Comparison of efficacy of low-volume bowel cleansers prior to colonoscopy: a randomised, prospective, open-label trial

INTRODUCTION

The aim of the study was to compare the efficacy and tolerability of polyethylene glycol/ascorbic acid (PEGA), sodium picosulfate/magnesium citrate (SPMC) and the oral sulfate formula (SIR) in a single- or split-dose regimen for bowel preparation prior to colonoscopy.

METHODS

Randomised, multicentre, open-label study. The subjects received either PEGA, SPMC or SIR in the single- or split-dose regimen before the colonoscopy. Quality and tolerability of the preparation and complaints during preparation were recorded using a 5 point scale.

RESULTS

558 subject were analysed. Preparation quality was comparable in the single-dose regimen. The rate of satisfactory bowel cleansing (Aronchick score 1+2) was higher for split-dose SIR and PEGA compared to SPMC (95.6%, 86.2% vs. 72.5%, p.

The role of adapted and non-adapted resistance sources in breeding resistance of winter wheat to Fusarium head blight and deoxynivalenol contamination

Since resistance is the most important agent in regulating deoxynivalenol (DON), breeding for higher resistance is the key to improve food safety. Fusarium damaged kernels (FDK) show a closer correlation with DON than visual symptoms. This implies a difference in genetic regulation. For this reason, the mapping should be extended not only for the visual symptoms, but also for FDK and DON. Quantitative trait loci influencing only Fusarium head blight (FHB) symptoms, may not be relevant for FDK and DON. Type I and II were pooled to overall resistance at spray inoculation. From 2010 to 2016 three selection platforms were compared by checking running variety breeding programs. The use of exotic sources in breeding significantly increased the number of more resistant genotypes in each selection phase from F3-F8 generations compared to the control program where crosses were not planned for FHB resistance and screening in early generations was also not performed. However, also in this breeding platform – at a lower rate – moderately or highly resistant genotypes could be selected. Of them, eight cultivars were/are in commercial production. The Fusarium breeding program using only adapted and more resistant parents generally gave closer results to exotic breeds, and several highly resistant genotypes were produced as a result. For winter wheat the phenotypic screening at high disease pressure is the key to select highly resistant materials. At low infection pressure the high and medium resistant genotypes come in the same group. The use of more isolates increases the chance to have strong selection pressure each year. FHB resistance was combined with leaf rust, yellow rust, powdery mildew, leaf spot resistance and high protein content (15-18%). The cultivar registration and post registration screening is the key in improving food safety in commercial production.

Study of Ni-Catalyzed Graphitization Process of Diamond by in Situ X-ray Photoelectron Spectroscopy

Graphene on diamond has been attracting considerable attention due to the unique and highly beneficial features of this heterostructure for a range of electronic applications. Here, ultrahigh-vacuum X-ray photoelectron spectroscopy is used for in situ analysis of the temperature dependence of the Ni-assisted thermally induced graphitization process of intrinsic nanocrystalline diamond thin films (65 nm thickness, 50-80 nm grain size) on silicon wafer substrates. Three major stages of diamond film transformation are determined from XPS during the thermal annealing in the temperature range from 300 °C to 800 °C. Heating from 300 °C causes removal of oxygen; formation of the disordered carbon phase is observed at 400 °C; the disordered carbon progressively transforms to graphitic phase whereas the diamond phase disappears from the surface from 500 °C. In the well-controllable temperature regime between 600 °C and 700 °C, the nanocrystalline diamond thin film is mainly preserved, while graphitic layers form on the surface as the predominant carbon phase. Moreover, the graphitization is facilitated by a disordered carbon interlayer that inherently forms between diamond and graphitic layers by Ni catalyst. Thus, the process results in formation of a multilayer heterostructure on silicon substrate.

The Doctor of Delayed Publications: The Remarkable Life of George Streisinger (1927-1984)

The history of science offers multiple examples of how the perseverance of a single visionary person could open the floodgates for a whole new area of research. Zebrafish research is one of these fields with an exciting founding story, as it was the dogged persistence of one man, George Streisinger, that ultimately lifted this little fish out of the obscurity of pet shops into the pantheon of genetic model organisms. The Hungarian born Streisinger was one of the most gifted geneticists of his era and his network of mentors and friends really reads like a who-is-who of 20th century genetics. And it was not only science where he excelled: the way he took his civic duties seriously and outspokenly fought social injustice wherever he met it offers an important lesson on integrity for today's scientists as well.

Implementation of the European health interview survey (EHIS) into the German health update (GEDA)

Background

This methodological paper describes the integration of the ‘European Health Interview Survey wave 2’ (EHIS 2) into the ‘German Health Update’ 2014/2015 (GEDA 2014/2015-EHIS).

Methods

GEDA 2014/2015-EHIS is a cross-sectional health survey. A two-stage stratified cluster sampling approach was used to recruit persons aged 15 years and older with permanent residence in Germany. Two different modes of data collection were used, self-administered web questionnaire and self-administered paper questionnaire. The survey instrument implemented the EHIS 2 modules on health status, health care use, health determinants and social background variables and additional national questions. Data processing was conducted according to the quality and validation rules specified by Eurostat.

Results

In total, 24,824 questionnaires were completed. The response rate was 27.6%. The two-stage cluster sample method seems to have been successful in achieving a sample with high representativeness. The final micro data file was inspected, approved and certified by Eurostat. Access to micro data of the EHIS 2 can be provided by Eurostat via research contract and to the GEDA 2014/2015-EHIS public use file by the Research Data Centre of the Robert Koch Institute. First EHIS 2 results are available at the Eurostat website.

Conclusions

Integrating a multinational health survey into an existing national health monitoring system was a challenge in Germany. The national survey methodology for conducting the survey had to be further developed in order to meet the overarching goal of harmonizing the health information from national statistical offices and public health research institutes across the European Union. The harmonized EHIS 2 data source will profoundly impact international public health research in the near future. The next EHIS wave 3 will be conducted around 2019.

Level-2 perspectives computed quickly and spontaneously: Evidence from eight- to 9.5-year-old children

It has been widely assumed that computing how a scene looks from another perspective (level-2 perspective taking, PT) is an effortful process, as opposed to the automatic capacity of tracking visual access to objects (level-1 PT). Recently, adults have been found to compute both forms of visual perspectives in a quick but context-sensitive way, indicating that the two functions share more features than previously assumed. However, the developmental literature still shows the dissociation between automatic level-1 and effortful level-2 PT. In the current paper, we report an experiment showing that in a minimally social situation, participating in a number verification task with an adult confederate, eight- to 9.5-year-old children demonstrate similar online level-2 PT capacities as adults. Future studies need to address whether online PT shows selectivity in children as well and develop paradigms that are adequate to test preschoolers' online level-2 PT abilities. Statement of Contribution What is already known on this subject? Adults can access how objects appear to others (level-2 perspective) spontaneously and online Online level-1, but not level-2 perspective taking (PT) has been documented in school-aged children What the present study adds? Eight- to 9.5-year-olds performed a number verification task with a confederate who had the same task Children showed similar perspective interference as adults, indicating spontaneous level-2 PT Not only agent-object relations but also object appearances are computed online by eight- to 9.5-year-olds.

Cholecystectomy for Acute Cholecystitis After Renal Transplantation

BACKGROUND

The aim of our study was to evaluate the rate of surgical complications, patient outcomes, and impact on graft function in renal transplant recipients in whom cholecystectomy for acute cholecystitis was performed.

METHODS

We reviewed data on transplant patients from January 1, 2006, to December 31, 2013. The subgroup of patients who required subsequent cholecystectomy for acute cholecystitis was assessed, and their data were further analyzed.

RESULTS

Thirty-one patients who underwent cholecystectomy for acute cholecystitis after renal transplantation were included in the study. Clinical signs such as pain in the right upper quadrant, temperature >38°C, and elevation in bilirubin levels occurred in 20 (64.5%), 8 (25.8%), and 3 (9.7%) patients, respectively. Ultrasound signs of acute cholecystitis were present in 27 patients (87.1%). In terms of laboratory values, white blood cell counts >10 × 10(9)/L occurred in 17 patients (54.8%), and C-reactive protein levels >40 mg/L were reported in 21 patients (67.7%). The conversion rate to open surgery was 32.3% (10 patients). In 13 cases, acalculous cholecystitis was present (41.9%). The average serum creatinine level 1 year after cholecystectomy had no statistically significant differences. One patient required temporary dialysis during the postoperative period (with subsequent graft recovery), and 1 graft was lost.

CONCLUSIONS

Acute cholecystitis in kidney transplant recipients is a serious complication, with frequent difficulties related to evaluation and diagnosis. Because clinical signs could be very mild compared with severity of gallbladder affliction, there is little room if any for conservative treatment in these patients. We have not noticed adverse impact of acute cholecystitis on 1-year graft function.

Biosystem models, generated from a complex rule/reaction/influence network and from two functionality prototypes

In this work we have further developed the Direct Computer Mapping (DCM) based modelling and simulation methodology. A unified, transition-based representation of complex rule, reaction and influence networks has been introduced and two prototypes (one general state- and another general transition-prototype) have been developed for the unified functional modelling of the state and transition nodes. Starting from the network and from the functional prototypes, an automatic generation method of the graphically editable and extensible GraphML description of biosystem models has been elaborated. The new developments have been implemented in the improved kernel of DCM models. The applied knowledge representation makes possible the unified generation and execution of the balance-based quantitative and influence- or rule-based qualitative, as well as optionally time-driven, multiscale biosystem models. Application of the developed methodology has been illustrated by the improved implementation of the formerly studied and upgraded example biosystem model for combining the detailed, quantitative p53/miR34a signalling system with the pathological model through an extended rule-based coupling model.

Measurement of capillary fragility: a useful tool to differentiate lipedema from obesity?

Lipedema is a disproportional obesity featuring spontaneous or light pressure-induce pain and frequent hematoma formation due to even minor traumatic injuries. It is generally distinguished from general obesity primarily based on clinical hallmarks; however, this becomes difficult when appearing in a concomitant form (combination of obesity and lipedema). Our study group has recently demonstrated that lipedema-associated bruising is correlated with increased capillary fragility (CF) and also that CF could be significantly improved by complex decongestive physiotherapy (CDP). In this study, we measured CF in female subjects with lipedema (15) or non-complicated obesity (15) who were body mass index (BMI) and waist-to-hip ratio (WHR) matched. CF was evaluated with the vacuum suction method (VSM) using Parrot's angiosterrometer in both groups. Application of VSM resulted in a significantly higher number of petechiae in subjects with lipedema. Capillary fragility measurement appears to be a useful differential diagnostic tool between lipedema and obesity under these trial parameters.

AUTEN-67, an autophagy-enhancing drug candidate with potent antiaging and neuroprotective effects

Autophagy is a major molecular mechanism that eliminates cellular damage in eukaryotic organisms. Basal levels of autophagy are required for maintaining cellular homeostasis and functioning. Defects in the autophagic process are implicated in the development of various age-dependent pathologies including cancer and neurodegenerative diseases, as well as in accelerated aging. Genetic activation of autophagy has been shown to retard the accumulation of damaged cytoplasmic constituents, delay the incidence of age-dependent diseases, and extend life span in genetic models. This implies that autophagy serves as a therapeutic target in treating such pathologies. Although several autophagy-inducing chemical agents have been identified, the majority of them operate upstream of the core autophagic process, thereby exerting undesired side effects. Here, we screened a small-molecule library for specific inhibitors of MTMR14, a myotubularin-related phosphatase antagonizing the formation of autophagic membrane structures, and isolated AUTEN-67 (autophagy enhancer-67) that significantly increases autophagic flux in cell lines and in vivo models. AUTEN-67 promotes longevity and protects neurons from undergoing stress-induced cell death. It also restores nesting behavior in a murine model of Alzheimer disease, without apparent side effects. Thus, AUTEN-67 is a potent drug candidate for treating autophagy-related diseases.

Suitability of a preserved human cadaver model for the simulation of facemask ventilation, direct laryngoscopy and tracheal intubation: a laboratory investigation

BACKGROUND

Using fresh or formalin-embalmed cadavers has not been generally accepted for the purposes of teaching airway management. We investigated whether cadavers 'preserved according Thiel's embalming method' (PATEM) are suitable for the simulation of facemask ventilation and tracheal intubation by direct laryngoscopy.

METHODS

This observational cluster sampling, controlled simulation study, included eight PATEM cadavers and eight manikins in two clusters. Twenty experienced anaesthetists were randomly assigned to execute 80 facemask ventilations and 80 tracheal intubations in both groups. The ease of facemask ventilation was the primary endpoint. The secondary endpoint was the composite outcomes of laryngoscopy and tracheal intubation.

RESULTS

The success rate at the first attempt at mask ventilation was 74% (59/80 attempts) on cadavers and 41% (33/80 attempts) on manikins (P<0.0001). Twenty one subjects received an oral airway in both groups and succeeded in facemask ventilation 20 times on cadavers and four times on manikins (P=0.004). Two-handed technique mask ventilation was required 24 times on manikins and once on cadavers (P=0.0016). In one attempt on a manikin the mask ventilation was impossible. Poor laryngeal view (Cormack-Lehane grade 3) occurred 14 times among cadavers (17.5%) and once in manikins (1.25%) (P=0.007), whereas difficulties in tracheal intubation were encountered 16 times in cadavers (20%) vs 17 times in manikins (21.25%) (P=0.84). In a subjective evaluation the participants preferred the cadaver model over the manikins (P<0.0001).

CONCLUSIONS

PATEM cadavers were better suited for facemask ventilation and provided a more realistic environment for laryngoscopy and tracheal intubation than the studied manikins.

SignaFish: A Zebrafish-Specific Signaling Pathway Resource

Understanding living systems requires an in-depth knowledge of the signaling networks that drive cellular homeostasis, regulate intercellular communication, and contribute to cell fates during development. Several resources exist to provide high-throughput data sets or manually curated interaction information from human or invertebrate model organisms. We previously developed SignaLink, a uniformly curated, multi-layered signaling resource containing information for human and for the model organisms nematode Caenorhabditis elegans and fruit fly Drosophila melanogaster. Until now, the use of the SignaLink database for zebrafish pathway analysis was limited. To overcome this limitation, we created SignaFish ( http://signafish.org ), a fish-specific signaling resource, built using the concept of SignaLink. SignaFish contains more than 200 curation-based signaling interactions, 132 further interactions listed in other resources, and it also lists potential miRNA-based regulatory connections for seven major signaling pathways. From the SignaFish website, users can reach other web resources, such as ZFIN. SignaFish provides signaling or signaling-related interactions that can be examined for each gene or downloaded for each signaling pathway. We believe that the SignaFish resource will serve as a novel navigating point for experimental design and evaluation for the zebrafish community and for researchers focusing on nonmodel fish species, such as cyclids.

Is ionized oxygen negatively or positively charged more effective for carboxyhemoglobin reduction compare to medical oxygen at atmospheric pressure?

Carbon monoxide (CO) reversibly binds to hemoglobin forming carboxyhemoglobin (COHb). CO competes with O(2) for binding place in hemoglobin leading to tissue hypoxia. Already 30 % saturation of COHb can be deadly. Medical oxygen at atmospheric pressure as a therapy is not enough effective. Therefore hyperbaric oxygen O(2) inhalation is recommended. There was a question if partially ionized oxygen can be a better treatment at atmospheric pressure. In present study we evaluated effect of partially ionized oxygen produced by device Oxygen Ion 3000 by Dr. Engler in elimination of COHb in vitro experiments and in smokers. Diluted blood with different content of CO was purged with 5 l/min of either medicinal oxygen O(2), negatively ionized O(2) or positively ionized O(2) for 15 min, then the COHb content was checked. In vivo study, 15 smokers inhaled of either medicinal oxygen O(2) or negatively ionized O(2), than we compared CO levels in expired air before and after inhalation. In both studies we found the highest elimination of CO when we used negatively ionized O(2). These results confirmed the benefit of short inhalation of negatively ionized O(2), in frame of Ionized Oxygen Therapy (I O(2)Th/Engler) which could be used in smokers for decreasing of COHb in blood.

De novo Prograf versus de novo Advagraf: are trough level profile curves similar?

BACKGROUND

According to the clinical trials, Advagraf (ADV) has efficacy and safety profile similar to Prograf (PROG). The aim of this study was to compare the graft functions, dosages, and tacrolimus (TAC) trough level profile curves of patients on de novo PROG and ADV therapy.

METHODS

The ADV group included 39 de novo renal cases who had received initial immunosuppression (IS) with once-daily TAC (1 × 0.2 mg/kg from day1 after transplantation). We compared them with a PROG group of 38 transplant patients who received equivalent IS with twice-daily TAC (2 × 0.1 mg/kg from day1). In both groups, the IS was combined with antimetabolites and steroids. The mean follow-up time was similar (13.5 ± 7 days) in both groups after renal transplantation until the emission of the patients from our clinic.

RESULTS

TAC mean total daily dose was reduced and whole-blood trough levels decreased over the time in early postoperative days. Only on day 3 and day 4 after transplant, a significant higher adjustment in the ADV dosage was necessary to achieve sufficient TAC trough levels. The average TAC trough level profile curves were similar in PROG and ADV groups, but the individual curves were very different. Mainly in patients on ADV therapy, the initial concentrations were often >30 ng/mL, and in some cases on the 9th posttransplant day decreased to <5 ng/mL, then slowly increased into the required therapeutic range.

CONCLUSIONS

The results demonstrate that patients after renal transplantation can be safely treated de novo with ADV. Setting the required therapeutic TAC blood levels may require more attention to avoid the "fluctuations" of trough level profile curve during the early postoperative period. Our data suggest that dose adjustment of ADV can be carried out more carefully compared with PROG on the basis of clinical symptoms and the value of TAC blood levels to avoid acute rejection and toxicity.

Endogenous thrombin potential and examination of a further 31 analytes in liver transplant candidates

BACKGROUND

To predict the change in patient status and differentation of the basic diseases, endogenous thrombin potential (ETP), clinical chemistry, and coagulation variables were measured in liver transplant-listed patients with different etiologies.

METHODS

Differences in values of ETP and analytes of 30 control persons and 164 cirrhotic patients were examined by means of binary logistic regression. The relationship between the analytes and ETP parameters were analyzed by means of Spearman correlation. The different etiologies of cirrhosises were studied by factor and discriminant analyses. Binary logistic regression was applied to forecast changes in clinical status. Survival analysis was carried out with the appropriate variable.

RESULTS

International Normalized Ratio and activated partial thromboplastin time values were higher, whereas the area-under-the-curve values were lower in cirrhosis than in healthy subjects. A strong relationship was found only between the peak height and the anti-thrombin III (ATIII) values. In the factor analysis, 3 factors were found, which explained 81.6% of the total variance. Combination of aspartate aminotransferase and ATIII mostly separated the basic disease groups from each other in the discriminant analysis. From 35 variables, the lactate dehydrogenase (LDH) and ATIII have been suited for predicting the change in patient status. Eighty percent of patients with low ATIII and high LDH levels had deterioration of their clinical status.

CONCLUSIONS

Our study demonstrated that the ETP parameters did not provide additional information compared with "conventional" coagulation tests in cirrhosis. On the basis of our study, LDH and ATIII appear to be promising analytes to assess the clinical status of patients with cirrhosis. In our opinion, the classification system of liver transplant-listed patients can be improved with their use.