BRAF V600E status adds incremental value to current risk classification systems in predicting papillary thyroid carcinoma recurrence.

Background: Papillary thyroid cancer (PTC) recurrence risk is difficult to predict. No current risk classification system incorporates BRAF mutational status. Here, we assess the incremental value of BRAF mutational status in predicting PTC recurrence relative to existing recurrence risk algorithms.

A protection system for the JET ITER-like wall based on imaging diagnostics.

The new JET ITER-like wall (made of beryllium and tungsten) is more fragile than the former carbon fiber composite wall and requires active protection to prevent excessive heat loads on the plasma facing components (PFC). Analog CCD cameras operating in the near infrared wavelength are used to measure surface temperature of the PFCs. Region of interest (ROI) analysis is performed in real time and the maximum temperature measured in each ROI is sent to the vessel thermal map.

Undiagnosed medical comorbidities in the uninsured: a significant predictor of mortality following trauma.

Background: Lack of health care insurance has been correlated with increased mortality after trauma. Medical comorbidities significantly affect trauma outcomes. Access to health care and thereby being diagnosed with a pretrauma comorbidity is highly dependent on insurance status.

Infections after trauma are associated with subsequent cardiac injury.

Background: Trauma produces profound inflammatory and immune responses. A second hit such as an infection further disrupts the inflammatory cascade. Inflammatory responses, following traumatic injuries, infections, or both, are emerging as biologic mediators of cardiac disease including myocardial ischemia and infarction.

Assessing eating context and fruit and vegetable consumption in children: new methods using food diaries in the UK National Diet and Nutrition Survey Rolling Programme.

Background: Eating context is the immediate environment of each eating occasion (EO). There is limited knowledge on the effects of the eating context on food consumption in children, due to the difficulty in measuring the multiple eating contexts children experience throughout the day. This study applied ecological momentary assessment using food diaries to explore the relationships between eating context and fruit and vegetable consumption in UK children.

Clinical disorders in a post war British cohort reaching retirement: evidence from the First National Birth Cohort study.

Background: The medical needs of older people are growing because the proportion of the older population is increasing and disease boundaries are widening. This study describes the distribution and clustering of 15 common clinical disorders requiring medical treatment or supervision in a representative British cohort approaching retirement, and how health tracked across adulthood.

Methods And Findings: The data come from a cohort of 2661 men and women, 84% of the target sample, followed since birth in England, Scotland and Wales in 1946, and assessed at 60-64 years for: cardio and cerebro-vascular disease, hypertension, raised cholesterol, renal impairment, diabetes, obesity, hypothyroidism, hyperthyroidism, anaemia, respiratory disease, liver disease, psychiatric problems, cancers, atrial fibrillation on ECG and osteoporosis.

5-Arylidenethioxothiazolidinones as inhibitors of tyrosyl-DNA phosphodiesterase I.

Tyrosyl-DNA phosphodiesterase I (Tdp1) is a cellular enzyme that repairs the irreversible topoisomerase I (Top1)-DNA complexes and confers chemotherapeutic resistance to Top1 inhibitors. Inhibiting Tdp1 provides an attractive approach to potentiating clinically used Top1 inhibitors. However, despite recent efforts in studying Tdp1 as a therapeutic target, its inhibition remains poorly understood and largely underexplored.

The role of lifestyle behaviors on 20-year cognitive decline.

This study examined the association between smoking, physical activity and dietary choice at 36 and 43 years, and change in these lifestyle behaviors between these ages, and decline in verbal memory and visual search speed between 43 and 60-64 years in 1018 participants from MRC National Survey of Health and Development (NSHD, the British 1946 birth cohort). ANCOVA models were adjusted for sex, social class of origin, childhood cognition, educational attainment, adult social class, and depression; then the lifestyle behaviors were additionally mutually adjusted. Results showed that healthy dietary choice and physical activity were associated, respectively, with slower memory and visual search speed decline over 20 years, with evidence that increasing physical activity was important.

Adult macronutrient intake and physical capability in the MRC National Survey of Health and Development.

Background: poor physical capability is associated with higher subsequent risk of disability and mortality in older people. Energy and macronutrient intakes may play a role in the maintenance of physical capability. This analysis aimed to examine the role of intakes of energy and the macronutrients, protein, carbohydrate and fat in early and mid-adulthood on objective measures of physical capability in later adulthood in the MRC National Survey of Health and Development (1946 British birth cohort).

Empiric antibiotics pending bronchoalveolar lavage data in patients without pneumonia significantly alters the flora, but not the resistance profile, if a subsequent pneumonia develops.

Introduction: Ventilator-associated pneumonia (VAP) occurs in up to 25% of mechanically ventilated patients, with an associated mortality up to 50%. Early diagnosis and appropriate empiric antibiotic coverage of VAP are crucial. Given the multitude of noninfectious clinical and radiographic anomalies within trauma patients, microbiology from bronchioalveolar lavage (BAL) is often needed.

Preoperative localization strategies for primary hyperparathyroidism: an economic analysis.

Background: Strategies for localizing parathyroid pathology preoperatively vary in cost and accuracy. Our purpose was to compute and compare comprehensive costs associated with common localization strategies.

Methods: A decision-analytic model was developed to evaluate comprehensive, short-term costs of parathyroid localization strategies for patients with primary hyperparathyroidism.

Time-of-day and nutrient composition of eating occasions: prospective association with the metabolic syndrome in the 1946 British birth cohort.

Background: Diet is a key modifiable factor in the prevention and treatment of the metabolic syndrome. However, few studies have examined the prospective association between time-of-day of nutrient intake and the metabolic syndrome.

Objective: To examine the association between time-of-day and nutrient composition of eating occasions and the long-term development of metabolic syndrome in the Medical Research Council (MRC) National Survey of Health and Development (NSHD; 1946 British birth cohort).

Diagnostic yield of nondiagnostic thyroid nodules is not altered by timing of repeat biopsy.

Background: Guidelines from the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference recommend a repeat fine-needle aspiration biopsy (FNAB) after 3 months for thyroid nodules with a nondiagnostic (ND) result. Our aims were to assess which factors influenced their clinical management and to determine if the timing of the repeat FNAB affects the diagnostic yield.

Methods: A retrospective institutional review of 298 patients from 1/2006 to 12/2007 with an ND FNAB was performed.

Estimating the alcohol-breast cancer association: a comparison of diet diaries, FFQs and combined measurements.

The alcohol-breast cancer association has been established using alcohol intake measurements from Food Frequency Questionnaires (FFQ). For some nutrients diet diary measurements are more highly correlated with true intake compared with FFQ measurements, but it is unknown whether this is true for alcohol. A case-control study (656 breast cancer cases, 1905 matched controls) was sampled from four cohorts in the UK Dietary Cohort Consortium.

Synthesis and biological evaluation of the first dual tyrosyl-DNA phosphodiesterase I (Tdp1)-topoisomerase I (Top1) inhibitors.

Substances with dual tyrosyl-DNA phosphodiesterase I-topoisomerase I inhibitory activity in one low molecular weight compound would constitute a unique class of anticancer agents that could potentially have significant advantages over drugs that work against the individual enzymes. The present study demonstrates the successful synthesis and evaluation of the first dual Top1-Tdp1 inhibitors, which are based on the indenoisoquinoline chemotype. One bis(indenoisoquinoline) had significant activity against human Tdp1 (IC(50) = 1.

The role and requirements of digestible dietary carbohydrates in infants and toddlers.

Digestible carbohydrates are one of the main sources of dietary energy in infancy and childhood and are essential for growth and development. The aim of this narrative review is to outline the intakes of digestible carbohydrates and their role in health and disease, including the development of food preferences, as well the consequences of excess carbohydrate. Key experts in these fields provided up-to-date reviews of the literature.

Oxime-based linker libraries as a general approach for the rapid generation and screening of multidentate inhibitors.

The described oxime-based library protocol provides detailed procedures for the linkage of aminooxy functionality with aldehyde building blocks that result in the generation of libraries of multidentate inhibitors. Synthesis of inhibitors for protein tyrosine phosphatases (PTPs) and antagonists directed against the human tumor susceptibility gene 101 (TSG101) are shown as examples. Three steps are involved: (i) the design and synthesis of aminooxy platforms; (ii) tethering with aldehydes to form oxime-based linkages with sufficient purity; and (iii) direct in vitro biological evaluation of oxime products without purification.

Bereavement care for older people in healthcare settings: qualitative study of experiences.

Aim: This study aimed to explore the experiences of healthcare staff of caring for bereaved older people, and older people's experiences of bereavement care.

Background: Loss through death of close family members, partners and friends inhibits the physical, emotional and social well being of older people. The rising population of older people and pressure on healthcare services to reduce costs indicate the necessity of developing strategies that enable coping and independence.

Daily profiles of energy and nutrient intakes: are eating profiles changing over time?

Background/objectives: Associations between timing of eating occasions and their nutrient composition and health have been described in interventional and cross-sectional studies. However, data from longitudinal data are limited. This study examined 17-year changes in energy and macronutrient intake across eating occasions in the 1946 British birth cohort.

Atypical squamous metaplasia in a benign cystic thyroid nodule mimicking high-grade carcinoma.

Squamous metaplasia (SM) occurs in a variety of thyroid conditions, both neoplastic and non-neoplastic. In a small subset of benign thyroid lesions, SM can create a diagnostic pitfall by mimicking a malignant process. Here, we describe the case of a 52-year-old male with a 1.

Vitamins, minerals, essential fatty acids and colorectal cancer risk in the United Kingdom Dietary Cohort Consortium.

The risk for colorectal cancer may be influenced by the dietary intake of various vitamins, minerals and essential fatty acids. We conducted a pooled analysis of dietary data collected using food diaries in seven prospective studies in the United Kingdom Dietary Cohort Consortium. Five hundred sixty-five cases of colorectal cancer were matched with 1,951 controls on study centre, age, sex and recruitment date.

Preoperative basal calcitonin and tumor stage correlate with postoperative calcitonin normalization in patients undergoing initial surgical management of medullary thyroid carcinoma.

Background: The optimal initial operative management of medullary thyroid cancer (MTC) and the use of biomarkers to guide the extent of operation remain controversial. We hypothesized that preoperative serum levels of calcitonin and carcinoembryonic antigen (CEA) correlate with extent of disease and postoperative levels reflect the extent of operation performed.

Methods: We assessed retrospectively clinical and pathologic factors among patients with MTC undergoing at least total thyroidectomy; these factors were correlated with biomarkers using regression analyses.