Real-world impact of laparoscopic surgery for rectal cancer: a population-based analysis.

Background: Randomized trials have demonstrated equivalent oncologic outcomes and decreased morbidity in patients with rectal cancer who undergo laparoscopic surgery (lapsx) compared with open surgery (opensx). The objective of the present study was to compare short-term outcomes after lapsx and opensx in a real-world setting. Methods: A national discharge abstract database was used to identify all patients who underwent rectal cancer resection in Canada (excluding Quebec) from April 2004 through March 2015. Short-term outcomes examined included same-admission mortality and length of stay (los). Results: Of 28,455 patients, 82.4% underwent opensx, and 17.6%, lapsx. The use of lapsx increased to 34% in 2014 from 5.9% in 2004 (p < 0.0001). Same-admission mortality was lower among patients undergoing lapsx than among those undergoing opensx (1.08% and 1.95% respectively, p < 0.0001). On multivariable analysis, the odds of same-admission mortality with lapsx was 36% lower than that with opensx (odds ratio: 0.64; p = 0.003). Median los was shorter after lapsx than after opensx (5 days and 8 days respectively, p = 0.0001). The strong association of lapsx with shorter los was maintained on multivariable analysis controlling for patient, surgeon, and hospital factors. Conclusions: For patients with rectal cancer, shorter los and decreased same-admission mortality are associated with the use of lapsx compared with opensx.

Rigid-body motion correction in hybrid PET/MRI using spherical navigator echoes.

Integrated positron emission tomography and magnetic resonance imaging (PET/MRI) is an imaging technology that provides complementary anatomical and functional information for medical diagnostics. Both PET and MRI are highly susceptible to motion artifacts due, in part, to long acquisition times. The simultaneous acquisition of the two modalities presents the opportunity to use MRI navigator techniques for motion correction of both PET and MRI data. For this task, we propose spherical navigator echoes (SNAVs)-3D k-space navigators that can accurately and rapidly measure rigid body motion in all six degrees of freedom. SNAVs were incorporated into turbo FLASH (tfl)-a product fast gradient echo sequence-to create the tfl-SNAV pulse sequence. Acquiring in vivo brain images from a healthy volunteer with both sequences first compared the tfl-SNAV and product tfl sequences. It was observed that incorporation of the SNAVs into the image sequence did not have any detrimental impact on the image quality. The SNAV motion correction technique was evaluated using an anthropomorphic brain phantom. Following a stationary reference image where the tfl-SNAV sequence was acquired along with simultaneous list-mode PET, three identical PET/MRI scans were performed where the phantom was moved several times throughout each acquisition. This motion-up to 11° and 14 mm-resulted in motion artifacts in both PET and MR images. Following SNAV motion correction of the MRI and PET list-mode data, artifact reduction was achieved for both the PET and MR images in all three motion trials. The corrected images have improved image quality and are quantitatively more similar to the ground truth reference images.

Focusing and scanning microscopy with propagating surface plasmons.

Here we demonstrate a novel surface plasmon polariton (SPP) microscope which is capable of imaging below the optical diffraction limit. A plasmonic lens, generated through phase-structured illumination, focuses SPPs down to their diffraction limit and scans the focus with steps as small as 10 nm. This plasmonic lens is implemented on a metallic nanostructure consisting of alternating hole array gratings and bare metal arenas. We use subwavelength scattering holes placed within the bare metal arenas to determine the resolution of our microscope. The resolution depends on the size of the scanning SPP focus. This novel technique has the potential for biomedical imaging microscopy, surface biology, and functionalization chemistry.

Optical control of plasmonic Bloch modes on periodic nanostructures.

We study and actively control the coherent properties of surface plasmon polaritons (SPPs) optically excited on a nanohole array. Amplitude and phase of the optical excitation are externally controlled via a digital spatial light modulator (SLM) and SPP interference fringe patterns are designed and observed with high contrast. Our interferometric observations reveal SPPs dressed with the Bloch modes of the periodic nanostructure. The momentum associated with these dressed plasmons (DP) is highly dependent on the grating period and fully matches our theoretical predictions. We show that the momentum of DP waves can, in principle, exceed the SPP momentum. Actively controlling DP waves via programmable phase patterns offers the potential for high field confinement applicable in lithography, surface enhanced Raman scattering, and plasmonic structured illumination microscopy.

BMI and attitudes and beliefs about physical activity and nutrition of parents of adolescents with intellectual disabilities.

BACKGROUND: The purpose of this study was: (1) to evaluate the beliefs, attitudes and behaviours associated with nutrition and physical activity of parents with adolescents with intellectual disabilities (ID); (2) to determine if these variables related to the body mass index (BMI) of the adolescents and the parents' BMI; and (3) to investigate if the parents' perception of their child's weight status was accurate. METHODS: A survey was used to collect information on BMI and attitudes and beliefs about nutrition and physical activity from parents (n = 207) of adolescents with ID attending schools participating in the Best Buddies Program. RESULTS: Approximately 45% of the adolescents were overweight or obese and over two-thirds of the parents were either overweight or obese. There was a significant difference in child's BMI by parents' description, F(3,158) = 72.75, P < 0.001. Factor analysis on questions on physical activity and nutrition revealed three factors (Factor 1 - Family Healthy Habits, Factor 2 - Parental Role and Factor 3 - Parental Activity) extracting 63% of the variance. The BMI of the adolescents significantly correlated with Factors 2 and 3. Children categorised as having a lower BMI had parents who agreed significantly more (r = -0.22, P < 0.005) with questions about being role models. There was a significant correlation between BMI for both the parents and adolescents and frequency of fast foods purchased. CONCLUSION: Efforts need to be made to provide parents of adolescents with ID tailored information about how they can assist their child in managing their weight. This information should emphasise to parents the important part they play as role models and as providers for healthy choices for physical activity as well as nutrition.

Varying the effective refractive index to measure optical transport in random media.

We introduce a new approach for measuring both the effective medium and the transport properties of light propagation in heterogeneous media. Our method utilizes the conceptual equivalence of frequency variation with a change in the effective index of refraction. Experimentally, we measure intensity correlations via spectrally resolved refractive index tuning, controlling the latter via changes in the ambient pressure. Our experimental results perfectly match a generalized transport theory that incorporates the effective medium and predicts a precise value for the diffusion constant. Thus, we directly confirm the applicability of the effective medium concept in strongly scattering materials.

Dental hygiene regulation: a global perspective.

Occupational regulation of health personnel is important to professional associations and their members, the public that relies on their services and the regulatory agencies responsible for their conduct. There is increasing interest in ensuring that dental hygiene regulation fosters the continuing evolution of the profession and its contribution to oral health. The keynote address for the 2007 Regulatory Forum on Dental Hygiene, this paper discusses the rationale for and issues pertaining to occupational regulation, outlines the evolvement of dental hygiene and identifies regulatory options for the profession. Professional regulation exists to ensure public safety, health and welfare. However, negative political-economic side effects coupled with environmental pressures have resulted in increased scrutiny for health professionals. One such profession is dental hygiene. Its evolution has been dramatic, in particular over the past few decades, as illustrated by its rapidly increasing numbers and broader distribution globally, gradual shift to the baccalaureate as the entry-level educational requirement and increase in postgraduate programs and expanding scope of practice and increased professional autonomy. Regulatory changes have been more gradual. Regulation is mandatory for the vast majority of dental hygienists. Of the options available, the practice act - the most rigorous type, is predominant. Globally, regulation tends to be administered directly by the government (n = 9 countries) more so than indirectly through a dental board (n = 4) or self-regulation (n = 3). Whether regulated directly or indirectly, dental hygienists increasingly are seeking a greater role in shaping their professional future. Self-regulation, its responsibilities, misperceptions and challenges, is examined as an option.

Full characterization of anisotropic diffuse light.

We demonstrate a method for fully characterizing diffuse transport of light in a statistically anisotropic opaque material. Our technique provides a simple means of determining all parameters governing anisotropic diffusion. Anisotropy in the diffusion constant, the mean free path, and the extrapolation length are, for the first time, determined independently. These results show that the anisotropic diffusion model is effective for modeling transport in anisotropic samples, providing that the light is allowed to travel several times the transport mean free path from the source.

Chemical composition of inks of diverse marine molluscs suggests convergent chemical defenses.

Some marine molluscs, notably sea hares, cuttlefish, squid, and octopus, release ink when attacked by predators. The sea hare Aplysia californica releases secretions from the ink gland and opaline gland that protect individuals from injury or death from predatory spiny lobsters through a combination of mechanisms that include chemical deterrence, sensory disruption, and phagomimicry. The latter two mechanisms are facilitated by millimolar concentrations of free amino acids (FAA) in sea hare ink and opaline, which stimulate the chemosensory systems of predators, ultimately leading to escape by sea hares. We hypothesize that other inking molluscs use sensory disruption and/or phagomimicry as a chemical defense. To investigate this, we examined concentrations of 21 FAA and ammonium in the defensive secretions of nine species of inking molluscs: three sea hares (Aplysia californica, Aplysia dactylomela, Aplysia juliana) and six cephalopods (cuttlefish: Sepia officinalis; squid: Loligo pealei, Lolliguncula brevis, Dosidicus gigas; octopus: Octopus vulgaris, Octopus bimaculoides). We found millimolar levels of total FAA and ammonium in these secretions, and the FAA in highest concentration were taurine, aspartic acid, glutamic acid, alanine, and lysine. Crustaceans and fish, which are major predators of these molluscs, have specific receptor systems for these FAA. Our chemical analysis supports the hypothesis that inking molluscs have the potential to use sensory disruption and/or phagomimicry as a chemical defense.

The complement regulatory proteins CD55 (decay accelerating factor) and CD59 are expressed on the inner acrosomal membrane of human spermatozoa as well as CD46 (membrane cofactor protein).

The complement regulatory proteins CD55 and CD59 are expressed on the plasma membrane of human spermatozoa, whereas CD46 is only on the inner acrosomal membrane (IAM) which becomes surfaced exposed after the acrosome reaction when sperm assume fertilisation-competence. CD55 & CD59, two glycosylphosphatidylinositol (GPI)-anchored proteins, have been detected previously in some studies also in the acrosomal region of chemically fixed spermatozoa but never demonstrated at this site on unfixed spermatozoa. Dual labelling immunofluorescence and confocal microscopy on fresh unfixed spermatozoa, with minimal subsequent time to fixation, has shown CD55 to be markedly expressed on the IAM, more than on the plasma membrane. However, unlike for CD46, CD55 displayed patchy staining over the acrosome, with some variation between individual spermatozoa. All IAM-associated CD55 was localised within GM1-containing lipid rafts. CD59 was expressed also on the IAM, but in a pronounced granular pattern with more variation observed from one spermatozoa to another. Both CD55 & CD59 were released from the IAM by PI-PLC, demonstrating them to be GPI-anchored. Analysis of acrosome-reacted spermatozoal CD55 by Western blotting revealed a novel single 55 kDa protein lacking significant oligosaccharides susceptible to glycosidases. Antibody-induced membrane rafting and release of CD55 & CD59 in vitro may have influenced previous results. Significant coexpression of CD55 & CD46 on the IAM suggests some functional cooperation at this site.

The association of anti-phospholipid antibodies with parity in placental malaria.

Anti-phospholipid antibodies (aPL) are autoantibodies associated with both infections and the pathogenesis of certain pregnancy complications. In the latter, but not the former, aPL are dependent on a co-factor, beta(2) glycoprotein I (beta2GPI), which can also be used as an antigen for detection of such aPL in pregnancy. A cross-sectional study was carried out on serum samples from Kumasi, Ghana, to determine the occurrence and beta2GPI-dependence of aPL in placental malaria. Anti-cardiolipin, anti-phosphatidylserine and anti-beta2GPI enzyme-linked immunosorbent assays (ELISAs) were performed on sera from 103 HIV-non-infected gravid women. Placental malaria, both active and past infection, was diagnosed in 33/103 (32%) based on placental histology. In multiparae, beta2GPI-independent IgM antibodies to cardiolipin (P = 0.018) and phosphatidylserine (P = 0.009) were observed, which were most pronounced in past placental malaria infection. In primiparae, no association emerged between aPL and placental malaria. Trends for improved clinical parameters were identified in infected women with levels of anti-cardiolipin beyond the 99th multiple of the median for a healthy, non-malarious population. This study in placental malaria reports parity associations of beta2GPI-independent aPL profiles, and does not support a role for beta2GPI-dependent aPL. It is of significance in the context of the known parity differences in pregnancy malaria immunity.

P450 arom y microambiente estrogénico en endometrios eutópicos de mujeres con endometriosis / P450Arom and estrogenic microenvironment of eutopic endometria in endometriosis

Background: Endometriosis, a common gynecologic disorder characterized by endometrial glands and stroma outside the uterus, is diagnosed by direct visualization of peritoneal and ovarian implants during laparoscopy. Aim: To study the estrogenic microenvironment in eutopic endometria of women with and without endometriosis. Patients and methods: Eutopic endometria, obtained during laparoscopy from 23 women with endometriosis and 20 fertile cyclic women undergoing tubal sterilization, was studied. P450Arom mRNA expression (RT-PCR) was measured. Also, P450Arom activity was assessed measuring testosterone conversion to estradiol and the concentration of this last hormone in cultured endometrial explants. Results: Age and body mass index was similar in both groups studied. Seventy nine percent of endometria from women with endometriosis and in 29.4 percent from control group expressed P450Arom mRNA (p <0.01). The intensity of the band was higher in secretory endometria from women with endometriosis when compared to controls (p <0.01), but it was similar during the proliferative phase. Estradiol secretion to the culture media by proliferative endometria explants from women with endometriosis was 3-fold higher than secretory endometria (p <0.01) and endometria from control women in both phases. P450Arom activity, in the presence of testosterone, was 7-fold higher in endometrial cultures from women with endometriosis, when compare with the basal culture (p <0.01). However, in endometrial explant cultures from control women, this activity was not statistical different. Conclusions: These results indicate that in women with endometriosis, the microenvironment in the endometria is estrogenic as a consequence of an increased expression and activity of the P450 Arom.

Toxic effects of mebendazole at high dose on the haematology of red-legged pademelons (Thylogale stigmatica).

OBJECTIVE: To investigate the effects of mebendazole at high dose on the haematology of macropods. Experimental. PROCEDURE: Five red-legged pademelons (Thylogale stigmatica) were dosed orally with mebendazole at 50 mg/kg/d for 5 to 6 days. Two control pademelons were dosed with water. Regular blood samples were taken for haematology over 20 days. RESULTS: All four treated pademelons sampled at 5 days developed severe leucopenia and neutropenia, moderate lymphopenia, thrombocytopenia, eosinopenia and monocytopenia, as well as bone marrow aplasia within 5 to 11 days after the first mebendazole dose. Four pademelons died unexpectedly or became ill and were euthanased 5 to 11 days after the first dose while the other animal recovered after 5 days of illness. Necropsy revealed systemic infection with opportunistic enteric bacteria, non-suppurative inflammation in tissues, haemorrhage and ulceration of the gastrointestinal tract. CONCLUSIONS: Red-legged pademelons rapidly develop bone-marrow aplasia and subsequent septicaemia after administration of high doses of mebendazole. Mebendazole at high doses should not be used for macropods.

Aberrant cytokine production by peripheral blood mononuclear cells in recurrent pregnancy loss?

BACKGROUND: Successful pregnancy may depend on a Th2-type cytokine response, whilst, conversely, a poor pregnancy outcome may be associated with an increase in Th1 cytokines and a concomitant decrease in Th2 cytokines. This prospective study was designed to elucidate whether a failure of the cytokine shift pre-dated miscarriage and was therefore likely to be an aetiological factor in recurrent pregnancy loss (RPL). METHODS: Cytokine production by stimulated peripheral blood mononuclear cells from 46 pregnant women who had previously suffered idiopathic RPL during early pregnancy was compared with 25 gestationally age-matched pregnant controls and 11 non-pregnant women. RESULTS: Production of IFN-gamma was lower in pregnant than in non-pregnant women and even lower in RPL pregnant women (P = 0.0191). IL-10 was increased in pregnant women compared with non-pregnant controls, and further increased in RPL patients (P = 0.026). IL-4 was also increased in women with RPL (P = 0.0001). No differences in IFN-gamma, IL-10 or IL-4 secretion were observed in RPL patients who subsequently miscarried compared with those who successfully completed the pregnancy. RPL women with a successful reproductive outcome had similar concentrations of TNF-alpha to pregnant women, RPL women who subsequently miscarried had significantly lower levels than either pregnant women (P = 0.02) or non-pregnant controls (P = 0.0004). CONCLUSIONS: Contrary to our hypothesis, the cytokine shift, which appears to characterize normal pregnancy, was accentuated rather than diminished in RPL pregnant women.

Interlayer structures of the chiral smectic liquid crystal phases revealed by resonant X-ray scattering.

The structures of the liquid crystalline chiral subphases exhibited by several materials containing either a selenium or sulphur atom have been investigated using a resonant x-ray scattering technique. This technique provides a unique structural probe for the ferroelectric, ferrielectric, antiferroelectric, and SmC(*)(alpha) phases. An analysis of the scattering features allows the structural models of the different subphases to be distinguished, in addition to providing a measurement of the helical pitch. This paper reports resonant scattering features in the antiferroelectric hexatic phase, the three- and four-layer intermediate phases, the antiferroelectric and ferroelectric phases and the SmC(*)(alpha) phase. The helicoidal pitch has been measured from the scattering peaks in the four-layer intermediate phase as well as in the antiferroelectric and ferroelectric phases. In the SmC(*)(alpha) phase, an investigation into the helical structure has revealed a pitch ranging from 5 to 54 layers in different materials. Further, a strong resonant scattering signal has been observed in mixtures of a selenium containing material with as much as 90% nonresonant material.

Is interleukin-3 important in antiphospholipid antibody-mediated pregnancy failure?

OBJECTIVE: To investigate the effect of interleukin-3 (IL-3) on trophoblast proliferation and expression of beta2-glycoprotein I. DESIGN: In vitro cell culture using primary trophoblasts and the cell lines Jeg-3, Jar, and BeWo. SETTING: Department of Obstetrics and Gynaecology, University of Auckland. PATIENT(S): Women with normal pregnancies. INTERVENTION(S): Increasing amounts of IL-3 were added to cultures of primary human trophoblasts, cell lines, or cells treated with a proliferation inhibiting antiphospholipid-like antibody. RNA was extracted from primary human trophoblasts or cell lines. MAIN OUTCOME MEASURE(S): We examined basal and IL-3-stimulated cellular proliferation by [3H] thymidine incorporation assay and secretion of beta2-glycoprotein I into culture medium by semiquantitative immunoblot analysis. Reverse transcriptase-polymerase chain reaction analysis was used to demonstrate the presence of IL-3 receptor transcripts. RESULT(S): The IL-3 treatment did not induce proliferation of highly purified primary trophoblast cultures or cell lines but did induce proliferation of contaminating CD45+ cells in trophoblast cultures. The IL-3 did not overcome the antiproliferative effect of an antiphospholipid-like monoclonal antibody on trophoblast. Secretion of beta2-glycoprotein I by trophoblast cultures was time dependent but unaltered by IL-3 treatment. CONCLUSION(S): Our results question the proposed importance of IL-3 in antiphospholipid antibody-mediated fetal death.

International profiles of dental hygiene 1987 to 1998: a 19-nation comparative study.

AIM: Development of an international longitudinal database to examine patterns, trends and changes in dental hygiene. METHOD: Three surveys of national dental hygienists' associations, mainly members of the International Federation of Dental Hygienists. Data were collected by mail in 1987, 1992 and 1998, using a 40-item questionnaire. Sample size increased over time; results presented are based on responses for 13, 15 and 19 countries respectively. Preliminary tabulations were circulated to respondents for validation. RESULTS: Overall, characteristics of the profession were remarkably similar; most noteworthy was the scope of dental hygiene clinical practice. Regarding historical development, education and professional organisation, the profession was more similar than dissimilar. Greater variation was evident in terms of numbers, distribution, workforce behaviour, predominant work setting and remuneration. While apparent change over the relatively short period 1987 to 1998 was viewed with caution, several observations were of particular interest: marked increases in the supply of dental hygienists, scope of practice and range of practice settings, accompanied by a decline in mandated level of work supervision. A slight but gradual increase in independent dental hygiene practice also was noted. CONCLUSION: By 1998 the profiles reflected the vast majority of the world's population of dental hygienists. While rate of change varied across the countries examined, the nature of the change tended to be consistent, resulting in a continuing homogeneity in the profession worldwide. Changes and emerging trends should continue to be monitored in terms of improved access to quality oral health services and technical efficiency in the provision of those services.

Age-related radical-induced DNA damage is linked to prostate cancer.

We measured concentrations and ratios of mutagenic (8-OH) lesions to putatively nonmutagenic formamidopyrimidine (Fapy) lesions of adenine (Ade) and guanine (Gua) to elucidate radical (.OH)-induced changes in DNA of normal, normal from cancer, and cancer tissues of the prostate. The relationship between the lesions was expressed using the mathematical model log(10)[(8-OH-Ade + 8-OH-Gua)/(FapyAde + FapyGua)]. Logistic regression analysis of the log ratios for DNA of normal and cancer tissues discriminated between the two tissue groups with high sensitivity and specificity. Correlation analysis of log ratios for normal prostates revealed a highly significant increase in the proportion of mutagenic base lesions with age. Data from correlation analysis of the log ratios for normal tissues from cancer were consistent with an age-dependent, dose-response relationship. The slopes for both correlations intersected at approximately 61 years, an age when prostate cancer incidence is known to rise sharply. The age-related increase in the proportion of.OH-induced mutagenic base lesions is likely a significant factor in prostate cancer development.