The weight loss predicts the function impairment 1 month after surgery in head and neck cancer patients with surgical treatment / 中国实用护理杂志

Objective@#To explore the prediction of weight loss to the function 1 month after surgery in head and neck cancer (HNC) patients with surgical treatment.@*Methods@#During August to November 2017, 122 HNC patients from a tertiary hospital in Chengdu were included and investigated by the General Information Questionnaire and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30.@*Results@#1 month after surgery, the function scores of HNC patients ranged from 86.67(73.33, 93.33) to 100.00(100.00, 100.00), and the physical function score was the lowest. Patients with weight loss during hospitalization had lower score in physical, role and social function (P<0.05). According to the results of Logistic regression analysis, age (OR=6.262, P<0.05) and Weight loss during hospitalization (OR=4.363, P<0.05) were risk factors for the physical function of HNC patients 1 month after surgery. For social function 1 month after surgery, weight loss during hospitalization (OR=3.306, P<0.05) was the risk factor.@*Conclusions@#Weight loss during hospitalization in HNC patients with surgical treatment can predict the impairment of function 1 month after surgery. Healthcare providers should pay more attention to perioperative nutritional problems of HNC patients, especially the elder patients, and take effective interventions to control the weight during hospitalization to improve patients′ function and quality of life.

Effects of a Standard American Diet and an anti-inflammatory diet in male and female mice.

BACKGROUND: Obesity and chronic pain are prevalent concerns. Pain is frequently experienced in weight-bearing joints, but is common in other areas of the body as well, suggesting other factors. Poor diet often contributes to obesity and can directly influence the immune system. We have shown that poor diet prolongs recovery from inflammatory injury. Therefore, our goal was to determine whether poor-quality diet-induced consequences could be prevented or reversed by an anti-inflammatory diet (AID). METHODS: A Standard American Diet (SAD) was developed to investigate the effects of poor diet on pain. The SAD includes amounts of refined sugar, carbohydrates and fats that better model the typical American diet, as compared to high-fat diets. We developed an AID to explore whether the effects of the SAD could reverse or whether the AID would enhance recovery prophylactically. The AID was developed using ingredients (epigallocatechin gallate, sulforaphane, resveratrol, curcumin and ginseng) with known anti-inflammatory properties. Following 15 weeks of diet [SAD, AID or regular (REG)] exposure, male and female mice underwent inflammatory injury, at which point some animals had their diets switched for the remainder of the study. RESULTS: Animals who consumed the SAD showed longer recovery compared to the AID- and REG-fed animals. Animals switched off the SAD had faster recovery times, with AID-fed animals recovering as fast as REG-fed animals. CONCLUSIONS: Poor diet prolonged recovery from inflammatory injury. Substitution of SAD with AID or REG promoted faster recovery. These findings suggest diet can be used as a non-pharmacological intervention following injury. SIGNIFICANCE: Obesity may increase susceptibility to chronic pain often due to poor diet. Diet has potential to be used as treatment for pain. This study investigates the use of a novel translatable diet to act as a preventative (i.e. prior to surgery) or an intervention (i.e. following an injury).

Precision nursing:trend and implication / 中华护理杂志

The purpose of this article is to provide an overview of precision nursing and its implications for education,practice and research.The emphases are on the contributions of nursing practice and research to genomics as well as precision health and precision medicine.Recommendations are elucidated on how to build knowledge and competence of precision nursing within the broad arena of precision health and precision medicine to promote the development of precision nursing.

Newcastle disease virus in little owls (Athene noctua) and African penguins (Spheniscus demersus) in an Israeli zoo.

Newcastle disease is a contagious and often fatal disease, capable of affecting all species of birds. A velogenic Newcastle disease virus (vNDV) outbreak occurred in an Israeli zoo, in which Little owls (Athene noctua) and African penguins (Spheniscus demersus) were found positive for presence of NDV. Some of them have died. The diagnostic process included: post-mortem examination, histopathology, real-time RT-PCR assay, virus isolation, serology, intracerebral pathogenicity index and phylogenetic analysis. A vNDV was diagnosed and found to be closely related to isolates from vNDV outbreaks that occurred in commercial poultry flocks during 2011. All isolates were classified as lineage 5d.

Three-dimensional optical transfer of rotating beams.

Systems in which the point spread function (PSF) is a rotating beam have increasing use in three-dimensional (3D) microscopy and depth estimation. We analyze in several ways the 3D optical transfer function (OTF) of Gauss Laguerre modes and rotating beams. This is based on analysis of 3D OTFs of general aperture functions. Consequently, we suggest a criterion for depth resolution based on an effective cutoff of the axial frequency response. This criterion can be used to optimize PSFs explicitly and directly, to maximize axial resolution.

Development of a real-time TaqMan RT-PCR assay for the detection of H9N2 avian influenza viruses.

Avian influenza viruses (AIVs) of the H9N2 subtype are a major economic problem in the poultry industry in Israel. Most field isolates from the last decade differ significantly from H9N2 isolates from Europe and the USA, rendering published detection methods inadequate. This study aimed to develop a real-time TaqMan((R)) RT-PCR assay, based on a conserved region in the HA9 gene. The assay was validated with viruses representing different genetic subtypes and other common avian pathogens, and was found specific to H9N2. The real-time RT-PCR assay was compared to RT-PCR, which is in routine diagnostic use. Real-time RT-PCR was found to be more sensitive than RT-PCR by 1.5-2.5 orders of magnitude when testing tracheal swabs directly and by 2-3 orders of magnitude allantoic fluid after AIV propagation in embryonated eggs. Sensitivity was quantified by using 10-fold dilutions of the H9-gene amplification fragment, and real-time RT-PCR was found to be 10(4)-fold more sensitive than RT-PCR. Clinical samples, which included tracheal and cloacal swabs, as well as allantoic fluid, were tested by both methods. By real-time RT-PCR 20% more positive H9N2 samples were detected than by RT-PCR. The real-time RT-PCR assay was found suitable for detection and epidemiological survey not only of Israeli H9N2 viruses, but also for isolates from other parts of the world.

Framing physical activity as a distinct and uniquely valuable behavior independent of weight management: a pilot randomized controlled trial for overweight and obese sedentary persons.

PURPOSE: Promoting benefits of physical activity independent of weight management may help overweight/obese persons. DESIGN: Pilot randomized-controlled-trial. SUBJECTS: Twenty-six sedentary, overweight/obese persons receiving health-care at Stanford Medical Center, no contraindications for exercise. CONTROL/INTERVENTION GROUPS: Usual medical care and community weight-management/fitness resources versus same plus a brief intervention derived from behavioral-economic and evolutionary psychological theory highlighting benefits of activity independent of weight-management. ANALYSIS: Intent-to-treat. Cohen's d effect-sizes and 95% confidence intervals (95%CI) for changes in moderate-intensity-equivalent physical activity/week, cardiorespiratory fitness, and depression at 3 months relative to baseline. RESULTS: Intervention group participants demonstrated 3.76 hour/week of increased physical activity at study endpoint, controls only 0.7 hours/week (Cohen's d=0.74, 95% CI -0.06 to +1.5). They also improved cardiorespiratory fitness (Cohen's d=0.51, 95% CI -0.3 to +1.3) and reduced depression relative to controls (Cohen's d=0.66, 95% CI -0.1 to +1.4). CONCLUSION: Promoting activity independent of weight-management appears promising for further study.

Assessment of the clinical significance of production of extended-spectrum beta-lactamases (ESBL) by Enterobacteriaceae.

BACKGROUND: We conducted a retrospective, cohort-controlled study to evaluate the effect of extended-spectrum beta-lactamase (ESBL) production by Enterobacteriaceae isolated from blood cultures, and of third or fourth generation cephalosporin treatment, on outcome. METHODS: Four hundred and fifty patient-unique Enterobacteriaceae, isolated from blood cultures during 2000 (before routine ESBL testing was introduced), were tested for ESBL by double-disk method and by E-test, assessing cefotaxime, ceftazidime and cefpodoxime, with and without clavulanate. Cases consisted of ESBL-positive (+) samples, originally reported as ceftazidime-susceptible; controls were ESBL-negative (-). Patient records were extensively reviewed. RESULTS: We identified 68 Enterobacteriaceae that were ESBL(+); they were compared with 186 ESBL(-) control organisms. Patients with sepsis due to an ESBL(+) organism more often had nosocomial infection, resided in nursing homes, were functionally dependent, had an indwelling catheter, had Klebsiella, and had a lower serum albumin level (all p < 0.001). Survival of patients with ESBL(+) and ESBL(-) sepsis was, respectively, 71% and 84% (p < 0.05). Multivariate analysis revealed that the only independent risk factor for death was a low serum albumin. Neither empiric nor definite treatment with cephalosporins was found to be an independent risk factor for death. Subset analysis was conducted on 15 patients with ESBL(+) sepsis and 21 controls with ESBL(-) sepsis, who had been treated with ceftazidime or cefepime only. In this subset, ESBL(+) patients more often resided in nursing homes (< 0.05), they had a significantly lower APACHE-II score (< 0.01) and the infection was more often nosocomial (< 0.005). Survival of ESBL(+) and ESBL(-) patients was 67% and 71%, respectively (NS). Time till defervescence did not differ between cases and controls. CONCLUSION: Mortality of patients with ESBL(+) sepsis was higher than that of patients with ESBL(-) sepsis. The reason appears to be related to other factors rather than to empiric treatment with cephalosporins or the nature or resistance pattern of the organism. This, at least, appears to be the case for patients with urosepsis, who constituted the majority of patients in this study.

S1 gene characteristics and efficacy of vaccination against infectious bronchitis virus field isolates from the United States and Israel (1996 to 2000).

The S1 genes of isolates of avian coronavirus infectious bronchitis virus (IBV) from commercial chickens in the US and Israel (20 isolates from each country) were studied using reverse transcription-polymerase chain reaction restriction fragment length polymorphism and sequencing. Partial sequences spanning the amino terminus region of S1 from amino acid residues 48 to 219, based on the Beaudette strain, were used for analysis. Phylogenetic clustering and high-sequence identity values were used to identify isolates that appeared to be derived from live IBV vaccines used in the two countries. Novel variant strains, unrelated by S1 sequencing and restriction fragment length polymorphism analyses to reference and vaccine strains, were also identified. Based on S1 sequence identity to available vaccines, the potential to use vaccination to control IBV infections was evaluated. Vaccination with commercial live strains Massachusetts (Mass), Arkansas (Ark) or DE/072/92, generally produced immunity against vaccine-related field isolates displaying high S1 sequence similarities (> or = 90%) to the respective vaccine strains. Immunization with a bivalent vaccine containing the Mass and Ark strains provided good cross-protection, averaging 81% against challenge with five variant isolates from the US having amino acid identity values ranging from 62 to 69% to Mass and from 68 to 83% to Ark, respectively. In contrast, the H120 vaccine strain induced low levels of protection, ranging from 25 to 58% against variant field isolates from Israel with amino acid identity values from 65 to 67%.

Vaccine and adjuvant activity of recombinant subunit B of E. coli enterotoxin produced in yeast.

Escherichia coli heat-labile enterotoxin (LT) and cholera toxin (CT) have been studied intensively as vaccines against diseases caused by those bacteria and as adjuvants for mucosal vaccination. Two major problems interfere with the use of these promising adjuvants: their toxicity and the residual bacterial endotoxins mixed with the desired LT. In this study, subunit B of LT was expressed in Pichia pastoris yeast cells (yrLTB) and the recombinant protein was purified and concentrated by ion-exchange chromatography. The final yield of the recombinant protein was 5-8 mg/l induction medium. The molecule is in pentameric form and binds to GM1 gangliosides. When given orally to chickens, anti-LTB antibodies were produced, exhibiting its ability to cross the digestive system and induce an immune response. The adjuvant activity of yrLTB was proven by fusing it to viral protein 2 (VP2) of infectious bursal disease virus. Birds intramuscularly vaccinated with this molecule exhibit 70-100% protection, in a dose-response-dependent manner. This method eliminated the bacterial endotoxins and enabled the production of large quantities of LTB. Expression in a eukaryotic system allows the production of fusion proteins that require post-translational modifications. This may allow oral vaccination with a protein fused to yrLTB. The approach described in this study will enable the efficient production of a non-toxic, eukaryotically expressed enterotoxin as a vaccine against the toxin itself or as a carrier or adjuvant for foreign vaccine molecules.

Identification of a novel nephropathogenic infectious bronchitis virus in Israel.

A novel infectious bronchitis variant, designated as IS/885/00, associated with nephritis, was isolated from outbreaks in 23 broiler farms in Israel. The virus was first identified by reverse transcriptase-polymerase chain reaction and showed a distinct restriction fragment length polymorphism pattern from previously described Israeli isolates. Sequence analysis of the S1 gene and the deduced amino acid sequence revealed 97.2% protein similarity to genotype IS/ 720/99 and 71.6% similarity to the vaccine strain H120, the only strain permitted for use in this country. A database search in GenBank revealed a closely related isolate from Egypt, Egypt/Beni-Seug/01, with 96.6% similarity. Other published nephropathogenic infectious bronchitis virus strains/isolates shared less than 77% similarity with IS/885/00. A vaccine protection test in specific-pathogen-free chicks indicated 91% protection to the trachea and only 25% protection to the kidneys in vaccinated birds challenged with IS/885/00.

Physical fitness qualities of professional rugby league football players: determination of positional differences.

A total of 146 professional rugby league football players, contracted to 2 teams competing in England (n = 45) and Australia (n = 101), participated in this study. All players completed the following series of physical fitness performance tests: 1 repetition maximum squat and bench press, 15- and 40-m sprint, agility run, 5-minute run for distance, 60-second sit-up, 30-second plyometric push-up, and measurement of body weight and subcutaneous skinfold (4 sites). Analysis of variance with a criterion alpha level of p < 0.05, was used to determine if any significant difference could be found when grouping players into 3 different positional categories typically identified in the sport. There were a number of significant differences with respect to test results between categories, and this was apparent for all 3 systems of categorization. On the basis of these findings, we recommend that to more efficiently structure the physical fitness training of players, the players should be grouped either according to the 2 broad positional categories of forwards or backs or according to the 4 categories of forwards, distributors, adjustables, and outside backs. Grouping players according to the 9 specific positions played on the team is not warranted.

Best estimated inverse versus inverse of the best estimator.

The construction of a feed-forward controller frequently requires the estimation of an inverse function. Two possible methods to achieve this are: (i) learning the best estimated inverse (BEI), a method that is sometimes referred to as direct inverse learning and (ii) learning the inverse of the best estimator (IBE), a method that is sometimes referred to as indirect inverse learning. We analyze a general control problem, in the presence of noise, and show analytically that these two methods are asymptotically significantly different, even for simple linear non-redundant systems. We further demonstrate that the IBE method is typically superior for control purposes.

Molecular typing of infectious bursal disease virus of Israeli field and vaccine strains by the reverse transcription/polymerase chain reaction/restriction fragment length polymorphism assay.

Infectious bursal disease viruses (IBDVs) were examined by testing bursa samples from 37 commercially reared chicken flocks and three vaccine strains by the reverse transcription (RT)/polymerase chain reaction (PCR)/restriction fragment length polymorphism assay (RFLP). The assay was conducted with a 717-bp fragment of the VP2 gene with the restriction enzymes BstNI and MboI. The presence of a restriction site for SspI was used to predict a very virulent phenotype. Results indicated the existence of two molecular groups within the field isolates; four samples showed one pattern of RFLPs, and the majority, 30 out of the 37 tested, showed a second RFLP pattern. Three samples tested negative for IBDV. Eight bursa samples, representing the two molecular groups, were also tested by the RT/PCR/RFLP assay as developed by Jackwood. A comparison of the RFLP profiles by the two methods indicated that four isolates belonged to molecular group 6 and 30 isolates belonged to a new molecular group. All field isolates had a very virulent phenotype. One vaccine strain, produced from a local isolate, was classified as molecular group 6. The other two vaccine strains had RFLPs that differed from those of the field isolates.

On the optimality of neural-network approximation using incremental algorithms.

The problem of approximating functions by neural networks using incremental algorithms is studied. For functions belonging to a rather general class, characterized by certain smoothness properties with respect to the L2 norm, we compute upper bounds on the approximation error where error is measured by the Lq norm, 1< or =q< or =infinity. These results extend previous work, applicable in the case q=2, and provide an explicit algorithm to achieve the derived approximation error rate. In the range q< or =2 near-optimal rates of convergence are demonstrated. A gap remains, however, with respect to a recently established lower bound in the case q>2, although the rates achieved are provably better than those obtained by optimal linear approximation. Extensions of the results from the L2 norm to Lp are also discussed. A further interesting conclusion from our results is that no loss of generality is suffered using networks with positive hidden-to-output weights. Moreover, explicit bounds on the size of the hidden-to-output weights are established, which are sufficient to guarantee the established convergence rates.

Almost linear VC-dimension bounds for piecewise polynomial networks

We compute upper and lower bounds on the VC dimension and pseudo-dimension of feedforward neural networks composed of piecewise polynomial activation functions. We show that if the number of layers is fixed, then the VC dimension and pseudo-dimension grow as WlogW, where W is the number of parameters in the network. This result stands in opposition to the case where the number of layers is unbounded, in which case the VC dimension and pseudo-dimension grow as W2. We combine our results with recently established approximation error rates and determine error bounds for the problem of regression estimation by piecewise polynomial networks with unbounded weights.

Approximation bounds for smooth functions in C(IRd) by neural and mixture networks.

We consider the approximation of smooth multivariate functions in C(IRd) by feedforward neural networks with a single hidden layer of nonlinear ridge functions. Under certain assumptions on the smoothness of the functions being approximated and on the activation functions in the neural network, we present upper bounds on the degree of approximation achieved over the domain IRd, thereby generalizing available results for compact domains. We extend the approximation results to the so-called mixture of expert architecture, which has received considerable attention in recent years, showing that the same type of approximation bound may be achieved.

Injury consequences from participation in professional rugby league: a preliminary investigation.

OBJECTIVE: To conduct a preliminary investigation to determine if injuries sustained while playing professional rugby league have long term consequences for players after retirement from their playing careers. METHOD: Twenty eight retired players, who had competed in the professional Australian Rugby League competition, responded to a 23 item survey. Respondents were asked to recall all injuries that resulted in them being unable to play for five or more consecutive games. The survey asked players to provide information about age, playing weight, number of games played, position played, number and type of major injuries sustained during their career, and the effects of these injuries both during their career and after retirement. RESULTS: Within the limitations of this study's small sample, it is suggested that players with long term consequences of injury may experience a variety of detrimental effects into retirement, including job limitations, reduced income earning potential, and increased personal medical costs. CONCLUSION: Although research relating to the type and severity of injuries sustained while playing rugby league has been previously undertaken, investigation into the effect injuries sustained during a professional career have on players after retirement has been neglected. This preliminary investigation suggests that retired professional rugby league players may have at least one long term consequence of injuries sustained during their playing career.

Anserine bursitis and non-insulin dependent diabetes mellitus.

OBJECTIVE: To determine the relationship between non-insulin dependent diabetes mellitus (NIDDM), knee pain, and anserine bursitis, and its relation to sex, age, or body mass index (BMI). METHODS: Ninety-four consecutive patients with NIDDM, 66 women and 28 men, and 57 nondiabetic patients, 36 women and 22 men, were examined at an outpatient clinic of a tertiary care hospital. Date of onset in patients with NIDDM was noted, and serum was analyzed for either hemoglobin A1C (HbA1C) or glycosylated hemoglobin (GHb) in 69 of these patients. Anserine bursitis was diagnosed if knee pain and tenderness at the bursal site were found on examination. RESULTS: On examination 34 (36%) patients with NIDDM were found to have anserine bursitis. Of these, 31 (91%) were women and 3 (9%) were men (p < 0.05). Age, BMI, duration of diabetes, HbA1C or GHb, and age of onset of diabetes were found not to differ significantly between patients with and those without anserine bursitis. CONCLUSION: A relationship exists between NIDDM, knee pain, and anserine bursitis unrelated to age, BMI, duration and control of diabetes, and age at the diagnosis of diabetes.