Is moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion superior to deep hypothermic circulatory arrest in elective aortic arch surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion (SACP) is more beneficial than deep hypothermic circulatory arrest in elective aortic arch surgery. Altogether, 1028 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question.

Chinese Herbal Medicine and Salmeterol and Fluticasone Propionate for Chronic Obstructive Pulmonary Disease: Systematic Review and Network Meta-Analysis.

Among Chinese populations worldwide, Chinese herbal medicines (CHMs) are often used as an adjunct to pharmacotherapy in managing chronic obstructive pulmonary disease (COPD). However, the relative performance among different CHM is unknown.The aim of this study was to evaluate comparative effectiveness of different CHM when used with salmeterol and fluticasone propionate (SFP), compared with SFP alone.

Multitargeted combination effects of a triherbal formulation containing ELP against osteoporosis: in vitro evidence.

Objectives: An anti-osteoporotic herbal formula ELP containing Epimedii Herba (E), Ligustri Lucidi Fructus (L) and Psoraleae Fructus (P) was studied to investigate the herb-herb interaction (or the possible synergistic effect) among each component and to identify the principal herbs in different modes of action.

Methods: Rat osteoblast-like UMR-106 cells proliferation, rat MSCs-derived osteoblastogenesis and RANKL-induced RAW 264.7 osteoclastogenesis were adopted to investigate the bone-forming activity and bone-degrading activity of the herbal extracts.

Combined Use of Gene Expression Modeling and siRNA Screening Identifies Genes and Pathways Which Enhance the Activity of Cisplatin When Added at No Effect Levels to Non-Small Cell Lung Cancer Cells In Vitro.

Platinum-based combination chemotherapy is the standard treatment for advanced non-small cell lung cancer (NSCLC). While cisplatin is effective, its use is not curative and resistance often emerges. As a consequence of microenvironmental heterogeneity, many tumour cells are exposed to sub-lethal doses of cisplatin.

Usability of the Massachusetts Prescription Drug Monitoring Program in the Emergency Department: A Mixed-methods Study.

Objectives: Prescription drug monitoring programs (PDMPs) are underutilized, despite evidence showing that they may reduce the epidemic of opioid-related addiction, diversion, and overdose. We evaluated the usability of the Massachusetts (MA) PDMP by emergency medicine providers (EPs), as a system's usability may affect how often it is used.

Methods: This was a mixed-methods study of 17 EPs.

Chinese Herbal Medicine for Improving Quality of Life Among Nonsmall Cell Lung Cancer Patients: Overview of Systematic Reviews and Network Meta-Analysis.

For patients with nonsmall cell lung cancer (NSCLC) receiving chemotherapy, current clinical evidence has indicated add-on benefit of Chinese herbal medicine (CHM) in improving quality of life (QoL). However, the relative performance among different CHM is unknown. The aim of this overview of systematic reviews (SRs) and network meta-analyses (NMA) is to evaluate the comparative effectiveness of different CHM.

Death by homicide in National Collegiate Athletic Association athletes between 2003 and 2013.

Background: The incidence of homicide-related death among individuals of college age in the United States population is estimated at 15.5/100,000. The incidence of homicide among National Collegiate Athletic Association (NCAA) athletes is unknown.

Fumarate Hydratase-deficient Cell Line NCCFH1 as a New In Vitro Model of Hereditary Papillary Renal Cell Carcinoma Type 2.

Background/aim: Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare autosomal dominant disorder characterized by fumarate hydratase (FH) gene mutation. It is associated with the development of very aggressive kidney tumors, characterized by early onset and high metastatic potential, and has no effective therapy. The aim of the study was to establish a new preclinical platform for investigating morphogenetic and metabolic features, and alternative therapy of metastatic hereditary papillary renal cell carcinoma type 2 (PRCC2).

Best Practices for Prescription Drug Monitoring Programs in the Emergency Department Setting: Results of an Expert Panel.

Prescription drug monitoring programs are generally underused in emergency departments (ED) and nationwide enrollment is low among emergency physicians. We aimed to develop consensus recommendations for prescription drug monitoring program policy and design to optimize their functionality and use in the ED. We assembled a technical expert panel with key stakeholders in emergency medicine, public health, and public policy.

A Simple Algorithm for Finding All k-Edge-Connected Components.

The problem of finding k-edge-connected components is a fundamental problem in computer science. Given a graph G = (V, E), the problem is to partition the vertex set V into {V1, V2,…, Vh}, where each Vi is maximized, such that for any two vertices x and y in Vi, there are k edge-disjoint paths connecting them. In this paper, we present an algorithm to solve this problem for all k.

Ensemble learning for prediction of the bioactivity capacity of herbal medicines from chromatographic fingerprints.

Background: Recent quality control of complex mixtures, including herbal medicines, is not limited to chemical chromatographic definition of one or two selected compounds; multivariate linear regression methods with dimension reduction or regularisation have been used to predict the bioactivity capacity from the chromatographic fingerprints of the herbal extracts. The challenge of this type of analysis requires a multi-dimensional approach at two levels: firstly each herb comprises complex mixtures of active and non-active chemical components; and secondly there are many factors relating to the growth, production, and processing of the herbal products. All these factors result in the significantly diverse concentrations of bioactive compounds in the herbal products.

Predictive Factors for BRCA1 and BRCA2 Genetic Testing in an Asian Clinic-Based Population.

Purpose: The National Comprehensive Cancer Network (NCCN) has proposed guidelines for the genetic testing of the BRCA1 and BRCA2 genes, based on studies in western populations. This current study assessed potential predictive factors for BRCA mutation probability, in an Asian population.

Methods: A total of 359 breast cancer patients, who presented with either a family history (FH) of breast and/or ovarian cancer or early onset breast cancer, were accrued at the National Cancer Center Singapore (NCCS).

Mining Symptom-Herb Patterns from Patient Records Using Tripartite Graph.

Unlike the western medical approach where a drug is prescribed against specific symptoms of patients, traditional Chinese medicine (TCM) treatment has a unique step, which is called syndrome differentiation (SD). It is argued that SD is considered as patient classification because prior to the selection of the most appropriate formula from a set of relevant formulae for personalization, a practitioner has to label a patient belonging to a particular class (syndrome) first. Hence, to detect the patterns between herbs and symptoms via syndrome is a challenging problem; finding these patterns can help prepare a prescription that contributes to the efficacy of a treatment.

Mutation signatures implicate aristolochic acid in bladder cancer development.

Background: Aristolochic acid (AA) is a natural compound found in many plants of the Aristolochia genus, and these plants are widely used in traditional medicines for numerous conditions and for weight loss. Previous work has connected AA-mutagenesis to upper-tract urothelial cell carcinomas and hepatocellular carcinomas. We hypothesize that AA may also contribute to bladder cancer.

Body Mass Index and Smoking Affect Thioguanine Nucleotide Levels in Inflammatory Bowel Disease.

Introduction: Optimal levels of the thiopurine metabolite, 6-thioguanine nucleotides [6-TGN] correlate with remission of inflammatory bowel disease [IBD]. Apart from variations in the thiopurine methyl transferase [TPMT] gene, little is known about other predictors of 6-TGN levels. Obesity adversely affects response to infliximab and adalimumab and clinical course in IBD, but little is known about the interaction of thiopurines and obesity.

Effect of grass pollen immunotherapy on clinical and local immune response to nasal allergen challenge.

Rationale: Nasal allergen provocations may be useful in investigating the pathophysiology of allergic rhinitis and effects of treatments.

Objective: To use grass pollen nasal allergen challenge (NAC) to investigate the effects of allergen immunotherapy in a cross-sectional study.

Methods: We studied nasal and cutaneous responses in untreated subjects with seasonal grass-pollen allergic rhinitis (n = 14) compared with immunotherapy-treated allergics (n = 14), plus a nonatopic control group (n = 14).

Evaluating external contamination of polybrominated diphenyl ethers in human hair: clinical and research implications.

Background: Human hair is a well-validated matrix for detecting a variety of xenobiotics, including drugs of abuse (cocaine, tetrahydrocannabinol, and morphine) and fatty acid ethyl ethers. Recent studies have shown that hair can also be useful in determining an individual's exposure to polybrominated diphenyl ethers (PBDEs), flame retardants that contaminate the dust in our daily environment. Hair processing before assay varies with each analyte; in particular, the wash protocol must be optimized to remove external contaminants while not affecting levels of the chemical of interest.

STIM2 regulates PKA-dependent phosphorylation and trafficking of AMPARs.

STIMs (STIM1 and STIM2 in mammals) are transmembrane proteins that reside in the endoplasmic reticulum (ER) and regulate store-operated Ca(2+) entry (SOCE). The function of STIMs in the brain is only beginning to be explored, and the relevance of SOCE in nerve cells is being debated. Here we identify STIM2 as a central organizer of excitatory synapses.

Increased workload for systematic review literature searches of diagnostic tests compared with treatments: challenges and opportunities.

Background: Comprehensive literature searches are conducted over multiple medical databases in order to meet stringent quality standards for systematic reviews. These searches are often very laborious, with authors often manually screening thousands of articles. Information retrieval (IR) techniques have proven increasingly effective in improving the efficiency of this process.

A co-culture genome-wide RNAi screen with mammary epithelial cells reveals transmembrane signals required for growth and differentiation.

Introduction: The extracellular signals regulating mammary epithelial cell growth are of relevance to understanding the pathophysiology of mammary epithelia, yet they remain poorly characterized. In this study, we applied an unbiased approach to understanding the functional role of signalling molecules in several models of normal physiological growth and translated these results to the biological understanding of breast cancer subtypes.

Methods: We developed and utilized a cytogenetically normal clonal line of hTERT immortalized human mammary epithelial cells in a fibroblast-enhanced co-culture assay to conduct a genome-wide small interfering RNA (siRNA) screen for evaluation of the functional effect of silencing each gene.

An improved independent component analysis model for 3D chromatogram separation and its solution by multi-areas genetic algorithm.

Background: The 3D chromatogram generated by High Performance Liquid Chromatography-Diode Array Detector (HPLC-DAD) has been researched widely in the field of herbal medicine, grape wine, agriculture, petroleum and so on. Currently, most of the methods used for separating a 3D chromatogram need to know the compounds' number in advance, which could be impossible especially when the compounds are complex or white noise exist. New method which extracts compounds from 3D chromatogram directly is needed.

Whole-exome sequencing studies of parathyroid carcinomas reveal novel PRUNE2 mutations, distinctive mutational spectra related to APOBEC-catalyzed DNA mutagenesis and mutational enrichment in kinases associated with cell migration and invasion.

Context: Cell division cycle 73 (CDC73), encoding the protein parafibromin, is the most prevalent mutated gene in familial and sporadic parathyroid carcinoma (PC).

Objective: To identify additional genetic abnormalities in PCs.

Design: Whole-exome sequencing was performed using DNA from seven pairs of matched PCs and one triplet containing double primary tumor and normal leukocyte.

Hair as a biomarker of systemic exposure to polybrominated diphenyl ethers.

The efficacy of using hair as a biomarker for exposure to polybrominated diphenyl ether (PBDE) flame retardants was assessed in humans and an animal model. Paired human hair and serum samples were obtained from adult men and women (n = 50). In parallel, hair, serum, liver, and fat were collected from adult male Sprague-Dawley rats exposed to increasing doses of the PBDE mixture found in house dust for 70 days via the diet.

Mutation signatures of carcinogen exposure: genome-wide detection and new opportunities for cancer prevention.

Exposure to environmental mutagens is an important cause of human cancer, and measures to reduce mutagenic and carcinogenic exposures have been highly successful at controlling cancer. Until recently, it has been possible to connect the chemical characteristics of mutagens to actual mutations observed in human tumors only indirectly. Now, next-generation sequencing technology enables us to observe in detail the DNA-sequence-level effects of well-known mutagens, such as ultraviolet radiation and tobacco smoke, as well as endogenous mutagenic processes, such as those involving activated DNA cytidine deaminases (APOBECs).

Safety of the newer class of opioid antagonists in pregnancy.

Question: I have a patient recently confirmed to be 6 weeks pregnant. For the past 6 months she has been treated for an opioid addiction with buprenorphine-naloxone combination. Should I be concerned about her exposure to this drug combination up to this point of the pregnancy? Should I switch her medication to methadone now that she is pregnant?

Answer: The limited data on buprenorphine exposure during pregnancy show no increased risk of adverse outcomes in the newborn.