Notes

Capabilities and also crucial training needed for specialized medical librarians: a good exploratory study the librarians' views.
the human body, reducing the human tissues' exposure to their toxicity.To date, landfilling remains the most common waste management practice in Greece in spite of enforced regulations aiming at increasing recycling, pre-selection of waste and energy and material recovery. In this study, selected alternative scenarios aiming at minimizing the unused material fraction to be disposed of in landfills are analyzed, using the life cycle assessment methodology. The methodology was applied in the case of municipal solid waste (MSW) management in Athens and Thessaloniki, with a special focus on energy and material balance, including potential global and local scale airborne emissions. Results are given in the form of indices efficiency, effectiveness, environmental and public health impacts. Material flow accounting, gross energy requirement, emergy intensity, emission and release intensity and morbidity or mortality indicators have been used to support the comparative assessment. However, not all options are equally benign to the local environment and to the health of the local population, since both the former and the latter are still affected by non-negligible local emissions. With regard to public health impacts, adverse effects on respiratory health, congenital malformations, low birth weight and cancer incidence were estimated. A significant and not intuitive result is the fact that life cycle analysis produces different conclusions than a simple environmental impact assessment based only on estimated or measured emissions. Taking into account the overall life cycle of both the waste streams and of the technological systems and facilities envisaged alters the relative attractiveness of the solutions considered.Ataxin-3 is a deubiquitinase involved in protein quality control and other essential cellular functions. It preferentially interacts with polyubiquitin chains of four or more units attached to proteins delivered to the ubiquitin-proteasome system. Ataxin-3 is composed of an N-terminal Josephin domain and a flexible C terminus that contains two or three ubiquitin-interacting motifs (UIMs) and a polyglutamine tract, which, when expanded beyond a threshold, leads to protein aggregation and misfolding and causes spinocerebellar ataxia type 3. CPI-613 The high-resolution structure of the Josephin domain is available, but the structural and dynamical heterogeneity of ataxin-3 has so far hindered the structural description of the full-length protein. Here, we characterize non-expanded and expanded variants of ataxin-3 in terms of conformational ensembles adopted by the proteins in solution by jointly using experimental data from nuclear magnetic resonance and small-angle X-ray scattering with coarse-grained simulations. Our results pave the way to a molecular understanding of polyubiquitin recognition.Cross-linking mass spectrometry (MS) has substantially matured as a method over the past 2 decades through parallel development in multiple labs, demonstrating its applicability to protein structure determination, conformation analysis, and mapping protein interactions in complex mixtures. Cross-linking MS has become a much-appreciated and routinely applied tool, especially in structural biology. Therefore, it is timely that the community commits to the development of methodological and reporting standards. This white paper builds on an open process comprising a number of events at community conferences since 2015 and identifies aspects of Cross-linking MS for which guidelines should be developed as part of a Cross-linking MS standards initiative.Heart contraction depends on a complicated array of interactions between sarcomeric proteins required to convert chemical energy into mechanical force. Cyclic interactions between actin and myosin molecules, controlled by troponin and tropomyosin, generate the sliding force between the actin-based thin and myosin-based thick filaments. Alterations in this sophisticated system due to missense mutations can lead to cardiovascular diseases. Numerous structural studies proposed pathological mechanisms of missense mutations at the myosin-myosin, actin-tropomyosin, and tropomyosin-troponin interfaces. However, despite the central role of actomyosin interactions a detailed structural description of the cardiac actomyosin interface remained unknown. Here, we report a cryo-EM structure of a cardiac actomyosin complex at 3.8 Å resolution. The structure reveals the molecular basis of cardiac diseases caused by missense mutations in myosin and actin proteins.
To examine associations between indoor airborne microbial concentration and dry eye (DE) measures.

Prospective, observational, cross-sectional study.

A total of 157 individuals with normal external ocular anatomy were recruited from the Miami Veterans Affairs eye clinic. Subjects underwent a clinical evaluation that included assessment of DE symptoms and signs. Indoor air was sampled using bioaerosol impactors with nutrient and soy media, and samples were incubated for 48 hours at 37 C with 5% CO
. Number of microbial colonies (CFU) was recorded. Outcome measures were DE symptoms and signs.

A total of 157 unique subjects participated in home and clinical visits and of these, 93 completed a 6-month follow-up of home and clinical visits. Older homes were found to have higher CFU compared to newer homes. A 1% increase in humidity was associated with a 3% increase in nutrient CFU (95% confidence interval [CI]= 0.01 to 0.04; P < .001). Instrumented CFU significantly associated with 2 DE measures corneal epithelial disruption and lower eyelid meibomian gland (MG) dropout, adjusted for age and sex (odds ratio [OR]= 28.07, 95% CI=1.8, 443.8, P < .05; OR= 39.6, CI= 1.8, 875.2, P < .05 for soy, respectively). After adjusting for other confounders, CFU and age remained significantly associated with MG dropout. Other DE measures did not significantly associate with CFU.

Individuals with higher CFU counts in the home had more severe MG dropout, after adjusting for age and other confounders. This finding suggests that home CFU exposure may impact MG dropout, one of the DE measures, and may be a target for intervention.
Individuals with higher CFU counts in the home had more severe MG dropout, after adjusting for age and other confounders. This finding suggests that home CFU exposure may impact MG dropout, one of the DE measures, and may be a target for intervention.
Colonoscopy surveillance after adenoma removal is an increasing burden in many countries. Surveillance recommendations consider characteristics of removed adenomas, but not colonoscopist performance. We investigated the impact of colonoscopist performance on colorectal cancer risk after adenoma removal.

We compared colorectal cancer risk after removal of high-risk adenomas, low-risk adenomas, and after negative colonoscopy for all colonoscopies performed by colonoscopists with low vs high performance quality (adenoma detection rate <20% vs ≥20%) in the Polish screening program between 2000 and 2011, with follow-up until 2017. Findings were validated in the Austrian colonoscopy screening program.

A total of 173,288 Polish colonoscopies were included in the study. Of 262 colonoscopists, 160 (61.1%) were low performers, and 102 (38.9%) were high performers; 11.1% of individuals had low-risk and 6.6% had high-risk adenomas removed at screening; 82.2% had no adenomas. During 10 years of follow-up, 443 colng.
Our results suggest that endoscopist performance may be an important contributor in addition to polyp characteristics in determining colorectal cancer risk after colonoscopy screening.
Sodium-glucose co-transporter 2 inhibitors might enhance erythropoiesis and increase red blood cell mass. We assessed the long-term effects of canagliflozin on anaemia-related outcomes.

In a post-hoc analysis of the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial, we included patients with type 2 diabetes and chronic kidney disease who were randomly assigned to treatment with canagliflozin or placebo at 690 sites in 34 countries. We assessed the effects of canagliflozin versus matched placebo on haemoglobin and haematocrit using linear mixed-effects models. The primary outcome of this post-hoc analysis was a composite outcome of investigator-reported anaemia or treatment for anaemia, which was assessed using Kaplan-Meier analysis and Cox regression models. All analyses were done by intention to treat.

Between March 24, 2014, and May 5, 2017, 4401 participants were randomly assigned to receive canagliflozin (100 mg; n=2202) or placebo (n=2199).up, participants in the canagliflozin group also had lower risks of anaemia events alone (0·58, 0·47-0·72; p<0·0001), initiation of iron preparations (0·64, 0·52-0·80; p<0·0001), and need for erythropoiesis-stimulating agents (0·65, 0·46-0·91; p=0·012).

These data suggest that canagliflozin reduces the risk of anaemia-associated outcomes, including the need for erythropoiesis-stimulating agents, among patients with type 2 diabetes and chronic kidney disease.

Janssen Research and Development.
Janssen Research and Development.
Adrenal tumours are commonly encountered in clinical practice, but epidemiological data mainly originate from referral centres. We aimed to determine incidence, prevalence, and rates of malignancy and hormone excess in patients with adrenal tumours in a standardised geographically well defined population.

In this retrospective population-based cohort study we assessed the standardised incidence rate of adrenal tumours in all patients with tumours who lived in Olmsted County, MN, USA, from Jan 1, 1995, to Dec 31, 2017. The Rochester Epidemiology Project infrastructure, which links medical records across all health-care providers for the entire population of Olmsted County since 1966, was used to allow researchers to identify individuals with specific diagnoses, surgical interventions, and other procedures, and to locate their medical records, which were then used in the analysis. Incidence rates and prevalence were standardised for age and sex according to the 2010 US Population.

An adrenal tumour was di of 30 Hounsfield units or more (20% vs 1% for <20 Hounsfield units; p<·0001), and bilateral masses (16% vs 7% for unilateral, p=0·0004).

Adrenal tumour standardised incidence rates increased 10 times from 1995 to 2017. Population-based data revealed lower rates of malignancy, phaeochromocytoma, and overt steroid hormone excess than previously reported.

National Institutes of Health.
National Institutes of Health.
We recently reported early postoperative results comparing use of anastomosis-assist device (Device) with side-biting clamp for ascending aorta during coronary artery bypass grafting (CABG) except for transient neurological complications that occurred less often with Device. Here, we evaluated perioperative safety of Device against aorta no-touch technique (No-touch).

We evaluated patients receiving isolated off-pump CABG with either Device or No-touch approach in 2014-2016 from Japan Adult Cardiovascular Surgery Database. We performed one-to-one matched analysis based on propensity score modeled from patient demographics, comorbidities, cardiac conditions and procedural characteristics. We compared early outcomes in both groups using Pearson's chi-square test/Wilcoxon rank sum test as appropriate with p<0.05 being statistically significant.

Among 9,546 Device and 6,890 No-touch patients, we found 5,012 patient matches for each group. Device operation time significantly longer (293 versus 281 minutes; p<0.
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