关键词： Cancer   Complementary and alternative medicines   Evidence-based   Education  

摘要： Complementary and alternative medicine (CAM) usage amongst cancer patients is high globally and in Australia. CAM use in cancer care has the ability to increase chemotherapy toxicity or cause sub-therapy due to altered metabolism as well as increase a patient's bleeding risk. Furthering these risks, people with cancer are largely obtaining their CAM use information from non-evidence-based sources. This study aimed to determine whether the implementation of a CAM education influenced decision-making with regard to CAM usage amongst cancer patients. Twenty people with cancer were recruited for participation in this study. The aims of this study were achieved by surveying patients via questionnaire, both prior to and following receiving an evidence-based CAM education, in either or both written or audiovisual format. This exploratory study found, consistent with the literature, that the majority of participants were obtaining their CAM use information from non-evidenced-based sources. Additionally, it found that the participants wanted more CAM use information and that they demonstrated some altered decision-making after receiving evidenced-based information. On the post-educational questionnaire, the number of participants that stated that they would use CAMs decreased by almost 14%, and some participants made CAM use decisions in accordance with the information provided in the resources. Furthermore, a small increase in CAM knowledge was demonstrated, and it was reported that the resource had prompted them to look further into CAM information. Lastly, the participants in this study found the resource to be mostly useful and helpful and preferred the animated video to the written information.

关键词： rolling element bearings   multiresolution symmetric difference   fault detection   analytic energy operator  

摘要： Teager energy operator (TEO), as a classic energy demodulation method, is specially employed to detect both the amplitude and frequency modulations of the vibration signals recorded from damaged elements. The fault characteristic frequency is identified in the spectrum of energy-transformed signal through the inherent amplitude demodulation. However, the TEO is easily sensitive to intensive noise and vibration interferences. To conquer this disadvantage, an alternative energy operator method, which is realized using a multiresolution symmetric difference and analytic energy operator, is proposed to cope with the vibration signals corrupted by strong noise and multiple vibration interference components. It is simple to implement bearing fault detection and provides excellent time resolution. So, the proposed energy detector is a fast and non-filtering method. The results of simulated tests and real experiments show that the enhanced energy operator can detect fault characteristics effectively in harsh working conditions and certify its superiority according to compare with previous energy operator techniques as well as some popular fault detection methods.

关键词： Atypical hemolytic uremic syndrome   Complement 3 glomerulopathy   Eculizumab   Avacopan  

摘要： The complement system plays a significant role within the pathological process of C3 glomerulopathy (C3GP) and atypical hemolytic uremic syndrome (aHUS). In daily practice, clinicians should differentiate the subgroups of C3GP because of they should apply different treatment modalities. In the past, C3GP was considered as a part of membranoproliferative glomerulonephritis (MPGN). MPGN is defined as glomerular capillary thickening secondary to the synthesis of the new glomerular basement membrane and mesangial cellular hyperplasia with mesangial matrix expansion. Atypical hemolytic uremic syndrome is an ultra-rare disease that can be outlined by the triad of Coombs negative microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Recent advances demonstrated that these diseases share common abnormalities of the control of the alternative complement system. Therefore, nowadays, most researchers advocate that there may be overlap in the pathogenesis of C3GP and aHUS. This review will provide recent novel mechanisms and treatment options in these diseases. For the purposes that we mentioned above and to help clinicians, we aimed to describe the etiology, pathophysiology, and treatment of C3GP and aHUS in this comprehensive review.

关键词： Devonian   euphyllophyte   Emsian   fossil   phylogeny   secondary growth   seed plant   structural complexity  

摘要： An abrupt transition in the fossil record separates Early Devonian euphyllophytes with a simple structure from a broad diversity of structurally complex Middle-Late Devonian plants. Morphological evolution and phylogeny across this transition are poorly understood due to incomplete sampling of the fossil record. We document a new Early Devonian radiatopsid and integrate it in analyses addressing euphyllophyte relationships. Anatomically preserved Emsian fossils (402-394 Ma) from the Battery Point Formation (Gaspe, Quebec, Canada) are studied in serial sections. The phylogenetic analysis is based on a matrix of 31 taxa and 50 characters emphasising vegetative morphology (41 discrete, nine continuous). The new plant, Kenrickia bivena gen. et sp. nov., is one of very few structurally complex euphyllophytes documented in the Early Devonian. Inclusion of Kenrickia overturns previously established phylogenetic relationships among Radiatopses, reiterating the need for increased density of Early Devonian taxon sampling. Kenrickia is recovered as the sister lineage to all other radiatopsids, a clade in which paraphyletic Stenokoleales led to a lignophyte clade where archaeopterids and seed plants fall into sister clades. Our results shed light on early euphyllophyte relationships and evolution, indicating early exploration of structural complexity by multiple lineages and reiterating the potential of a single origin of secondary growth in euphyllophytes.

关键词： cell death   cell viability   chemotherapy   cisplatin   mass cytometry  

摘要： The identification and discrimination of viable cells is important to understand how experimental variables may influence biochemical processes such as cell metabolism, cell cycle, and signaling pathways. Cisplatin is commonly used as a viability stain in mass cytometry studies, however, recent work by Mei et al. has demonstrated that cisplatin can also be used to label antibodies, complicating the simultaneous use of the platinum measurement channels for both antibody and viability staining. This study demonstrates that other metal salts (hafnium chloride, niobium chloride, and zirconium chloride) can serve as substitutes for cisplatin in viability staining. These stains yield similar fractions of live and dead cells and stain the same dead cells in parallel high parameter analyses. In addition, this study demonstrates how a variety of protein antigen viability markers (pRb, Ki-67, Histone H1, cleaved PARP, and GAPDH) can be used to discriminate live and dead cell populations, without the need for a separate viability staining step. As few as two of these protein antigen viability markers can help identify live and dead cell populations in fixed samples and can identify the same viable cells in high dimensional analyses with or without use of viability stain information. This study demonstrates several alternative approaches to mass cytometry viability assessment that can facilitate use of platinum isotopes for antibody staining and enables identification of live and dead cell populations in samples for which a separate viability stain is not practical.

关键词： Pyricularia oryzae   Rice blast   Oryza sativa   Wild rice Oryza australiensis   Wheat   Barley   Corn   Ryegrass   Inoculum reservoirs  

摘要： Rice blast (Pyricularia oryzae) has become a serious disease on commercial rice (Oryza sativa) crops in northern Australia and is present there on wild rice (O. australiensis). Characterisation of the host range of P. oryzae is fundamental to both reducing disease spread and to preventing development of epidemics via better management of Poaceae inoculum reservoirs in Australia. Studies on response of three different wild O. australiensis sources toward four isolates of P. oryzae showed all genotypes very susceptible to three isolates [WAC13466 (race IA-1), BRIP53376 (race IB-3), NT2014a (race unknown)], but resistant to isolate BRIP39772 (race IA-3). Studies to investigate levels of blast disease development following inoculation on a range of Poaceae hosts showed both P. oryzae isolates (WAC13466, BRIP53376) were highly virulent on barley (disease index, DI = 100%), and on Phalaris and O. australiensis (DI = 70%). However, isolate BRIP53376 showed a significantly higher level of aggressiveness (DI similar to 80%) on ryegrass, wild oat and rice. Of the two wheat cultivars tested, only one cultivar showed disease and only from WAC13466 (DI similar to 30%). Sweet corn and goosegrass were also susceptible to both blast isolates, but DI was <50%. That P. oryzae was virulent across these diverse Poaceae hosts, highlights, for Australia, the possibility for these species in, first, harbouring P. oryzae isolates highly virulent to commercial rice, second, fostering spread of rice-attacking P. oryzae strains into regions currently free of rice blast, and third, potential for these alternative host species to encourage development of more virulent host-specific strains of P. oryzae. The current study is an important step towards facilitating improved crop protection in the medium and long term from reducing P. oryzae disease epidemics via a better understanding and management of inoculum reservoirs in Australia.

关键词： penile neoplasms   recurrence   neoplasm metastasis  

摘要： Purpose: Our primary objective is to detail the incidence, site, and timing of penile squamous cell carcinoma (pSCC) recurrence after inguinal lymph node dissection (ILND). Materials and Methods: We performed a retrospective analysis of 551 patients who underwent ILND for pSCC from 2000 to 2017. The primary outcome was pSCC recurrence after ILND. Recurrences were identified and stratified by site. Timing of recurrence was determined. Multivariable logistic regression analysis determined associations with recurrence. Multivariable Cox regression analysis determined associations with overall survival (OS). Sub-group analysis of the distant recurrences analyzed timing and OS by site of distant recurrence. Results: After ILND pSCC recurred in 176 (31.9%) patients. Median time to recurrence was 10 months for distant recurrences, 12 for inguinal, 10.5 for pelvic, and 44.5 for local. Greater than 95% of distant, inguinal, and pelvic recurrences occurred within 48 months of ILND, versus 127 months for local recurrences. Post-ILND recurrence was associated with pN2 (OR 1.99, 95% CI 1.0-4.1), and pN3 (OR 7.2, 95% CI 4.0-13.7). Patients who had local recurrence had similar OS to those without (HR 1.5, 95% CI 0.6-3.8), and worse OS was identified in patients with inguinal (HR 4.5, 95% CI 2.8-7.1), pelvic (HR 2.6, 95% CI 1.5-4.5), or distant (HR 4.0, 95% CI 2.7-5.8) recurrences. Patients with lung recurrences had worse OS than other sites (HR 2.2, 95% CI 1.1-4.3). Conclusions: Of the patients 31.9% had post-ILND recurrence associated with high pN staging. Greater than 95% of distant, inguinal, and pelvic recurrences occurred within 48 months, suggesting surveillance beyond this is low yield. Local recurrences occurred over a longer timeline, emphasizing necessity of long-term surveillance of the primary site.

关键词： Esophageal cancer   Anastomotic leak   Endoscopic vacuum therapy   Stent   Profit center analysis  

摘要： Background Endoscopic vacuum therapy (EVT) has become a promising option in the management of anastomotic leakage (AL) after esophagectomy. However, EVT is an effortful approach associated with multiple interventions. In this study, we conduct a comparative cost analysis for methods of management of AL. Methods All patients who experienced AL treated by EVT, stent, or reoperation following Ivor Lewis esophagectomy for esophageal cancer were included. Cases that were managed by more than one modality were excluded. For the remaining cases, in-patient treatment cost was collected for material, personnel, (par)enteral nutrition, intensive care, operating room, and imaging. Results 42 patients were treated as follows: EVT n = 25, stent n = 13, and reoperation n = 4. The mean duration of therapy as well as length of overall hospital stay was significantly shorter in the stent than the EVT group (30 vs. 44d, p = 0.046;34 vs. 53d, p = 0.02). The total mean cost for stent was euro33.685, and the total cost for EVT was euro46.136, resulting in a delta increase of 37% for EVT vs. stent cost. 75% (euro34.320, EVT), respectively, 80% (euro26.900, stent) of total costs were caused by ICU stay. Mean pure costs for endoscopic management were relatively low and comparable between both groups (EVT: euro1.900, stent: euro1.100, p = 0.28). Conclusion Management of AL represents an effortful approach that results in high overall costs. The expenses directly related to EVT and stent therapy were however comparatively low with more than 75% of costs being attributable to the ICU stay. Reduction of ICU care should be a central part of cost reduction strategies.

关键词： Feline herpesvirus   Felis catus   Viral vector   Feline pathogen   Immunocontraception  

摘要： Herpesviruses are attractive vaccine vector candidates due to their large double stranded DNA genome and latency characteristics. Within the scope of veterinary vaccines, herpesvirus-vectored vaccines have been well studied and commercially available vectored vaccines are used to help prevent diseases in different animal species. Felid alphaherpesvirus 1 (FHV-1) has been characterised as a vector candidate to protect against a range of feline pathogens. In this review we highlight the methods used to construct FHV-1 based vaccines and their outcomes, while also proposing alternative uses for FHV-1 as a viral vector.

关键词： Breast cancer   Complementary and alternative medicine   Systematic review   AGREE II   Clinical practice guideline  

摘要： Purpose of Review Up to 80% of patients with breast cancer are reported to use complementary and alternative medicine (CAM). Despite this high prevalence, many healthcare providers have little knowledge and education surrounding this topic and may be inadequately prepared to discuss such therapies with their patients. Given this knowledge gap, the purpose of this study was to systematically identify the quantity and assess the quality of CAM recommendations in clinical practice guidelines (CPGs) for the treatment and/or management of breast cancer. Recent Findings Thirty-four CPGs were deemed eligible, 5 of which mentioned CAM, and 4 of which made CAM recommendations. Eligible CPGs containing CAM recommendations were assessed with the AGREE II instrument. Scaled domain percentages from highest to lowest were (% overall, % CAM) as follows: scope and purpose (100.0%, 100.0%), editorial independence (100.0%, 100.0%), clarity of presentation (97.2%, 80.6%), rigour of development (80.2%, 80.2%), stakeholder involvement (88.9%, 77.8%), and applicability (58.3%, 58.3%). CPGs with favourable scores may provide practitioners with guidance on safe and effective use of CAM therapies. A need exists to improve the quality of CAM recommendations in CPGs.