Short-term outcomes of a self-expandable metallic stent as a bridge to surgery vs. a transanal decompression tube for malignant large-bowel obstruction: a meta-analysis

Abstract

Purpose

Preoperative intestinal decompression, using either a self-expandable metallic stent (SEMS) as a bridge to surgery (BTS) or a transanal decompression tube (TDT), provides an alternative to emergency surgery for malignant large-bowel obstruction (MLBO). We conducted this meta-analysis to compare the short-term outcomes of SEMS placement as a BTS vs. TDT placement for MLBO.

Methods

We conducted a comprehensive electronic search of literature published up to March, 2018, to identify studies comparing the short-term outcomes of BTS vs. TDT. Decompression device-related and surgery-related variables were evaluated and a meta-analysis was performed using random-effects models to calculate odd ratios with 95% confidence intervals.

Results

We analyzed 14 nonrandomized studies with a collective total of 581 patients: 307 (52.8%) who underwent SEMS placement as a BTS and 274 (47.2%) who underwent TDT placement. The meta-analyses showed that the BTS strategy conferred significantly better technical and clinical success, helped to maintain quality of life by allowing free food intake and temporal discharge, promoted laparoscopic one-stage surgery without stoma creation, and had equivalent morbidity and mortality to TDT placement.

Conclusions

Although the long-term outcomes are as yet undetermined, the BTS strategy using SEMS placement could be a new standard of care for preoperative decompression to manage MLBO.

https://ift.tt/2ThjWlw

Complex abdominal wall reconstruction, harnessing the power of a specialized multidisciplinary team to improve pain and quality of life

Abstract

Introduction

Patients who require highly complex abdominal wall hernia repair with composite soft tissue free flap coverage represent the most challenging population, and the most difficult to definitively treat. For many, this combined procedure represents their last chance to restore any sense of normalcy to their lives. To date, patient reported post-operative outcomes have been limited in the literature, in particular, quality of life has been an under-reported component of successful management.

Methods

Patient-reported outcomes were analyzed using the 12-question HerQLes survey, a validated hernia-related quality of life survey to assess patient function after complex abdominal wall reconstruction. Using synthetic mesh for structural stability, and microsurgical flaps for soft tissue coverage, ten consecutive heterogeneous patients underwent repair of massive abdominal wall defects. Baseline preoperative HerQLes and numerical pain scores were then compared to those obtained postoperatively (at or greater than 6 months).

Results

All patients experienced improvement in their quality of life and pain scores post operatively with average follow-up at 15.9 months, even in those who experienced complications. All microsurgical flaps survived. There were no hernia recurrences.

Conclusion

Despite the extraordinary preoperative morbidity of massive abdominal wall defects, with an experienced General Surgery and Plastic Surgery multidisciplinary team, these highly complex patients are able to achieve a significant improvement in their pain and quality of life following repair and reconstruction with complex mesh hernia repair and microsurgical free tissue transfer.

https://ift.tt/2Eq9hwQ

An individualized patient-reported outcome measure (PROM) based patient decision aid and surgeon report for patients considering total knee arthroplasty: protocol for a pragmatic randomized controlled trial

Abstract

Background

While the rates of total knee arthroplasty (TKA) continue to rise worldwide, there are concerns about whether all surgeries are appropriate. Guidelines for appropriateness suggest that patients should have realistic expectations for total knee arthroplasty (TKA), and that the patient and their surgeon should agree that the potential benefits outweigh the potential harms. The objective of this study is to evaluate whether routinely collected pre- and post-TKA patient-reported outcome measures (PROMs) could be integrated into a patient decision aid to better inform these appropriateness criteria. This randomised trial will evaluate the preliminary efficacy of a tailored PROM-based patient decision aid and surgeon report (compared to usual care) for patients considering TKA on decision quality.

Methods

This is a pragmatic, randomised controlled trial conducted at one site in Alberta, Canada. Adults over the age of 30 years, who have been scheduled for a TKA consultation at the Edmonton Bone and Joint Centre with a participating surgeon, who understand, speak, and read English, and can provide informed consent, are eligible to participate. Participants will be randomised to receive a PROM-based patient decision aid and surgeon report before their surgical consultation or usual care. The decision aid will provide patients with information on their expected outcomes based on the EQ-5D-5L PROM, and these estimates are individualized based on clinical and demographic characteristics. The primary outcome of this trial is decision quality. Analysis will consider outcomes intention to treat, and feasibility outcomes for implementing the trial to routine practise.

Discussion

This patient decision aid and surgeon report intervention could contribute to improved treatment decision-making for patients considering total knee arthroplasty.

Trial registration (registry and number)

ClinicalTrials.gov: NCT03240913. Registered on August 1, 2017.

https://ift.tt/2BONr4x

The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030

Abstract

Background

Comprehensive national joint replacement registries with well-validated data offer unique opportunities for examining the potential future burden of hip and knee osteoarthritis (OA) at a population level. This study aimed to forecast the burden of primary total knee (TKR) and hip replacements (THR) performed for OA in Australia to the year 2030, and to model the impact of contrasting obesity scenarios on TKR burden.

Methods

De-identified TKR and THR data for 2003–2013 were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Population projections and obesity trends were obtained from the Australian Bureau of Statistics, with public and private hospital costs sourced from the National Hospital Cost Data Collection. Procedure rates were projected according to two scenarios: (1) constant rate of surgery from 2013 onwards; and (2) continued growth in surgery rates based on 2003–2013 growth. Sensitivity analyses were used to estimate future TKR burden if: (1) obesity rates continued to increase linearly; or (2) 1–5% of the overweight or obese population attained a normal body mass index.

Results

Based on recent growth, the incidence of TKR and THR for OA is estimated to rise by 276% and 208%, respectively, by 2030. The total cost to the healthcare system would be $AUD5.32 billion, of which $AUD3.54 billion relates to the private sector. Projected growth in obesity rates would result in 24,707 additional TKRs totalling $AUD521 million. A population-level reduction in obesity could result in up to 8062 fewer procedures and cost savings of up to $AUD170 million.

Conclusions

If surgery trends for OA continue, Australia faces an unsustainable joint replacement burden by 2030, with significant healthcare budget and health workforce implications. Strategies to reduce national obesity could produce important TKR savings.

https://ift.tt/2TZQOww

Risk factors associated with long-term outcomes after active and supporting periodontal treatments: impact of various compliance definitions on tooth loss

Abstract

Objectives

The aim of this retrospective study was to determine factors influencing tooth loss during a long-term follow-up, emphasizing the impact of various compliance definitions.

Materials and methods

Patients with periodontitis who were treated and presenting for maintenance care for at least up to 6 years were included. The effects of compliance and other patient- and treatment-related factors on tooth loss were assessed. Lack of compliance was defined in three ways: (1) fewer than 1.4 visits per year (irregular compliers), (2) no maintenance visit over a 2-year period (erratic compliers), and (3) no maintenance visit over a 2- to 5-year period (partial compliers) and no maintenance visit for a period of more than 5 years (non-compliers).

Results

One hundred and one patients were selected. The mean follow-up was 9.72 ± 1.17 years. Tooth loss per patient-year was significantly higher in erratic compliers (0.35 ± 0.19) and non-compliers (0.40 ± 0.20) compared with compliers (0.18 ± 0.10). No significant differences were found for irregular (0.30 ± 0.17) and partial (0.25 ± 0.15) compliers. Similar results were obtained for the number of patients who lost more than three teeth. Multivariable regression analysis showed that lack of compliance and periodontitis severity (more than 3% of periodontal pockets > 7 mm at baseline) were independent risk factors for tooth loss.

Conclusions

During long-term follow-up, non-compliance and initial periodontitis severity were the principal risk factors that increased tooth loss.

Clinical relevance

Tooth loss associated with lack of compliance was essentially observed in patients with long continuous periods without maintenance visits and was less influenced by patients' attended mean visit frequency.

https://ift.tt/2NlOdu3

Robotic hepatectomy for benign and malignant liver tumors

Abstract

Minimally invasive hepatectomy for benign and malignant liver lesions has gained popularity in the past decade due to improved perioperative outcomes when compared to conventional 'open' technique. We aim to investigate our initial experience of robotic hepatectomy undertaken in our hepatobiliary program. All patients undergoing robotic hepatectomy between 2013 and 2018 were prospectively followed. Data are presented as median (mean ± SD). A total of 80 patients underwent robotic hepatectomy within the study period. 60% of the patients were women, age of 63 (62.4 ± 14.1), body mass index of 28 (29.6 ± 9.4), ASA class of 2.5 (2.5 ± 0.6), and MELD score of 7 (8.2 ± 2.8). Size of resected lesion was 3.9 (4.6 ± 3) cm. Indications for resection were metastatic lesions (30%), hepatocellular carcinoma (28%), cholangiocarcinoma (7%), gallbladder cancer (5%), neuroendocrine tumors (4%), and benign lesions (26%). Formal hepatectomy (right or left) was performed in 30% of the patients. Operative time was 233 (267.2 ± 109.6) minutes, and estimated blood loss was 150 (265.7 ± 319.9) ml. Length of hospital stay was 3 (5.0 ± 4.6) days. One patient was converted to 'open' approach. 10 patients experienced postoperative complications. Readmissions within 30 days of hospital discharge were seen in eight patients. Our data support that robotic hepatectomy is safe and feasible, with favorable short-term outcomes and low conversion rate. Robotic technology extends the application of minimally invasive techniques in the field of hepatobiliary surgery.

https://ift.tt/2Er5ak7

Journal of Artificial Organs 2018: the year in review

https://ift.tt/2NlClII

Stabilization of formaldehyde into polydimethylsiloxane composite: application to the in situ determination of illicit drugs

Abstract

The Marquis test is the most frequently used spot color assay for the screening of unknown drugs such as amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-metilenedioxymethamphetamine, and morphine. However, this test involves the use of the toxic reagent formaldehyde, as well as the manipulation of concentrated sulfuric acid. Here, we report a new format of this test that improves the sustainability and safety for the operator by immobilizing formaldehyde into a polydimetylsiloxane composite. In contact with a solution (or suspension) of the suspected sample in sulfuric acid, the dispositive delivers formaldehyde and the reaction takes place in a few seconds. Under the proposed conditions, only small amounts of the drug (μg) are necessary to produce intense changes of color. In addition, the percentage of the drug in the sample can be established by obtaining pictures of the test vials and subsequent analysis of the digitalized images. The responses were linear for amphetamine-like drugs up to a concentration of 100 mg L⁻¹, and the precision achieved was adequate (relative standard deviations, RSDs < 10%). The developed composites were tested for the determination of MDMA in several drug street samples, and a good correlation with the results obtained by a reference method based on liquid chromatography was found. The main advantages of the proposed approach over the traditional Marquis test format are better portability and safety for the operator at a lower cost and the possibility of using it for quantitative analysis.

https://ift.tt/2GYq0J7

Highly parallel remote SPR detection of DNA hybridization by micropillar optical arrays

Abstract

Remote detection by surface plasmon resonance (SPR) is demonstrated through microstructured optical arrays of conical nanotips or micropillars. Both geometries were fabricated by controlled wet chemical etching of bundles comprising several thousands of individual optical fibers. Their surface was coated by a thin gold layer in order to confer SPR properties. The sensitivity and resolution of both shapes were evaluated as a function of global optical index changes in remote detection mode performed by imaging through the etched optical fiber bundle itself. With optimized geometry of micropillar arrays, resolution was increased up to 10⁻⁴ refractive index units. The gold-coated micropillar arrays were functionalized with DNA and were able to monitor remotely the kinetics of DNA hybridization with complementary strands. We demonstrate for the first time highly parallel remote SPR detection of DNA via microstructured optical arrays. The obtained SPR sensitivity combined with the remote intrinsic properties of the optical fiber bundles should find promising applications in biosensing, remote SPR imaging, a lab-on-fiber platform dedicated to biomolecular analysis, and in vivo endoscopic diagnosis.

Graphical abstract

We present a single fabrication step to structure simultaneously all the individual cores of an optical fiber bundle composed of thousands of fibers. The resulting sensor is optimized for reflection mode (compatible with in vivo applications) and is used to perform for the first time highly parallel remote SPR detection of DNA via several thousands of individual optical fiber SPR sensors paving the way for multiplexed biological detection.

https://ift.tt/2txgm8F

Determination of glyphosate and aminomethylphosphonic acid by sequential-injection reversed-phase chromatography: method improvements and application in adsorption studies

Abstract

This paper describes a low-cost reversed-phase sequential injection chromatography method for the determination of glyphosate and aminomethylphosphonic acid in environmental samples. The method is based on the pre-column conversion of glyphosate to glycine by hypochlorite, followed by reaction with o-phthaldialdehyde in presence of 2-mercaptoethanol in borate buffer (pH 9.5) to produce the fluorescent 1-(2′-hydroxyethylthio)-2-N-alkylisoindole. In addition to producing detectable fluorescent indoles, the pre-column derivatization also decreases the polarity of the analytes, favoring their retention on a C₁₈ monolithic column. The isocratic reversed-phase chromatography enabled the separation of both glyphosate and aminomethylphosphonic acid derivatives from polar compounds such as organic acids, humic substances, and carbohydrates which are commonly found in waters and soil extracts. This separation minimizes the laborious sample preparation procedures prior to the analysis. The linear response was observed for concentrations between 0.10 and 12.8 μM. The limits of detection and quantification were 0.03 and 0.10 μM (glyphosate), and 0.015 and 0.050 μM (aminomethylphosphonic acid). At the 0.10 μM concentration level, the relative standard deviations were 21 and 25% for aminomethylphosphonic acid and glyphosate, respectively (n = 5). Recoveries between 80 and 120% were found in the determination of glyphosate and aminomethylphosphonic acid in spiked lake waters (0.80 to 6.4 μM). The method was applied in the determination of kinetic and thermodynamic parameters related to the adsorption of glyphosate on two horizons of an Alfisol from the Paraná State in South Brazil.

https://ift.tt/2GZ6Rag

Advances in chemometric control of commercial diesel adulteration by kerosene using IR spectroscopy

Abstract

Adulteration is a recurrent issue found in fuel screening. Commercial diesel contamination by kerosene is highly difficult to be detected via physicochemical methods applied in market. Although the contamination may affect diesel quality and storage stability, there is a lack of efficient methodologies for this evaluation. This paper assessed the use of IR spectroscopies (MIR and NIR) coupled with partial least squares (PLS) regression, support vector machine regression (SVR), and multivariate curve resolution with alternating least squares (MCR-ALS) calibration models for quantifying and identifying the presence of kerosene adulterant in commercial diesel. Moreover, principal component analysis (PCA), successive projections algorithm (SPA), and genetic algorithm (GA) tools coupled to linear discriminant analysis were used to observe the degradation behavior of 60 samples of pure and kerosene-added diesel fuel in different concentrations over 60 days of storage. Physicochemical properties of commercial diesel with 15% kerosene remained within conformity with Brazilian screening specifications; in addition, specified tests were not able to identify changes in the blends' performance over time. By using multivariate classification, the samples of pure and contaminated fuel were accurately classified by aging level into two well-defined groups, and some spectral features related to fuel degradation products were detected. PLS and SVR were accurate to quantify kerosene in the 2.5–40% (v/v) range, reaching RMSEC < 2.59% and RMSEP < 5.56%, with high correlation between real and predicted concentrations. MCR-ALS with correlation constraint was able to identify and recover the spectral profile of commercial diesel and kerosene adulterant from the IR spectra of contaminated blends.

https://ift.tt/2tC8L8w

Ligand fishing with cellular membrane-coated cellulose filter paper: a new method for screening of potential active compounds from natural products

Abstract

Ligand fishing is a widely used approach for screening active compounds from natural products. Recently, cell membrane (CM) as affinity ligand has been applied in ligand fishing, including cell membrane chromatography (CMC) and CM-coated magnetic bead. However, these methods possess many weaknesses, including complicated preparation processes and time-consuming operation. In this study, cheap and easily available cellulose filter paper (CFP) was selected as carrier of CM and used to fabricate a novel CM-coated CFP (CMCFP) for the first time. The type of CFP was optimized according to the amount of immobilized protein, and the immobilization of CM onto CFP by the insertion and self-fusion process was verified by confocal imaging. The CMCFP exhibited good selectivity and stability and was used for fishing potentially active compounds from extracts of Angelica dahurica. Three potentially active compounds, including bergapten, pabulenol, and imperatorin, were fished out and identified. The traditional Chinese medicine systems pharmacology database and analysis platform was used to build an active compound-target protein network, and accordingly, the gamma-aminobutyric acid receptor subunit alpha-1 (GABRA1) was deduced as potential target of CM for the active compounds of Angelica dahurica. Molecular docking was performed to evaluate the interaction between active compounds and GABRA1, and bergapten was speculated as a new potentially active compound. Compared with other methods, the fishing assay based on CMCFP was more effective, simpler, and cheaper.

https://ift.tt/2H0Mpph

High titer MVA and influenza A virus production using a hybrid fed-batch/perfusion strategy with an ATF system

Abstract

A cultivation strategy to increase the productivity of Modified Vaccinia Ankara (MVA) virus in high-cell density processes is presented. Based on an approach developed in shake flask cultures, this strategy was established in benchtop bioreactors, comprising the growth of suspension AGE1.CR.pIX cells to high cell densities in a chemically defined medium before infection with the MVA-CR19 virus strain. First, a perfusion regime was established to optimize the cell growth phase. Second, a fed-batch regime was chosen for the initial infection phase to facilitate virus uptake and cell-to-cell spreading. Afterwards, a switch to perfusion enabled the continuous supply of nutrients for the late stages of virus propagation. With maximum infectious titers of 1.0 × 10¹⁰ IU/mL, this hybrid fed-batch/perfusion strategy increased product titers by almost one order of magnitude compared to conventional batch cultivations. Finally, this strategy was also applied to the production of influenza A/PR/8/34 (H1N1) virus considered for manufacturing of inactivated vaccines. Using the same culture system, a total number of 3.8 × 10¹⁰ virions/mL was achieved. Overall, comparable or even higher cell-specific virus yields and volumetric productivities were obtained using the same cultivation systems as for the conventional batch cultivations. In addition, most viral particles were found in the culture supernatant, which can simplify further downstream operations, in particular for MVA viruses. Considering the current availability of well-described perfusion/cell retention technologies, the present strategy may contribute to the development of new approaches for viral vaccine production.

https://ift.tt/2GEPSKN

A novel multi-atlas and multi-channel (MAMC) approach for multiple sclerosis lesion segmentation in brain MRI

Abstract

This paper presents a novel approach for automatic segmentation of MS lesion including both of number and volume. The novelty includes the combination of the multiplicative intrinsic component optimization algorithm (Li et al. in Magn Reson Imaging 32:913–923, 2014) in bias field correction and normal tissue segmentation simultaneously, and the development of a multi-atlas and multi-channel (MAMC) segmentation approach. The first research focus is the classification of brain tissue into white matter, cerebrospinal fluid and gray matter in T1-w image and FLAIR image. The second research focus is the segmentation of MS lesion in white matter region using atlas. In label fusion, the coefficient as a specific weight is assigned to target label image based on the correlation function between atlases. This novel MAMC approach is evaluated by 20 training cases obtained from Medical Image Computing and Computer Aided Intervention Society 2008 MS Lesions Segmentation Challenge. The numerical results are presented in terms of accuracy, specificity and absolute volume difference. A comparison of MAMC approach and other conventional approaches is presented in terms of the true positive rate and the positive predictive value. Furthermore, the total lesion volume is calculated and compared with expert delineation. It can be seen that the MAMC approach is able to acquire a larger mean value of the Dice similarity coefficient than the other conventional approaches do. Therefore, this novel approach is an added value for the clinical evaluation of MS patients.

https://ift.tt/2VhFWue

Impact of growth temperature on the adhesion of colistin-resistant Escherichia coli strains isolated from pigs to food-contact-surfaces

Abstract

This study investigated the effect of the growth temperature (20 and 37 °C) of Escherichia coli strains isolated from pigs on their adhesion to stainless steel and polycarbonate. This study also evaluated the ability of the DLVO and XDLVO mathematical models to predict this adhesion. The rise of growth temperature from 20 to 37 °C significantly influenced the adhesion of studied E. coli strains. The data also underlined that the mathematical prediction did not fully match with the experimental bacterial adhesion to surfaces. Furthermore, results showed that the colistin-resistant and sensitive E. coli strains adhesion depends on the type of abiotic surface. Based on these results, the mathematical models are limited in the prediction of the bacterial adhesion to abiotic surfaces. The surface roughness is a major parameter of the bacterial adhesion and should be included in the future mathematical models predicting the bacterial adhesion.

https://ift.tt/2NmRQQF

An ultra-high-performance liquid chromatography tandem mass spectrometry method for oxidative stress biomarker analysis in wastewater

Abstract

Reported herein is the development of an analytical method for the detection of four oxidative stress biomarkers in wastewater using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) and solid phase extraction (SPE). The following four biomarkers of oxidative stress and lipid peroxidation have been investigated: hydroxynonenal–mercapturic acid (HNE-MA), 8-iso-prostglandin F2beta (8-iso-PGF_2β), 8-nitroguanine (8-NO₂Gua) and 8-hydroxy-2-deoxyguanosine (8-OHdG). The method showed very good performance: accuracy (> 87%), precision (> 90%), method quantification limits (1.3–3.0 ng L⁻¹) and biomarker stability in wastewater in the case of HNE-MA, 8-OHdG and 8-iso-PGF_2β. In contrast, 8-NO₂Gua was found to be less stable in wastewater, which affected its method performance: accuracy (> 63%), precision (> 91%) and method quantification limits (85.3 ng L⁻¹). Application of the developed method resulted in, for the first time, HNE-MA being successfully observed and quantified within wastewater over a study period of a week (displayed average daily loads per capita of 48.9 ± 4.1 mg/1000/people/day). 8-iso-PGF_2β was detected with good intensity but could not be quantified due to co-elution with other isomers. 8-OHdG was detected, albeit at < MQL. This study demonstrates the potential for expanding on the possible endogenous biomarkers of health used in urban water fingerprinting to aid in measuring health in near-real time on a community-wide scale.

https://ift.tt/2BMHtkq

Correction to: Ruptured posterior circulation aneurysms: epidemiology, patterns of care, and outcomes from the Swiss SOS national registry

The name of Roy Thomas Daniel was incorrectly captured in the original manuscript.

https://ift.tt/2TbtrTf

Osteochondritis dissecans (OCD) in Horses – Molecular Background of its Pathogenesis and Perspectives for Progenitor Stem Cell Therapy

Abstract

Osteochondrosis (osteochondrosis dissecans; OCD) is a disease syndrome of growing cartilage related to different clinical entities such as epiphysitis, subchondral cysts and angular carpal deformities, which occurs in growing animals of all species, including horses. Nowadays, these disorders are affecting increasing numbers of young horses worldwide. As a complex multifactorial disease, OCD is initiated when failure in cartilage canals because of existing ischemia, chondrocyte biogenesis impairment as well as biochemical and genetic disruptions occur. Recently, particular attention have been accorded to the definition of possible relations between OCD and some metabolic disorders; in this way, implication of mitochondrial dysfunctions, endoplasmic reticulum disruptions, oxidative stress or endocrinological affections are among the most considered axes for future researches. As one of the most frequent cause of impaired orthopaedic potential, which may result in a sharp decrease in athletic performances of the affected animals, and lead to the occurrence of complications such as joint fragility and laminitis, OCD remains as one of the primary causes of considerable economic losses in all sections of the equine industry. It would therefore be important to provide more information on the exact pathophysiological mechanism(s) underlying early OC(D) lesions, in order to implement innovative strategies involving the use of progenitor stem cells, which are considered nowadays as a promising approach to regenerative medicine, with the potential to treat numerous orthopaedic disorders, including osteo-degenerative diseases, for prevention and reduction of incidence of the disease, not only in horses, but also in human medicine, as the equine model is already widely accepted by the scientific community and approved by the FDA, for the research and application of cellular therapies in the treatment of human conditions.

https://ift.tt/2BSdE1X

Engineering for Success: Approaches to Improve Chimeric Antigen Receptor T Cell Therapy for Solid Tumors

Abstract

While impressive clinical responses have been observed using chimeric antigen receptor (CAR) T cells targeting CD19+ hematologic malignancies, limited clinical benefit has been observed using CAR T cells for a variety of solid tumors. Results of clinical studies have highlighted several obstacles which CAR T cells face in the context of solid tumors, including insufficient homing to tumor sites, lack of expansion and persistence, encountering a highly immunosuppressive tumor microenvironment, and heterogeneous antigen expression. In this review, we review clinical outcomes and discuss strategies to improve the antitumor activity of CAR T cells for solid tumors.

https://ift.tt/2SkuGLu

Cluster headache in relation to different age groups

Abstract

Cluster headache (CH) has always been considered a type of primary headache affecting predominantly male subjects in early and medium adulthood. However, recent studies carried out in large case series of patients with CH show that not infrequently it may set in also after age 50; by contrast, onset before adolescence is very rare. Additionally, when onset occurs before age 14 or from the sixth decade of life onward, male predominance decreases to the point that in chronic forms CH predominantly affects the female sex. This particular pattern of the gender ratio in relation to onset in different age groups suggests that hormonal factors may actually play a role in the genesis of CH. In particular, future studies should be aimed at investigating the possible protective role of estrogen.

https://ift.tt/2U3j9lD

Protective effects of atorvastatin on high glucose-induced oxidative stress and mitochondrial apoptotic signaling pathways in cultured chondrocytes

Abstract

The high glucose concentration is able to disturb chondrocyte homeostasis and contribute to OA pathogenesis. This study was designed to investigate the protective effects of atorvastatin (ATO) on high glucose (HG)-mediated oxidative stress and mitochondrial apoptosis in C28I2 human chondrocytes. The protective effect of ATO (0.01 and 0.1 μM) on HG (75 mM)-induced oxidative stress and apoptosis was evaluated in C28I2 cells. The effects of ATO on HG-induced intracellular ROS production and lipid peroxidation were detected and the protein expression levels of Bax, Bcl-2, caspase-3, total and phosphorylated JNK and P38 MAPKs were analyzed by Western blotting. The mRNA expression levels of antioxidant enzymes including heme oxygenase-1, NAD(P)H quinine oxidoreductase, glutathione S-transferase-P1, catalase, superoxide dismutase-1, glutathione peroxidase-1, -3, -4 were evaluated by reverse transcription-polymerase chain reaction. Pretreatment with ATO remarkably increased the gene expression levels of antioxidant enzymes and reduced HG-induced elevation of ROS, lipid peroxidation, Bax/Bcl-2 ratio, caspase-3 activation, and JNK and P38 phosphorylation. Atorvastatin could considerably reduce HG-induced oxidative stress and mitochondrial apoptosis through increasing the expression of antioxidant enzymes. Atorvastatin may be considered as a promising agent to prevent high glucose-induced cartilage degradation in OA patients.

https://ift.tt/2STyGI1

Decision Regret up to 4 Years After Gastric Bypass and Gastric Banding

Abstract

Background

Weight loss surgery (WLS) is neither risk-free nor universally effective. Few studies have examined what proportion of patients regret having undergone WLS.

Methods

We interviewed patients at two WLS centers before and after WLS about weight loss, quality of life/QOL (Impact of Weight on QOL-lite), and decision regret (modified Brehaut Regret scale, range 0–100). We conducted separate multivariable logistic regression models to examine the association between weight loss and ∆QOL scores and having decision regret (score > 50).

Results

Of 205 RYGB patients, only 2.2% (year 1) to 5.1% (year 4, n = 134) reported regret scores > 50 over 4 years; 2.0–4.5% did not think they made the right decision; 2.0–4.5% would not undergo WLS again. In contrast, of 188 gastric banding patients (n = 123 at year 4), 8.2–20.3% had regret scores > 50; 5.9–19.5% did not think they made the right decision; 7.1–19.5% would not undergo WLS again. Weight loss and ∆QOL scores were significant correlates of decision regret after banding although weight loss was a stronger correlate with lower model quasi-likelihood under the independence model criterion score. Four years after banding, mean weight loss for patients with regret scores > 50 was 7.4% vs. 21.1% for those with scores < 50; the AOR for regret score > 50 was 0.90 (95% CI 0.87–0.94) for every 1% greater weight loss. Poor sexual function, but not weight loss or other QOL factors, was significantly correlated with decision regret after RYGB.

Conclusion

Few patients regret undergoing RYGB but 20% regret undergoing gastric banding with weight loss being a major driver.

https://ift.tt/2tyQAkc

Influence of interfacial bonding conditions on the anti-penetration performance of ceramic/metal composite targets

Abstract

This study analyzes the influence of bonded and unbonded interface conditions on the anti-penetration performance of a ceramic/metal composite target and determines the associated mechanism. The 3D finite element and 3D smoothed particle hydrodynamics simulation results revealed that a bonded ceramic/metal target exhibited better anti-penetration performance than an unbonded target, and the associated mechanism was determined. Notably, the bond strength between the ceramic and metal backplate plays an important role in the formation of the ceramic conoid, and the ceramic conoid that formed in the bonded target effectively consumed the kinetic energy of the projectile, thereby improving the anti-penetration performance of ceramic composite armor. To verify this conclusion, we also compare and analyze the anti-penetration performance of interface bonded and unbonded metal/metal composite targets. The results show that due to the absence of the ceramic conoid, the interfacial bonding conditions have little influence on the anti-penetration performance of a metal/metal composite target.

https://ift.tt/2T9w8EX

Detection and measurements of apical lesions in the upper jaw by cone beam computed tomography and panoramic radiography as a function of cortical bone thickness

Abstract

Objectives

In the current literature, cone beam computed tomography (CBCT) seems to be more accurate in detecting apical lesions (AL) than two-dimensional radiographs. Cortical bone thickness might have an influence on AL visibility. Therefore, the purpose of the study was to directly compare the diagnostic accuracy of panoramic radiography (PANO) and CBCT in detecting AL in the upper jaw and determine the influence of cortical bone thickness on AL visibility.

Materials and methods

Anonymised digital images of 351 patients who received a CBCT image and a panoramic radiograph within 90 days were examined for AL in the upper jaw. The analysis was conducted by a trained examiner and reviewed by an expert in dental radiology. Further, the dimensions of AL and cortical bone thickness in the region affected by AL were measured to determine their influence on visibility. Statistical analysis was carried out by means of statistical software (IBM SPSS 25; Armonk, NY, USA).

Results

The mean age of the patients was 58.9 years with an almost equal gender distribution. A total of 2223 teeth in the upper jaw were included in the final analysis. CBCT detected AL on 144 teeth (6.5%), of which only 23 were also visible on a PANO. The difference between both methods was significant (p < 0.001). The dimensions of AL measured within a PANO were approximately twice as high as those measured by CBCT. However, the difference was not significant (p ≥ 0.005). Cortical bone thickness had no influence on AL visibility.

Conclusions and clinical relevance

Panoramic radiographs are unsuitable for a reliable diagnosis of AL in the upper jaw, while CBCT leads to a better visualisation of AL. Bone thickness has no significant influence on AL visibility with either imaging method.

https://ift.tt/2Taozhm

Quantitative Characterization of Aortic Valve Endothelial Cell Viability and Morphology In Situ Under Cyclic Stretch

Abstract

Current protocols for mechanical preconditioning of tissue engineered heart valves have focused on application of pressure, flexure and fluid flow to stimulate collagen production, ECM remodeling and improving mechanical performance. The aim of this study was to determine if mechanical preconditioning with cyclic stretch could promote an intact endothelium that resembled the viability and morphology of a native valve. Confocal laser scanning microscopy was used to image endothelial cells on aortic valve strips subjected to static incubation or physiological strain regimens. An automated image analysis program was designed and implemented to detect and analyze live and dead cells in images captured of a live aortic valve endothelium. The images were preprocessed, segmented, and quantitatively analyzed for live/dead cell ratio, minimum neighbor distance and circularity. Significant differences in live/dead cellular ratio and the minimum distance between cells were observed between static and strained endothelia, indicating that cyclic strain is an important stimulus for maintaining a healthy endothelium. In conclusion, in vitro application of physiological levels of cyclic strain to tissue engineered heart valves seeded with autologous endothelial cells would be advantageous.

https://ift.tt/2GKA35B

Treatment of Hexavalent Chromium Contaminated Wastewater Using Activated Carbon Derived from Coconut Shell Loaded by Silver Nanoparticles: Batch Experiment

Abstract

Chromium (Cr(VI)) causes serious impacts on the environment and human. In this study, the commercial activated carbon-loaded silver nanoparticle (AgNPs-AC) was used as a new adsorbent to remove Cr(VI) from the aqueous solution. Batch adsorption experiments were conducted to evaluate the effects of pH, the initial concentration of Cr(VI), contact time, and dose of AgNPs-AC upon removal of Cr(VI) from the aqueous solution. The results showed that at pH of 4, the contact time of 150 min, 40 mg/L of initial Cr(VI), and dosage of 20 mg AgNPs-AC/25 mL were the most suitable condition for absorption of Cr(VI) onto AgNPs-AC from the aqueous solution. The maximum adsorption capacity achieved at abovementioned conditions was 27.70 mg/g. Meanwhile, the adsorption capacity of commercial activated carbon from a coconut shell obtained only 7.61 mg/g in the case where the initial Cr(VI) concentration is 10 mg/L and the contact time is 60 min. The adsorption kinetic data were found to fit best to the pseudo-second-order model with a high correlation coefficient (R² = 0.9597). The adsorption process was controlled by chemisorption due to the appearance of new chemical species on the adsorbent surface. The positively charged functional groups rapidly reduced Cr(VI) to Cr(III), and Cr(III) was subsequently adsorbed by the carboxyl group on the adsorbent's surface. From this study, it can be concluded that AgNPs-AC is a fully promising, low-cost adsorbent in the removal of Cr(VI) from the aqueous solution.

https://ift.tt/2GKAoVV

International Conference on Ferromagnetic Shape Memory Alloys, ICFSMA’19

https://ift.tt/2Nl7T1e

Efficacy and Safety of Valproic Acid for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis

Abstract

Background

Spinal muscular atrophy (SMA) is a neuromuscular disorder classified into four types based on the age of onset of the disease. Early onset is correlated with a higher mortality rate, mainly due to respiratory complications. Valproic acid (VPA) is a histone deacetylase (HDAC) inhibitor that has shown positive results on SMA both in experimental and cohort studies.

Objectives

This systematic review and meta-analysis aimed to investigate the efficacy and safety of VPA in patients with SMA.

Methods

Eleven databases were systematically searched on 30 May 2017 for clinical trials that reported the efficacy and safety of VPA in SMA patients. The primary outcome was the efficacy of VPA in terms of gross motor function and expression of both full-length spinal motor neuron (SMN) gene (FL-SMN) and exon 7-lacking SMN. The secondary outcome was the safety of VPA in terms of reported adverse effects. The protocol was registered at PROSPERO (CRD42017067203).

Results

Five of the ten included studies were used in the meta-analysis (n = 126). The overall effect estimate, comparing pre- and post-VPA treatment, regardless of carnitine co-administration and design of the studies, showed significant improvement in gross motor function (standard mean difference [SMD] = 0.302, 95% confidence interval [CI] 0.048–0.556, P = 0.02) using the Hammersmith Functional Motor Scale (HFMS), Modified Hammersmith Functional Motor Scale (MHFMS), and MHFMS-Extend, with no significant heterogeneity. Similarly, in non-randomized controlled studies, the results indicated that there was a significant improvement detected (SMD = 0.335, 95% CI 0.041–0.628, P = 0.025), with no significant heterogeneity. Meanwhile, our results suggest that there was no significant improvement in treatment with co-administered carnitine (SMD = 0.28, 95% CI − 0.02 to 0.581, P = 0.067). No significant differences were found between pre- and post-VPA treatment co-administered with carnitine, in terms of the change in FL-SMN and exon 7-lacking SMN. Qualitative synthesis showed that other motor functions were not improved, while respiratory function test results were contradictory. Regarding the safety of the treatment, a double-blind, randomized, placebo-controlled trial reported no statistically significant differences for adverse events (AEs) between groups. Moreover, most of the included studies reported no serious AEs related to VPA use, although weight gain, gastrointestinal symptoms and respiratory symptoms were notable problems.

Conclusions

Our study suggests that VPA treatment results in an improvement in gross motor functions for SMA patients, but not in other assessments of motor function or, possibly, in respiratory function. Furthermore, VPA appears to be a relatively safe drug, although treatment may be associated with a wide range of AEs (including body weight increase, fatigue, fever, flu-like symptoms, irritability, and pain). Double-blind, randomized, controlled trials are required to confirm these findings.

https://ift.tt/2BO05jX

Top-Down Analysis of Proteins in Low Charge States

Abstract

The impact of charging methods on the dissociation behavior of intact proteins in low charge states is investigated using HCD and 193 nm UVPD. Low charge states are produced for seven different proteins using the following four different methods: (1) proton transfer reactions of ions in high charge states generated from conventional denaturing solutions; (2) ESI of proteins in solutions of high ionic strength to enhance retention of folded native-like conformations; (3) ESI of proteins in high pH solutions to limit protonation; and (4) ESI of carbamylated proteins. Comparison of sequence coverages, degree of preferential cleavages, and types and distribution of fragment ions reveals a number of differences in the fragmentation patterns depending on the method used to generate the ions. More notable differences in these metrics are observed upon HCD than upon UVPD. The fragmentation caused by HCD is influenced more significantly by the presence/absence of mobile protons, a factor that modulates the degree of preferential cleavages and net sequence coverages. Carbamylation of the lysines and the N-terminus of the proteins alters the proton mobility by reducing the number of proton-sequestering, highly basic sites as evidenced by decreased preferential fragmentation C-terminal to Asp or N-terminal to Pro upon HCD. UVPD is less dependent on the method used to generate the low charge states and favors non-specific fragmentation, an outcome which is important for obtaining high sequence coverage of intact proteins.

https://ift.tt/2BNV2Al

Online Sol-gel Capillary Microextraction-Mass Spectrometry (CME-MS) Analysis of Illicit Drugs

Abstract

Providing rapid and sensitive sample cleanup, sol-gel capillary microextraction (CME) is a form of solid phase microextraction (SPME). The capillary format of CME couples easily with mass spectrometry (MS) by employing sol-gel sorbent coatings in inexpensive fused silica capillaries. By leveraging the syringe pump and six-port valve readily available on the commercial MS, we can obviate the need for chromatography for samples as complex as urine in quantitative assays. Two different sol-gel materials were studied as microextraction sorbents: one with a single ligand of octadecyl (C₁₈) and the other with a dual-ligand combination of C₁₈ and phenyl (Phe) groups. The CME-MS method was optimized for flow rate and solvent desorption and studied for overall microextraction performance between the two sorbents studied. We extract illicit drugs including cocaine, heroin, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, and oxycodone, proving good run-to-run reproducibility (RSD% < 10%) and low detection limits (< 10 ng mL⁻¹). The dual-ligand sorbent demonstrated superior performance due to typical hydrophobic properties of C₁₈ as well as potential π-π interactions of the Phe functionality and the aromatic moiety common to many drugs. This study demonstrates the advantage of fine-tuning sol-gel sorbents for application-specific CME-MS. We apply our method to the analysis of various drugs in synthetic and human urine samples and show low carryover effect (~ 5%) and low matrix effect in the presence of the urine matrix. Thus, the sol-gel CME-MS technique described herein stands to be an attractive alternative to other SPME-MS techniques.

https://ift.tt/2U4o5GG

A perspective on the diagnostics, prognostics, and therapeutics of microRNAs of triple-negative breast cancer

Abstract

Triple-negative breast cancer (TNBC) is the most aggressive and prevalent subtype of breast cancer in women worldwide. Currently, chemotherapy remains the main modality for the treatment at an early stage, as there is no approved targeted therapy for early TNBC. In this review, we investigate the use of microRNAs (miRNAs), which play a key role in the post-transcriptional regulation of genes involved in the key biological processes, namely proliferation, differentiation, angiogenesis, migration, apoptosis, and carcinogenesis. Here, we emphasize the importance of the recent advances related to miRNAs, involving diagnosis, prognosis, and treatment of TNBC. We focus on the development, optimization, and stabilization of miRNA-based drugs; improvement of miRNA delivery; and control of the off-target effects of miRNA therapeutics. We speculate as to which features may present themselves as promising approaches in the treatment of TNBC.

https://ift.tt/2E7Oehd

Emergence of synaptic and cognitive impairment in a mature-onset APP mouse model of Alzheimer’s disease

Abstract

The synaptic changes underlying the onset of cognitive impairment in Alzheimer's disease (AD) are poorly understood. In contrast to the well documented inhibition of long-term potentiation (LTP) in CA3-CA1 synapses by acute Aβ application in adult neurons from rodents, young amyloid precursor protein (APP) transgenic mouse models often, surprisingly, show normal LTP. This suggests that there may be important differences between mature-onset and developmental-onset APP expression/ Aβ accumulation and the ensuing synaptic and behavioural phenotype. Here, in agreement with previous studies, we observed that developmental expression of APP_Sw,Ind (3–4 month old mice from line 102, PLoS Med 2:e355, 2005), resulted in reduced basal synaptic transmission in CA3-CA1 synapses, normal LTP, impaired spatial working memory, but normal spatial reference memory. To analyse early Aβ-mediated synaptic dysfunction and cognitive impairment in a more mature brain, we used controllable mature-onset APP_Sw,Ind expression in line 102 mice. Within 3 weeks of mature-onset APP_Sw,Ind expression and Aβ accumulation, we detected the first synaptic dysfunction: an impairment of LTP in hippocampal CA3-CA1 synapses. Cognitively, at this time point, we observed a deficit in short-term memory. A reduction in basal synaptic strength and deficit in long-term associative spatial memory were only evident following 12 weeks of APP_Sw,Ind expression. Importantly, the plasticity impairment observed after 3 weeks of mature-onset APP expression is reversible. Together, these findings demonstrate important differences between developmental and mature-onset APP expression. Further research targeted at this early stage of synaptic dysfunction could help identify mechanisms to treat cognitive impairment in mild cognitive impairment (MCI) and early AD.

https://ift.tt/2Vd1EPJ

Intranasal Losartan Decreases Perivascular Beta Amyloid, Inflammation, and the Decline of Neurogenesis in Hypertensive Rats

Abstract

The contribution of the local angiotensin receptor system to neuroinflammation, impaired neurogenesis, and amyloid beta (Aβ) accumulation in Alzheimer's disease (AD) and in hypertension is consistent with the remarkable neuroprotection provided by angiotensin receptor blockers (ARBs) independent of their blood pressure-lowering effect. Considering the causal relationship between hypertension and AD and that targeting cerebrovascular pathology with ARBs does not necessarily require their systemic effects, we tested intranasal losartan in the rat model of chronic hypertension (spontaneously hypertensive stroke-prone rats, SHRSP). Intranasal losartan at a subdepressor dose decreased mortality, neuroinflammation, and perivascular content of Aβ by enhancing key players in its metabolism and clearance, including insulin-degrading enzyme, neprilysin, and transthyretin. Furthermore, this treatment improved neurologic deficits and increased brain IL-10 concentration, hippocampal cell survival, neurogenesis, and choroid plexus cell proliferation in SHRSP. Losartan (1 μM) also reduced LDH release from cultured astroglial cells in response to toxic glutamate concentrations. This effect was completely blunted by IL-10 antibodies. These findings suggest that intranasal ARB treatment is a neuroprotective, neurogenesis-inducing, and Aβ-decreasing strategy for the treatment of hypertensive stroke and cerebral amyloid angiopathy acting at least partly through the IL-10 pathway.

https://ift.tt/2TgOofX

Microbial Bioleaching of Ag, Au and Cu from Printed Circuit Boards of Mobile Phones

Abstract

Electronic waste (E-Waste) is consumed at high speed in the world. These residues contain metals that increase their price each year, generating new research on the ability of microorganisms to recover the metals from these wastes. Therefore, this work evaluated the biologic lixiviation of Cu, Ag and Au from printed circuit boards (PCB) of mobile phones by three strains of Aspergillus niger, Candida orthopsilosis, Sphingomonas sp. and their respective consortia, in addition to leaching with citric acid. The microorganisms were cultured in mineral media with 0.5 g of PCB, and the treatments with 1M citric acid were added the same amount of PCB. All treatments were incubated for 35 days at room temperature. The results showed that Sphingomonas sp. MXB8 and the consortium of C. orthopsilosis MXL20 and A. niger MXPE6 can increase their dry biomass by 147% and 126%, respectively, in the presence of PCB. In the bioleaching of metals, the inoculation of A. niger MXPE6, the consortium of Sphingomonas sp. MXB8/C. orthopsilosis MXL20 and Sphingomonas sp. MXB8 leached 54%, 44.2% and 35.8% of Ag. The consortium of A. niger MX5 and A. niger MXPE6 showed a leaching of 0.53% of Au. A. niger MX5 leaching 2.8% Cu. Citric acid increased Cu leaching by 280% compared to treatments inoculated with microorganisms. Although further research is required, A. niger MXPE6 and the consortium of Sphingomonas sp. MXB8/C. orthopsilosis MXL20 could be an alternative to recover Ag from PCB of mobile phones.

https://ift.tt/2GFjLLe

Journal of Clinical Monitoring and Computing 2017/2018 end of year summary: monitoring—and provocation—of the microcirculation and tissue oxygenation

Abstract

The microcirculation is the ultimate goal of hemodynamic optimization in the perioperative and critical care setting. In this fourth end-of-year summary of the Journal of Clinical Monitoring and Computing on this topic, we take a closer look at papers published in the last 2 years that focus on this important aspect. The majority of these papers investigated the use of either cerebral or peripheral tissue oxygen saturation, derived non-invasively using near infrared spectroscopy (NIRS). In some of these studies, the microcirculation was "provocated" by inducing short-term tissue hypoxia, allowing the assessment of functional microvascular reserve. Additionally, studies on technical differences between NIRS monitors are summarized, as well as studies investigating the feasibility of NIRS monitoring, mainly in the pediatric patient population. Last but not least, novel monitoring tools allow assessing oxygenation at a (sub)cellular level, and those papers incorporating these techniques are also reviewed here.

https://ift.tt/2txTN3B

Cardinal color fusion network for single image haze removal

Abstract

Haze during bad weather degrades visibility of the scene drastically. Degradation of the scene visibility varies concerning the transmission map (TrMap) of the scene. Estimation of accurate TrMap is a key step to reconstruct the haze-free scene. Previous approaches, DehazeNet (Cai et al. in IEEE Trans Image Process 25(11):5187–5198, 2016), MSCNN (Ren et al., in: European conference on computer vision, Springer, New York, 2016), overcome the drawbacks of handcrafted features. However, they fail to recover the haze-free scene without color distortion. In this paper, cardinal color (red, green and blue) fusion network is proposed to estimate the robust TrMap. Proposed network recovers haze-free scene without color distortion. In the first stage, it generates multi-channel depth maps using a novel parallel convolution filter bank. The second stage comprises of multi-scale convolution filter bank which extracts the scale-invariant features. Further, spatial pooling followed by convolution filter estimates the robust scene transmission map. In the last stage, estimated TrMap is given to the optical model to recover the haze-free scene. Three benchmark datasets namely D-HAZY (Ancuti et al., in: 2016 IEEE international conference on image processing (ICIP), 2016), ImageNet (Deng et al., in: IEEE conference on computer vision and pattern recognition, 2009 (CVPR 2009), 2009) and a set of real-world hazy scenes are used to analyze the effectiveness of the proposed approach. Structural similarity index, mean square error and peak signal-to-noise ratio are used to evaluate the proposed network for single image haze removal. Further, the effect of haze on object detection is analyzed and robust cascaded pipeline, i.e., haze removal followed by Faster RCNN is proposed for object detection in the hazy environment. Performance analysis shows that the proposed network estimates robust TrMap and recovers haze-free scene without color distortion.

https://ift.tt/2SUeTZ5

A High Efficient Method to Isolate Exosomes from Small Intestinal Epithelium

Abstract

The intestinal epithelium is an important receptor that is not only exposed to nutrients but also to pathogens, such as ingested toxins, bacterial flora, and their metabolites. The sensory information is communicated to extensive endocrine, neural, immune systems, and the exosomes acts as carriers of communication from cell-to-cell. Isolation of exosomes from small intestinal epithelium remains more complex to obtain as a source of exosomes, as it contains varying proportions of exosomes derived from many different cells. Current studies on exosomes have been largely performed using supernatants of cultured cells. This is because, in a cell culture, the origin of exosomes can be determined and isolation of exosomes devoid of 'contaminating' proteins, lipids, and sugars involves relatively simple composition of most culture media facilitates. However, this is hard to achieve in intestinal epithelial cells (IECs) due to several technical issues, including recapitulation of in vivo physiology, operational simplicity, culture stability over time, and assay throughput. Meanwhile, separation of exosomes from a specific cell type remains to be a considerable problem, as the isolated supernatant exosomal fraction may represent only a small fraction of the total instead of reflecting the overall situation. Herein, we proposed an efficient protocol for enrichment of exosomes from the interstitial space of small intestinal epithelium. This method maintains the integrity of the vesicles as well as their contents. Also, it may help to better understand the properties of exosomes and explore their role in cell-to-cell communication of small intestinal epithelium.

https://ift.tt/2T2XyMX

Quantitative computed tomography for predicting cardiopulmonary complications after lobectomy for lung cancer in patients with chronic obstructive pulmonary disease

Abstract

Objectives

In lung cancer resection, chronic obstructive pulmonary disease is a risk factor for post-operative complications. Few studies on post-operative complications of lung cancer resection have considered radiographic emphysematous change as an index. Here, we have examined the relationship between the regional ratio of the emphysematous area in pre-operative computed tomography images and cardiopulmonary complications in patients with chronic obstructive pulmonary disease who underwent lung cancer resection.

Methods

We retrospectively evaluated 159 patients with chronic obstructive pulmonary disease who underwent lobectomy for lung cancer at Shizuoka Cancer Center Hospital, Shizuoka, Japan, between 2002 and 2011. Pre-operative factors, including the proportion of the emphysematous area measured by computed tomography as a percentage of the low attenuation area (LAA%), as well as intraoperative factors were analyzed. Cardiopulmonary complications, including pyothorax, pneumonia and atelectasis, acute pulmonary injury, indwelling chest tube, long duration of oxygen supply, and arrhythmia, were evaluated.

Results

Cardiopulmonary complications were observed among 61 patients (38%). Univariate analysis revealed that patient age, percentage of forced expiratory volume in 1 s, LAA%, and volume of blood loss were significantly associated with cardiopulmonary complications. Multivariate analysis indicated patient age and LAA% as being significant independent predictors of cardiopulmonary complications.

Conclusions

The regional ratio of the emphysematous area is useful for predicting cardiopulmonary complications in patients with chronic obstructive pulmonary disease who undergo lobectomy for lung cancer. In such patients who are also ≥ 70 years of age and exhibit LAA% ≥ 1.0%, careful intra- and post-operative management is warranted.

https://ift.tt/2ItGZ8B

Reliability of calcium–phosphorus (Ca/P) ratio as a new, accurate and inexpensive tool in the diagnosis of some Ca–P disorders

Abstract

Purpose

The serum calcium/phosphorus (Ca/P) ratio is an accurate tool to differentiate patients with primary hyperparathyroidism (PHPT) from healthy subjects. However, other disorders of the Ca–P metabolism might impair the Ca/P ratio, such as hypophosphatemia (HypoP) not PHPT related. The aim of this study is to examine the diagnostic value of Ca/P ratio in the diagnosis of PHPT and HypoP not PHPT related.

Methods

Single-center, retrospective, case–control study, including 150 patients with PHPT and 306 patients with HypoP, compared with 150 controls. HypoP patients were enrolled among HIV-infected patients by selecting those with Fanconi-like syndrome due to antiretroviral treatment. Parameters which were measured were serum Ca, P, parathyroid hormone (PTH), 25-OH vitamin D, albumin and creatinine).

Results

The Ca/P ratio was significantly higher in PHPT and HypoP patients, compared to controls (p < 0.0001). At receiver operator characteristic (ROC) curve analysis, the cut-off of 3.56 (2.75 SI) for Ca/P ratio was able to identify patients with PHPT and HypoP (sensitivity 95%; specificity 93%). Among patients with Ca/P ratio above 3.56, the thresholds of 10.3 mg/dL (2.6 mmol/L) for serum Ca (sensitivity 93%; specificity 98%) and 80.5 pg/mL for PTH (sensitivity 91%; specificity 91%) were defined for the specific diagnosis of PHPT.

Conclusions

The Ca/P ratio above 3.56 (2.75 SI) is a highly accurate tool to identify PHPT and HypoP not PHPT-related patients. Thanks to its simplicity, this index can be proposed as a screening and first-line examination in the diagnostic work-up when a disorder of Ca–P metabolism is suspected or should be ruled out.

https://ift.tt/2EqXnCP

A genetic algorithm for spatiosocial tensor clustering

Abstract

Tensor clustering is a knowledge management technique which is well known as a major algorithmic and technological driver behind a broad applications spectrum. The latter ranges from multimodal social media analysis and geolocation processing to analytics tailored for large omic data. However, known exact tensor clustering problems when reduced to tensor factorization are provably NP hard. This is attributed in part to the volume of data contained in a tensor, proportional to the product of its dimensions, as well as to the increased interdependency between the tensor entries across its dimensions. One well studied way to circumvent this inherent difficulty is to resort to heuristics. This article presents an enhanced version of a genetic algorithm tailored for community discovery structure in tensors containing spatiosocial data, namely linguistic and geolocation data. The objective function as well as the chromosome fitness functions by design take into account elements of linguistic propagation models. The genetic operators of selection, crossover, and mutation as well as the newly added double mutation operator work directly on the community level. Moreover, various policies for maintaining gene variability across generations are studied in an extensive simulation powered by Google TensorFlow. As with its predecessor, the proposed genetic algorithm has been applied to a dataset consisting of a large number of Tweets and their associated geolocations from the Grand Duchy of Luxembourg, a historically and de facto trilingual country. The results are compared with those obtained from the original genetic algorithm and their differences are interpreted.

https://ift.tt/2SRmk3l

Characterization of the binding of tau imaging ligands to melanin-containing cells: putative off-target-binding site

Abstract

Objective

Amyloid-β plaques and neurofibrillary tangles composed of tau protein are the neuropathological hallmarks of Alzheimer's disease. In recent years, marked progress has been made in Alzheimer's disease research using tau ligands for positron emission tomography (PET). However, the issue of off-target binding, that is, the binding of ligands to regions without tau pathology, remains unresolved. Tissues with melanin-containing cells (MCCs) have been suggested as binding targets for tau ligands. In the present study, we characterized the MCC-binding properties of representative tau PET ligands.

Methods

Autoradiographic studies of [¹⁸F]AV-1451 and [¹⁸F]THK5351 were conducted using postmortem human midbrain sections. Saturation-binding assays of [¹⁸F]AV-1451 and [¹⁸F]THK5351 were performed with B16F10 melanoma cells. The blocking effects of 25 compounds against [¹⁸F]THK5351 binding to B16F10 cells were used to investigate the relationship between chemical structure and MCC binding.

Results

Autoradiography demonstrated specific binding of the radioligands in the substantia nigra. [¹⁸F]AV-1451 and [¹⁸F]THK5351 exhibited saturable binding to melanoma cells ([¹⁸F]AV-1451: K_d = 669 ± 196 nM, B_max = 622 ± 269 pmol/mg protein; [¹⁸F]THK5351: K_d = 441 ± 126 nM, B_max = 559 ± 75.5 pmol/mg protein). In blocking studies with melanoma cells, compounds bearing multiple aromatic rings and an aminopyridine group, including tau ligands such as AV-1451, PBB3, and a lead compound of MK-6240, exhibited the inhibition of [¹⁸F]THK5351 binding comparable to self-blocking by THK5351 (> 70% at 10 µM).

Conclusions

These studies suggest that the binding properties of [¹⁸F]AV-1451 and [¹⁸F]THK5351 are sufficient to expect highlighting of tissues with a high density of MCCs. The findings of the present study should aid the development of neuroimaging ligands that do not bind to MCC.

https://ift.tt/2U00rLu

Thyroid hormones act as mitogenic and pro survival factors in rat ovarian follicles

Abstract

Purpose

Thyroid disorders are clinically associated with impaired fertility in women, and these abnormalities can be improved by restoring the euthyroid state. The exact mechanisms of thyroid effect on female fertility are not well known; however, it is conceivable that thyroid hormones (THs) might act on ovarian physiology via receptors in granulosa cells. This work is aimed at evaluating the effects of THs on non-tumoral granulosa cells and follicles.

Methods

Freshly isolated rat ovarian follicles and granulosa cells were exposed to T3 or T4 (THs). Cell growth and viability were evaluated by cell counting and the MTT assay, respectively, follicle growth was evaluated by volume measurements. Apoptosis was evaluated by the TUNEL assay and active Caspase 3 staining. rGROV cells were exposed to T3, and apoptosis was induced by serum deprivation. Bcl2, Bcl-2-associated X protein (BAX), Akt and pAkt expression were evaluated by western blot.

Results

T3 induced a 40% increase in follicle volume (after 7 days). This increase was presumably due to the observed decrease (33%) in the apoptotic rate of the granulosa cell population. Both T3 and T4 caused a dose-dependent increase in rat granulosa cell number and viability. In addition, THs decreased the cell apoptotic rate in a dose-dependent manner. In both conditions, T3 appeared to be more efficient. In rGROV cells, 100 nM T3 induced cell growth and, in the absence of growth factors, reduced cell apoptosis by 40%, downregulating Caspase 3 and BAX. This effect was associated with an increase in pAkt levels. The involvement of the PI3 K pathway was confirmed by the ability of the PI3 K specific inhibitor (LY-294,002) to abolish T3 pro-survival action.

Conclusions

THs influence cell survival of ovarian granulosa cells. This effect likely contributes to the TH-induced follicle volume increase.

https://ift.tt/2KiJ0V6

Follow-up of parenchymal changes in the thyroid gland with diffuse autoimmune thyroiditis in children prior to the development of papillary thyroid carcinoma

Abstract

Purpose

To present the outcomes of ultrasound (US) follow-ups in children with autoimmune thyroid disease who did not have a thyroid nodule on admission but developed papillary thyroid carcinoma (PTC) and to characterize the parenchymal changes in the thyroid gland prior to the development of PTC.

Methods

A retrospective thyroid US scan review of 327 patients diagnosed with AIT was performed. Forty patients (40/327, 12.2%) presented nodular AIT variant with a normoechogenic background. Eleven patients (11/327, 3.4%, 11/40, 27.5%) presenting this variant were diagnosed with PTC (nine females—mean age 15.3 years; two males aged 11 and 13 years). In five of 11 patients, the suspicious nodule that was later confirmed to be PTC was detected on the initial US at presentation. For the remaining six females (6/11) who developed PTC during the follow-up, we retrospectively analysed their US thyroid scans and these patients were selected for analysis in this study.

Results

On admission, the US evaluation revealed an enlarged normoechogenic thyroid gland in three patients and a hypoechogenic thyroid gland with fibrosis as indicated by irregular, chaotic hyperechogenic layers in three patients. No thyroid nodules were identified. Ultrasound monitoring revealed increasing echogenicity of the thyroid parenchyma during the follow-up. PTC developed in a mean time of 4.6 years (1 9/12–7 4/12 years) since referral to the outpatient thyroid clinic and 2.9 years (6/12–6 9/12) since the last nodule-free US thyroid scan.

Conclusions

Sonographic follow-up assessments warrant further exploration as a strategy to determine PTC susceptibility in the paediatric population.

https://ift.tt/2Jfg3tv

Mystical marriage of Saint Catherine by Paolo Veronese (1528–1588)

https://ift.tt/2SUrqLV

Peptide receptor radionuclide therapy with 177 Lu-DOTA-TATE as a promising treatment of malignant insulinoma: a series of case reports and literature review

Abstract

Introduction

Insulinomas are a rare type of pancreatic neuroendocrine tumours characterized by insulin hypersecretion. They are considered malignant when metastases are present. Traditional therapies often promote only temporarily symptomatic relief and may be associated with severe adverse effects. There is scarce experience in treating malignant insulinomas with peptide receptors radionuclide therapy (PRRNT).

Patients and methods

We describe PRRNT results in four patients with inoperable malignant insulinomas with poorly controllable hypoglycaemia. All patients received therapy with ¹⁷⁷Lu-DOTA-TATE after conventional therapies failed in controlling disease progression and symptoms. The activity administered per cycle was 4.8–7.4 GBq. The interval between cycles was 10–16 weeks. Haematology, liver and kidney function tests were performed before treatment initiation and 5 and 10 weeks after each cycle.

Results

Patient 1 presented significant clinical benefit for 13 months after PRRNT, with imaging improvement. Patient 2 obtained reduction of the number and severity of hypoglycaemic episodes during 15 months after therapy. Patient 3 is asymptomatic since PRRNT first cycle performed 23 months ago and revealed significant imaging improvement. Patient 4 had resolution of hypoglycaemia only 3 days after PRRNT first cycle and today, 16 months after therapy, the disease seems to be in remission and the patient maintains euglycaemic state. PRRNT was well tolerated, with only hematologic grade 2 toxicity in patient 1 and mild kidney toxicity in patient 3.

Conclusions

After the start of ¹⁷⁷Lu-DOTA-TATE all patients achieved hypoglycaemia symptomatic control and had evident improvement of their quality of life. Three patients showed imagiological improvement suggesting reduced tumour load.

https://ift.tt/2Jn7bSu

Therapeutic effects of obeticholic acid (OCA) treatment in a bleomycin-induced pulmonary fibrosis rat model

Abstract

Purpose

We recently demonstrated a protective effect of the farnesoid X receptor agonist obeticholic acid (OCA) in rat models of bleomycin-induced pulmonary fibrosis (PF). Aim of the present study was to investigate whether the positive effects of OCA treatment are apparent also on ongoing bleomycin-induced PF, i.e., after 2 weeks of bleomycin administration.

Methods

Bleomycin-induced PF rats were treated 2 weeks after bleomycin administration with OCA or pirfenidone for two additional weeks. Pulmonary function test was performed at 2 and 4 weeks in all experimental groups. At the same time points, lung morphological features and mRNA expression profile of genes related to fibrosis, inflammation and epithelial–mesenchymal transition were also assessed.

Results

After 2 weeks, bleomycin significantly increased the pressure at the airway opening (PAO), a functional parameter related to fibrosis-induced lung stiffness, and induced diffuse lung interstitium fibrosis, with upregulation of inflammation (IL1β, MCP1) and tissue remodeling (COL1A1, COL3A1, ET1, MMP7, PDGFa, αSMA, SNAI1) markers. At week four, a further increase of lung fibrosis and PAO was observed, accompanied by upregulation of extracellular matrix-related mRNA expression. OCA administration, even after the establishment of PF, significantly improved pulmonary function, normalizing PAO, and reverted the bleomycin-induced lung alterations, with significant reduction of markers of inflammation (CD206, COX2, HIF1, IL1β, MCP1), epithelial proliferation (CTGF, PDGFa) and fibrosis (COL1A1, COL3A1, ET1, FN1, MMPs, αSMA, SNAIs, TGFβ1, TIMPs). Results with OCA were similar or superior to those obtained with pirfenidone.

Conclusions

In conclusion, our results demonstrate a significant therapeutic effect of OCA in already established PF.

https://ift.tt/2K3cOow

High serum osteopontin levels are associated with prevalent fractures and worse lipid profile in post-menopausal women with type 2 diabetes

Abstract

Purpose

Patients with type 2 diabetes (T2DM) have increased fracture risk. Osteopontin (OPN) is a protein involved in bone remodeling and inflammation. The aim of this study was to evaluate the association of OPN with fracture prevalence and with metabolic parameters in post-menopausal women with T2DM.

Methods

Sixty-four post-menopausal women with T2DM (age 67.0 ± 7.8 years, diabetes duration 8.9 ± 6.7 years), enrolled in a previous study, were followed up (3.6 ± 0.9 years). Previous fragility fractures were recorded. The FRAX score (without BMD) was calculated and biochemical parameters (plasma glucose, HbA1c, lipid profile and renal function) were assessed. Serum 25OH-vitamin D, calcium, PTH and OPN were evaluated at baseline. The association between OPN and fracture prevalence at baseline was evaluated by a logistic model.

Results

OPN levels were higher in patients with previous fractures (n.25) than in patients without previous fractures at baseline (n.39) (p = 0.006). The odds of having fractures at baseline increased by 6.7 (1.9–31.4, 95% CI, p = 0.007) for each increase of 1 ng/ml in OPN levels, after adjustment for vitamin D and HbA1c levels. Fracture incidence was 4.7%. Higher OPN associated with a decrease in HDL-cholesterol (p = 0.048), after adjustment for age, basal HDL-cholesterol, basal and follow-up HbA1c and follow-up duration. 25OH-vitamin D associated with an increase in FRAX-estimated probability of hip fracture at follow-up (p = 0.029), after adjustment for age, 25OH-vitamin D and time.

Conclusions

In post-menopausal women with T2DM, OPN might be a useful marker of fracture and worse lipid profile.

https://ift.tt/2JLKMOU

Dangerous non-food products : Products with serious risks Click to enlarge 1 of 1 photo Share on Alert number: A12/0321/19 Category: Gadgets Product: Waterproof phone case Brand: Unknown Name: Waterproof Case Type / number of model: B74031 Batch number / Barcode: Unknown Risk type: Environment The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 0.32%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. The product does not comply with the Regulation on persistent organic pollutants (POP Regulation). Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor Click to enlarge 1 of 1 photo Share on Alert number: A12/0318/19 Category: Hand tools Produc

Products with serious risks 

1 of 1 photo Share on             Alert number: A12/0321/19        Category:  Gadgets   Product:  Waterproof phone case   Brand: Unknown   Name: Waterproof Case   Type / number of model:  B74031   Batch number / Barcode: Unknown   Risk type:  Environment   The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 0.32%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0318/19        Category:  Hand tools   Product:  Garden hose   Brand: Green>it   Name: Green hose set   Type / number of model:  9025811   Batch number / Barcode:  5708614912768   Risk type:  Environment   The hose contains short-chain chlorinated paraffins (SCCPs) (measured value up to 4.66%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment.  The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0300/19        Category:  Hobby/sports equipment   Product:  Fitness mat   Brand: Deuser   Name: Fitness-Matte   Type / number of model:  121041R   Batch number / Barcode:  4007480015704   Risk type:  Chemical, Environment   The plastic in the mat contains short-chain chlorinated paraffins (SCCPs) (measured value: 2.2%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. SCCPs are suspected human carcinogens. Prolonged exposure to them through the skin may cause cancer.  The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures ordered by public authorities (to: Other): Withdrawal of the product from the market

1 of 1 photo Share on             Alert number: A12/0330/19        Category:  Hobby/sports equipment   Product:  Bicycle saddle cover   Brand: Unknown   Name: Unknown   Type / number of model:  248   Batch number / Barcode: Unknown   Risk type:  Environment   The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 1.12%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the persecutor

1 of 1 photo Share on             Alert number: A12/0334/19        Category:  Hobby/sports equipment   Product:  Football   Brand: Unknown   Name: Unknown   Type / number of model:  9048306   Batch number / Barcode:  5706245581810   Risk type:  Chemical   The plastic ball contains di-2-ethylhexyl phthalate (DEHP) (measured value up to 0.13% by weight). This phthalate may harm the health of children, causing possible damage to their reproductive system.  The product does not comply with the REACH Regulation.   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 2 photos PreviousNext Share on             Alert number: A12/0332/19        Category:  Jewellery   Product:  Necklace   Brand: Jewelry Fashion   Name: Unknown   Type / number of model:  54314   Batch number / Barcode:  6 438278 543143   Risk type:  Chemical   The smaller round medallion contains cadmium (measured value: 94 % by weight). Cadmium is harmful to human health because it accumulates in the body, can damage organs and may cause cancer. The product does not comply with the REACH Regulation.   Measures ordered by public authorities (to: Importer): Import rejected at border

1 of 1 photo Share on             Alert number: A12/0319/19        Category:  Lighting equipment   Product:  LED helmet light   Brand: STEEDS   Name: Unknown   Type / number of model:  940150   Batch number / Barcode:  4052083104386   Risk type:  Environment   The solder in the product contains lead above limit values (measured value up to 46% by weight). Lead poses a risk to the environment.  The product does not comply with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0325/19        Category:  Lighting equipment   Product:  Foldable desk lamp   Brand: Unknown   Name: Unknown   Type / number of model:  93302   Batch number / Barcode:  PO702084   Risk type:  Environment   The solder contains lead (measured value up to 71% by weight) in concentrations above limit values. Lead poses a risk to the environment.  The product does not comply with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0329/19        Category:  Lighting equipment   Product:  Torch   Brand: Unknown   Name: Unknown   Type / number of model:  P513.822   Batch number / Barcode: Unknown   Risk type:  Environment   The solders contain cadmium (measured value up to 0.39% by weight) and lead (measured value up to 48% by weight) in concentrations above limit values. Cadmium and lead pose a risk to the environment.  The product does not comply with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0331/19        Category:  Lighting equipment   Product:  Torch   Brand: Unknown   Name: Unknown   Type / number of model:  341377VN   Batch number / Barcode: Unknown   Risk type:  Environment   The solder contains lead (measured value up to 50% by weight) in concentrations above limit values. Lead poses a risk to the environment.  The product does not comply with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 3 photos PreviousNext Share on             Alert number: A12/0337/19        Category:  Lighting equipment   Product:  Table lamp   Brand: ArtHome   Name: Lume   Type / number of model:  SM1451   Batch number / Barcode:  8034048202029 (on the product); 8034048202128 (on the packaging)   Risk type:  Burns, Electric shock   The insulation is inadequate. Moreover, the power cord can easily detach or become damaged, giving access to live parts. The user can touch live or hot parts and receive an electric shock or suffer burns. The product does not comply with the requirements of the Low Voltage Directive and the relevant European standard EN 60598-1.   Measures ordered by public authorities (to: Distributor): Recall of the product from end users, Withdrawal of the product from the market

Share on             Alert number: A12/0309/19        Category:  Motor vehicles   Product:  Passenger car   Brand: Porsche   Name: Cayenne - conventional and hybrid(PHEV), Macan   Type / number of model:  Cayenne: Type-approval numbers: e13*2007/46*1085* (92A M1G) e13*2007/46*1106* (92A N1G) e13*2007/46*1107* (92AH N1G) e13*2007/46*1108* (92AH M1G) Types: 92A, 92AN, 92AH, 92AHN, Macan: Type-approval numbers: e13*2007/46*1165 (M1) e13*2007/46*1164 (N1) Types: 95B, 95BN   Batch number / Barcode:  The vehicles in question were manufactured between January 2017 and February 2018.   Risk type:  Injuries   The retaining straps on the vehicle's ski bag may be defective. The ski bag may not stay in position when subjected to a high load.   Measures taken by economic operators: Recall of the product from end users (By: Manufacturer)

1 of 2 photos PreviousNext Share on             Alert number: A12/0315/19        Category:  Protective equipment   Product:  Inflatable armbands   Brand: Numerous Star   Name: Arm circle   Type / number of model:  8" X 6"   Batch number / Barcode:  50112393   Risk type:  Chemical   The valve of the inflatable armband contains di(2-etylhexyl) phthalate-DEHP (measured value 21 % by weight) and di-'isononyl' phthalate (DINP) (measured value: 0.3 % by weight). These phthalates may harm the health of children, causing possible damage to the reproductive system and the liver. The product does not comply with the REACH Regulation and the Personal Protective Equipment regulation.   Measures ordered by public authorities (to: Retailer): Withdrawal of the product from the market

1 of 1 photo Share on             Alert number: A12/0322/19        Category:  Protective equipment   Product:  Safety reflector   Brand: Unknown   Name: Unknown   Type / number of model:  731211-z   Batch number / Barcode: Unknown   Risk type:  Environment   The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 0.38%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0328/19        Category:  Protective equipment   Product:  Safety reflector   Brand: Unknown   Name: Unknown   Type / number of model:  288   Batch number / Barcode: Unknown   Risk type:  Environment   The solders contain lead (measured value up to 81%) above limit values and the plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 0.931%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. Lead poses a risk to the environment.  The product does not comply with the Regulation on persistent organic pollutants (POP Regulation) and with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 7 photos PreviousNext Share on             Alert number: A12/0312/19        Category:  Childcare articles and children's equipment   Product:  Baby carrier   Brand: Kekk   Name: Backpack Plus Black   Type / number of model:  Backpack Plus / Baby Pack Plus 015-014-004   Batch number / Barcode:  8 718531 445109   Risk type:  Injuries   The frame of the product is not strong enough and has no locking mechanism. It could break or spontaneously fold while still carrying a baby, causing the baby to fall. The product does not comply with the relevant European Standard EN 13209-1.   Measures taken by economic operators: Recall of the product from end users (By: Manufacturer)

1 of 3 photos PreviousNext Share on             Alert number: A12/0298/19        Category:  Toys   Product:  Inflatable swim-ring   Brand: Sainteve   Name: Swim Ring   Type / number of model:  ITEM N0: SY-A1098   Batch number / Barcode: Unknown   Risk type:  Chemical   The plastic of the swim-ring and the valve contain bis (2-ethylhexyl) phthalate (DEHP) (measured value: 5% and 0.9% by weight, respectively). This phthalate may harm the health of children, causing possible damage to their reproductive system. The product does not comply with the REACH Regulation.   Measures ordered by public authorities (to: Retailer): Withdrawal of the product from the market

1 of 3 photos PreviousNext Share on             Alert number: A12/0299/19        Category:  Toys   Product:  Toy Microphone   Brand: Johntoy   Name: Microphone - Mit light - Avec lumiére - Con luz   Type / number of model:  Item Number: 29389   Batch number / Barcode:  8 711866 293896   Risk type:  Chemical, Environment, Injuries   The microphone can easily break, causing the button batteries to become accessible. A child may put them in the mouth, causing damage to the gastrointestinal tract. Additionally, the solder in three different places inside the toy contains too much lead (measured value up to: 70% by weight). Lead poses a risk to the environment.  The product does not comply with the requirements of the Toy Directive, the relevant European standard EN 62115 and the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures ordered by public authorities (to: Importer): Recall of the product from end users

1 of 3 photos PreviousNext Share on             Alert number: A12/0303/19        Category:  Toys   Product:  Glow stick   Brand: Unknown   Name: Unknown   Type / number of model:  2151-7/1.75   Batch number / Barcode:  8591044542172   Risk type:  Chemical, Choking   The battery compartment can easily be opened without the use of any tools, leaving button cell batteries accessible. A child may put these in the mouth, which could cause damage to the child's gastrointestinal tract. They may also cause choking if swallowed by a small child. The product does not comply with the requirements of the Toy Safety Directive and with the relevant European standard EN 71-1 and EN 62115.   Measures ordered by public authorities (to: Retailer): Withdrawal of the product from the market

1 of 4 photos PreviousNext Share on             Alert number: A12/0304/19        Category:  Toys   Product:  Toy pushchair with doll   Brand: Unknown   Name: Baby Small Cart   Type / number of model:  No. S876   Batch number / Barcode:  6998880080035   Risk type:  Chemical, Injuries   The pushchair is not sufficiently resistant to load and can easily collapse, causing injuries. In addition, the doll contains di-(2-ethylhexyl) phthalate (DEHP) (measured value up to 4.8% by weight). This phthalate may harm the health of children, causing possible damage to their reproductive system.   Measures ordered by public authorities (to: Distributor): Recall of the product from end users, Withdrawal of the product from the market

1 of 3 photos PreviousNext Share on             Alert number: A12/0305/19        Category:  Toys   Product:  Toy slime   Brand: Unknown   Name: Crystal Mud   Type / number of model:  CX-1731   Batch number / Barcode:  6 951325 166800   Risk type:  Chemical   The migration of boron from the toy slime is too high (measured value: 879 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 4 photos PreviousNext Share on             Alert number: A12/0307/19        Category:  Toys   Product:  Toy slime   Brand: Unknown   Name: Pu Noise Putty   Type / number of model:  LCP-001   Batch number / Barcode:  Lot No. 0019/12 8 435124 170858   Risk type:  Chemical   The migration of boron from the toy slime is too high (measured value: 981 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 1 photo Share on             Alert number: A12/0308/19        Category:  Toys   Product:  Children's fancy-dress costume   Brand: Star Wars   Name: Executioner Trooper   Type / number of model:  Item No 640110   Batch number / Barcode:  Code: 8 83028 23993, Lot No 7045   Risk type:  Burns   The fancy-dress costume is easily flammable and the flame propagation is too high. If it catches fire, the child could suffer burns. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-2.   Measures taken by economic operators: Withdrawal of the product from the market (By: Retailer)

1 of 7 photos PreviousNext Share on             Alert number: A12/0310/19        Category:  Toys   Product:  Toy slime   Brand: Unknown   Name: Slyme clay   Type / number of model:  55-2   Batch number / Barcode:  6 958455 624569, 6 987542 687507   Risk type:  Chemical   The migration of boron from the toy slime is too high (measured value: up to 546 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 3 photos PreviousNext Share on             Alert number: A12/0313/19        Category:  Toys   Product:  Plastic doll   Brand: ABABABY, SMILE   Name: Annie Baby   Type / number of model:  Item Nr.: KJ883, HKJ368D, YKJ368B   Batch number / Barcode:  6920778206622   Risk type:  Chemical   The plastic material of the doll's head contains 2-ethylhexyl phthalate (DEHP) (measured value: 31 % by weight). This phthalate may harm the health of children, causing possible damage to the reproductive system. The product does not comply with the REACH Regulation.   Measures ordered by public authorities (to: Distributor): Recall of the product from end users, Withdrawal of the product from the market

1 of 2 photos PreviousNext Share on             Alert number: A12/0314/19        Category:  Toys   Product:  Soft toy   Brand: Baby Gong Wei Gang   Name: Unknown   Type / number of model:  V51-3   Batch number / Barcode: Unknown   Risk type:  Choking   The eyes and nose of the toy can easily detach. In addition, the fibrous stuffing material of the toy is easily accessible due to the weakness of the plastic zipper. A small child may put the small parts in the mouth and choke. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-1.   Measures ordered by public authorities (to: Distributor): Recall of the product from end users, Withdrawal of the product from the market

1 of 1 photo Share on             Alert number: A12/0333/19        Category:  Toys   Product:  Wooden toy rattle   Brand: Classic World   Name: Unknown   Type / number of model:  3053   Batch number / Barcode:  6927049001185   Risk type:  Choking   The product contains a small wooden ball that can easily fall out between the bars of the rattle. A small child could put it in the mouth and choke on it. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-1.   Measures taken by economic operators: Recall of the product from end users (By: Distributor)

1 of 3 photos PreviousNext Share on             Alert number: A12/0338/19        Category:  Toys   Product:  Toy slime   Brand: Unknown   Name: Unknown   Type / number of model:  Unknown   Batch number / Barcode:  6 958455 624569   Risk type:  Chemical   The migration of boron from the toy slime is too high (measured value: 533 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 4 photos PreviousNext Share on             Alert number: A12/0339/19        Category:  Toys   Product:  Toy Slime   Brand: Unknown   Name: Unicorn Crystal Mud   Type / number of model:  Unknown   Batch number / Barcode:  6 958455 624569   Risk type:  Chemical   The migration of boron from the toy slime is too high (measured value: 506 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system.  The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 6 photos PreviousNext Share on             Alert number: A12/0341/19        Category:  Toys   Product:  Toy slime   Brand: Unknown   Name: CRYSTAL SOIL - HELLO SUMMER   Type / number of model:  PL00605   Batch number / Barcode:  2 900000 225268   Risk type:  Chemical   The migration of boron from the toy slimes is too high (measured value: up to 874 mg/kg for red). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system.  The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 6 photos PreviousNext Share on             Alert number: A12/0342/19        Category:  Toys   Product:  Toy slime   Brand: Unknown   Name: CRYSTAL MUD   Type / number of model:  PL00604   Batch number / Barcode:  2 900000 225251   Risk type:  Chemical   Due to the container's characteristic form, appearance and size, this product may be mistaken for a foodstuff. This may lead consumers, and specially children, to put them in the mouth and ingest its content. The migration of boron from the toy slime is too high (measured value: up to 1461 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system.  The product does not comply with the requirements of the Food Imitating Products Directive, the Toy Safety Directive and the relevant European standard EN 71-3.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 3 photos PreviousNext Share on             Alert number: A12/0345/19        Category:  Toys   Product:  Play tent   Brand: Eureka Kids   Name: My Little Explorer   Type / number of model:  Ref. 94570874   Batch number / Barcode:  8435404813369   Risk type:  Choking   Some pieces of velcro on the tent can become detached, generating a small part. A small child may put them in the mouth and choke. The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-1.   Measures ordered by public authorities (to: Importer): Import rejected at border

1 of 6 photos PreviousNext Share on             Alert number: A12/0346/19        Category:  Toys   Product:  Toy slime   Brand: HTI   Name: Teamsterz Slime   Type / number of model:  1374304   Batch number / Barcode:  Batch: 05BB1 5 050837 430414   Risk type:  Chemical   The migration of boron from the toy slime is too high (measured value up to 2165 mg/kg). Ingestion or contact with an excessive quantity of boron may harm the health of children by damaging their reproductive system.  The product does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-3.   Measures taken by economic operators: Voluntary withdrawal (By: Manufacturer)

1 of 2 photos PreviousNext Share on             Alert number: A12/0301/19        Category:  Clothing, textiles and fashion items   Product:  Children's dress   Brand: Cutey Pie   Name: Unknown   Type / number of model:  50JTC1005   Batch number / Barcode:  3 664795 008992   Risk type:  Chemical   The dress contains azo-dyes releasing the aromatic amine 4-methyl-m-phenylenediamine (2,4-toluenediamine) (measured concentration: 342 mg/kg). When in direct and prolonged contact with the skin, the aromatic amines may be absorbed by the skin. Aromatic amines can cause cancer, cell mutations and affect reproduction. The product does not comply with the REACH Regulation.   Measures ordered by public authorities (to: Other): Withdrawal of the product from the market

1 of 3 photos PreviousNext Share on             Alert number: A12/0335/19        Category:  Clothing, textiles and fashion items   Product:  Children's sweatshirt   Brand: Hello baby   Name: Unknown   Type / number of model:  XH-9119   Batch number / Barcode:  2100005300094, 5272017091196   Risk type:  Strangulation   The drawstrings may become trapped during various activities of the child, leading to strangulation. The product does not comply with European standard EN 14682.   Measures ordered by public authorities (to: Distributor): Withdrawal of the product from the market

1 of 1 photo Share on             Alert number: A12/0320/19        Category:  Communication and media equipment   Product:  iPad holder   Brand: Unknown   Name: Unknown   Type / number of model:  R.320.601   Batch number / Barcode: Unknown   Risk type:  Environment   The holder contains short-chain chlorinated paraffins (SCCPs) (measured value up to 2.75%). The placing on the market and use of articles containing SCCPs is banned. SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment.  The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market, Withdrawal of the product from the market (By: Distributor, Importer) Measures ordered by public authorities (to: Distributor): Recall of the product from end users

1 of 1 photo Share on             Alert number: A12/0323/19        Category:  Communication and media equipment   Product:  Earbuds   Brand: Unknown   Name: Unknown   Type / number of model:  P326.231   Batch number / Barcode:  8714612097212   Risk type:  Environment   The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 1.89%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0324/19        Category:  Communication and media equipment   Product:  Earbuds   Brand: Unknown   Name: Unknown   Type / number of model:  1899   Batch number / Barcode: Unknown   Risk type:  Environment   The solder contains lead (measured value up to 83% by weight) in concentrations above limit values. Lead poses a risk to the environment.  The product does not comply with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0326/19        Category:  Communication and media equipment   Product:  Headphones   Brand: Unknown   Name: Unknown   Type / number of model:  86004-14   Batch number / Barcode:  7393107720340   Risk type:  Environment   The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 0.32%). SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment. The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 1 photo Share on             Alert number: A12/0327/19        Category:  Communication and media equipment   Product:  Headphones   Brand: Unknown   Name: Unknown   Type / number of model:  91268   Batch number / Barcode:  PO6022829   Risk type:  Environment   The solder contains lead (measured value up to 54% by weight) in concentrations above limit values. Lead poses a risk to the environment.  The product does not comply with the requirements of the Commission Directive on the restriction of the use of certain hazardous substances in electrical and electronic equipment (RoHS 2 Directive).   Measures taken by economic operators: Withdrawal of the product from the market (By: Importer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 2 photos PreviousNext Share on             Alert number: A12/0302/19        Category:  Cosmetics   Product:  Body lotion   Brand: Judith Leiber   Name: Night   Type / number of model:  150 ml reference 17X610203   Batch number / Barcode:  barcode 899219002819   Risk type:  Chemical   The body lotion contains isobutylparaben which has a potential endocrine disrupting activity. At the same time, the product contains limonene, linalool, coumarin, citronellol, alpha-isomethyl ionone (measured values: more than 0.001% by weight). These substances can induce allergic reactions and sensitisation. Consumers are not aware of their presence because they are not indicated in the list of ingredients. The product does not comply with the Cosmetic Products Regulation.   Measures taken by economic operators: Recall of the product from end users (By: Retailer)

1 of 1 photo Share on             Alert number: A12/0317/19        Category:  Electrical appliances and equipment   Product:  Power supply   Brand: Unknown   Name: Powerbank   Type / number of model:  PB0041   Batch number / Barcode: Unknown   Risk type:  Environment   The plastic contains short-chain chlorinated paraffins (SCCPs) (measured value up to 1.65 % by weight). The placing on the market and use of articles containing SCCPs is banned. SCCPs persist in the environment, are toxic to aquatic organisms at low concentrations and bioaccumulate in wildlife and humans, posing a risk to human health and the environment.  The product does not comply with the Regulation on persistent organic pollutants (POP Regulation).   Measures taken by economic operators: Withdrawal of the product from the market (By: Manufacturer) Measures ordered by public authorities (to: Other): The company is reported to the prosecutor

1 of 3 photos PreviousNext Share on             Alert number: A12/0336/19        Category:  Electrical appliances and equipment   Product:  Power Inverter   Brand: Clear view   Name: Unknown   Type / number of model:  H130609520 and H130609476   Batch number / Barcode:  5 999885 948178   Risk type:  Electric shock   Single-pole or partial insertion of a plug into the product's socket is possible. When using the inverter, live pins of the inserted plug could remain accessible, which could result in the user receiving an electric shock. The product does not comply with the requirements of the Low Voltage Directive and the relevant standards EN 60950 and IEC 60884.   Measures ordered by public authorities (to: Distributor): Recall of the product from end users, Withdrawal of the product from the market

1 of 3 photos PreviousNext Share on             Alert number: A12/0340/19        Category:  Electrical appliances and equipment   Product:  Electric shaver   Brand: Surker   Name: RECHARGEABLE SHAVER   Type / number of model:  RSCW-2015 REF: 10105   Batch number / Barcode:  6 955519 320153 (on the packaging); 5 995858 101052 (on a label)   Risk type:  Electric shock   The dimensions of the socket outlet on the mains lead of the shaver are not suitable. The user could consequently touch live parts while connecting the mains lead to the shaver, leading to electric shock. The insulation between live parts and the accessible metal housing is insufficient. Consequently accessible parts could become live, this could cause the user to receive an electric shock when holding the shaver. The product does not comply with the requirements of the Low Voltage Directive and the relevant European standard EN 60335.   Measures ordered by public authorities (to: Distributor): Recall of the product from end users, Withdrawal of the product from the market

1 of 2 photos PreviousNext Share on             Alert number: A12/0344/19        Category:  Electrical appliances and equipment   Product:  Electrical plug cover   Brand: Eastern   Name: 13A Socket Cover Safety Plug   Type / number of model:  SW201   Batch number / Barcode:  3 579901 283883   Risk type:  Electric shock   The product does not have shutters on live parts, nor a fuse. A user could touch live parts of the socket and receive an electric shock. The product does not comply with the relevant National standards BS 1363-3 and BS 8546.   Measures ordered by public authorities (to: Importer): Withdrawal of the product from the market

Products with other risk levels 

1 of 1 photo Share on             Alert number: A11/0009/19        Category:  Toys   Product:  Soft toy animal   Brand: Greenlife   Name: Hibou brun (brown owl)   Type / number of model:  ref 11053413   Batch number / Barcode: Unknown   Risk type:  Choking   The stuffing material is easily accessible. Young children may put it in the mouth, ingest it and choke on it.  The toy does not comply with the requirements of the Toy Safety Directive and the relevant European standard EN 71-1.    Measures taken by economic operators: This product listing was removed by Amazon., Withdrawal of the product from the market (By: Other)