Simple Self-Assembled Targeting DNA Nano Sea Urchin as a Multivalent Drug Carrier.

An ideal drug delivery platform with high cell selectivity, drug payload capacity, and cellular internalization capability is usually of the essence for targeted cancer chemotherapy. Herein, by combining palindromic DNA strands with a targeting aptamer probe, we demonstrated a self-assembled nanoscale sea urchin-shaped structure (called aptamer-NSU) as a multivalent carrier capable of executing targeted cancer cell imaging and drug delivery. The DNA nanostructure is composed of a spherical trunk and surface-confined spines: the former is assembled from only one biotinylated DNA containing four different palindrome domains, and the latter is a biotinylated aptamer (Sgc8) conjugated to the trunk surface via streptavidin-biotin affinity interaction. The spherical trunk can densely load doxorubicin (Dox), and the surface-confined Sgc8 probes can function as targeting moieties to specifically bind to target cells in a polyvalent-binding fashion. Atomic force microscopy (AFM) and gel electrophoresis show the assembly of Sgc8-NSU. The confocal fluorescence imaging demonstrates that fluorescently labeled Sgc8-NSU can specifically image CEM cells. Flow cytometric analyses indicate that Sgc8-NSU exhibits the multivalent binding effect, achieving the significant improvement in binding affinity and selectivity compared with free Sgc8. Moreover, the CCK-8 assay confirmed that Dox-loaded Sgc8-NSU induces an enhanced cellular cytotoxicity to target cancer cells but not to negative nontarget cells. The developed DNA nanoplatform is expected to provide a valuable insight into constructing structural DNA nanotechnology-based drug delivery nanovehicles suitable for targeted cancer therapy.

Indirect estimation of student marijuana consumers population in Hamadan using PRM and NSU methods.

Background: Finding social causes of a particular disease or specific health problem in groups or hidden illnesses, such as drug misuse is difficult. To estimate the population size, it should be taken into account that under enumeration usually occurs in direct estimation of population of certain high-risk groups. The present study used indirect methods to accurately estimate the population of students who have once experienced marijuana abuse. Methods: This cross sectional research was conducted on 461 students in Hamadan. Two indirect methods, the Network Scale-up (NSU) and proxy respondent method (PRM), were used. Data were analyzed by statistical tests and SPSS version 16 and Excel. Results: The mean age (standard deviation) was 22.51 (4.19 years), and the prevalence of marijuana misuse was 1.94%, 4.12%, and 2.6%, respectively, in girls and 14.57%, 12.58%, and 10.4% in boys using NSU, PRM, and direct method. Conclusion: Direct and NSU methods had higher bias than PRM, the frequency of PRM was closer to reality, and the once use prevalence of marijuana was higher in the young male population than in the female.

The balance between food and dietary supplements in the general population.

In the past, vitamins and minerals were used to cure deficiency diseases. Supplements nowadays are used with the aim of reducing the risk of chronic diseases of which the origins are complex. Dietary supplement use has increased in the UK over recent decades, contributing to the nutrient intake in the population, but not necessarily the proportion of the population that is sub-optimally nourished; therefore, not reducing the proportion below the estimated average requirement and potentially increasing the number at risk of an intake above the safety limits. The supplement nutrient intake may be objectively monitored using circulation biomarkers. The influence of the researcher in how the supplements are grouped and how the nutrient intakes are quantified may however result in different conclusions regarding their nutrient contribution, the associations with biomarkers, in general, and dose-response associations specifically. The diet might be sufficient in micronutrients, but lacking in a balanced food intake. Since public-health nutrition guidelines are expressed in terms of foods, there is potentially a discrepancy between the nutrient-orientated supplement and the quality of the dietary pattern. To promote health, current public-health messages only advocate supplements in specific circumstances, but not in optimally nourished populations.

The experience of breastfeeding infants affected by congenital diaphragmatic hernia or esophageal atresia.

BACKGROUND: Newborns with congenital diaphragmatic hernia (CDH) and esophageal atresia (EA) might experience breastfeeding difficulties. The aim of this study was to detect the prevalence of breastfeeding in newborns with CDH and EA at different time points. METHODS: We performed an epidemiological study and retrospective survey on the prevalence of breastfeeding in CDH and EA affected newborns. We identified 40 CDH and 25 EA newborns who were fed through breastfeeding procedures according to WHO categorized definitions, and compared the breastfeeding procedures at the beginning of hospitalization and at three months of life. RESULTS: Although all the mothers attempted breastfeeding after birth, only 44 (67.7%) were still breastfeeding at the time of discharge. Exclusive breastfeeding was successful for only 19 (29%) mothers. The rate of exclusive breastfeeding at three months of life did not differ statistically from discharge and between the two groups of study. CONCLUSION: A large percentage of mothers of children with CDH and EA who breastfed at the beginning of hospitalization did not continue at three months. It would be important to increase the breastfeeding rate in CDH and EA affected newborns by following specific steps for vulnerable infants and sustaining breastfeeding after discharge.

The Frequency of Alcohol Use in Iranian Urban Population: The Results of a National Network Scale Up Survey.

BACKGROUND: In Islamic countries alcohol consumption is considered as against religious values. Therefore, estimation of frequency of alcohol consumptions using direct methods is prone to different biases. In this study, we indirectly estimated the frequency of alcohol use in Iran, in network of a representative sample using network scale up (NSU) method. METHODS: In a national survey, about 400 participants aged above 18 at each province, around 12 000 in total, were recruited. In a gender-match face to face interview, respondents were asked about the number of those who used alcohol (even one episode) in previous year in their active social network, classified by age and gender. The results were corrected for the level of visibility of alcohol consumption. RESULTS: The relative frequency of alcohol use at least once in previous year, among general population aged above 15, was estimated at 2.31% (95% CI: 2.12%, 2.53%). The relative frequency among males was about 8 times higher than females (4.13% versus 0.56%). The relative frequency among those aged 18 to 30 was 3 times higher than those aged above 30 (3.97% versus 1.36%). The relative frequency among male aged 18 to 30 was about 7%. CONCLUSION: It seems that the NSU is a feasible method to monitor the relative frequency of alcohol use in Iran, and possibly in countries with similar culture. Alcohol use was lower than non-Muslim countries, however, its relative frequency, in particular in young males, was noticeable.

The management and outcome for patients with chronic subdural hematoma: a prospective, multicenter, observational cohort study in the United Kingdom.

OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland. This provides a resource both for current clinical practice and future clinical research on CSDH. METHODS Data on management and outcomes for patients with CSDH referred to UK and Ireland NSUs were collected prospectively over an 8-month period and audited against criteria predefined from the literature: NSU mortality < 5%, NSU morbidity < 10%, symptomatic recurrence within 60 days requiring repeat surgery < 20%, and unfavorable functional status (modified Rankin Scale score of 4-6) at NSU discharge < 30%. RESULTS Data from 1205 patients in 26 NSUs were collected. Bur-hole craniostomy was the most common procedure (89%), and symptomatic recurrence requiring repeat surgery within 60 days was observed in 9% of patients. Criteria on mortality (2%), rate of recurrence (9%), and unfavorable functional outcome (22%) were met, but morbidity was greater than expected (14%). Multivariate analysis demonstrated that failure to insert a drain intraoperatively independently predicted recurrence and unfavorable functional outcome (p = 0.011 and p = 0.048, respectively). Increasing patient age (p < 0.00001), postoperative bed rest (p = 0.019), and use of a single bur hole (p = 0.020) independently predicted unfavorable functional outcomes, but prescription of high-flow oxygen or preoperative use of antiplatelet medications did not. CONCLUSIONS This is the largest prospective CSDH study and helps establish national standards. It has confirmed in a real-world setting the effectiveness of placing a subdural drain. This study identified a number of modifiable prognostic factors but questions the necessity of some common aspects of CSDH management, such as enforced postoperative bed rest. Future studies should seek to establish how practitioners can optimize perioperative care of patients with CSDH to reduce morbidity as well as minimize CSDH recurrence. The BNTRC is unique worldwide, conducting multicenter trainee-led research and audits. This study demonstrates that collaborative research networks are powerful tools to interrogate clinical research questions.

The management and outcome for patients with chronic subdural hematoma: a prospective, multicenter, observational cohort study in the United Kingdom.

OBJECTIVE: Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland. This provides a resource both for current clinical practice and future clinical research on CSDH. METHODS: Data on management and outcomes for patients with CSDH referred to UK and Ireland NSUs were collected prospectively over an 8-month period and audited against criteria predefined from the literature: NSU mortality < 5%, NSU morbidity < 10%, symptomatic recurrence within 60 days requiring repeat surgery < 20%, and unfavorable functional status (modified Rankin Scale score of 4-6) at NSU discharge < 30%. RESULTS: Data from 1205 patients in 26 NSUs were collected. Bur-hole craniostomy was the most common procedure (89%), and symptomatic recurrence requiring repeat surgery within 60 days was observed in 9% of patients. Criteria on mortality (2%), rate of recurrence (9%), and unfavorable functional outcome (22%) were met, but morbidity was greater than expected (14%). Multivariate analysis demonstrated that failure to insert a drain intraoperatively independently predicted recurrence and unfavorable functional outcome (p = 0.011 and p = 0.048, respectively). Increasing patient age (p < 0.00001), postoperative bed rest (p = 0.019), and use of a single bur hole (p = 0.020) independently predicted unfavorable functional outcomes, but prescription of high-flow oxygen or preoperative use of antiplatelet medications did not. CONCLUSIONS: This is the largest prospective CSDH study and helps establish national standards. It has confirmed in a real-world setting the effectiveness of placing a subdural drain. This study identified a number of modifiable prognostic factors but questions the necessity of some common aspects of CSDH management, such as enforced postoperative bed rest. Future studies should seek to establish how practitioners can optimize perioperative care of patients with CSDH to reduce morbidity as well as minimize CSDH recurrence. The BNTRC is unique worldwide, conducting multicenter trainee-led research and audits. This study demonstrates that collaborative research networks are powerful tools to interrogate clinical research questions.

2015 UK National Guideline on the management of non-gonococcal urethritis.

We present the updated British Association for Sexual Health and HIV guideline for the management of non-gonococcal urethritis in men. This document includes a review of the current literature on its aetiology, diagnosis and management. In particular it highlights the emerging evidence that azithromycin 1 g may result in the development of antimicrobial resistance in Mycoplasma genitalium and that neither azithromycin 1 g nor doxycycline 100 mg twice daily for seven days achieves a cure rate of >90% for this micro-organism. Evidence-based diagnostic and management strategies for men presenting with symptoms suggestive of urethritis, those confirmed to have non-gonococcal urethritis and those with persistent symptoms following first-line treatment are detailed.

Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic.

We conducted a study to determine the prevalence of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) in men with urethritis, attending an urban sexual health clinic, in order to inform screening and treatment policies. Men attending an urban sexual health clinic between June 2011 and January 2012 were evaluated. Urine samples were collected from men with urethritis and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and TV using transcription-mediated amplification and for MG and UU using polymerase chain reaction. Eighty-three samples were analysed. The prevalence of CT was 33.7% (28/83), GC was 16.8% (14/83), TV was 3.6% (3/83), MG was 12.0% (10/83) and UU was 4.8% (4/83). Fifteen men had recurrent urethritis. Of these, three were found to have had TV, five to have had MG and none to have had UU, at initial presentation. Given the prevalence of MG in this study, there is an urgent need for further larger studies looking at optimal treatment regimens and screening strategies in urethritis.

The urethral smear as a tool in diagnosing adenovirus-induced urethritis.

Adenovirus is a recognised cause of non-gonococcal urethritis, and is not uncommonly associated with extragenital signs and symptoms. This case report describes a patient with symptoms of conjunctivitis, meatitis and urethritis. The urethral smear revealed almost exclusively monocytes microscopically, raising the suspicion of a viral aetiology. Results confirmed the presence of adenovirus in both the eyes and urethra. Despite waning reliance on the urethral smear in sexual health clinics, it can still be an important diagnostic tool in assessing the aetiology of non-specific urethritis. Finding an obvious monocytic cell response in the urethral smear can indicate a viral cause and allow the clinician to optimise management, counsel appropriately, and potentially reduce unnecessary antibiotic use.

Factors associated with asymptomatic non-chlamydial non-gonococcal urethritis in heterosexual men: findings from a case-control study.

The significance of asymptomatic non-chlamydial non-gonococcal urethritis (NCNGU) is unclear. Organisms associated with NCNGU, e.g. Mycoplasma genitalium, for which there is no widely available test, are linked to reproductive sequelae in women but UK guidance no longer recommends urethral smear microscopy to screen for asymptomatic NCNGU. This case-control study of heterosexual male genitourinary (GU) medicine clinic attenders aimed to identify clinical, demographic and sexual behaviour factors associated with asymptomatic NCNGU so that we could determine whether the presence or absence of symptoms provides a rational basis for deciding to whom we should offer microscopy and whom we should treat. Men with asymptomatic NCNGU were very similar to men with symptomatic NCNGU, except for more consistent condom use. Asymptomatic and symptomatic NCNGU could be different ends of the same clinical syndrome. Until the microbiological basis of NCNGU is understood, we recommend treatment of men with NCNGU irrespective of symptoms.

Do método para estimar o tamanho médio das redes pessoais e o tamanho de populações difíceis de contar / Of a method for estimating the average population size of personal networks and the size of hard-to-count populations / /Sobre el método para estimar el tamaño medio de las redes personales y el tamaño de poblaciones difíciles de calcular

O método conhecido como Network Scale-Up (NSU) - método de ampliação das redes sociais -, utilizado para estimar "populações difíceis de contar" (hard-to-count populations), baseia-se na ideia de que as populações humanas se organizam numa rede complexa de interações sociais, na qual todos os indivíduos, independentemente de atributos pessoais distintos, estão conectados. Conhecendo-se, então, o padrão das redes pessoais associado a determinados atributos individuais, é possível estimar "parcelas" da população que possuem esses mesmos atributos. Os emigrantes internacionais, em especial os que se encontram em situação irregular, enquadram-se nesse tipo de subpopulação, cujo tamanho é desconhecido dada a dificuldade ou até mesmo a impossibilidade de mensurá-la diretamente. A descrição do método da ampliação das redes sociais e dos procedimentos metodológicos para obtenção dos dados necessários à aplicação desse método para estimar o número de emigrantes e de retornados internacionais de uma cidade brasileira de porte médio hipotética constitui o objetivo deste texto.

The method known as Network Scale-Up (NSU) - used for expanding social networks - is used to estimate hard-to-count populations, based on the idea that human populations are organized in a complex web of social interactions, to which all individuals, regardless of specific personal attributes, are connected. If we know the pattern of personal networks associated with certain individual attributes, we can estimate "parcels" of the population that have these same attributes. International migrants, especially those who are undocumented, fit into this type of subpopulation whose size is unknown because of the difficulty or even impossibility of measuring it directly. This article aims at describing the Network Scale-Up method and the methodological procedures necessary to estimate the number of international and returned migrants in a hypothetical, medium-sized, Brazilian city.

El método conocido como Network Scale-Up (NSU) -método de ampliación de las redes sociales-, utilizado para estimar "poblaciones difíciles de calcular" (hard-to-count populations), se basa en la idea de que las poblaciones humanas se organizan en una red compleja de interacciones sociales, en la que todos los individuos, independientemente de sus atributos personales diferenciados, están conectados. Conociéndose entonces el patrón de las redes personales, asociado a determinados atributos individuales, es posible estimar "porciones" de la población que posean estos mismos atributos. Los emigrantes internacionales, en especial los que se encuentran en situación irregular, se encuadran en este tipo de subpoblación, cuyo tamaño es desconocido, dada la dificultad o hasta incluso la imposibilidad de calcularlo directamente. La descripción del método de la ampliación de las redes sociales, y de los procedimientos metodológicos con el objeto de obtener los datos necesarios para la aplicación de este método en la estimación del número de emigrantes y de retornados internacionales de una hipotética ciudad brasileña de porte medio, constituye el objetivo de este trabajo.