Let me Google that for you:a time series analysis of seasonality in internet search trends for terms related to foot and ankle pain

BACKGROUND: The analysis of internet search traffic may present the opportunity to gain insights into general trends and patterns in information seeking behaviour related to medical conditions at a population level. For prevalent and widespread problems such as foot and ankle pain, this information has the potential to improve our understanding of seasonality and trends within these conditions and their treatments, and may act as a useful proxy for their true incidence/prevalence characteristics. This study aimed to explore seasonal effects, general trends and relative popularity of internet search terms related to foot and ankle pain over the past decade. METHODS: We used the Google Trends tool to obtain relative search engine traffic for terms relating to foot and ankle pain and common treatments from Google search and affiliated pages for major northern and southern hemisphere English speaking nations. Analysis of overall trends and seasonality including summer/winter differences was carried out on these terms. RESULTS: Searches relating to general foot pain were on average 3.4 times more common than those relating to ankle pain, and twice as common as searches relating to heel pain. Distinct seasonal effects were seen in the northern hemisphere, with large increases in search volumes in the summer months compared to winter for foot (p = 0.004, 95 % CI [22.2–32.1]), ankle (p = 0.0078, 95 % CI [20.9–35.5]), and heel pain (p = 0.004, 95 % CI [29.1–45.6]). These seasonal effects were reflected by data from Australia, with the exception of ankle pain. Annual seasonal effects for treatment options were limited to terms related to foot surgery and ankle orthoses (p = 0.031, 95 % CI [3.5–20.9]; p = 0.004, 95 % CI [7.6–25.2] respectively), again increasing in the summer months. CONCLUSIONS: A number of general trends and annual seasonal effects were found in time series internet search data for terms relating to foot and ankle pain. This data may provide insights into these conditions at population levels. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13047-015-0074-9) contains supplementary material, which is available to authorized users

P660Molecular insight in apoM-S1P-induced cardioprotection against ischemia/reperfusion injury

Purpose: Apolipoprotein M (apoM) is a plasma lipoprotein that mainly associates with high-density lipoproteins (HDL) and that serves as a carrier of the bioactive lipid Sphingosine-1-Phosphate (S1P). Recent studies indicate that S1P binding to G-protein-coupled receptors, known as S1P-receptors, in the heart activates signalling pathways promoting cardiomyocyte survival, but downstream targets are largely unknown. Here, we investigate the putative role of the apoM-S1P axis in relation to cardioprotection against ischemia/reperfusion (IR) injury. Methods and Results: ApoM transgenic (Apom-Tg) mice, in which plasma S1P is increased by >250%, and wild-type (WT) mice were subjected to 30 min of left coronary artery ligation and 24 hrs reperfusion in vivo. We found a reduction of infarct size in Apom-Tg mice (15±1%) in comparison with WT mice (29±4%, N=8-9, p<0.01). In agreement, neutrophil infiltration into the infarcted area was lower in Apom-Tg mice (14.8±0.2% vs. 25.9±5.1 in WT, N=3, p<0.05). Interestingly, 5 min of S1P treatment at the onset of reperfusion reduced infarct size in response to 30 min of no-flow global ischemia (control: 23±3%, S1P-treated: 11±2%, N=5, p<0.05) in ex vivo Langendorff perfused hearts, suggesting that S1P exerts a direct protective effect on cardiomyocytes. Moreover, the sensitivity to ex vivo IR of Apom-Tg mice was not different from WT mice, further supporting that the cardioprotective effect observed in vivo is due to increased plasmatic S1P in these mice. To obtain further insight into the mechanism underlying S1P-induced cardioprotection, neonatal rat ventricular cardiomyocytes were treated for 5 min with S1P after pre-incubation with PKC kinase inhibitors or with specific antagonists of S1P receptors. We found by Western blot that S1P induced phosphorylation of the gap junction protein Connexin43 (Cx43) on Serine 368 by a PKC-dependent mechanism and that this phosphorylation was mediated by S1P2 and S1P3 but not by S1P1 receptors. Finally, 5 min of S1P treatment reduced gap junctional communication between cardiomyocytes (9±1 cells, N=29) in comparison to control conditions (15±2 cells, N=34, p<0.01), as assessed by dye coupling assay. Conclusion: Increased plasma apoM-S1P in mice protects the heart against IR injury. The molecular mechanism might involve reduced cardiomyocyte death by activation of S1P2 and S1P3 receptors, which leads to PKC-dependent phosphorylation of Cx43 and reduction of cell-to-cell couplin

Deep subcutaneous application of poly-L-lactic acid as a filler for facial lipoatrophy in HIV-infected patients

Introduction: Facial lipoatrophy is a crucial problem of HIV-infected patients undergoing highly active antiretroviral therapy (HAART). Poly-L-lactic acid (PLA), provided as New-Fill(R)/Sculptra(TM), is known as one possible treatment option. In 2004 PLA was approved by the FDA as Sculptra(TM) for the treatment of lipoatrophy of the face in HIV-infected patients. While the first trials demonstrated relevant efficacy, this was to some extent linked to unwanted effects. As the depth of injection was considered relevant in this context, the application modalities of the preparation were changed. The preparation was to be injected more deeply into subcutaneous tissue, after increased dilution. Material and Methods: To test this approach we performed a pilot study following the new recommendations in 14 patients. Results: While the efficacy turned out to be about the same, tolerability was markedly improved. The increase in facial dermal thickness was particularly obvious in those patients who had suffered from lipoatrophy for a comparatively small period of time. Conclusion: With the new recommendations to dilute PLA powder and to inject it into the deeper subcutaneous tissue nodule formation is a minor problem. However, good treatment results can only be achieved if lipoatrophy is not too intense; treatment intervals should be about 2 - 3 weeks. Copyright (C) 2005 S. Karger AG, Basel

VARIABILITAS SUHU PERMUKAAN LAUT DAN KONSENTRASI KLOROFIL-A DI SAMUDERA HINDIA BAGIAN TIMUR LAUT SEBELAH BARAT SUMATERA

The variability of sea surface temperature (SST) and concentration of chlorophyll-a (Chl-a) in the Northeastern Indian Ocean west off Sumatra was studied using satellite data over a period of 22 years. The study used a combination of NOAA-AVHRR and MODIS data for SST, SeaWiFS and MODIS data for Chl-a, and monthly surface wind data from the European Center for Medium Range Weather Forecasts (ECMWF). Supporting data such as the monthly El Nino Southern Oscillation (ENSO) index and the Dipole Mode Index (DMI) were obtained from the web page of https://www.ncdc.noaa.gov/teleconnections/ enso/indicators/soi/ and https://www. jamstec.go.jp/virtualearth/general/en/index.html, respectively. The results showed that the range of SST during 22 years (1997-2019) was 27,57°C-34,41°C where the higher SST occurred during the West Season and Transition Season-1, while the lower values were found during the East Season and Transition Season-2. The negative IOD caused higher SST and lower Chl-a concentration than normal. Chl-a for 22 years ranged from 0,0757 mg/m3-1,3006 mg/m3 where higher Chl-a occurred start from the end of East Season (August) to early West Season (December), while lower values were found during Transition Season 1. The evidence of higher SST around Transition Season 1 (March-May) coincided with the evidence of lower Chl-a in the same seasons was due to negative IOD phenomenon. The variability of SST and Chl-a was influenced by the patterns of the seasonal wind, the water mass circulation, and IODM.Variabilitas suhu permukaan laut (SPL) dan konsentrasi klorofil-a (Chl-a) di Samudera Hindia bagian Timur Laut sebelah barat Sumatera diteliti menggunakan data satelit selama kurun waktu 22 tahun. Penelitian ini menggunakan gabungan data citra NOAA-AVHRR dan MODIS untuk SPL, data citra SeaWiFS dan MODIS untuk Chl-a, data angin permukaan bulanan diperoleh dari European Centre for Medium-Range Weather Forecasts (ECMWF). Data pendukung berupa indeks El Nino Southern Oscillation (ENSO) bulanan diperoleh dari laman https://www.ncdc.noaa.gov/teleconnections/enso/ indicators/soi/ dan Dipole Mode Index (DMI) bulanan diperoleh dari laman https://www.jamstec.go.jp/ virtualearth/general/en/index.html. Hasil penelitian menunjukkan bahwa SPL di daerah penelitian selama 22 tahun (1997-2019) berada pada kisaran 27,57°C-34,41°C. Nilai SPL yang lebih tinggi terjadi saat Musim Barat sampai Musim Peralihan-1, sementara nilai yang lebih rendah pada Musim Timur sampai Musim Peralihan-2. Variabilitas nilai SPL dipengaruhi oleh pola angin musiman, intensitas radiasi matahari, dan Indian Ocean Dipole Mode (IODM). Saat IOD Negatif menyebabkan nilai SPL yang lebih tinggi dan konsentrasi Chl-a lebih rendah dari biasanya. Konsentrasi klorofil-a selama 22 tahun berkisar antara 0,0757 mg/m3-1,3006 mg/m3, konsentrasi klorofil-a yang lebih tinggi terjadi saat akhir Musim Timur (Agustus) dan awal Musim Barat (Desember), sementara nilai yang lebih rendah saat Musim Peralihan-1. Tingginya SPL pada Musim Peralihan-1 (Maret-Mei) bersamaan dengan rendahnya Chl-a pada musim yang sama diduga akibat terjadinya fenomena IOD negatif. Variabilitas Chl-a dipengaruhi oleh pola angin musiman, pergerakan massa air, dan IOD

Validating child vaccination status in a demographic surveillance system using data from a clinical cohort study: evidence from rural South Africa

&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Childhood vaccination coverage can be estimated from a range of sources. This study aims to validate vaccination data from a longitudinal population-based demographic surveillance system (DSS) against data from a clinical cohort study.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; The sample includes 821 children in the Vertical Transmission cohort Study (VTS), who were born between December 2001 and April 2005, and were matched to the Africa Centre DSS, in northern KwaZulu-Natal. Vaccination information in the surveillance was collected retrospectively, using standardized questionnaires during bi-annual household visits, when the child was 12 to 23 months of age. DSS vaccination information was based on extraction from a vaccination card or, if the card was not available, on maternal recall. In the VTS, vaccination data was collected at scheduled maternal and child clinic visits when a study nurse administered child vaccinations. We estimated the sensitivity of the surveillance in detecting vaccinations conducted as part of the VTS during these clinic visits.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Vaccination data in matched children in the DSS was based on the vaccination card in about two-thirds of the cases and on maternal recall in about one-third. The sensitivity of the vaccination variables in the surveillance was high for all vaccines based on either information from a South African Road-to-Health (RTH) card (0.94-0.97) or maternal recall (0.94-0.98). Addition of maternal recall to the RTH card information had little effect on the sensitivity of the surveillance variable (0.95-0.97). The estimates of sensitivity did not vary significantly, when we stratified the analyses by maternal antenatal HIV status. Addition of maternal recall of vaccination status of the child to the RTH card information significantly increased the proportion of children known to be vaccinated across all vaccines in the DSS.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusion:&lt;/b&gt; Maternal recall performs well in identifying vaccinated children aged 12-23 months (both in HIV-infected and HIV-uninfected mothers), with sensitivity similar to information extracted from vaccination cards. Information based on both maternal recall and vaccination cards should be used if the aim is to use surveillance data to identify children who received a vaccination.&lt;/p&gt

The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review

PMCID: PMC3408383The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1741-7015/10/75. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

What constitutes a "clinical trial"?: A survey of oncology professionals

<p>Abstract</p> <p>Background</p> <p>What constitutes a "clinical trial" is inconsistently defined in the medical literature. With an initiative by Cancer Care Ontario (CCO) to report institutional clinical trials activity across the province of Ontario, Canada, we sought to investigate the variability in the interpretation of the term by local oncology professionals.</p> <p>Methods</p> <p>A survey amongst the physicians and nurses at the Juravinski Cancer Centre at Hamilton Health Sciences, Ontario was conducted. The survey included 12 summaries of local clinical research studies, and respondents were asked which they believed represented a clinical trial. Subsequently, they were asked which of the same 12 studies they believed should be labeled as clinical trials when considering separate definitions provided by CCO and by the Ontario Cancer Research Network (OCRN).</p> <p>Results</p> <p>A total of 66 (54%) of 123 surveys were completed; 32/46 (70%) by physicians, 21/59 (36%) by primary care nurses, and 13/18 (72%) by clinical trial nurses. Without a standardized definition, all studies, 12/12, were considered to be clinical trials by at least 50% of respondents. When provided with the CCO definition only 6/12 studies were considered to be clinical trials by the majority of respondents, while with the OCRN definition it was 9/12 studies. Studies evaluating natural health products, non-traditional medical interventions, and non-randomized studies with standard interventions consistently ranked the lowest, regardless of the definition used.</p> <p>Conclusion</p> <p>Oncology professionals appear to have a broadly inclusive baseline definition of what constitutes a clinical trial. Establishing rigor and consistency in the definition of a clinical trial is important for any program, institutional or jurisdictional based comparisons of clinical trials activity, especially when used as a quality indicator of patient care.</p

Glucose-induced down regulation of thiamine transporters in the kidney proximal tubular epithelium produces thiamine insufficiency in diabetes

Increased renal clearance of thiamine (vitamin B1) occurs in experimental and clinical diabetes producing thiamine insufficiency mediated by impaired tubular re-uptake and linked to the development of diabetic nephropathy. We studied the mechanism of impaired renal re-uptake of thiamine in diabetes. Expression of thiamine transporter proteins THTR-1 and THTR-2 in normal human kidney sections examined by immunohistochemistry showed intense polarised staining of the apical, luminal membranes in proximal tubules for THTR-1 and THTR-2 of the cortex and uniform, diffuse staining throughout cells of the collecting duct for THTR-1 and THTR-2 of the medulla. Human primary proximal tubule epithelial cells were incubated with low and high glucose concentration, 5 and 26 mmol/l, respectively. In high glucose concentration there was decreased expression of THTR-1 and THTR-2 (transporter mRNA: −76% and −53% respectively, p<0.001; transporter protein −77% and −83% respectively, p<0.05), concomitant with decreased expression of transcription factor specificity protein-1. High glucose concentration also produced a 37% decrease in apical to basolateral transport of thiamine transport across cell monolayers. Intensification of glycemic control corrected increased fractional excretion of thiamine in experimental diabetes. We conclude that glucose-induced decreased expression of thiamine transporters in the tubular epithelium may mediate renal mishandling of thiamine in diabetes. This is a novel mechanism of thiamine insufficiency linked to diabetic nephropathy

Heterotic Line Bundle Standard Models

In a previous publication, arXiv:1106.4804, we have found 200 models from heterotic Calabi-Yau compactifications with line bundles, which lead to standard models after taking appropriate quotients by a discrete symmetry and introducing Wilson lines. In this paper, we construct the resulting standard models explicitly, compute their spectrum including Higgs multiplets, and analyze some of their basic properties. After removing redundancies we find about 400 downstairs models, each with the precise matter spectrum of the supersymmetric standard model, with one, two or three pairs of Higgs doublets and no exotics of any kind. In addition to the standard model gauge group, up to four Green-Schwarz anomalous U(1) symmetries are present in these models, which constrain the allowed operators in the four-dimensional effective supergravity. The vector bosons associated to these anomalous U(1) symmetries are massive. We explicitly compute the spectrum of allowed operators for each model and present the results, together with the defining data of the models, in a database of standard models accessible at http://www-thphys.physics.ox.ac.uk/projects/CalabiYau/linebundlemodels/index.html. Based on these results we analyze elementary phenomenological properties. For example, for about 200 models all dimension four and five proton decay violating operators are forbidden by the additional U(1) symmetries.Comment: 55 pages, Latex, 3 pdf figure