Photoacoustic imaging of the human placental vasculature

Minimally invasive fetal interventions require accurate imaging from inside the uterine cavity. Twin‐to‐twin transfusion syndrome (TTTS), a condition considered in this study, occurs from abnormal vascular anastomoses in the placenta that allow blood to flow unevenly between the fetuses. Currently, TTTS is treated fetoscopically by identifying the anastomosing vessels, and then performing laser photocoagulation. However, white light fetoscopy provides limited visibility of placental vasculature, which can lead to missed anastomoses or incomplete photocoagulation. Photoacoustic (PA) imaging is an alternative imaging method that provides contrast for hemoglobin, and in this study, two PA systems were used to visualize chorionic (fetal) superficial and subsurface vasculature in human placentas. The first system comprised an optical parametric oscillator for PA excitation and a 2D Fabry‐Pérot cavity ultrasound sensor; the second, light emitting diode arrays and a 1D clinical linear‐array ultrasound imaging probe. Volumetric photoacoustic images were acquired from ex vivo normal term and TTTS‐treated placentas. It was shown that superficial and subsurface branching blood vessels could be visualized to depths of approximately 7 mm, and that ablated tissue yielded negative image contrast. This study demonstrated the strong potential of PA imaging to guide minimally invasive fetal therapies.      

Laminin-1 is phosphorylated by ecto-protein kinases of monocytes

Monocytes encounter basement membranes and interact with laminins while crossing the vascular barrier. It is known that these cells possess ecto-protein kinase activity on their surface. Several proteins of the extracellular matrix can be phosphorylated by ectokinases. Therefore, it has been hypothesized that monocyte ectokinases could phosphorylate laminins and influence their biological properties. In order to test the above hypothesis, we used intact human monocytes and adenosine triphosphate labeled with radioactive phosphate at the third phosphate ([gamma-32P]-ATP) to phosphorylate laminin-1. Autoradiography after sodium dodecyl sulphate polyacrylamyde gel electrophoresis (SDS-PAGE) electrophoresis indicated phosphorylation of laminin-1 on the beta and/or gamma chains. After phosphorylation, phosphoserine could be detected on Western blots by a specific monoclonal antibody. Phosphorylation was not detected when monocytes were pre-treated with trypsin and was inhibited by a specific ecto-protein kinase inhibitor (K252b). Laminin phosphorylation was also inhibited by heparin, a known inhibitor of casein kinase II and by pretreatment of monocytes by a monoclonal anti-casein kinase II antibody. Heparin binding, cell attachment and proliferation, and monocyte migration were enhanced on the phosphorylated laminin-1 as compared to the non-phosphorylated controls. These data indicate that laminin-1 can be phosphorylated by monocyte casein kinase II type ectokinase. This phosphorylation influences important functions of laminin and therefore could provide an additional means for the interaction of monocytes with basement membranes.     

Evaluation of Radiofrequency and Extremely Low‐Frequency Field Levels at Children's Playground Sites in Greece From 2013 to 2018

From 2013 to 2018, in‐situ measurements of radiofrequency (RF) electromagnetic fields (EMF) and extremely low‐frequency (ELF) electric and magnetic fields in 317 existing and under‐construction children's playground facilities, in 16 municipalities all over Greece, were carried out by the Greek Atomic Energy Commission (EEAE). These measurements were conducted following legislative framework established in 2009, which requires that compliance with the established exposure limits for EMFs should be verified in playground areas. The results are presented by the value of the electric field (E) and exposure ratio (Λ) for the RF EMF, as well as the value of the electric field (E) and magnetic flux density (B) for the ELF electric and magnetic fields. Statistical analysis tools were applied on measurement data and conclusions have been made, taking into consideration: (i) environment type (urban/suburban), and (ii) vicinity to any transmitting installations. Measurement results correspond to the typical EMF background levels for each environment type. Concerning the environment type, RF EMF, and ELF electric/magnetic field measurements reveal no differentiation between urban and suburban environments. Bioelectromagnetics. 2019;40:602–605. © 2019 Bioelectromagnetics Society.     

Epidemiological survey for the prevalence of overweight and abdominal obesity in Greek adolescents

This study was designed to provide estimates of overweight (OW), obesity (OB), and abdominal OB (AO) in a representative sample of adolescents throughout the whole of Greece. A total of 14,456 adolescents aged 13-19 years (6,677 boys and 7,779 girls) had direct measurements (height, weight, waist circumference (WC)) taken at school during 2003. The overall prevalence of OW including OB in the population studied was 29.4% in boys and 16.7% in girls. OB prevalence was also higher in boys than in girls (6.1% vs. 2.7%), whereas prevalence of AO was higher in girls than in boys (21.7% vs. 13.5%). Rates of OW, OB, and AO were significantly more prevalent in the Greek than in the foreign male population (immigrants). OW% in adolescent girls was independently associated with smoking and alcohol consumption. The prevalence of OW and OB in Greek adolescents is high, particularly in boys, comparable with that reported for most Mediterranean European countries. AO, mainly in adolescent girls, also appears high. Preventive and treatment strategies are urgently needed to combat this OB epidemic in Greece.     

Evidence for a coiled-coil interaction mode of disordered proteins from bacterial type III secretion systems

Gene clusters encoding various type III secretion system (T3SS) injectisomes, frequently code downstream of the conserved atpase gene for small hydrophilic proteins whose amino acid sequences display a propensity for intrinsic disorder and coiled-coil formation. These properties were confirmed experimentally for a member of this class, the HrpO protein from the T3SS of Pseudomonas syringae pv phaseolicola: HrpO exhibits high alpha-helical content with coiled-coil characteristics, strikingly low melting temperature, structural properties that are typical for disordered proteins, and a pronounced self-association propensity, most likely via coiled-coil interactions, resulting in heterogeneous populations of quaternary complexes. HrpO interacts in vivo with HrpE, a T3SS protein for which coiled-coil formation is also strongly predicted. Evidence from HrpO analogues from all T3SS families and the flagellum suggests that the extreme flexibility and propensity for coiled-coil interactions of this diverse class of small, intrinsically disordered proteins, whose structures may alter as they bind to their cognate folded protein targets, might be important elements in the establishment of protein-protein interaction networks required for T3SS function.     

Late Quaternary stratigraphy and sedimentology of Orphan Basin: Implications for meltwater dispersal in the southern Labrador Sea

Orphan Basin is a deep-water basin on the continental margin off Newfoundland, which throughout the late Quaternary received proglacial sediment from local ice that crossed the continental shelf. Sediment from more distant sources was transported southward in the Labrador Current as proglacial plumes and in icebergs. Five sedimentary facies related to glacial processes are distinguished in cores recovered from Orphan Basin: hemipelagic sediment, nepheloid-layer deposits (layered mud), beds rich in ice-rafted detritus (IRD), sand and mud turbidites, and glaciogenic debris-flow deposits. IRD-rich beds correspond to periods of intensified iceberg calving, and layered mud, turbidites, and glaciogenic debris-flow deposits with glacial meltwater discharge.

In the Late Wisconsinan, eight periods of meltwater discharge and iceberg calving from the Newfoundland ice sheet are interpreted from the sediment facies in Orphan Basin. These discharges coincide with the terminations of the colder periods of the D–O cycles recorded in Greenland ice cores. The oldest minor meltwater event (27.5–28.5 cal ka) corresponds to the first Late Wisconsinan ice advance across the Grand Banks and NE Newfoundland Shelf. The following three meltwater discharges (23–23.5, 23.8–24.5, and 25–27 cal ka) deposited sand turbidites and glaciogenic debris-flow deposits seaward of Trinity Trough, which was occupied by an ice stream at this time, and mud turbidites in the southern part of the basin derived from a mid-shelf ice margin on the Grand Banks. Four periods of meltwater discharge occurred during the deglaciation and are centered at 15, 18.5, 19.75, and 20.75 cal ka. The youngest is correlated to Heinrich event 1. In the literature, the 18.5 and 20.75 cal ka events have been recorded in multiple glacial settings in the North Atlantic, and therefore, are interpreted as large-scale events of meltwater discharge and iceberg calving, but in Orphan Basin the 19.75 cal ka event is also of similar scale.     

Endoscopic application of n-butyl-2-cyanoacrylate on esophagojejunal anastomotic leak: a case report

Introduction

Chryseobacterium indologenes is an uncommon human pathogen. Most infections have been detected in hospitalized patients with severe underlying diseases who had indwelling devices implanted. Infection caused by C. indologenes in a newborn has not been previously reported.

Case presentation

We present a case of ventilator-associated pneumonia caused by C. indologenes in a full-term Caucasian newborn baby boy with congenital heart disease who was successfully treated with piperacillin-tazobactam.

Conclusion

C. indologenes should be considered as a potential pathogen in newborns in the presence of invasive equipment or treatment with long-term broad-spectrum antibiotics. Appropriate choice of effective antimicrobial agents for treatment is difficult because of the unpredictability and breadth of antimicrobial resistance of these organisms, which often involves resistance to many of the antibiotics chosen empirically for serious Gram-negative infections.     

EMBalance - validation of a decision support system in the early diagnostic evaluation and management plan formulation of balance disorders in primary care: study protocol of a feasibility randomised controlled trial

BackgroundBalance problems are caused by multiple factors and often lead to falls and related fractures, bringing large socio-economic costs. The complexity of balance control mechanisms, the lack of medical expertise, and the absence of specialised equipment contribute to the delayed or incorrect diagnosis and management ofthese patients. Advances in computer science have allowed the development of computer systems that support clinical diagnosis and treatment decisions based on individualised patient data. The aim of the EMBalance decision support system (DSS) is to support doctors facing this clinical challenge, to make a definitive diagnosis and implement an effective management plan. The EMBalance study will determine the accuracy of this supportive tool when used by non-specialist doctors. This study is funded by the European Union’s Seventh Framework Programme.Methods/designEMBalance is a proof-of-concept study designed as a non-commercial, international, multi-centre, single-blind, parallel-group randomised controlled trial to be carried out at four clinical sites in the United Kingdom, Germany, Greece and Belgium. The study is comprised of three stages: internal pilot, phase I (diagnosis) and stage II (management). For this purpose, 200 patients presenting with persistent dizziness (>3 months’ duration) to primary care services will be randomised to either the intervention group (diagnostic assessment with the DSS) or a control group (diagnostic assessment without the DSS). Patients allocated to the intervention group will be assessed by a doctor with the support of the EMBalance DSS, while patients allocated to the control group will receive a visit as per standard practice. Ultimately, all patients’ diagnoses and management plans will be certified by a consultant in neuro-otology.DiscussionEMBalance is the first trial to test the accuracy of a DSS in both the diagnosis of and the management plan for vestibular disorders across the healthcare systems of four different countries. The EMBalance study is the result of a combined effort of engineers and physicians to develop an accurate tool to support non-specialist doctors, with no risk for the patient. This trial will provide reliable information about the benefits of implementing DSSs in primary care while supporting the feasibility of testing the EMBalance algorithms in further research.

Trial registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02704819","term_id":"NCT02704819"}}NCT02704819. Registered 29 February 2016.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1568-x) contains supplementary material, which is available to authorized users.