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Background The relationship between the number of parathyroid glands autotransplanted and hypoparathyroidism as well as recovery of parathyroid function is not understood fully. The aim was to ascertain whether the number of autotransplanted glands affected the incidence of hypoparathyroidism and recovery of parathyroid function in long-term follow-up after thyroidectomy. Methods A retrospective cohort study included all patients with papillary thyroid carcinoma who underwent first-time total thyroidectomy with central neck dissection between June 2012 and June 2015. The patients were divided into 4 groups (0, 1, 2, and 3) on the basis of the number of parathyroid glands autotransplanted. Results Of the 766 patients, 283 (36.9%) had no gland autotransplanted, and 373 (48.7%), 97 (12.7%), and 13 (1.7%) had 1, 2, and 3 glands autotransplanted, respectively. More lymph nodes and more metastatic ones in the central compartment were retrieved in groups 2 and 3 ( P  < .05). With increasing number of autotransplanted glands, the incidence of transient hypoparathyroidism was 26.1%, 36.2%, 52.6%, and 84.6% ( P  < .05), and the incidence of permanent hypoparathyroidism was 1.8%, 1.1%, 1.0%, and 0% ( P  > .05). The recovery rates of serum parathyroid hormone concentration were 84.7%, 82.2%, 82.0%, and 79.2% after 2-year follow-up ( P  > .05). Conclusion Autotransplantation is an effective strategy for restoration of parathyroid function. Transient hypoparathyroidism is positively correlated to the number of autotransplanted parathyroid glands during total thyroidectomy with central neck dissection. There is no increase in permanent hypoparathyroidism in patients with a higher number of autotransplanted glands, despite more extensive lymph node disease. (Surgery 2018;161:XXX-XXX.) [ABSTRACT FROM AUTHOR]

In this paper we study the following nonlinear fractional Schrödinger equation ( − Δ ) s u + V ( x ) u = f ( x , u ) , x ∈ R N , where s ∈ ( 0 , 1 ) , ( − Δ ) s is the fractional Laplacian operator of order s , and V , f are asymptotically periodic functions in x . Under suitable conditions, the existence of nontrivial solution is obtained by using variational methods and concentration compactness argument. [ABSTRACT FROM AUTHOR]

Summary Although compensatory islet hyperplasia in response to insulin resistance is a recognized feature in diabetes, the factor(s) that promote β cell proliferation have been elusive. We previously reported that the liver is a source for such factors in the liver insulin receptor knockout (LIRKO) mouse, an insulin resistance model that manifests islet hyperplasia. Using proteomics we show that serpinB1, a protease inhibitor, which is abundant in the hepatocyte secretome and sera derived from LIRKO mice, is the liver-derived secretory protein that regulates β cell proliferation in humans, mice, and zebrafish. Small-molecule compounds, that partially mimic serpinB1 effects of inhibiting elastase activity, enhanced proliferation of β cells, and mice lacking serpinB1 exhibit attenuated β cell compensation in response to insulin resistance. Finally, SerpinB1 treatment of islets modulated proteins in growth/survival pathways. Together, these data implicate serpinB1 as an endogenous protein that can potentially be harnessed to enhance functional β cell mass in patients with diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Notification of critical values to clinical staff is an important post-analytical process in all acute care clinical laboratories. No data are available however on how laboratories obtain or establish critical values, particularly in pediatric settings. This study was designed to examine and compare critical values used for pediatric patients in biochemistry laboratories in Canada and assess potential interlaboratory variability. Design and methods: Fourteen clinical laboratories, including two in pediatric hospitals and twelve in hospitals caring for both children and adults, participated in a survey that included 14 pre-selected STAT chemistry tests and 19 pre-selected therapeutic drug monitoring (TDM) tests. Results: Among fourteen chemistry tests, good agreement was observed for critical values used for sodium and pH at both low and high levels within 14 participant laboratories. Significant interlaboratory variability existed for glucose critical values at the high end, magnesium at high end, and PO2 at the low end. For 19 TDM tests, the majority of laboratories did not have alert values to report values over the therapeutic level but not toxic. For critical values greater than the toxic range, significant variability existed at both trough and peak levels among laboratories surveyed. When asked to provide the source for critical values established at each site, only a limited number of laboratories identified their sources as either internal decision or published references. Conclusion: Although all laboratories have established and routinely use critical values to alert clinical staff, considerable variability exists in both the critical limits reported as well as the source of such values. There is a clear need for new national efforts to standardize pediatric critical value reporting and establish evidence-based critical limits for all medical laboratories across Canada. [Copyright &y& Elsevier]

Abstract: Objective: To determine using a simplified study design trimester-specific FT4 reference intervals in pregnancy with the Roche Modular immunoassay in routine use. Design and methods: Surplus blood from 300 women in each trimester, drawn at documented times in the gestation, and from 40 age-matched nonpregnant women were assayed for FT4, thyroid stimulating hormone (TSH) and antithyroid peroxidase autoantibody (anti-TPO). Results: After excluding women positive for anti-TPO and with abnormal TSH, reference intervals were calculated as 12.5–19.1 pmol/L (nonpregnant group), 11–19 pmol/L (first trimester), 9.7–17.5 pmol/L (second trimester) and 8.1–15.3 pmol/L (third trimester). 3rd trimester FT4 was significantly lower than that of the second trimester (p <0.001) which, in turn, was lower than that of the first trimester (p <0.001). FT4 reference intervals in pregnancy were significantly lower than in the nonpregnant women (p <0.002). Conclusions: The observed trimester-specific FT4 reference intervals progressively decline with advancing gestation and differ significantly from one another. [Copyright &y& Elsevier]

This study adopted the spillover-crossover model to examine proactive personality as a potential antecedent of marital satisfaction among dual-earner couples in China. We collected data from 241 Chinese dual-earner couples, and found that proactive personality was positively associated with marital satisfaction through increased work-family facilitation and decreased work-family conflict for men. However, the effect of proactive personality on marital satisfaction was complex and overall negative for women. Specifically, proactive personality was positively related to work-family facilitation and work-family conflict, which in turn positively and negative predicted marital satisfaction, respectively. Furthermore, our results showed a direct crossover effect of marital satisfaction between partners, suggesting that the effect of people's proactive personality on their own marital satisfaction might cross over to their spouses. This study contributes to a broader understanding of the effect of proactive personality. [ABSTRACT FROM AUTHOR]

Semi-quantitative and quantitative immunoassays are the most commonly used methodology to evaluate immunity post immunization. Objectives : To compare four quantitative SARS-CoV-2 serological assays in COVID-19 patients and immunized healthy individuals, cancer patients, and patients with immunosuppressive therapy. Study design : 210 serological samples from COVID-19 infection and vaccination cohorts were used to create a serological sample repository. Serological methods from four manufacturers, namely Euroimmun, Roche, Abbott, and DiaSorin, were evaluated for quantitative, semi-quantitative, and qualitative antibody measurements. All four methods measure IgG antibodies against the SARS-CoV-2 spike receptor–binding domain and report the results in Binding Antibody Unit/mL (BAU/mL). A Total Error Allowable (TEa) of ±25% was chosen as the criteria to determine whether two methods are clinically equivalent quantitatively. Semi-quantitative results (titers) were derived using numeric antibody concentration divided by the cut-off value for each method. Results : All paired quantitative comparisons demonstrated unacceptable performance. With ±25% as TEa, the best agreement was 74 (35.2% out of 210 samples) between Euroimmun and DiaSorin, whereas the lowest agreement was 11 (5.2% out of 210 samples) between Euroimmun and Roche. Antibody titers amongst all four methods were significantly different (p < 0.001). The highest titer difference from the same sample is between Roche and DiaSorin with a 1392-fold difference. On qualitative comparison, none of the paired comparison showed acceptable comparison (p < 0.001). Conclusions : Poor correlation exists between four evaluated assays, quantitatively, semi-quantitatively, and qualitatively. Further harmonization of assays is required to achieve comparable measurements. [ABSTRACT FROM AUTHOR]

Background and Aims Bacteremia is a common serious manifestation of disease in the intensive care unit (ICU), which requires quick and accurate determinations of pathogens to select the appropriate antibiotic treatment. To overcome the shortcomings of traditional bacterial culture (BC), we have adapted next-generation sequencing (NGS) technology to identify pathogens from cell-free plasma DNA. Methods In this study, 78 plasma samples from ICU patients were analyzed by both NGS and BC methods and verified by PCR amplification/Sanger sequencing and ten plasma samples from healthy volunteers were analyzed by NGS as negative controls to define or calibrate the threshold of the NGS methodology. Results Overall, 1578 suspected patient samples were found to contain bacteria or fungi by NGS, whereas ten patients were diagnosed by BC. Seven samples were diagnosed with bacterial or fungal infection both by NGS and BC. Among them, two samples were diagnosed with two types of bacteria by NGS, whereas one sample was diagnosed with two types of bacteria by BC, which increased the detectability of bacteria or fungi from 11 with BC to 17 with NGS. Most interestingly, 14 specimens were also diagnosed with viral infection by NGS. The overall diagnostic sensitivity was significantly increased from 12.82% (10/78) by BC alone to 30.77% (24/78) by NGS alone for ICU patients, which provides more useful information for establishing patient treatment plans. Conclusion NGS technology can be applied to detect bacteria in clinical blood samples as an emerging diagnostic tool rich in information to determine the appropriate treatment of septic patients. [ABSTRACT FROM AUTHOR]

• SARS-CoV-2 serology offers limited clinical utility for individuals. • SARS-CoV-2 serology may be useful for seroprevalence studies. • Claims regarding protective immunity or infectivity cannot be made using serology. • Assay clinical sensitivity and specificity should approach 100%. • Harmonized reporting of SARS-CoV-2 serology minimizes result misinterpretation. Clinical laboratories across the world are working to validate and perform testing for SARS-CoV-2 antibodies. Herein, we present interim consensus guidance for Canadian clinical laboratories testing and reporting SARS-CoV-2 serology, with emphasis on the capabilities and limitations of these tests and recommendations for interpretative comments in an effort to achieve harmonized laboratory practices. The consensus document provides a broad overview of topics including sample type and contamination risk; kinetics of antibody response to COVID-19 and the impact on serology testing; clinical utility of SARS-CoV-2 serology testing; clinical performance of commercial laboratory-based assays commonly deployed in North America; recommendations for interim reporting; utility of SARS-CoV-2 antibody testing for pediatric patients; and utility of point-of-care testing. The information is based on the current literature and is subject to change as additional information becomes available. [ABSTRACT FROM AUTHOR]

Abstract The incidence of sparganosis, a parasitic disease caused by plerocercoid larvae of the genus Spirometra , has gradually risen worldwide (especially in remote areas) in recent years. Pulmonary and pleural sparganosis, as well as other sites of infestation, including the subcutaneous tissues, the abdominal viscera, brain and eyes, has been reported. In clinical practice, due to the atypical signs and symptoms as well as limited laboratory approaches for the specific detection of sparganum, sparganosis is often misdiagnosed. In the present study, an 11-year-old girl visited the Department of Infectious Diseases in Shanghai Children's Medical Center for recurrent shoulder and chest pain and shortness of breath. Imaging tests demonstrated bilateral pleural and pericardial effusion, enlarged lymph nodes in front of the tracheal carina, and infection of the left lower lobe. Sparganum were not observed in the dissected soft tissue at the root of the right thigh with naked-eye and light microscopy examination. Histologic examination revealed granulomatous inflammation and tunnel-like necrosis with eosinophilic, neutrophilic and lymphocytic infiltration. Although the patient's serum was positive for sparganum antibodies, the diagnosis of sparganosis was not confirmed for more than three months. Ultimately, genomic DNA of Spirometra erinaceieuropaei was detected in the mass at the root of the right thigh using next-generation sequencing (NGS), confirming the diagnosis of sparganosis. The patient was treated with praziquantel (150 mg/kg/day) without recurrence after an eight-month follow-up. We present, for the first time, a study of human sparganosis diagnosed using NGS, which provided a clinically actionable diagnosis of a specific infectious disease from an uncommon pathogen. Highlights • Sparganosis is one of the parasitic diseases and its atypical clinical manifestations can mislead or delay the diagnosis. • This is the first study to apply next-generation sequencing (NGS) for the diagnosis of human sparganosis. • NGS is a clinically actionable approach for the diagnosis of a specific infectious disease caused by an uncommon pathogen. [ABSTRACT FROM AUTHOR]

Vascular recovery or re-angiogenesis after radiotherapy plays a significant role in tumor recurrence, whereas molecular mechanisms of this process remain elusive. In this work, we found that dying glioma cells promoted post-irradiation angiogenesis through a caspase 3 dependent mechanism. Evidence in vitro and in vivo indicated that caspase 3 inhibition undermined proangiogenic effects of dying glioma cells. Proteolytic inactivation of caspase 3 in glioma cells reduced tumorigenicity. Importantly, we identified that NF-κB/COX-2/PGE2 axis acted as downstream signaling of caspase 3, mediating proangiogenic response after irradiation. Additionally, VEGF-A, regulated by caspase 3 possibly through phosphorylated eIF4E, was recognized as another downstream factor participating in the proangiogenic response. In conclusion, these data demonstrated that caspase 3 in dying glioma cells supported the proangiogenic response after irradiation by governing NF-κB/COX-2/PGE2 axis and p-eIF4E/VEGF-A signaling. While inducing caspase 3 activation has been a generally-adopted notion in cancer therapeutics, our study counterintuitively illustrated that caspase 3 activation in dying glioma cells unfavorably supported post-irradiation angiogenesis. This double-edged role of caspase 3 suggested that taming caspase 3 from the opposite side, not always activating it, may provide novel therapeutic strategies due to restricted post-irradiation angiogenesis. [ABSTRACT FROM AUTHOR]

Abstract: The O-polysaccharide (O-antigen) of Escherichia coli O102 was studied by sugar analysis along with one- and two-dimensional 1H and 13C NMR spectroscopy. The following structure of the branched pentasaccharide repeating unit was established: Display Omitted The O-antigen gene cluster of E. coli O102 was sequenced. The gene functions were tentatively assigned by comparison with sequences in the available databases and found to be in full agreement with the E. coli O102 O-polysaccharide structure. [Copyright &y& Elsevier]