) and identification of their major virulence genes within a single reaction, simultaneously. This study also determined the successful ability of the FTA™ card as an alternative to commercial DNA extraction method for conducting multiplex STEC PCR assays. The FTA™ card combined with multiplex PCR holds promise for the food industry by offering a simple and rapid DNA sample method for reducing time, cost and labour for detection of STEC in food and environmental samples.

[Shunt-induced craniosynostosis: topicality of the problem, choice of the approach, and features of surgical treatment]

RATIONALE

Shunt-induced craniosynostosis is one of the late complications of CSF shunting surgery, which affects the patient's condition, clinical picture, and treatment approach.

OBJECTIVE

to evaluate the prevalence rate and clinical significance of this disease, define the indications for surgery, and choose the optimal surgical approach.

MATERIAL AND METHODS

The study included 59 children with shunt system dysfunction, aged 1 to 14 years, who were treated at the Department in the period from 2014 to 2016. The inclusion criteria were as follows: 1) age at the time of examination is older than 1 year; 2) implantation of a shunt system in the first 12 months of life. The state of cranial sutures was assessed using three-dimensional reconstruction of patient's computerized tomography images. Images obtained before or in the first months after primary implantation of a shunt system were used to exclude cases of primary craniosynostosis.

RESULTS

Premature synostosis of the cranial sutures was detected in 27 (46%) cases. Of these, 3 (11%) patients with clinical symptoms of increased intracranial pressure and radiographic signs of craniocerebral disproportion underwent cranial vault remodeling surgery: two biparietal craniotomies and one fronto-parieto-occipital reconstruction. In two cases, simultaneous replacement of a valve with a programmable one was performed. There were no complications after reconstructive surgery.

CONCLUSION

Shunt-associated craniosynostosis is one of the late complications of CSF shunting surgery. However, its presence is not an indication for surgery and should not be a reason for surgical aggression. Surgery for increasing the intracranial volume is indicated only for secondary craniosynostosis combined with signs of craniocerebral disproportion. In these cases, reconstructive surgery is an effective treatment option for improving the patient's condition.

Effects of Single Nucleotide Polymorphism Marker Density on Haplotype Block Partition

Many researchers have found that one of the most important characteristics of the structure of linkage disequilibrium is that the human genome can be divided into non-overlapping block partitions in which only a small number of haplotypes are observed. The location and distribution of haplotype blocks can be seen as a population property influenced by population genetic events such as selection, mutation, recombination and population structure. In this study, we investigate the effects of the density of markers relative to the full set of all polymorphisms in the region on the results of haplotype partitioning for five popular haplotype block partition methods: three methods in Haploview (confidence interval, four gamete test, and solid spine), MIG++ implemented in PLINK 1.9 and S-MIG++. We used several experimental datasets obtained by sampling subsets of single nucleotide polymorphism (SNP) markers of chromosome 22 region in the 1000 Genomes Project data and also the HapMap phase 3 data to compare the results of haplotype block partitions by five methods. With decreasing sampling ratio down to 20% of the original SNP markers, the total number of haplotype blocks decreases and the length of haplotype blocks increases for all algorithms. When we examined the marker-independence of the haplotype block locations constructed from the datasets of different density, the results using below 50% of the entire SNP markers were very different from the results using the entire SNP markers. We conclude that the haplotype block construction results should be used and interpreted carefully depending on the selection of markers and the purpose of the study.

Akt activation by Evodiae Fructus extract protects ovary against 4-vinylcyclohexene diepoxide-induced ovotoxicity

ETHNOPHARMACOLOGICAL RELEVANCE

Evodiae Fructus (EF) is the dried, unripe fruit of Evodia rutaecarpa Benth., and one of the main components of traditional herbal prescriptions issued for the treatment of sterility caused by irregular menstruation in Korea. However, scientific evidence regarding the efficacy and action mechanism of EF is lacking.

AIM OF THE STUDY

In this study, the authors established an in vitro screening tool to identify promising new drug candidates in herbal medicines for the prevention and treatment of premature ovarian failure. The protective effects of EF extracts against 4-vinylcyclohexene diepoxide (VCD)-induced ovotoxicity were investigated and the molecular mechanism responsible was sought.

MATERIAL AND METHODS

EF extract was prepared by boiling EF in water and its quality was confirmed by high performance liquid chromatography. CHO-K1 (Chinese hamster ovary cells) and COV434 (human ovarian granulosa cells) cells were plated, pretreated with EF extract for 2h and then treated with 1.5mM or 0.5mM VCD for 24h, respectively. Cell viabilities were measured using an MTT assay, and protein levels were determined by western blotting.

RESULTS

VCD significantly suppressed the viability of both CHO-K1 and COV434 cells in a dose-dependent manner and induced the apoptosis of CHO-K1 cells at 1.5mM. EF extract dose-dependently blocked the ovotoxicity induced by treatment with VCD. Furthermore, EF extract significantly activated Akt and downstream effectors such as mTOR and GSK-3β in CHO-K1 cells. The ability of EF extract to prevent cytotoxicity by VCD was antagonized by pretreatment of LY294002, a PI3K/Akt inhibitor.

CONCLUSION

EF has the ability to protect ovary cells against VCD-induced ovotoxicity, probably via Akt activation. These results suggest that the beneficial effects of EF might be useful for preventing premature ovarian failure or unexplained infertility caused by environmental factors.

Addition of Digital Breast Tomosynthesis to Full-Field Digital Mammography in the Diagnostic Setting: Additional Value and Cancer Detectability

Purpose

The purpose of this study was to assess the value of adding digital breast tomosynthesis (DBT) to full-field digital mammography (FFDM) in the diagnostic workup of breast cancer and to determine which lesion variables affect cancer detectability in the combined modality.

Methods

Between March and May 2012, paired FFDM and DBT images were obtained from 203 women as part of a diagnostic workup for breast cancer. Images from FFDM alone, DBT alone, and DBT combined with FFDM were reviewed in separate sessions by six blinded readers. Jackknife alternative free-response receiver operating characteristic (JAFROC) figure of merit (FOM), sensitivity, and specificity were compared between the modalities. Lesion characteristics affecting the cancer detection rate when using the combined modality were also analyzed.

Results

Among the 203 women, 126 women had a total of 129 malignancies and 77 women had total of 77 benign lesions. The overall JAFROC FOM of the combined modality was higher than that of FFDM alone (0.827 vs. 0.775, p<0.001) and that of DBT alone was higher than that of FFDM alone (0.807 vs. 0.775, p=0.027). The overall sensitivity of the combined modality was higher than that of FFDM alone (80.0% vs. 73.2%, p<0.001) and that of DBT alone was higher than that of FFDM alone (78.3% vs. 73.2%, p=0.007). Compared to FFDM alone, the combined modality detected an additional 48 cancers. Using the combined modality, the presence of masses or microcalcifications was significantly associated with the cancer detection rate (p<0.001).

Conclusion

The combination of DBT with FFDM results in a higher diagnostic yield than FFDM alone. Additionally, DBT alone performs better than FFDM alone. However, even when DBT is combined with FFDM, breast cancers with no discernible masses and those lacking calcifications are difficult to detect.

Resilience Mediates Impact of Some Childhood Maltreatment on Post-Traumatic Stress Symptoms in Conscripted Marines in the Republic of Korea

Although it is known that post-traumatic stress symptoms (PTSS) can result from military service, the variance in PTSS unexplained by military service warrants further investigation, and no researchers have investigated South Korean Marines' vulnerability during their 2-year conscripted service as the first line of national defense against threats from North Korea. This study was designed to examine whether resilience mediated the relationship between childhood maltreatment and PTSS in 169 Korean conscripts into the Marine Corps. In a cross-sectional study design, the Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment, including abuse and neglect. The Impact of Event Scale-Revised and the Connor-Davidson Resilience Scale were used to measure PTSS and resilience. Structural equation modeling was used for data analysis. Half the conscripts reported at least one type of childhood maltreatment, and 22.3% had high PTSS, even in a short period of service. Childhood abuse was significantly associated with PTSS during military service, a relationship that was not mediated by resilience. However, resilience mediated the relationship between childhood neglect and PTSS during military service. Assessment of childhood maltreatment and resilience prior to military service is crucial for identifying conscripts at increased risk for PTSS during even brief military service. In addition to direct interventions for abuse effects among all Marines, interventions enhancing resilience may benefit conscripts who experienced childhood neglect. © 2016 Wiley Periodicals, Inc.

Microbicidal effects of plain soap vs triclocarban-based antibacterial soap

The aim of this study was to determine the bactericidal effects of plain and antibacterial soap. The bactericidal effects of plain and antibacterial soap containing 0.3% triclocarban were examined against 10 Gram-positive and 10 Gram-negative bacterial strains after exposure at 22°C and 40°C for 20 s. Gram-negative bacteria were more susceptible to both soaps than Gram-positive bacteria. However, with one exception (Enterococcus faecalis ATCC 19433 at 40°C), there was no significant difference between the effects of medicated and non-medicated soap at either temperature. Triclocarban in soap does not lead to a meaningful reduction in bacterial levels during use.

Off-site evaluation of three-dimensional ultrasound for the diagnosis of thyroid nodules: comparison with two-dimensional ultrasound

OBJECTIVES

We compared the diagnostic performance of off-site evaluation between prospectively obtained 3D and 2D ultrasound for thyroid nodules.

METHODS

3D and 2D ultrasonographies were preoperatively obtained from 85 consecutive patients (mean age, 51 years; age range, 28-83 years) who were referred for a total thyroidectomy. Three radiologists independently evaluated 3D and 2D images of 91 pathologically confirmed thyroid nodules (30 benign and 61 malignant nodules) for nodule characterization. Diagnostic performance, interobserver agreement and time for scanning were compared between 3D and 2D.

RESULTS

3D had significantly higher sensitivities than 2D for predicting malignancy (78.7 % vs. 61.2 %, P < 0.01) and extrathyroidal extension (66.7 % vs. 46.4 %, P = 0.03) in malignancy. In terms of specificities, there were no statistically significant differences between 2D and 3D for predicting malignancy (78.4 % vs. 74.8 %, P = 1.00) and extrathyroidal extension (63.6 % vs. 57.6 %, P = 0.46). With respect to interobserver agreement, 3D showed moderate agreement (κ = 0.53) for predicting extrathyroidal extension in malignancy compared with 2D ultrasound, which showed fair agreement (κ = 0.37). 3D saved time (30 ± 56.52 s) for scanning compared with 2D.

CONCLUSION

For off-site evaluation, 3D US is more useful for diagnosis of thyroid nodules than 2D US.

KEY POINTS

• 3D had higher sensitivity than 2D for predicting malignancy and extrathyroidal extension. • 3D showed better agreement for predicting extrathyroidal extension in malignancy than 2D. • 3D thyroid ultrasound saved time for scanning compared with 2D. • For off-site evaluation of thyroid nodules, 3D is more useful than 2D.

Changes in the Microbial Composition of Microbrewed Beer during the Process in the Actual Manufacturing Line

This study investigated changes in the microbial composition of microbrewed beer during the manufacturing processes and identified potential microbial hazards, effective critical quality control points, and potential contamination routes. Comprehensive quantitative (aerobic plate count, lactic acid bacteria, fungi, acetic acid bacteria, coliforms, and Bacillus cereus) and qualitative (Escherichia coli and eight foodborne pathogens) microbiological analyses were performed using samples of raw materials (malt and manufacturing water), semiprocessed products (saccharified wort, boiled wort, and samples taken during the fermentation and maturation process), and the final product obtained from three plants. The initial aerobic plate count and lactic acid bacteria counts in malt were 5.2 and 4.3 log CFU/g, respectively. These counts were reduced to undetectable levels by boiling but were present at 2.9 and 0.9 log CFU/ml in the final product. Fungi were initially present at 3.6 log CFU/g, although again, the microbes were eliminated by boiling; however, the level in the final product was 4.6 log CFU/ml. No E. coli or foodborne pathogens (except B. cereus) were detected. B. cereus was detected at all stages, although it was not present in the water or boiled wort (total detection rate ¼ 16.4%). Results suggest that boiling of the wort is an effective microbial control measure, but careful management of raw materials and implementation of effective control measures after boiling are needed to prevent contamination of the product after the boiling step. The results of this study may constitute useful and comprehensive information regarding the microbiological quality of microbrewed beer.

[The use of frameless navigation during endoscopic interventions in children with multilocular hydrocephalus]

INTRODUCTION

The use of the endoscopic technique largely improves treatment outcomes in patients with multilocular hydrocephalus. However, impaired anatomy and the lack of usual landmarks often cause problems in planning and intraoperative identification of changed structures. The use of frameless navigation during endoscopic interventions can significantly facilitate surgeon tasks and increases the efficacy of surgery. During surgery, the neuronavigation system visualizes a rigid endoscope that interconnects separated ventricles and cysts. Surgery can be completed with guiding a stent through an operating channel of the endoscope and implanting a shunt system.

MATERIAL AND METHODS

Ten children underwent 11 endoscopic interventions using frameless intraoperative navigation at our clinic in 2013-2014. The number of surgically interconnected compartments ranged from 3 to 5. Simultaneous placement of a shunt system was performed in 8 of 11 interventions.

RESULTS

Clinical improvement as a result of the operation was achieved in all children. 2 patients underwent re-operations 5 months and 1 year after endoscopic intervention.

CONCLUSION

Thus, the use of frameless navigation during endoscopic interventions makes their implementation most efficient and safe for the patient.

Regional differences in mu and kappa opioid receptor G-protein activation in brain in male and female prairie voles

Prairie voles are unusual mammals in that, like humans, they are capable of forming socially monogamous pair bonds, display biparental care, and engage in alloparental behaviors. Both mu and kappa opioid receptors are involved in behaviors that either establish and maintain, or result from pair bond formation in these animals. Mu and kappa opioid receptors both utilize inhibitory G-proteins in signal transduction mechanisms, however the efficacy by which these receptor subtypes stimulate G-protein signaling across the prairie vole neuraxis is not known. Utilizing [(35)S]GTPγS autoradiography, we characterized the efficacy of G-protein stimulation in coronal sections throughout male and female prairie vole brains by [D-Ala2,NMe-Phe4,Gly-ol5]-enkephalin (DAMGO) and U50,488H, selective mu and kappa opioid agonists, respectively. DAMGO stimulation was highest in the forebrain, similar to that found with other rodent species. U-50,488H produced greater stimulation in prairie voles than is typically seen in mice and rats, particularly in select forebrain areas. DAMGO produced higher stimulation in the core versus the shell of the nucleus accumbens (NAc) in females, while the distribution of U-50,488H stimulation was the opposite. There were no gender differences for U50,488H stimulation of G-protein activity across the regions examined, while DAMGO stimulation was greater in sections from females compared to those from males for NAc core, entopeduncular nucleus, and hippocampus. These data suggest that the kappa opioid system may be more sensitive to manipulation in prairie voles compared to mice and rats, and that female prairie voles may be more sensitive to mu agonists in select brain regions than males.

Bactericidal effects of triclosan in soap both in vitro and in vivo

OBJECTIVES

On December 2013, the US FDA proposed a rule stating that manufacturers must provide data to demonstrate that antibacterial soap is more effective than plain soap or water. The objective of the present study was to examine the in vitro and in vivo bactericidal effect of triclosan (the most widely used antiseptic agent in soap) in soap.

METHODS

Twenty bacterial strains (proposed by the FDA) were exposed to plain and antibacterial soaps (the same formulation as plain soap, but containing 0.3% triclosan) for 20 s at 22°C (room temperature) and 40°C (warm temperature). The temperature and time were selected to simulate the hand washing conditions and procedures used by consumers. The triclosan concentration of 0.3% is the maximum allowed by law. The decontamination efficacy of plain soap and antibacterial soap was also examined in vivo: the hands of volunteers were artificially inoculated with Serratia marcescens.

RESULTS

There was no significant difference (P > 0.05) in bactericidal activity between plain soap and antibacterial soap at either test temperature. However, antibacterial soap showed significantly greater bactericidal effects after 9 h. These results suggest that although triclosan-containing soap does have antibacterial activity, the effects are not apparent during the short time required for hand washing.

CONCLUSIONS

Antibacterial soap containing triclosan (0.3%) was no more effective than plain soap at reducing bacterial contamination when used under 'real-life' conditions. The present study provides practical information that may prove useful for both industry and governments.

Does adding diffuse optical tomography to sonography improve differentiation between benign and malignant breast lesions? Observer performance study

OBJECTIVES

The purpose of this study was to investigate the added value of diffuse optical tomographic categories combined with conventional sonography for differentiating between benign and malignant breast lesions.

METHODS

In this retrospective database review, we included 145 breast lesions (116 benign and 29 malignant) from 145 women (mean age, 46 years; range, 16-86 years). Five radiologists independently reviewed sonograms with and without a diffuse optical tomographic category. Each lesion was scored on a scale of 0% to 100% for suspicion of malignancy and rated according to the American College of Radiology Breast Imaging Reporting and Data System classification. Diagnostic performance was analyzed by comparing area under receiver operating characteristic curve values. Reader agreement was assessed by intraclass correlation coefficients.

RESULTS

In the multireader multicase receiver operating characteristic analysis, adding a diffuse optical tomographic category to sonography improved the diagnostic accuracy of sonography (mean areas under the curve, 0.923 for sonography alone and 0.969 for sonography with diffuse optical tomography; P = .039). The interobserver correlation was also improved (0.798 for sonography alone and 0.904 for sonography with diffuse optical tomography). The specificity increased for 4 reviewers from a mean of 19.5% to 45.8% (P < .001 for reviewers 1-4; P = .238 for reviewer 5) with no significant change in the sensitivity. When the diffuse optical tomographic category was applied strictly, the specificity increased for all reviewers from a mean of 19.5% to 68.3% (P < .001 for all reviewers) with no significant change in the sensitivity.

CONCLUSIONS

The addition of diffuse optical tomographic categories to sonography may improve diagnostic performance and markedly decrease false-positive biopsy recommendations.

Characterization of breast lesions: comparison of digital breast tomosynthesis and ultrasonography

Objective

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant.

Materials and Methods

A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared.

Results

Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different.

Conclusion

Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.

Synergistic antimicrobial activity of caprylic acid in combination with citric acid against both Escherichia coli O157:H7 and indigenous microflora in carrot juice

The identification of novel, effective, and non-thermal decontamination methods is imperative for the preservation of unpasteurized and fresh vegetable juices. The aim of this study was to examine the bactericidal effects of caprylic acid + citric acid against the virulent pathogen Escherichia coli O157:H7 and the endogenous microflora in unpasteurized fresh carrot juice. Carrot juice was treated with either caprylic acid, citric acid, or a combination of caprylic acid + citric acid at mild heating temperature (45 °C or 50 °C). The color of the treated carrot juice as well as microbial survival was examined over time. Combined treatment was more effective than individual treatment in terms of both color and microbial survival. Caprylic acid + citric acid treatment (each at 5.0 mM) at 50 °C for 5 min resulted in 7.46 and 3.07 log CFU/ml reductions in the E. coli O157:H7 and endogenous microflora populations, respectively. By contrast, there was no apparent reduction in either population following individual treatment. A validation assay using a low-density E. coli O157:H7 inoculum (3.31 log CFU/ml) showed that combined treatment with caprylic acid (5.0 mM) + citric acid (2.5 mM) at 50 °C for >5 min or with caprylic acid + citric acid (both at 5.0 mM) at either 45 °C or 50 °C for >5 min completely destroyed the bacteria. Combined treatment also increased the redness of the juice, which is a perceived indication of quality. Taken together, these results indicate that combined treatment with low concentrations of caprylic acid and citric acid, which are of biotic origin, can eliminate microorganisms from unpasteurized carrot juice.

[Effectiveness of the Military Mental Health Promotion Program]

PURPOSE

This study was done to evaluate the Military Mental Health Promotion Program. The program was an email based cognitive behavioral intervention.

METHODS

The research design was a quasi-experimental study with a non-equivalent control group pretest-posttest design. Participants were 32 soldiers who agreed to participate in the program. Data were collected at three different times from January 2012 to March 2012; pre-test, post-test, and a one-month follow-up test. The data were statistically analyzed using SPSS 18.0. The effectiveness of the program was tested by repeated measures ANOVA.

RESULTS

The first hypothesis that the level of depression in the experimental group who participated in the program would decrease compared to the control group was not supported in that the difference in group-time interaction was not statistically significant (F=2.19, p=.121). The second and third hypothesis related to anxiety and self-esteem were supported in group-time interaction, respectively (F=7.41, p=.001, F=11.67, p<.001).

CONCLUSION

Results indicate that the program is effective in improving soldiers' mental health status in areas of anxiety and self-esteem.

[Changes in the mucous membranes of the oral cavity in chronic renal failure (experimental study)]

Methods of light microscopy were used to study the morphological changes of the oral cavity mucosa in rats (n = 48) in chronic renal failure (CRF) of various degrees. It was found that after 6 months of modeling of mild and moderate CRF, lamina propria of the oral cavity mucous membranes was diffusely infiltrated with leukocytes. At the same time, relative density of the distribution of the components of blood and lymphatic vascular bed was increased. In severe CRF, the atrophy and hyperkeratosis of the epithelium of the oral cavity mucous membrane developed, while the lamina propria demonstrated sclerosis and significant increase of leukocyte (primarily neutrophil and monocyte) and macrophage numerical density with the formation of small leukocyte infiltrates. In addition, in moderate and severe CRF, the number of eosinophils and plasma cells was increased in the lamina propria which indicates the possible presence of allergic component in the initiation and maintenance of its inflammation.

Survival of foodborne pathogenic bacteria (Bacillus cereus, Escherichia coli O157:H7, Salmonella enterica serovar Typhimurium, Staphylococcus aureus, and Listeria monocytogenes) and Bacillus cereus spores in fermented alcoholic beverages (beer and refined rice wine)

Only limited information is available on the microbiological safety of fermented alcoholic beverages because it is still a common belief that such beverages do not provide a favorable environment for bacterial growth and survival. Thus, in this study, we examined the survival of major foodborne pathogens and spores in fermented alcoholic beverages. Foodborne pathogens (Bacillus cereus, Escherichia coli O157:H7, Listeria monocytogenes, Salmonella enterica serovar Typhimurium, and Staphylococcus aureus) and B. cereus spores (initial population, 3 to 4 log CFU/ml) were inoculated separately into three types of beer and refined rice wine, which were then stored at 5 and 22°C. Bacterial counts were assayed periodically for up to 28 days. Vegetative B. cereus counts decreased rapidly, whereas B. cereus spore counts remained constant (P > 0.05) for a long period of time in all beverages. Vegetative B. cereus cells formed spores in beer at 5 and 22°C, and the spores survived for long periods. Among vegetative cells, E. coli O157:H7 had the highest survival (only 1.49 to 1.56 log reduction during 28 days in beer at 5°C). Beer and refined rice wine supported microbial survival from several days to several weeks. Our results appear to contradict the common belief that pathogens cannot survive in alcoholic beverages. Long-term survival of pathogens (especially B. cereus and E. coli O157:H7) in beer and refined rice wine should be taken into consideration by the manufacturers of these beverages. This study provides basic information that should help further research into microbial survival in alcoholic beverages and increase the microbiological safety regulation of fermented alcoholic beverages.

[Morphological changes in the fatty tissue after a single exposure to the ultrasound]

The morphological changes in the fatty tissue of the posterior surface of knee joint were studied in rats (n = 96) using the method of light microscopy 1, 2, 3, 4 and 5 days after a single ultrasonic exposure of various duration (5, 10, 20 min)) in a diagnostic mode. This exposure resulted in hyperemia, lymphostasis and increase of vascular permeability. The degree of changes was found to increase in proportion to the duration of exposure. All the changes detected were reversible, and the majority of them disappeared within 1-2 days. During the practical application, it is necessary to take into account the possibility the induction of cell and tissue damage during the ultrasonographic examinations. Development and application of the measures directed to decrease the edema and to stabilize the vascular wall both during the ultrasonography and immediately after it are expedient. Ultrasonography should be performed only when there are significant medical indications, and to receive the required diagnostic information, the lowest power of the device should be used.

[Oral cavity pathology by renal failure]

The analysis of the scientific literature devoted to organ and tissue changes of oral cavity at the chronic renal insufficiency (CRI)is made. The number of patients in an end-stage of CRI constantly increases and patients receiving renal replacement therapy including hemodialysis, peritoneal dialysis or renal transplantation will comprise an enlarging segment of the dental patient population. Owing to CRI and its treatment there is a set of changes of teeth and oral cavity fabrics which remain even in a end-stage. Renal replacement therapy can affect periodontal tissues including gingival hyperplasia in immune suppressed renal transplantation patients and increased levels of bacterial contamination, gingival inflammation, formation of calculus, and possible increased prevalence and severity of destructive periodontal diseases. Besides, the presence of undiagnosed periodontitis may have significant effects on the medical management of the patients in end-stage of CRI.