Commissioning a multileaf collimator virtual cone for the stereotactic radiosurgery of trigeminal neuralgia.

A multileaf collimator (MLC), virtual-cone treatment technique has been commissioned for trigeminal neuralgia (TGN) at Tri-Cities Cancer Center (TCCC). This novel technique was initially developed at the University of Alabama in Birmingham (UAB); it is designed to produce a spherical dose profile similar to a fixed, 5-mm conical collimator distribution. Treatment is delivered with a 10-MV flattening-filter-free (FFF) beam using a high-definition MLC on a Varian Edge linear accelerator.

The endogenous circadian system worsens asthma at night independent of sleep and other daily behavioral or environmental cycles.

Asthma often worsens at night. To determine if the endogenous circadian system contributes to the nocturnal worsening of asthma, independent of sleep and other behavioral and environmental day/night cycles, we studied patients with asthma (without steroid use) over 3 wk in an ambulatory setting (with combined circadian, environmental, and behavioral effects) and across the circadian cycle in two complementary laboratory protocols performed in dim light, which separated circadian from environmental and behavioral effects: 1) a 38-h "constant routine," with continuous wakefulness, constant posture, 2-hourly isocaloric snacks, and 2) a 196-h "forced desynchrony" incorporating seven identical recurring 28-h sleep/wake cycles with all behaviors evenly scheduled across the circadian cycle. Indices of pulmonary function varied across the day in the ambulatory setting, and both laboratory protocols revealed significant circadian rhythms, with lowest function during the biological night, around 4:00 AM, uncovering a nocturnal exacerbation of asthma usually unnoticed or hidden by the presence of sleep.

Racial and ethnic differences in response to treatment for Marfan syndrome.

Objective: To determine whether racial/ethnic differences exist for the treatment of Marfan syndrome aortopathy. The 2014 Pediatric Heart Network randomised trial of losartan versus atenolol in Marfan syndrome paediatric and young adult patients showed no treatment differences in the rate of aortic root growth over 3 years; however, they did not examine racial/ethnic differences, and recent data suggest that angiotensin receptor blockers may have different pharmacologic effects in different racial/ethnic populations.

Methods: We performed a secondary analysis of public-use data from the Pediatric Heart Network randomised trial comparing the differences by race/ethnicity (non-Hispanic White, non-Hispanic Black, and Hispanic patients) amongst the treatment groups for the primary outcome of rate of aortic root enlargement by z score and secondary outcome of rate of change of absolute diameter of aortic root, z score and absolute diameter of ascending aorta, and blood pressure changes.

Corrosion of Titanium Spinal Explants Is Similar to That Observed in Oil Field Line Pipe Steel: Evidence of Microbial-Influenced Corrosion In Vivo.

Current explanations of biomedical alloy degradation are focused on the physicochemical mechanisms of galvanic, pitting, crevice, and fretting corrosion. Ultimately, these studies dismiss the corrosion mechanism as a function of the local microbiome. Sixty spine hardware constructs were examined immediately after explantation for biofilm formation.

Localization and functional consequences of a direct interaction between TRIOBP-1 and hERG proteins in the heart.

Reduced levels of the cardiac human (h)ERG ion channel protein and the corresponding repolarizing current can cause arrhythmia and sudden cardiac death, but the underlying cellular mechanisms controlling hERG surface expression are not well understood. Here, we identified TRIOBP-1, an F-actin-binding protein previously associated with actin polymerization, as a putative hERG-interacting protein in a yeast-two hybrid screen of a cardiac library. We corroborated this interaction by performing Förster resonance energy transfer (FRET) in HEK293 cells and co-immunoprecipitation in HEK293 cells and native cardiac tissue.

Three cases of metallosis associated with spine instrumentation.

The characteristic trait of metallosis is the presence of tissue staining. Analyzing explanted revision hardware from spine surgeries and performing ICPMS/AES analysis on removed tissue samples, a clinically relevant definition for metallosis may be developed. Results of the analysis identified hardware fretting wear and corrosion, and ICP-MS/AES analysis identified elevated metal ion concentrations in all cases.

Spine rod straightening as a possible cause for revision.

In a previous study, the authors examined the elastic and short-term anelastic springback of Ti6Al4V, CoCrMoC and A316L stainless steel spine rods to observe how the rods mechanically respond in OR contouring. In that study rods were 200 mm long and only the movement at the tip was recorded. The implication of that work was that rods will straighten in-vivo, however, in order for the mechanism of straightening to be determined, the movement of individual bends over time must first be elucidated.

Phage-mediated horizontal gene transfer of both prophage and heterologous DNA by ϕBB-1, a bacteriophage of Borrelia burgdorferi.

Horizontal gene transfer (HGT) in Borrelia burgdorferi, the Lyme disease agent, is likely mediated by bacteriophage. Studies of the B. burgdorferi phage, ϕBB-1 and its role in HGT have been hindered by the lack of an assay for readily characterizing phage-mediated DNA movement (transduction).

Indacaterol-Glycopyrronium versus Salmeterol-Fluticasone for COPD.

Background: Most guidelines recommend either a long-acting beta-agonist (LABA) plus an inhaled glucocorticoid or a long-acting muscarinic antagonist (LAMA) as the first-choice treatment for patients with chronic obstructive pulmonary disease (COPD) who have a high risk of exacerbations. The role of treatment with a LABA-LAMA regimen in these patients is unclear.

Methods: We conducted a 52-week, randomized, double-blind, double-dummy, noninferiority trial.

Use of the gamma probe to identify multigland disease in primary hyperparathyroidism.

Aim: The purpose of this study was to determine threshold gamma probe counts to distinguish single adenoma (SA) from multigland disease (MGD) during radioguided parathyroidectomy.

Methods: A retrospective analysis of 1656 patients was performed. counts of the first excised gland were taken and recorded as a percentage of background counts.

Antimicrobial activity and biologic potential of silver-substituted calcium phosphate constructs produced with self-propagating high-temperature synthesis.

There is significant demand for synthetic bone substitute materials that can decrease the incidence of implant-based bacterial infections. The intent of this research was to evaluate the antimicrobial activity and biologic potential of calcium phosphate (CaP) constructs substituted with silver (Ag) that were produced via self-propagating high-temperature synthesis (SHS). SHS is a combustion synthesis technique that has successfully generated porous CaP bioceramics intended for use in bone repair.

Biologic Potential of Calcium Phosphate Biopowders Produced via Decomposition Combustion Synthesis.

The aim of this research was to evaluate the biologic potential of calcium phosphate (CaP) biopowders produced with a novel reaction synthesis system. Decomposition combustion synthesis (DCS) is a modified combustion synthesis method capable of producing CaP powders for use in bone tissue engineering applications. During DCS, the stoichiometric ratio of reactant salt to fuel was adjusted to alter product chemistry and morphology.

Does levothyroxine administration impact parathyroid localization?

Background: Proper localization is crucial in performing minimally invasive parathyroidectomy for primary hyperparathyroidism. Ultrasonography (US) and Tc-99m sestamibi (MIBI) scintigraphy are common methods used for localization. As the appearance and activity of the thyroid gland may impact parathyroid localization, the purpose of this study was to determine how exogenous use of the thyroid hormone, levothyroxine (LT), affects parathyroid localization.

Impact of cleaning and other interventions on the reduction of hospital-acquired Clostridium difficile infections in two hospitals in England assessed using a breakpoint model.

Background: Clostridium difficile infection remains a major challenge for hospitals. Although targeted infection control initiatives have been shown to be effective in reducing the incidence of hospital-acquired C. difficile infection, there is little evidence available to assess the effectiveness of specific interventions.

Genome Sequence of Non-O1 Vibrio cholerae PS15.

The draft genome sequence of a non-O1 Vibrio cholerae strain, PS15, organized into 3,512 open reading frames within a 3.9-Mb genome, was determined. The PS15 genome sequence will allow for the study of the evolution of virulence and environmental adaptation in V.

Risk stratification for metastasis from cutaneous squamous cell carcinoma of the head and neck.

Background: The purpose of the study was to develop a system of risk stratification, based on clinical and histological factors that would aid prediction of metastasis from cutaneous squamous cell carcinoma (SCC) of the head and neck.

Method: The method used was a retrospective case control study comparing clinical and histological parameters of 78 patients who developed metastasis with 92 patients who did not develop metastasis over a 5-year period.

Results: The two 'absolute' (highest) risk factors for development of metastatic disease are poor histological differentiation and perineural/lymphovascular infiltration.

Personalized implant for high tibial opening wedge: combination of solid freeform fabrication with combustion synthesis process.

In this work a new generation of bioceramic personalized implants were developed. This technique combines the processes of solid freeform fabrication (SFF) and combustion synthesis (CS) to create personalized bioceramic implants with tricalcium phosphate (TCP) and hydroxyapatite (HA). These porous bioceramics will be used to fill the tibial bone gap created by the opening wedge high tibial osteotomy (OWHTO).

Evaluation of spinal instrumentation rod bending characteristics for in-situ contouring.

Bending characteristics were studied in rods used for spinal instrumentation at in-situ contouring conditions. Five groups of five 6 mm diameter rods made from: cobalt alloy (VITALLIUM), titanium-aluminum-vanadium alloy (SDI™), β-titanium alloy (TNTZ), cold worked stainless steel (STIFF), and annealed stainless steel (MALLEABLE) were studied. The bending procedure was similar to that typically applied for in-situ contouring in the operating room and included two bending cycles: first--bending to 21-24° under load with further release of loading for 10 min, and second--bending to 34-37° at the previously bent site and release of load for 10 min.

Cellular response of titanium and its alloys as implants.

The cellular response of osteocytes to commercially pure titanium (α) and its alloys (α + β and β) has been tested in a culture media, and the results have been supplemented by analyses from various techniques such as inductively coupled plasma atomic emission spectroscopic (ICP-AES) analysis, X-ray photoemission spectroscopy (XPS), scanning electron microscopy (SEM), metallography, and electrochemical measurements. These results have been correlated with respect to the presence of various alloying elements in these alloys to qualify them for human application. The newer β alloys have been examined for their potential use as implants.

Addition at the molecular level: signal integration in designed Per-ARNT-Sim receptor proteins.

Survival of organisms in dynamic environments requires accurate perception and integration of signals. At the molecular level, signal detection is mediated by signal receptor proteins that largely are of modular composition. Sensor modules, such as the widespread Per-ARNT-Sim (PAS) domains, detect signals and, in response, regulate the biological activity of effector modules.

Structure and function of plant photoreceptors.

Signaling photoreceptors use the information contained in the absorption of a photon to modulate biological activity in plants and a wide range of organisms. The fundamental-and as yet imperfectly answered-question is, how is this achieved at the molecular level? We adopt the perspective of biophysicists interested in light-dependent signal transduction in nature and the three-dimensional structures that underpin signaling. Six classes of photoreceptors are known: light-oxygen-voltage (LOV) sensors, xanthopsins, phytochromes, blue-light sensors using flavin adenine dinucleotide (BLUF), cryptochromes, and rhodopsins.