A theory of planned behavior-based intervention to improve quality of life in patients with knee/hip osteoarthritis: a randomized controlled trial

Clinical Rheumatology - Osteoarthritis (OA) is a common chronic disorder among elderly people that affects joints such as the knee and hip in particular. The objective of the current study was to...     

Interspecies plasmid transfer appears rare in sequential infections with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae

From a cohort of 1836 Swedish patients infected with ESBL-producing Enterobacteriaceae (EPE) during 2004–2014, 513 patients with recurrent EPE infection were identified. Only in 14 of the 513 patients was a change of species (ESBL-E. coli to ESBL-K. pneumoniae or vice versa) found between the index and subsequent infection. Eleven sequential urine isolates from 5 of the 14 patients were available for further analysis of possible transfer of ESBL-carrying plasmids. The plasmid content was studied using optical DNA mapping (ODM), PCR-based replicon typing, and ESBL gene sequencing. ODM allowed us to directly compare whole plasmids between isolates and found similar ESBL-carrying plasmids in 3 out of the 5 patients. The ODM results and the rarity in shift of species between ESBL-E. coli and ESBL-K. pneumoniae imply that in recurrent EPE infections interspecies plasmid transfer is uncommon.     

A micromechanical hyperelastic modeling of brain white matter under large deformation

A finite element based micromechanical model has been developed for analyzing and characterizing the microstructural as well as homogenized mechanical response of brain tissue under large deformation. The model takes well-organized soft tissue as a fiber-reinforced composite with nonlinear and anisotropic behavior assumption for the fiber as well as the matrix of composite matter. The procedure provides a link between the macroscopic scale and microscopic scale as brain tissue undergoes deformation. It can be used to better understand how macroscopic stresses are transferred to the microstructure or cellular structure of the brain. A repeating unit cell (RUC) is created to stand as a representative volume element (RVE) of the hyperelastic material with known properties of the constituents. The model imposes periodicity constraints on the RUC. The RUC is loaded kinematically by imposing displacements on it to create the appropriate normal and shear stresses. The homogenized response of the composite, the average stresses carried within each of the constituents, and the maximum local stresses are all obtained. For each of the normal and shear loading scenarios, the impact of geometrical variables such as the axonal fiber volume fraction and undulation of the axons are evaluated. It was found that axon undulation has significant impact on the stiffness and on how stresses were distributed between the axon and the matrix. As axon undulation increased, the maximum stress and stress in the matrix increased while the stress in the axons decreased. The axon volume fraction was found to have an impact on the tissue stiffness as higher axon volume fractions lead to higher stresses both in the composite and in the constituents. The direction of loading clearly has a large impact on how stresses are distributed amongst the constituents. This micromechanics tool provides the detailed micromechanics stresses and deformations, as well as the average homogenized behavior of the RUC, which can be efficiently used in mechanical characterization of brain tissue.     

Monitoring human cytomegalovirus infection in pediatric hematopoietic stem cell transplant recipients: using an affordable in‐house qPCR assay for management of HCMV infection under limited resources

Quantitative real‐time PCR (qPCR) assay is accepted as the method of choice for monitoring human cytomegalovirus (HCMV) infection in hematopoietic stem cell transplant recipients, but the high cost of commercial kits has hampered its use in many developing countries. In this study, an affordable in‐house qPCR was used to manage HCMV infection in pediatric patients and the diagnostic value of this method was compared with the conventional pp65 antigenemia assay. A total number of 1179 samples from 82 recipients were used in this study, and the effect of some potential risk factors on HCMV reactivation was evaluated. The qPCR was able to detect HCMV reactivation earlier and with higher sensitivity than antigenemia assay. Forty‐six episodes of reactivation were detected in 39 patients, of which all were detected by the qPCR assay, while only 21 episodes were diagnosed by antigenemia. The DNAemia level of 1284 IU/ml plasma was defined as the optimal cutoff value for starting pre‐emptive therapy. It was shown that the acute GVHD severity and the relationship of donor and recipient are the most significant risk factors for HCMV reactivation. The data suggest that the antigenemia method for monitoring HCMV reactivation could be substituted by the qPCR assay.     

A case–control study of reproductive factors and renal cell carcinoma among black and white women in the United States

Objective  

Renal cell carcinoma (RCC) incidence is higher among blacks than whites in the United States and has been associated with the frequency and timing of childbirth among women in some epidemiologic studies. We investigated whether reproductive factors are associated with RCC, overall and by race, within a population-based case–control study.