False Interpretation Research Articles

Multi-Surface Antigen Staining of Larger Extracellular Vesicles.

Larger extracellular vesicles, microparticles (MPs) or microvesicles (MVs), especially their acquisition and characterization by flow cytometry (FACS), is increasingly in focus of clinical/translational research efforts. Several laboratories have shown that MPs/MVs might be suitable for the diagnosis and predicting prognosis in various diseases including cancer. However, FACS staining of larger extracellular vesicles (EVs) can be difficult and results potentially in false positive and inconsistent data interpretation. Despite that FACS equipment is well maintained and the operators have ample experience, a reliable and for larger EVs optimized staining protocol is missing. Here, we aim to close that gap and provide a working multi-antibody staining protocol for larger EVs isolated from human serum samples. We describe in detail the needed steps as currently done in our laboratory. Staining is demonstrated exemplarily for multi-antibody mix including CD147 , a potential cancer marker if applied in combination with other MP/MV surface markers.

Increased F-FDG Uptake in Bilateral Gynecomastia Secondary to Feminizing Adrenal Tumor: A Rare Case Report and Review of Literature.

A 21 year old male who presented with painful enlargement of both the breasts and a hyperestrogenic state, was found to harbor a heterogeneous mass arising from the right adrenal on contrast enhanced Computed Tomography abdomen. The mass was hypermetabolic with no regional, nodal or distant metastases on Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography /Computed Tomography examination. Notably, substantial tracer uptake was seen in bilateral gynecomastia. The patient underwent a right adrenalectomy with the histopathology report confirming adrenocortical carcinoma. This case demonstrates utility of FDG PET/CT in adrenocortical carcinoma. However, when interpreting FDG PET/CT as a staging tool in oncological male patients, one should consider gynecomastia as a possible cause for increased FDG uptake in the breast as it may lead to a false positive interpretation.

Abstract B18: Molecular cancer testing of KRAS and miR-21 from EUS-guided biopsies of pancreatic tissue: Utility of aspirates vs. cytology

Abstract Introduction: Currently, there is a lack of reliable markers useable in diagnosis and/or management of the pancreatic ductal adenocarcinoma (PDAC). Although detection of KRAS point mutations for the differential diagnosis and determination of miR-21 expression for diagnostic and prognostic purposes have been widely investigated with promising results, neither KRAS nor miR-21 testing have become routine in clinical practice so far. One of the reasons is that analysis of KRAS mutations and miRNA expression is mainly performed on resected pancreatic tissue the use of which is relevant only for a minority of PDAC patients undergoing of surgical treatment. The present study describes development of a reliable methodology for analysis of KRAS mutations and miR-21 expression from samples acquired by endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB), applicable to all PDAC patients. Consequently, the success rates and clinical validity of KRAS mutation and miR-21 expression analysis in two common types of EUS-FNB samples, i.e. native aspirates and cytology specimens are compared. Experimental: The study included 118 patients with a confirmed diagnosis of pancreatic ductal adenocarcinoma (PDAC). Each patient underwent EUS-FNB and the sample was divided into two parts, one part was stored in a stabilizing solution as native aspirate and the rest was processed into the cytology specimen. DNA/RNA was extracted and then analyzed for KRAS mutations and miR-21 expression. For both sample types, the yields of DNA/RNA and success rates for KRAS and miR-21 testing were compared along with evaluation of mutant cell fractions. Finally, confirmation of miR-21 prognostic role was tested by Kaplan-Meier analysis. Data Summary: The overall amount of isolated DNA/RNA from native aspirates was significantly lower compared to the cytology specimens (147 ng vs. 642 ng for DNA, 10 ng vs 164 ng for RNA). The success rates for subsequent KRAS and miR-21 analysis was 100% for both sample types. The KRAS-mutant detection rates in native aspirates were 12% lower than in cytology specimens (78% vs. 90%). The average fraction of KRAS-mutant cells was lower in native aspirates (31%) compared to the cytology specimens (56%). The prognostic role of miR-21 in native aspirates did not reach statistical significance (p = 0.06), but was confirmed in cytology specimens (p = 0.02). Conclusions: Although both types of EUS-FNB samples are suitable for DNA/RNA extraction and subsequent DNA mutation and miRNA expression analysis, reliable results with clinical validity were only obtained for cytological specimens. Native aspirates exhibit a low and undefined fraction of tumor cells leading to false interpretation of molecular testing results. EUS-FNB samples in the form of cytology specimens are a perspective source for the study of molecular markers in virtually all PDAC patients, including patients in inoperable stages. Supported by Internal Grant Agency of the Czech Ministry of Health (IGA) grant No. NT 13638 Citation Format: Lucie Benesova, Tereza Halkova, Bohus Bunganic, Barbora Belsanova, Eva Traboulsi, Miroslav Zavoral, Marek Minarik.{Authors}. Molecular cancer testing of KRAS and miR-21 from EUS-guided biopsies of pancreatic tissue: Utility of aspirates vs. cytology. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr B18.

Detection of Copy-Move Forgery Exploiting LBP Features with Discrete Wavelet Transform

Copy-move forgery is being used at various fields to hide significant information or to append additional information in image. Image forgery results in false interpretations. In this forgery, one section of image is copied and then it is pasted over the same image at different location. Although, various techniques are suggested by researchers but finding forged section of varying size and located at different locations on image is complicated. To resolve such problems we introduce a new hybrid approach for finding copy-move forgery based on Discrete Wavelet Transform with Local Binary Pattern. At First, image is moldered into three color components. Discrete Wavelet Transform is applied over the image which results in four sub bands. Approximation sub image contains low frequency components having maximum information. LL subimage is divided in overlapping blocks. Local Binary Pattern is calculated for blocks to generate descriptors to match similar blocks. Shift vectors are computed to find group of block pairs with similar shifting. It is observed by our experimental results that proposed method can efficiently detect manipulated images having different forgery size with high detection accuracy and low false positive rate as comparison to other state-of-the-art.

Meaning-Less Differences: Exposing Fallacies and Flaws in “The Word Gap” Hypothesis That Conceal a Dangerous “Language Trap” for Low-Income American Families and Their Children

ABSTRACTThe present article compares and contrasts linguistic findings from longitudinal studies of low-income Americans derived from evidence of recorded family speech interactions. Hart and Risley (1995) employed research assistants who spent 1 hour per month observing language usage among families from different socioeconomic backgrounds in their homes for 2.5 years. Baugh (1983) spent 40 hours per week during seven consecutive summers between 1969 and 1976 as a participant observer in a low-income African American community, conducting tape recorded interviews with African American families in various social circumstances during the final 4 years, which always included recorded interviews within each family home. Comparison of the linguistic results derived from the alternative data collection procedures allow for a reinterpretation of Hart and Risley’s (1995, 2003) conclusions, casting doubt on their findings as well as their speculations about future linguistic prospects for Americans from diverse racial and socioeconomic backgrounds due to false positive interpretations of their results that wrongly conclude deceptively enticing causalities. Regrettably, the alleged “word gap” is another incarnation of a deficit language hypothesis that is fundamentally flawed and woefully uninformed by decades of extensive linguistic research that has been conducted by many different linguists in various American inner-city communities since 1968.

HbA1c is not always reliable in estimating glycaemic control

AbstractGlycated haemoglobin (HbA1c) is considered as a cornerstone for assessing long‐term glycaemic control. Several studies have established a strong correlation between HbA1c and diabetic comorbidities. However, in certain conditions it can lead to a false interpretation of diabetes control which may result in serious errors in patient management. It is essential clinicians are aware of the conditions that can affect glycated haemoglobin and use alternative methods of glycaemic control if there is a discrepancy between blood glucose readings and HbA1c.We report a case of a falsely low HbA1c which led to a wrong interpretation of glycaemic control resulting in a major comorbidity. Copyright © 2016 John Wiley & Sons.

“A new imaging modality to non-invasively assess multiple sclerosis pathology”

We describe a novel imaging method to assess central nervous system pathology called “Diffusion Basis Spectrum Imaging” (DBSI). Diffusion tensor imaging (DTI) has been widely used to estimate axonpathology and demyelination. However, in the settings of acute inflammation and chronic tissue loss asare common in multiple sclerosis, DTI signals can lead to false interpretations. DBSI is a computationallynovel method that separates isotropic from anisotropic components in imaging voxels. Isotropicdiffusion is believed to reflect inflammatory components (cells, edema), as well as intrinsic cells andextracellular space. DBSI enables the measurement of axial and radial diffusivities within the anisotropiccomponents of imaging voxels, which reflect the integrity of axon fibers and myelin, respectively.

Estudo epidemiológico e avaliação de fatores de risco da infecção por Toxoplasma gondii e achados clinico-patológicos da infecção aguda em cães admitidos em um Hospital Escola Veterinário

RESUMO: Esse trabalho teve como objetivo estudar a prevalência e respectivos fatores de risco para infecção do Toxoplasma gondii em cães provenientes de uma população hospitalar. Além disso, avaliou-se as taxas de ocorrência e as repercussões clínico-patológicas da infecção aguda pelo T. gondii nesses animais. Anticorpos foram detectados em 7% (26/386) da população estudada, composta de 386 cães de ambos os sexos e diferentes raças e idades. Somente as variáveis, ingestão de vísceras, origem rural e contato com bovinos apresentaram valores significativos com p<0.05. Adicionalmente os cães de origem rural apresentaram maiores risco (OD=7.00) de infecção do que aqueles de origem urbana. Em 6,5% (25/386) foram detectados títulos de contato (entre 16 e 256); esses títulos não significam necessariamente infecção aguda e sim apenas exposição prévia. É de fundamental importância o reconhecimento da infecção prévia por T. gondii nesses pacientes hospitalares. Dependendo da causa da admissão, mesmo não sendo a toxoplasmose a responsável, o paciente deve receber o tratamento anti-protozoário profilaticamente ou ser monitorado para posterior tratamento em caso de reagudização da enfermidade por recrudescência dos bradizoítos encistados. Apenas um animal (3.44%, 1/386) foi admitido com titulação elevada, o qual pode ser sugestivo de infecção aguda (titulo de 4096). Embora o animal com infecção aguda tenha sido apresentado com sinais neurológicos, cautela é necessária para não extrapolar uma falsa interpretação que a toxoplasmose é a grande responsável por quadros neurológico, uma vez que inúmeros outros casos incluídos nesse estudo tinham manifestações neurológicas e não tinham títulos de infecção aguda, nem mesmo título de contato prévio. A toxoplasmose aguda não foi uma afecção clínica expressiva nessa ambiência hospitalar, no entanto diagnóstico diferencial deve ser feito nos pacientes enfermos, principalmente os da área rural, e diagnostico definitivo deve ser alcançado para a correta conduta terapêutica.

Systematic Two-Dimensional DRT-Analysis of Battery and Fuel Cell Impedance Data

Electrochemical Impedance Spectroscopy (EIS) has become an important tool for the analysis of batteries and fuel cells. Thus, the interest in the ongoing development of this technique is high. The major drawback of EIS is the ambiguity caused by the necessity to select a particular model for fitting the experimental data. One approach to mitigate this problem is the analysis of impedance data by the distribution of relaxation times (DRT) of the underlying physico-chemical processes, which might be the reason for its recent popularity [1-3]. The DRT can be calculated by a variety of methods, such as Fourier filtering [4], maximum-entropy deconvolution [5], least-squares deconvolution [6], evolutionary programming [7] or regularization [8]. The advantage of regularization is its usability without any a priori knowledge of the system. In this work, an evolution of the widely applied Tikhonov regularization in standard form [9] with an RC kernel is presented. The algorithm is using a uniform penalty. It has the advantage that narrow, high amplitude features are less broadened than low amplitude features in the same DRT spectrum and that it is less susceptible to unphysical oscillations [10]. This allows us to avoid a non-negativity constraint or similar penalties, therefore inductive and capacitive features can be unraveled in the spectrum by their opposite sign. In addition, by performing the regularization on two-dimensional (2D) data even if only one dimension is inverted, an improved resolution in the DRT dimension and smoother features in the non-inverted dimension are achieved. With peak-fitting algorithms each identified process is quantified and subsequently back-transformed into the frequency domain. By this, the contributions of the different processes to the overall impedance are visualized. Regularization is, in general, vulnerable to artifacts [11]. Hence checking the validity of the inverted data to prevent false interpretations is necessary, for which a procedure is described. 2D-DRT is used for the analysis of impedance data obtained from measurements of solid oxide fuel cells (SOFC) and lithium-ion batteries (LIB). For instance, for the SOFC the impedance measurements were performed for varying temperatures between 700°C and 900°C and potentials between 1200 mV and 700 mV. With this approach five different physico-chemical processes could be quantified in the frequency range between 100 mHz and 100 kHz which is in accordance with the literature [12].

Preserved dopaminergic homeostasis and dopamine-related behaviour in hemizygous TH-Cre mice.

Cre-driver mouse lines have been extensively used as genetic tools to target and manipulate genetically defined neuronal populations by expression of Cre recombinase under selected gene promoters. This approach has greatly advanced neuroscience but interpretations are hampered by the fact that most Cre-driver lines have not been thoroughly characterized. Thus, a phenotypic characterization is of major importance to reveal potential aberrant phenotypes prior to implementation and usage to selectively inactivate or induce transgene expression. Here, we present a biochemical and behavioural assessment of the dopaminergic system in hemizygous tyrosine hydroxylase (TH)-Cre mice in comparison to wild-type (WT) controls. Our data show that TH-Cre mice display preserved dopaminergic homeostasis with unaltered levels of TH and dopamine as well as unaffected dopamine turnover in striatum. TH-Cre mice also show preserved dopamine transporter expression and function supporting sustained dopaminergic transmission. In addition, TH-Cre mice demonstrate normal responses in basic behavioural paradigms related to dopaminergic signalling including locomotor activity, reward preference and anxiolytic behaviour. Our results suggest that TH-Cre mice represent a valid tool to study the dopamine system, though careful characterization must always be performed to prevent false interpretations following Cre-dependent transgene expression and manipulation of selected neuronal pathways.

Comments on Lucire and Crotty, 2011.

Dear editor In a recent article, Yolande Lucire and Christopher Crotty presented their findings in an ongoing naturalistic study concerning a possible relationship between variant alleles in three CYP450 genes and a variety of behavioral problems.1 Unfortunately, the tested population of 129 persons was very heterogeneous and poorly characterized from a phenomenological perspective. In the results section of their article, the authors use the term “akathisia” to describe the adversity, but without defining this phenomenon. They also use this term in the title of their paper. Since they state that the majority of the persons who experienced adverse clinical events had akathisia, which is not expected considering their clinical characteristics, it is possible that the term has been used to describe other types of problems rather than this well-defined extrapyramidal motor disorder.2,3 In our opinion, this is unfortunate as it may lead to false interpretation of the mechanistic background of these putative side effects. As a matter of fact, such a false interpretation of the relationship between aggression and akathisia has probably led to misunderstandings during a number of court trials in the Netherlands. On one occasion, an accused person was sentenced to 24 years in prison because of an erroneous interpretation of the message of Lucire and Crotty’s paper.4 Because the motor symptoms of akathisia were not confirmed by a small number of layman observers prior to his committing the felony, the judges rejected akathisia as a possible explanation for this aggressive behavior. It is important, therefore, not to use the term “akathisia” as being synonymous with drug-induced aggression. There are many other possible mechanisms which could cause selective serotonin reuptake inhibitors to lead to this type of adversity5 and, in addition, it should be noted that adverse clinical events are only very rarely monocausally related to the intake of a drug.

Evaluation of an Automated System for Reading and Interpreting Disk Diffusion Antimicrobial Susceptibility Testing of Fastidious Bacteria.

Results of disk diffusion antimicrobial susceptibility testing depend on individual visual reading of inhibition zone diameters. Therefore, automated reading using camera systems might represent a useful tool for standardization. In this study, the ADAGIO automated system (Bio-Rad) was evaluated for reading disk diffusion tests of fastidious bacteria. 144 clinical isolates (68 β-haemolytic streptococci, 28 Streptococcus pneumoniae, 18 viridans group streptococci, 13 Haemophilus influenzae, 7 Moraxella catarrhalis, and 10 Campylobacter jejuni) were tested on Mueller-Hinton agar supplemented with 5% defibrinated horse blood and 20 mg/L β-NAD (MH-F, Oxoid) according to EUCAST. Plates were read manually with a ruler and automatically using the ADAGIO system. Inhibition zone diameters, indicated by the automated system, were visually controlled and adjusted, if necessary. Among 1548 isolate-antibiotic combinations, comparison of automated vs. manual reading yielded categorical agreement (CA) without visual adjustment of the automatically determined zone diameters in 81.4%. In 20% (309 of 1548) of tests it was deemed necessary to adjust the automatically determined zone diameter after visual control. After adjustment, CA was 94.8%; very major errors (false susceptible interpretation), major errors (false resistant interpretation) and minor errors (false categorization involving intermediate result), calculated according to the ISO 20776–2 guideline, accounted to 13.7% (13 of 95 resistant results), 3.3% (47 of 1424 susceptible results) and 1.4% (21 of 1548 total results), respectively, compared to manual reading. The ADAGIO system allowed for automated reading of disk diffusion testing in fastidious bacteria and, after visual validation of the automated results, yielded good categorical agreement with manual reading.

RNA protects a nucleoprotein complex against radiation damage.

Radiation damage during macromolecular X-ray crystallographic data collection is still the main impediment for many macromolecular structure determinations. Even when an eventual model results from the crystallographic pipeline, the manifestations of radiation-induced structural and conformation changes, the so-called specific damage, within crystalline macromolecules can lead to false interpretations of biological mechanisms. Although this has been well characterized within protein crystals, far less is known about specific damage effects within the larger class of nucleoprotein complexes. Here, a methodology has been developed whereby per-atom density changes could be quantified with increasing dose over a wide (1.3-25.0 MGy) range and at higher resolution (1.98 Å) than the previous systematic specific damage study on a protein-DNA complex. Specific damage manifestations were determined within the large trp RNA-binding attenuation protein (TRAP) bound to a single-stranded RNA that forms a belt around the protein. Over a large dose range, the RNA was found to be far less susceptible to radiation-induced chemical changes than the protein. The availability of two TRAP molecules in the asymmetric unit, of which only one contained bound RNA, allowed a controlled investigation into the exact role of RNA binding in protein specific damage susceptibility. The 11-fold symmetry within each TRAP ring permitted statistically significant analysis of the Glu and Asp damage patterns, with RNA binding unexpectedly being observed to protect these otherwise highly sensitive residues within the 11 RNA-binding pockets distributed around the outside of the protein molecule. Additionally, the method enabled a quantification of the reduction in radiation-induced Lys and Phe disordering upon RNA binding directly from the electron density.

La distance acromio-claviculaire est corrélée à la version glénoïdienne

BackgroundThe acromiohumeral distance (ACHD) is a radiographic parameter for evaluating the presence of a rotator cuff rupture. Previous investigations have demonstrated that several factors may influence the magnitude of the acromiohumeral distance, but glenoid version has not yet been considered. HypothesisOur hypothesis was that there is a direct correlation between glenoid version and acromiohumeral distance as well as subacromial clearance. MethodsFour right glenohumeral joints from adult fresh cadavers were anatomically dissected to the level of the rotator cuff. After fixation to a board and positioning of the humeral head in neutral position, an osteotomy of the glenoid neck was carried out and the version was altered in steps of 5°. The ACHD as well as the subacromial clearance (SAC) were measured for every degree of glenoid version. ResultsThe ACHD increased with increased anteversion and consistently decreased with increased retroversion of the glenoid. The SAC also depended on glenoid version: neutral version was associated with a minimal clearance under the anterior third of the acromion, retroversion transferred the minimal SAC posteriorly and anteversion transferred minimal SAC under the coracoacromial ligament. ConclusionOur results indicate that glenoid version correlates directly with the magnitude of ACHD and SAC. Therefore, variations of glenoid version can lead to false interpretations of cuff integrity. Type of studyBiomechanical investigation. Level of evidenceNot possible to define.

Assessment of Left Ventricular Diastolic Function in Egyptian Patients With Behçet's Disease.

This study aims to evaluate left ventricular diastolic function in Egyptian patients with Behçet's disease using variable echocardiographic parameters by combining both transmitral and tissue Doppler velocities to overcome the occasional false interpretation of preload dependent transmitral parameters and to detect the correlation between various left ventricular diastolic parameters and different disease manifestations. Forty patients (35 males, 5 females; mean age 31±8 years; range 19 to 52 years) with Behçet's disease and 32 age- and sex- matched healthy controls (26 males, 6 females; mean age 28±6 years; range 19 to 60 years) were enrolled. Left ventricular diastolic function was assessed using an algorithm that combined transmitral and tissue Doppler derived parameters. Mean disease duration of the patients was 7.4±6 years. Left and right ventricular systolic function was normal in both groups. The transmitral E/A was<1 in six patients (15%). There was no difference between patients and controls regarding the other left ventricular diastolic parameters. Compared to patients with an E/A ratio >1, patients with E/A<1 were significantly older and had a longer disease duration (p=0.001 and p<0.001, respectively). All the other echocardiographic parameters in both groups were comparable. Egyptian patients with Behçet's disease have normal left ventricular diastolic function regardless of disease duration and activity.

The importance of selecting the appropriate reference genes for quantitative real time PCR as illustrated using colon cancer cells and tissue

Quantitative real-time reverse-transcription polymerase chain reaction (RT-qPCR) remains the most sensitive technique for nucleic acid quantification. Its popularity is reflected in the remarkable number of publications reporting RT-qPCR data. Careful normalisation within RT-qPCR studies is imperative to ensure accurate quantification of mRNA levels. This is commonly achieved through the use of reference genes as an internal control to normalise the mRNA levels between different samples. The selection of appropriate reference genes can be a challenge as transcript levels vary with physiology, pathology and development, making the information within the transcriptome flexible and variable. In this study, we examined the variation in expression of a panel of nine candidate reference genes in HCT116 and HT29 2-dimensional and 3-dimensional cultures, as well as in normal and cancerous colon tissue. Using normfinder we identified the top three most stable genes for all conditions. Further to this we compared the change in expression of a selection of PKC coding genes when the data was normalised to one reference gene and three reference genes. Here we demonstrated that there is a variation in the fold changes obtained dependent on the number of reference genes used. As well as this, we highlight important considerations namely; assay efficiency tests, inhibition tests and RNA assessment which should also be implemented into all RT-qPCR studies. All this data combined demonstrates the need for careful experimental design in RT-qPCR studies to help eliminate false interpretation and reporting of results.

Dynamic Engagement of Cognitive Control Modulates Recovery From Misinterpretation During Real-Time Language Processing

Speech unfolds swiftly, yet listeners keep pace by rapidly assigning meaning to what they hear. Sometimes, though, initial interpretations turn out to be wrong. How do listeners revise misinterpretations of language input moment by moment to avoid comprehension errors? Cognitive control may play a role by detecting when processing has gone awry and then initiating behavioral adjustments accordingly. However, no research to date has investigated a cause-and-effect interplay between cognitive-control engagement and the overriding of erroneous interpretations in real time. Using a novel cross-task paradigm, we showed that Stroop-conflict detection, which mobilizes cognitive-control procedures, subsequently facilitates listeners’ incremental processing of temporarily ambiguous spoken instructions that induce brief misinterpretation. When instructions followed incongruent Stroop items, compared with congruent Stroop items, listeners’ eye movements to objects in a scene reflected more transient consideration of the false interpretation and earlier recovery of the correct one. Comprehension errors also decreased. Cognitive-control engagement therefore accelerates sentence-reinterpretation processes, even as linguistic input is still unfolding.

The acromiohumeral distance and the subacromial clearance are correlated to the glenoid version

BackgroundThe acromiohumeral distance (ACHD) is a radiographic parameter for evaluating the presence of a rotator cuff rupture. Previous investigations have demonstrated that several factors may influence the magnitude of the acromiohumeral distance, but glenoid version has not yet been considered. HypothesisOur hypothesis was that there is a direct correlation between glenoid version and acromiohumeral distance as well as subacromial clearance. MethodsFour right glenohumeral joints from adult fresh cadavers were anatomically dissected to the level of the rotator cuff. After fixation to a board and positioning of the humeral head in neutral position, an osteotomy of the glenoid neck was carried out and the version was altered in steps of 5°. The ACHD as well as the subacromial clearance (SAC) were measured for every degree of glenoid version. ResultsThe ACHD increased with increased anteversion and consistently decreased with increased retroversion of the glenoid. The SAC also depended on glenoid version. Neutral version was associated with a minimal clearance under the anterior third of the acromion, retroversion transferred the minimal SAC posteriorly and anteversion transferred minimal SAC under the coracoacromial ligament. ConclusionOur results indicate that glenoid version correlates directly with the magnitude of ACHD and SAC. Therefore, variations of glenoid version can lead to false interpretations of cuff integrity. Type of studyBiomechanical investigation. Level of evidenceNot possible to define.

Interpreting the Lactulose Breath Test for the Diagnosis of Small Intestinal Bacterial Overgrowth

IntroductionBased on literature review, a positive lactulose breath test (LBT) for small intestinal bacterial overgrowth requires an initial peak value of hydrogen within 100 minutes of lactulose ingestion with a second peak before 180minutes. However, using scintigraphic monitoring of lactulose transit time, mean oral-cecal arrival time has been reported as 73minutes. The goal was to propose new criteria for analysing the LBT to overcome false positive interpretations. MethodsLBTs from our referral center were interpreted as positive after ingestion of 10g of lactulose using the following approach for hydrogen concentrations: (1) The literature guidelines: greater than 20ppm from a baseline less than 10ppm achieved within 100minutes followed by a further rise of greater than 15ppm within 180minutes. (2) The proposed criteria: greater than 20ppm from a baseline less than 10ppm within either 60 or 80minutes followed by a further rise of greater than 15ppm during the 180-minute test. ResultsA total of 153 patients with symptoms suspicious for small-bowel bacterial overgrowth underwent testing. Of all, 26.1% patients tested positive by 100minutes, 11.8% patients tested positive by 60minutes and 18.3% patients tested positive by 80minutes. The percentage of positive LBTs at 60 and 80minutes was significantly lesser than for the 100minutes criteria (P < 0.05). ConclusionsThe first hydrogen peak increase should occur by either 60 or 80minutes to increase the specificity of LBT for small intestinal bacterial overgrowth based on the reality of lactulose cecal arrival times.

Progestins alter photo-transduction cascade and circadian rhythm network in eyes of zebrafish (Danio rerio)

Environmental progestins are implicated in endocrine disruption in vertebrates. Additional targets that may be affected in organisms are poorly known. Here we report that progesterone (P4) and drospirenone (DRS) interfere with the photo-transduction cascade and circadian rhythm network in the eyes of zebrafish. Breeding pairs of adult zebrafish were exposed to P4 and DRS for 21 days with different measured concentrations of 7–742 ng/L and 99-13´650 ng/L, respectively. Of totally 10 key photo-transduction cascade genes analyzed, transcriptional levels of most were significantly up-regulated, or normal down-regulation was attenuated. Similarly, for some circadian rhythm genes, dose-dependent transcriptional alterations were also observed in the totally 33 genes analyzed. Significant alterations occurred even at environmental relevant levels of 7 ng/L P4. Different patterns were observed for these transcriptional alterations, of which, the nfil3 family displayed most significant changes. Furthermore, we demonstrate the importance of sampling time for the determination and interpretation of gene expression data, and put forward recommendations for sampling strategies to avoid false interpretations. Our results suggest that photo-transduction signals and circadian rhythm are potential targets for progestins. Further studies are required to assess alterations on the protein level, on physiology and behavior, as well as on implications in mammals.