Clinical importance of the Korner's septum.
To evaluate the clinical importance of the petrosquamosal lamina (Korner's septum [KS]), which is not only a bony plate dividing the mastoid cells at the level of antrum, but is also a lamina starting from the posterior aspect of the glenoid fossa that extends above the middle ear cavity and courses in an inferior direction lateral to the facial canal and proceeds to the mastoid apex. A retrospective review of 688 mastoidectomies performed in University Hospital from 1987 to 1992. The study group consisted of 389 males and 299 females (mean age 30.85 +/- 12.80, the youngest being 8 and the oldest being 67 years of age). The main outcome measures were the prevalence of KS encountered during mastoidectomies and comparison of prevalence of retraction pockets (RPs) or retraction and/or adhesion of the whole tympanic membrane (R/A-TM) between ears with KS and without KS. The prevalence of KS was 30.4% among the ears with RP or R/A-TM, 6.58% in normal ears, and 17.4% in ears with chronic otitis media without RP or R/A-TM. KS is an important anatomic handicap predisposing the individual to chronic otitis media, particularly when it is characterized by attic retraction pockets and cholesteatoma, and adhesive otitis media, because KS contributes to attic blockage. This statement is in accordance with the original articles written by Cheatle (1910, 1923) and Williams (1966), and recently published data related to supratubal recess and the cog (Tono et al., 1996).


Effects of sidestream cigarette smoke exposure on baroreflex components in spontaneously hypertensive rats.
We evaluated short-term effects of sidestream cigarette smoke (SSCS) exposure on baroreflex function in spontaneously hypertensive rats (SHR) and Wistar Kyoto (WKY) normotensive rats. Rats were exposed to SSCS during three weeks, 180 min, five days per week, in a concentration of carbon monoxide (CO) between 100 and 300 ppm. We observed that SSCS exposure increased tachycardic peak and heart rate range while it attenuated bradycardic reflex in WKY. In respect to SHR, SSCS also increased tachycardic peak. Taken together, our data suggests that three weeks of exposure to SSCS affects the sympathetic and parasympathetic component of the baroreflex in normotensive WKY while it tended to affect the sympathetic component in SHR.


Epidemiological characteristics associated with uptake of pneumococcal vaccine among older adults living in the community in Singapore: Results from the National Health Surveillance Survey 2013.
In Singapore, pneumococcal vaccination is recommended for the elderly (i.e. those ≥65 years of age) and people with chronic medical conditions. We investigated epidemiological characteristics associated with the uptake of pneumococcal vaccine based on a nationally representative cross-sectional sample of community-living adults aged ≥50 years. The data were obtained from the National Health Surveillance Survey (NHSS) 2013. Associations between pneumococcal vaccination and sociodemographic and health-related variables were analysed using univariable and multivariable logistic regression models. Among 3672 respondents aged ≥50 years in the NHSS, 7.8% had taken the pneumococcal vaccination. A higher level of education and higher monthly household income were sociodemographic characteristics independently associated with pneumococcal vaccine uptake. Health-related characteristics predictive of pneumococcal vaccine uptake were better self-rated health and having a regular family doctor/general practitioner. Among those who responded to the two questions on vaccinations, 3.9% had been vaccinated against both seasonal influenza and pneumococcal infection, while 11.1% had taken only seasonal influenza vaccination in the past year. There is a need to boost pneumococcal vaccination coverage among community-dwelling older adults. These findings provide insights into reviewing and tailoring public-health strategies and programmes to increase vaccine uptake in at-risk population groups.


[Surgery on the fast track--"fast track" concepts in abdominal-/pediatric surgery and urology].
In surgical medicine there are traditions, myths, rites and dogmas which define concepts of treatment and strategies. Upheld and passed on without being examined or confirmed in further studies, these concepts and strategies include preoperative intestinal lavage and fasting, postoperative long-term drainage, tubes und catheters, long-term relaxation of the intestine after abdominal surgery or immobilisation for some days. New techniques and procedures in surgery and anaesthesia, including postoperative pain management like laparoscopic surgery and partial anaesthesia, reduce the need for surgery and minimize morbidity of treatment. For more than ten years now, the Copenhagen abdominal surgeon Henrik Kehlet and his team have systematically dealt with the question of how to reduce perioperative stress and improve postoperative conditions of recovery. The resulting concepts of an "enhanced recovery after surgery" (ERAS) seek to overcome handed-down myths und fix new clinical pathways. In current prospective studies of elective surgery, the clinical use of these fast track concepts have been confirmed in colon surgery, pediatric surgery and urology. Here, examples of some of these studies are discussed together with problems like general complications and length of stay, while aspects of insurance are also taken into consideration.


Central distribution of the stapedius motoneurons in the rat--a study of topographical anatomy and HRP transport experiments.
A detailed anatomical description of the stapedius muscle area in the rat was given and on this basis the central distribution of the neurons innervating the stapedius muscle was investigated by the horseradish peroxidase transport method. The stapedius muscle showed a circum-pennate structure with a para-centrally located tendon and was composed of about 500 muscle fibers. It contained no special sensory structures and was innervated by a single branch of the facial nerve consisting of myelinated axons. Horseradish peroxidase experiments provided the following findings. The stapedius muscle received few sensory components. The stapedius motoneurons resided in the brainstem ipsilaterally in a column-like region ventromedial to the facial motor nucleus. Some of them (up to 6%) were scattered rostrally as far as the level of the facial nerve exit. Almost all the stapedius motoneurons showed fusiform morphology with significantly smaller mean diameter and lesser size variation than the facial nucleus motoneurons. The number of the stapedius motoneurons per animal on one side amounted about 150 which was about the same as that of axons in the stapedius nerve. Their axons except for those of rostrally scattered ones shared the intramedullary route with axons of the facial nucleus motoneurons.


OSI-461 (OSI).
OSI Pharmaceuticals is developing OSI-461, a potent analog of exisulind, for the potential treatment of cancer and inflammatory bowel disease. In August 2001, OSI-461 entered phase II trials involving patients with chronic lymphocytic leukemia. In July 2002, the company embarked on a pilot phase II study evaluating OSI-461 for the treatment of Crohn's disease. By October 2002, Cell Pathways had selected hormone-refractory prostate cancer as the lead cancer indication for clinical development of OSI-461.


PEGylation of cationic, shell-crosslinked-knedel-like nanoparticles modulates inflammation and enhances cellular uptake in the lung.
The airway provides a direct route for administration of nanoparticles bearing therapeutic or diagnostic payloads to the lung, however optimization of nanoplatforms for intracellular delivery remains challenging. Poly(ethylene glycol) (PEG) surface modification improves systemic performance but less is known about PEGylated nanoparticles administered to the airway. To test this, we generated a library of cationic, shell crosslinked knedel-like nanoparticles (cSCKs), including PEG (1.5 kDa PEG; 2, 5, 10 molecules/polymer arm) on the outer shell. Delivery of PEGylated cSCK to the mouse airway showed significantly less inflammation in a PEG dose-dependent manner. PEGylation also enhanced the entry of cSCKs in lung alveolar epithelial cells and improved surfactant penetration. The PEGylation effect could be explained by the altered mechanism of endocytosis. While non-PEGylated cSCKs used the clathrin-dependent route for endocytosis, entry of PEGylated cSCK was clathrin-independent. Thus, nanoparticle surface modification with PEG represents an advantageous design for lung delivery. In this study, the effects of PEGylation were studied on cross linked knedel-like nanoparticles in drug delivery through the lungs, demonstrating less airway inflammation in the studied model than with non-PEGylated nanoparticles, which suggests an overall favorable profile of PEGylated nanoparticles for alveolar delivery.


Dermatology on Flickr.
Flickr, which was launched in 2004, is one of the oldest photo-sharing services online. The company, which was once at the forefront of the internet social media explosion, lost users and received criticism as its repeated acquisitions by other companies forced users to adapt to new owners. Now facing another acquisition by the online photo-sharing service SmugMug, the future is uncertain again for the once popular internet and mobile application service. Flickr, with its rapid rise in popularity, sudden halt in growth, and its gradual loss of users and popularity, has been repeatedly looked to as a lesson for other internet startups on the necessity of adapting quickly in the current internet age. Given the rise of social media use in the healthcare field, and the long-standing presence of Flickr on the internet, this study investigated the presence of dermatology-related content on Flickr and how the photo-sharing platform has applied to the visual field of dermatology, its dermatologists, and its professional associations.


Relationship between nutritional status and phase angle as a noninvasive method to predict malnutrition by sex in older inpatients.
Phase angle has been suggested as a useful, noninvasive, and objective index to evaluate the nutritional status of older people. However, there are no studies analyzing the relationship between nutritional status and phase angle in older patients, according to sex. The aim of this study was to clarify the relationship between phase angle and malnutrition, and to calculate cut-off points of malnutrition with phase angle in older inpatients, according to sex. This study was a retrospective cross-sectional study. Participants were older inpatients of a rehabilitation unit, and data within 1 week of hospitalization were collected from the medical records. We collected data of demographics, phase angle, and the Geriatric Nutritional Risk Index. Phase angle was measured with InBody S10. To confirm whether phase angle is an important factor in predicting malnutrition, we conducted binary logistic regression analysis. In addition, to determine the cut-off points of malnutrition in older inpatients, we used the receiver operator characteristic (ROC) curve. Participants included 59 men (mean age 76.5 years) and 101 women (mean age 78.8 years). As a result of statistical analysis, phase angle was an important factor related to malnutrition in both male and female inpatients. Our findings showed that cut-off points of 4.03 degrees (sensitivity; 87.0%, specificity; 75.9%) in male patients and 3.65 degrees (sensitivity; 78.6%, specificity; 60.5%) in female patients could be used to predict malnutrition. The results of this study suggest that phase angle may be useful as an indicator to predict the nutritional status of older inpatients.


How important is susceptibility-weighted imaging in mild traumatic brain injury?
Mild traumatic brain injury (mTBI) is a public health problem that is recognized as a 'silent epidemic' in its late stages due to undiagnosed axonal damage rated 13 and above on the Glasgow Coma Scale (GCS). Injury-related microhemorrhages often cannot be detected on computed tomography (CT) scans and conventional magnetic resonance imaging (MRI). This study aims to investigate whether susceptibility-weighted imaging is feasible in mTBI patients. Fifty-eight patients with GCS scores of 14 and 15 and with symptoms of brief mental fogs, impairment of concentration, memory loss, headache, dizziness, or imbalance after brain injury were examined at the emergency service. A brain CT scan and MRI containing diffusion-weighted and susceptibility-weighted imaging (SWI) sequences were performed on the patients whose symptoms did not seem to alleviate after the sixth hour. Thirteen patients were excluded from this study because of advanced age, diabetes, a history of hypertension or its chronic sequelae, or acute cerebrovascular disease; 45 patients were included in this study. The patients' CT results were normal, and no diffusion restrictions were observed. The SWI revealed microhemorrhages in seven patients (15.6%). Five of these patients had hyperintense areas in conventional sequences corresponding to the hemorrhages spotted in the SWI. In three of the five patients, these pockets of hemorrhages were higher in number and size in comparison with conventional in the SWI sequence. Susceptibility-weighted imaging, which can be used to assess the presence and severity of microhemorrhages due to diffuse axonal injury, is recommended for determining the cause of symptoms in patients with mTBI, to continue targeted treatment and prevent complications that may develop.


Prevalence of angiographically significant coronary artery disease in patients with rheumatic mitral stenosis.
In order to evaluate the prevalence of angiographically significant coronary artery disease (CAD) in patients with predominant mitral stenosis (mitral valve area < or = 1.5 cm2), coronary angiograms of the 837 consecutive patients with mitral stenosis (482 women and 355 men; median age = 50 years [ranging from 35 to 77]) were retrospectively analysed. Significant CAD was defined as at least 50% diameter narrowing of a major coronary artery. Significant CAD was detected in 63 patients (7.5%, 30 men and 33 women). Patients with CAD were significantly older than those without CAD (median: 59 vs. 49 years; p < 0.0001, respectively). With respect to coronary risk factors, diabetes mellitus (28.6% vs. 9.4%; p < 0.0001), hypertension (46% vs. 16.7%; p < 0.0001) and family history of CAD (34.9% vs. 17.3%; p = 0.001) were significantly more frequent in the CAD+ group as compared to the CAD- group. Serum levels of cholesterol were significantly higher in CAD+ group as compared to the CAD-patients (median: 199 vs. 176 mg/dl; p = 0.003). No significant differences were noted between the two groups in both serum levels of HDL-cholesterol (p = 0.12) and triglycerides (p = 0.08). Of the 63 patients with CAD, 21 (33.3%) had angina pectoris (AP) and, in patients free of CAD, AP was present in 106 (13.7%). The sensitivity and specificity of AP for the presence of significant CAD were 33.3% and 86.3%, respectively. The positive predictive value of AP for the presence of CAD was 16.5% and the negative predictive value of its absence was 94.1%. It is concluded that routine coronary angiography is not necessarily indicated in predominant mitral stenosis particularly in patients who are younger than 40 years and have no coronary risk factors and typical chest pain.


Construction of Two-Component Chemically Reactive Supramolecular Assemblies-Acyl Migration Reactions in Cocrystals of Napthalene-2,3-Diol and Its Diesters.
Reactions in solids are of contemporary interest due to applications in pharmaceutical industries to environmental sustainability. Although several reactive crystals that support chemical reactions have been identified and characterized, the same cannot be said about reactive cocrystals. Earlier we correlated the facile acyl group transfer reactions in crystals with supramolecular parameters obtained from the crystal structures. The structure-reactivity correlation revealed the requirement of proper juxtaposition of electrophile (C=O) and the nucleophile (OH) with distance (∼3.2 Å) and angle (∼90°) along the chain structure. The current article describes the preparation of cocrystals that are capable of supporting intermolecular acyl group transfer reactions in a group of structurally similar molecules. The cocrystals of naphthalene 2,3-diol and its corresponding diesters showed a facile solid state acyl transfer reaction, which has been well correlated with their crystal structures.


[Echographic follow-up after radical prostatectomy].
The abdominal and transrectal ultrasound is of a great importance in the follow-up and in the early postoperatory control in the patients which have undergone a radical prostatectomy. The abdominal ultrasonography can be used to identify the presence of abdominal or pelvic fluid collections in the postoperative period or to evaluating the upper urinary tract. Ultrasonography has come to play a primary role in the detection of lymphonodal and/or parenchymal metastasis. Transrectal ultrasound permits to identify the local illness relapse, whereas the ultrasonography examination during micturition allows the functional study of the bladder neck. Moreover, transrectal ultrasound is useful in guiding biopsy needle into a specific lesion seen on the sonogram in the perianastomotic region whereas random ecoguided biopsy in the perianastomotic area is necessary in patients with signs of recurrent cancer even in the absence of suspicious areas.


Addictive overeating: lessons learned from medical students' perceptions of Overeaters Anonymous.
To explore medical students' perceptions of Overeaters Anonymous (OA). 72 fifth-year medical students' reports of their experiences of attending OA meetings were analysed using thematic analysis. Students were required to submit these reports in order to complete a compulsory component of the Addiction Medicine run in their medical training at the University of Otago, Christchurch during 2002-2007. Analysis of the students' reports highlights an emerging understanding of the concepts of addiction in general and addictive overeating in particular. This understanding is reflected in the students' acceptance of addictive overeating as a potential disorder and their increased empathy and confidence in working with patients with this disorder. Improving treatment for people with obesity is a major contemporary health challenge. Addictive overeating could be a critical element in understanding the nature of obesity but has not been the subject of extensive research to date. Medical students in this study discovered that addiction to food is not just a theoretical construct but fits with the actual experience of people. The poignancy of these narratives illustrates how such information can promote greater understanding of medical and other life issues which may benefit their identification and treatment.


Patient satisfaction and informed consent for surgery.
Informed consent is a process that necessitates time and effort. Underlying this investment is the belief that informing patients about the surgery promotes patient satisfaction with the decision for surgery and potentially satisfaction more broadly. The objective of the study was to investigate the extent to which preoperative satisfaction with a decision to pursue surgery is associated with understanding after an informed consent discussion. We performed an observational study of adult women seeking surgical treatment for pelvic floor disorders. Study participants were recruited after routine preoperative counseling by board-certified or board-eligible urogynecologists. In our practice, the preoperative informed consent process typically includes a discussion of the indications, risks, benefits, alternatives, and chance of success of the procedures. Participants completed a 35 question survey preoperatively at one setting. The primary outcome, satisfaction with decision, was measured with a validated 6 item Satisfaction with Decision Scale-Pelvic Floor Disorder. Participants were classified as highly satisfied if they indicated the highest level of satisfaction for all items. The primary exposure was patient knowledge of the planned surgery, measured using a newly adapted 20 item Informed Consent Questionnaire including 15 yes/no questions and 5 free-text questions. Additionally, the survey included a validated 3 item tool for health literacy, a single-item anxiety measure, and demographic data. Analyses were performed with a χ2 test, a Student t test, and a multivariable logistic regression using the binary outcome variable, highly satisfied or not highly satisfied. A total of 150 participants were enrolled, with a mean age of 57.5 years. The majority were non-Hispanic (97.3%) or white (87.3%), with at least some college education (51.0%). The median number of days between the informed consent discussion and the survey was 35. The mean total Satisfaction with Decision score was 27.9 (SD, 2.6; range, 19-30), indicating overall high satisfaction with the decision. A patient's preoperative satisfaction with her decision was strongly associated with increased knowledge of the planned surgery, as measured on the Informed Consent Questionnaire (P = .003). The mean score for the highly satisfied group was 17.8 (n = 70; SD, 3.6; range, 6-20) and for the not highly satisfied group was 16.1 (n = 77; SD, 2.8; range, 9-20). There were no significant differences between the highly satisfied and not highly satisfied groups with respect to age, race, education level, anxiety score, or health literacy. The odds of being highly satisfied increased for every 1 point increase in the Informed Consent Questionnaire score (odds ratio, 1.28; 95% confidence interval, 1.06-1.32; P = .003). The association between decisional satisfaction and knowledge persisted after controlling for demographic and clinical variables including education level, health literacy, race/ethnicity, age, surgeon years since completing fellowship, diagnosis, surgery category, number of visits in the past 6 months, and number of days between informed consent discussion and survey. This study found that patient knowledge and understanding of surgery are important components of a patient's satisfaction with her decision to proceed with pelvic floor surgery. By measuring patient understanding after informed consent discussions, clinicians may be able to better manage preoperative expectations, increase patient satisfaction, and improve the informed consent process.


[Interventional effect of epalrestat on renal interstitial fibrosis in unilateral ureteral obstruction rats and its mechanism].
To observe the protective effects of epalrestat (EPS) on interstitial fibrosis in unilateral ureteral obstruction (UUO) rats and its mechanism. Rats were randomly divided into four groups: sham group, UUO group, UUO + epalrestat (50 or 100 mg/kg), 8 rats in each group.Rats in UUO and UUO + epalrestat group were obstructed left ureter.In the sham group, rats had their left ureters exposed and manipulated without ligation.Animals for epalrestat treatment received daily drug via gavage for 3 weeks, the rats of sham and UUO groups received equal amount of sodium carboxymethyl cellulose with the same regimen.Renal tissues pathological changes and collagen deposition were observed by HE and Masson's staining.The aldose reductase(AR) expression in renal tissues was measured by immunohistochemisty.The expression levels of collagen I, collagen III, alpha-smooth muscle actin (α-SMA), fibroblast-specific protein1 (FSP-1), fibronectin (FN), epithelial cadherin (E-cadherin), transforming growth factor-β1 (TGF-β1) and AR from kidney tissues were measured by real-time RT-PCR or Western blot. Compared with the sham group, the renal tissues of the UUO group showed significant fibrosis, including renal tubular epithelial cell atrophy and vacuolated degeneration, collagen deposition, fibroblasts and myofibroblasts proliferation and inflammatory cell infiltration, and concomitantly with the expressions of collagen I, collagen III, TGF-β1, AR, α-SMA, FSP-1 and FN were remarkably up-regulated, but E-cadherin was significantly reduced in UUO group.Compared with the UUO group, after 3 weeks epalrestat administration, the level of renal interstitial fibrosis was obviously ameliorated and the expressions of collagen I, collagen III, TGF-β1, AR, α-SMA, FSP-1 and FN were remarkably down-regulated, but E-cadherin was significantly increased in rats of epalrestat groups. These results suggest that epalrestat attenuates renal interstitial fibrosis possibly through inhibition of EMT via inhibiting TGF-β1 and AR expression.


[Herpes encephalitis in adults and interferon (author's transl)].
In 10 adult patients with herpes encephalitis type I interferon synthesis was detected in the cerebrospinal fluid at the onset of the disease, but not in serum collected the same day as the CSF. In 20 controls with various non-herpetic infections associated with neurological disorders, type I interferon was found neither in CSF samples nor in sera. The early intrathecal synthesis of type I interferon during adult encephalitis therefore strongly support the assumption of a herpetic origin. The role of CSF interferon in the pathogenesis of the disease and the absence, or presence in small amounts, of serum interferon are discussed. These findings raise queries about the treatment of herpes encephalitis with parenteral interferon combined with nucleoside analogues.


Considering reefscape configuration and composition in biophysical models advance seascape genetics.
Previous seascape genetics studies have emphasized the role of ocean currents and geographic distances to explain the genetic structure of marine species, but the role of benthic habitat has been more rarely considered. Here, we compared the population genetic structure observed in West Pacific giant clam populations against model simulations that accounted habitat composition and configuration, geographical distance, and oceanic currents. Dispersal determined by geographical distance provided a modelled genetic structure in better agreement with the observations than dispersal by oceanic currents, possibly due to insufficient spatial resolution of available oceanographic and coastal circulation models. Considering both habitat composition and configuration significantly improved the match between simulated and observed genetic structures. This study emphasizes the importance of a reefscape genetics approach to population ecology, evolution and conservation in the sea.


A veterinary perspective of on-farm evaluation of nutrition and reproduction.
Reproductive herd health programs of the 1960s and 1970s focused primarily on the control of infectious and noninfectious diseases of the reproductive tract, estrus detection, breeding technique, semen quality and handling, and endocrine imbalances. Despite veterinary intervention, conception rates dropped from 55% before this period to 45% after this period, but milk production increased greatly. Because studies have shown that the additional nutritional needs for high producing cows may be a factor limiting reproduction, bovine practitioners have become more involved with dairy nutrition. New emphasis has been placed on the concept of total production medicine with the anticipation that improved nutrition would improve reproduction. Because of a better understanding of the dynamics of energy in the dairy cow and its effect on reproduction, fertility examinations now include nutrition monitoring and body condition scoring. Several relationships between nutrition and fertility have been identified: high producing thin cows that drop 0.75 to 1.0 in body condition score resulting in anestrus; fat dry cows that develop fatty livers and associated postpartum disease; heifers that have good milk production but prolonged anestrus; dry cows with ration imbalances during the transition period that develop milk fever, retained placenta, displaced abomasum, metritis, or endometritis; lactating cows with disease in midlactation, especially feet and leg problems, resulting in lowered fertility; and healthy, lactating cows with poor conception that have high concentrations of urea N in blood or milk.


5-year clinical performance of posterior bulk-filled resin composite restorations: A double-blind randomized controlled trial.
The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE). Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05). Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002). The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation.


Oxidant generation and toxicity of size-fractionated ambient particles in human lung epithelial cells.
Exposure to ambient particulate matter (PM) is associated with respiratory and cardiovascular disease and lung cancer. In this study, we used size fractionated PM samples (3-7, 1.5-3, 0.95-1.5, 0.5-0.95, and <0.5 microm), collected at four contrasting locations (three urban sites, one remote background) in the UK with a Sierra-Andersen high volume cascade impactor. The H(2)O(2)-dependent oxidant generating capacity of the samples was determined by electron spin resonance with 5,5-dimethyl-1-pyrroline-N-oxide spin trapping. In A549 human lung epithelial cells, we determined the cytotoxicity of samples by LDH assay, and interleukin-8 (IL-8) release as an indicator of their inflammatory potency. Oxidative DNA damage was measured by the formamido-pyrimidine-glycosylase (fpg)-modified comet assay. Marked contrasts were observed for all endpoints. Remote background PM showed the lowest oxidant potential, was neither cytotoxic nor genotoxic and did not increase IL-8 release. For the other samples, effects were found to depend more on sampling location than on size fraction. PM collected at high-traffic locations generally showed the strongest oxidant capacity and toxicity. Significant correlations were observed between the oxidant generating potential and all toxicological endpoints investigated, which demonstrates that measurement of the oxidant generating potential by ESR represents a sensitive method to estimate the toxic potential of PM.


Percutaneous extraction of ePTFE-coated ICD leads: a single center comparative experience.
Percutaneous extraction of standard implantable cardioverter-defibrillator leads is often complicated by ingrowth of fibrotic tissue into the shocking coils. Leads with GORE™ expanded polytetrafluoroethylene (ePTFE) coating (W. L. Gore & Associates, Inc., Newark, DE, USA) designed to inhibit fibrosis are in use, but clinical data regarding their extraction are lacking. The study's purpose was to examine the feasibility, efficacy, and safety of percutaneous extraction involving defibrillator leads coated with ePTFE. We analyzed our database to identify all percutaneously extracted leads with ePTFE-coated shocking coils. Lead and procedure characteristics were compared to a cohort of noncoated leads of similar implant duration. One hundred fifty-six leads were extracted from 145 patients; 57 ePTFE-coated leads, with a mean implant duration of 621 days, were extracted and compared to 99 noncoated leads, with a mean implant duration of 763 days (P = 0.0641). Mean extraction time was 5 minutes for coated leads versus 9.75 minutes for noncoated leads (P = 0.0001). Extraction time of less than 1 minute was more frequent with coated leads (61% vs 35%, P = 0.0025). Adjunct extraction tools were required less frequently with coated leads than noncoated leads (39% vs 63%, P = 0.0071). There was no fibrosis where ePTFE covered the shocking coils. Alternatively, 23 of 99 (23%) noncoated leads demonstrated fibrosis adherent to the shock coil. There were no procedure-related complications in either group. Compared to noncoated leads, ePTFE-coated leads are associated with shorter extraction times and are less likely to require extraction tools for removal. The difference is likely related to the absence of fibrosis over the ePTFE-coated high-energy coils.


Imaging protein aggregates in the serum and cerebrospinal fluid in Parkinson's disease.
Aggregation of α-synuclein plays a key role in the development of Parkinson's disease. Soluble aggregates are present not only within human brain but also the CSF and blood. Characterizing the aggregates present in these biofluids may provide insights into disease mechanisms and also have potential for aiding diagnosis. We used two optical single-molecule imaging methods called aptamer DNA-PAINT and single-aggregate confocal fluorescence, together with high-resolution atomic force microscopy for specific detection and characterization of individual aggregates with intermolecular β-sheet structure, present in the CSF and serum of 15 early stage Parkinson's disease patients compared to 10 healthy age-matched controls. We found aggregates ranging in size from 20 nm to 200 nm, in both CSF and serum. There was a difference in aggregate size distribution between Parkinson's disease and control groups with a significantly increased number of larger aggregates (longer than 150 nm) in the serum of patients with Parkinson's disease. To determine the chemical composition of the aggregates, we performed aptamer DNA-PAINT on serum following α-synuclein and amyloid-β immunodepletion in an independent cohort of 11 patients with early stage Parkinson's disease and 10 control subjects. β-Sheet aggregates in the serum of Parkinson's disease patients were found to consist of, on average, 50% α-synuclein and 50% amyloid-β in contrast to 30% α-synuclein and 70% amyloid-β in control serum [the differences in the proportion of these aggregates were statistically significant between diseased and control groups (P = 1.7 × 10-5 for each species)]. The ratio of the number of β-sheet α-synuclein aggregates to β-sheet amyloid-β aggregates in serum extracted using our super-resolution method discriminated Parkinson's disease cases from controls with an accuracy of 98.2% (AUC = 98.2%, P = 4.3 × 10-5). Our data suggest that studying the protein aggregates present in serum can provide information about the disruption of protein homeostasis occurring in Parkinson's disease and warrants further investigation as a potential biomarker of disease.


Epidemiology of anal HPV infection in high-risk men attending a sexually transmitted infection clinic in Puerto Rico.
Recent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico. We conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regression models were performed to determine factors associated with any, high-risk (HR), and multiple anal HPV infection. The mean age of the study sample was 38.0±13.5 years. The most common HR types were 58, 51 and 31. Overall, HR anal HPV infection was found in 53.5% of the participants. Multiple HPV types in the anal canal were found in 47.6% of the sample. A third (29.8%) of participants reported being men who had sex with men (MSM). MSM had a significantly higher prevalence of any, HR and multiple HPV infection (p-value<0.05). Separate multivariate logistic regression analyses showed that being MSM was associated with any (OR = 4.5; [95%CI: 1.9-10.7]), HR (OR = 3.4; [95%CI: 1.1-10.3) and multiple anal HPV infection (OR = 3.6; [95%CI: 1.5-9.1). HIV was marginally associated with multiple anal HPV infection in multivariate analysis (OR = 3.3; 95%CI = 1.0-11.0). Anal HPV is common among sexually active men attending this STI clinic, with higher likelihood of anal HPV infection among MSM.


Mechanism of Action of Panaxytriol on Midazolam 1'-Hydroxylation and 4-Hydroxylation Mediated by CYP3A in Liver Microsomes and Rat Primary Hepatocytes.
In our previous study, panaxytriol (PXT) was shown to enhance midazolam (MDZ) 1'-hydroxylation significantly but to inhibit MDZ 4-hydroxylation. To explore the underlying mechanism, we investigated the effects of PXT on cytochrome P450 3A (CYP3A)-mediated MDZ metabolic pathways using rat liver microsomes (RLM), human liver microsomes (HLM), and rat primary hepatocytes. In the presence of PXT, the Vmax of 4-OH MDZ decreased from 0.72 to 0.51 nmol/min·mg pro in RLM and from 0.32 to 0.12 nmol/min·mg pro in HLM, and the Km value increased from 5.12 to 7.26 µM in RLM and from 27.87 to 32.80 µM in HLM. But the presence of PXT reduced the Km and increased the Vmax values of MDZ 1'-hydroxylation in RLM and HLM. Interestingly, the differential effect of PXT on MDZ 4-hydroxylation and 1'-hydroxylation was also observed in primary rat hepatocytes after 45-min culture. PXT did not affect the expression levels of CYP3A1/2 mRNA in rat hepatocytes. With extension of the culture time to 6 h, however, PXT significantly inhibited both MDZ 4-hydroxylation and 1'-hydroxylation, and the expression level of CYP3A1/2 mRNA was decreased to 87% and 80% (CYP3A1) and to 89% and 85% (CYP3A2) of those in controls in the presence of PXT 4.0 and 8.0 µg/mL, respectively. These results suggest that PXT could activate MDZ 1'-hydroxylation but inhibit MDZ 4-hydroxylation by changing the CYP3A enzyme affinity and metabolic rate after a short-term intervention. However, long-term treatment with PXT could inhibit both the 4-hydroxylation and 1'-hydroxylation of MDZ by downregulating CYP3A1/2 mRNA expression.


Comparative assessment of chordal preservation versus chordal resection in mitral valve replacement for mitral stenosis (long-term follow-up: 8 years).
Carrying out a mitral valve replacement (MVR) while preserving all chordae tendineae in patients with mitral regurgitation has been proven beneficial to the left ventricular performance. To evaluate the effectiveness of this technique in patients with mitral stenosis, a comparison of the echocardiographic data between patients who were operated on using this technique (Group Preservation = GroupP, n = 15), and those operated on using the conventional method of MVR (Group Conventional = GroupC, n = 15) was made. All patients were examined before surgery, 6 months after surgery and 8 years after surgery. The study population was limited to patients who had no evidence of coronary artery disease, aortic stenosis and/or regurgitation and patients who had pure mitral stenosis. Echocardiographic measurements obtained both 6 months and 8 years postoperatively revealed a significant decrease in the left ventricular ejection fraction in GroupC (61.33+/-9.29% preoperatively, 53.2+/-10.3% postoperatively). The difference between the decrease in the left ventricular ejection fraction of the two groups was statistically significant (-0.71+/-6.28% in GroupP, -8.07+/-13.35% in GroupC). There was no evidence of prosthetic valve dysfunction and no operative deaths. Two patients died in GroupP, 3 patients died in GroupC within the 8 year period. The conclusion was reached, that if suitable, mitral valve replacement while preserving the chordae tendineae is expected to have a beneficial effect on postoperative left ventricular performance in patients with mitral stenosis.


Whole-mount specimens in the analysis of en bloc samples obtained from revisions of resurfacing hip implants. A report of 4 early failures.
Modern metal-on-metal hip resurfacing implants are being increasingly used for young and active patients, although the long-term outcome and failure mechanisms of these implants are still unknown. In this consecutive revision case series, early failures of femoral implants (at < 4 years) were studied. 3 revisions were done due to a fracture of the femoral neck and 1 due to loosening and varus position of the femoral component. Femoral heads were removed en bloc 2-46 months after the primary operation, embedded in methylmethacrylate, sectioned, stained, and analyzed as whole-mount specimens in 4 55-62-year-old patients with osteoarthritis. Histopathology was characterized by new but also partly healed trabecular microfractures, bone demineralization, cysts, metallosis, and abnormal formation of new woven bone. All samples displayed signs of notching, osteoporosis, and aseptic necrosis, which seemed to have been the main reason for the subsequent development and symptoms of the patients and revision operations of the hips. Based on these early revision cases, it appears that aseptic necrosis is a common cause of early loosening of resurfacing hip implants.


Alterations induced in vitro by ochratoxin A in rat lymphoid cells.
Ochratoxin A (OTA) is a nephrotoxic mycotoxin produced by species of the genus Penicillium and Aspergillus that is present in food and feed as a natural contaminant. It modifies the immune function in animals and inhibits the proliferative response of lymphocytes in vitro. The toxic effect of OTA (0.5, 2, 20 microM) in lympho-proliferative response, natural killer (NK) cell activity, cytotoxic T lymphocytes (CTL) activity and macrophages' bacteriolytic capability was studied in vitro after 1 hour of treatment. The proliferative response of lymphocytes to concanavalin A and lipopolysaccharide was not affected by OTA; the cytotoxic activity of NK cells was dose-dependent decreased; the CTL activity was significantly decreased at the lowest concentration; the bacteriolytic activity of macrophages varied only slightly. These in vitro results reproduced, at least in part, some effects detected previously in vivo. The protein synthesis inhibition and the oxidative metabolism of OTA coupled to the prostaglandin synthesis are probably implicated in NK cells' toxicity, because the effects were reverted by the addition of phenylalanine or piroxicam to the culture medium. The induction of apoptosis seems to be the principal mechanism of action in the CTL effect. The intracellular concentration of OTA after 1 hour was analysed by HPLC and was found to be proportional to the quantity of OTA added to the culture medium for the three cell types; the presence of phenylalanine and piroxicam on the culture medium did not change the intracellular OTA concentration.


Optical assessment of mammographic breast density by a 12-wavelength vs a continuous-spectrum optical spectroscopy device.
A 12-laser-wavelength, fixed source-detector position, cup-based optical breast spectroscopy (OBS) device was developed for use in large-scale, multicenter trials as a mammographic breast density (MBD) quantification and breast cancer (BC) risk prescreening tool. In this study, the device was evaluated in comparison with a spectrometer-based device used in previous studies. The devices were compared on their ability to predict mammographic percent density (MPD) and to identify women with high MBD from optical spectra. OBS measurements were made on 60 women, (age 29-73), using both devices. Recent mammograms were collected for all women and MPD quantified from the mammograms. Principal components (PCs) analysis was performed on both sets of OBS spectra, and multivariate logistic regression analysis of the resulting PC scores was used to identify women with high MBD. Both devices are able to identify high MBD with very high sensitivity and specificity. Partial least-squares regression of the spectra was used to predict MPD. Both devices show a strong correlation between OBS-predicted MPD and MPD read from mammograms, however, the correlation is stronger for the continuous-spectrum device (r = 0.74, P = .001) than for the 12-wavelength device (r = 0.62, P = .004). Improvements to the cup-based device to reduce detector saturation should improve the prediction of MPD from the spectra.


Current evidence on the safety profile of NSAIDs for the treatment of PDA.
Patent ductus arteriosus (PDA) complicates the clinical course of preterm infants. Nonsteroidal anti-inflammatory drugs, especially Indomethacin and Ibuprofen, have been widely used for both prevention and treatment of PDA. Short-term efficacy of Indomethacin or Ibuprofen is equivalent, while Ibuprofen results show a higher safety profile. Ibuprofen is associated with fewer clinical gastrointestinal and renal side effects with respect to Indomethacin even if subclinical potential effects are reported. When administered as prophylaxis, Ibuprofen has no effects on prevention of intraventricular haemorrhage unlike Indomethacin. Considering the potential adverse effects of both these drugs, a careful monitoring during and after the treatment period is highly recommended.


Reviving medical education through teachers training programs: A literature review.
The art of teaching in undergraduate and post graduate medical curriculum was revised in last century with targeted programs to equip the medical faculty with advanced teaching technologies. Medical education units (MEUs) were established by the medical council to train the existing medical faculty of the country in teaching methodologies. This study aimed to evaluate the MEU's impact on teachers' training and compare the status of trained teachers before and after the MEU era. Published literature and statistics on the MCI website were compiled to compare teachers' training status over time empirically. MEU, R.C., and N.C. have been highly efficient in improving the proportion of teachers trained from 5.38 to 50.32% across the country, especially after the upgradation of MEU in 2009. Proportion of the teachers trained increased from 5.38% to 50.32% due to the programs organized by various MEU, regional and nodal centres, especially after the upgradation of MEU in 2009. Lack of trained resource persons and administrative support were the common challenges faced. Properly organized MEU and planned activities should be emphasized in every institute. for effective development of the faculties.


Use of Tubo-Ovarian Ligation Via Colpotomy as A Potential Method for Sterilization in Mares.
The goal of this study was to develop a safe, effective, and economical method for permanent sterilization of mares based upon tubo-ovarian ligation performed via colpotomy. In this study, we evaluated the application of a nylon cable tie (zip-tie) to the ovarian pedicle and oviduct of mares to induce ovarian ischemia and tubal ligation without removal of ovaries. Initially, efficiency of zip-ties on the ovarian pedicle was tested in vitro and in vivo. Based on the absence of leakage through the zip-tie ligated vessels in anatomic specimens, we confirmed the potential efficacy of the technique. Next, ligation of the ovarian pedicle via a standing colpotomy was conducted in five mares. Although the surgical procedure in these mares appeared to be quick and efficient, all five mares were noted to develop ovarian adhesions to surrounding abdominal viscera in either one or both ovaries postoperatively. Ovarian ischemia led to loss of ovarian activity based upon ultrasound examination, which was confirmed by a low plasma progesterone concentration in four of the five mares. During the postoperative period, four mares demonstrated clinical signs related to the ovarian adhesions and were euthanized. The postoperative complications associated with ovarian adhesions to abdominal viscera presented significant challenges, limiting the success of this study. While this technique resulted in ovarian ischemia and atrophy in four out of the five mares, we were unable to assess long-term effects on the health and reproduction of the mares due to the ovarian adhesions to the surrounding tissues and the potential for secondary complications. Although technically feasible, tubo-ovarian ligation via colpotomy does not appear to be a viable option for sterilization of mares using the described technique due to ovarian adhesions post procedure.


Systemic Inflammatory Response Syndrome in End-Stage Heart Failure Patients Following Continuous-Flow Left Ventricular Assist Device Implantation: Differences in Plasma Redox Status and Leukocyte Activation.
The role of oxidative stress and leukocyte activation has not been elucidated in developing systemic inflammatory response syndrome (SIRS) in heart failure (HF) patients after continuous-flow left ventricular assist device (CF-LVAD) implantation. The objective of this study was to investigate the change of plasma redox status and leukocyte activation in CF-LVAD implanted HF patients with or without SIRS. We recruited 31 CF-LVAD implanted HF patients (16 SIRS and 15 non-SIRS) and 11 healthy volunteers as the control. Pre- and postimplant blood samples were collected from the HF patients. Plasma levels of oxidized low-density lipoprotein (oxLDL), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD) in erythrocyte, myeloperoxidase (MPO), and polymorphonuclear elastase (PMN-elastase) were measured. The HF patients had a preexisting condition of oxidative stress than healthy controls as evident from the higher oxLDL and MDA levels as well as depleted SOD and TAC. Leukocyte activation in terms of higher plasma MPO and PMN-elastase was also prominent in HF patients than controls. Persistent oxidative stress and reduced antioxidant status were found to be more belligerent in HF patients with SIRS after the implantation of CF-LVAD when compared with non-SIRS patients. Similar to oxidative stress, the activation of blood leukocyte was significantly highlighted in SIRS patients after implantation compared with non-SIRS. We identified that the plasma redox status and leukocyte activation became more prominent in CF-LVAD implanted HF patients who developed SIRS. Our findings suggest that plasma biomarkers of oxidative stress and leukocyte activation may be associated with the development of SIRS after CF-LVAD implant surgery.


Inhibition of assembly of bacterial cell division protein FtsZ by the hydrophobic dye 5,5'-bis-(8-anilino-1-naphthalenesulfonate).
To gain further insight into the structural relatedness of tubulin and FtsZ, the tubulin-like prokaryotic cell division protein, we tested the effect of tubulin assembly inhibitors on FtsZ assembly. Common tubulin inhibitors, such as colchicine, colcemid, benomyl, and vinblastine, had no effect on Ca2+-promoted GTP-dependent assembly of FtsZ into polymers. However, the hydrophobic probe 5, 5'-bis-(8-anilino-1-naphthalenesulfonate) (bis-ANS) inhibited FtsZ assembly. The potential mechanisms for inhibition are discussed. Titrations of FtsZ with bis-ANS indicated that FtsZ has one high affinity binding site and multiple low affinity binding sites. ANS (8-anilino-1-naphthalenesulfonate), a hydrophobic probe similar to bis-ANS, had no inhibitory effect on FtsZ assembly. Because tubulin assembly has also been shown to be inhibited by bis-ANS but not by ANS, it supports the idea that FtsZ and tubulin share similar conformational properties. Ca2+, which promotes GTP-dependent FtsZ assembly, stimulated binding of bis-ANS or ANS to FtsZ, suggesting that Ca2+ binding induces changes in the hydrophobic conformation of the protein. Interestingly, depletion of bound Ca2+ with EGTA further enhanced bis-ANS fluorescence. These findings suggest that both binding and dissociation of Ca2+ are capable of inducing FtsZ conformational changes, and these changes could promote the GTP-dependent assembly of FtsZ.


Cardiac and regional haemodynamic effects of endothelin-1 in rats subjected to critical haemorrhagic hypotension.
In the present study, we examined cardiac and regional haemodynamic effects of endothelin-1 (ET-1), a potent vasoconstrictive factor, in a rat model of pressure-controlled irreversible haemorrhagic shock resulting in the death of all control animals within 30 min. Experiments were carried out in male ethylurethane-anaesthetised Wistar rats subjected to hypotension of 20-25 mmHg, which resulted in bradycardia, an extreme decrease in cardiac index (CI) and an increase in total peripheral resistance index (TPRI), with reductions in renal (RBF), hindquarters (HBF) and mesenteric blood flow (MBF). ET-1 (50, 200 pmol/kg) administered intravenously at 5 min of critical hypotension produced increases in mean arterial pressure (MAP) and heart rate (HR), which were significantly higher than those in normotensive animals, and a 100% survival at 2 h after treatment. The effects were accompanied by a rise in CI, a decrease in TPRI, with increases in RBF and HBF and persistently lowered MBF, and an increase in circulating blood volume 20 min after treatment. The cardiovascular effects of ET-1 were inhibited by the ETA receptor antagonist BQ-123 (1 mg/kg), while the ETB receptor antagonist BQ-788 (3 mg/kg) had no effect. In conclusion, ET-1 acting via ETA receptors produces reversal of haemorrhagic hypotension in rats due to the mobilisation of blood from venous reservoirs, with the improvements in cardiac function and the perfusion of peripheral tissues.


Chemical reactivation of resin-embedded pHuji adds red for simultaneous two-color imaging with EGFP.
The pH-sensitive fluorescent proteins enabling chemical reactivation in resin are useful tools for fluorescence microimaging. EGFP or EYFP is good for such applications. For simultaneous two-color imaging, a suitable red fluorescent protein is an urgent need. Here a pH-sensitive red fluorescent protein, pHuji, is selected and verified to remain pH-sensitive in HM20 resin. We observe 183% fluorescence intensity of pHuji in resin-embeded mouse brain and 29.08-fold fluorescence intensity of reactivated pHuji compared to the quenched state. pHuji and EGFP can be quenched and chemically reactivated simultaneously in resin, thus enabling simultaneous two-color micro-optical sectioning tomography of resin-embedded mouse brain. This method may greatly facilitate the visualization of neuronal morphology and neural circuits to promote understanding of the structure and function of the brain.


Tetralogy of Fallot.
Based on our experience and the data presented here the following general approach may be used in the management of patients with tetralogy of Fallot: 1. Symptomatic infants under 6 months of age should be considered for an initial palliative shunt, preferably a Blalock-Taussig shunt or a Gore-tex modification of that procedure. 2. Symptomatic patients older than 6 months of age should be considered candidates for total correction, unless there are anatomic contraindications (anomalous left anterior descending artery, severe hypoplasia of the main pulmonary artery, multiple branch stenoses, multiple ventricular septal defects, or pulmonary atresia), or the predicted PRV/LV is greater than 0.7. 3. Total correction with closure of shunt should be undertaken in all patients prior to 5 years of age.


Formation and Controlled Drug Release Using a Three-Component Supramolecular Hydrogel for Anti-Schistosoma Japonicum Cercariae.
A novel three-component supramolecular hydrogel based on riboflavin, melamine and amino acid derivatives were constructed for controlled release of pesticides, Niclosamide derivatives. The formation of hydrogel may be attributed to self-assemble via hydrogen bonding and π-π interaction, which have been researched via scanning electron microscopy (SEM) and Fourier transform infrared (FT-IR) spectra. The rheological experiments showed that the hydrogel materials and drug-loaded hydrogel all demonstrated good mechanical strength and high stability. Further experimental results indicated that the drug-loaded hydrogels show large drug loadings, long-term release time and relatively higher efficiency to anti-cercariae in the water environment.


[Combined coronary artery bypass-graft surgery and valve surgery. Cardiothoracic surgery department of a high specialty medical unit experience].
the combined heart valve surgery and coronary artery bypass graft surgery has increased in frequency. The combined procedures have an increased risk of perioperative complications and mortality and usually is realized in older patients. We present our experience with this combined procedure. we analyzed the files of patients treated with combined valve surgery and coronary artery bypass graft surgery, between June 1, 2008 and June 30, 2011. We evaluated risk factors, surgical time, morbidity and mortality. in the analyzed period, we included 74 patients. There were 51 male patients (69%) and 23 female patients (31%). The mean age was 63 ± 7.3 years. The most frequent procedure was aortic valve replacement with one or two coronary artery bypass grafts. The main complications were postoperative bleeding (18.9%), mediastinitis (8.1%) and cardiac rhythm disturbances (2.7%). The mortality was 2.7%. it was concluded that combined valve surgery with myocardial revascularization has similar results to that reported by other authors and on this basis this procedure is safe and useful.


Utility and limitations of chromosome banding in pre- and postnatal service cytogenetics.
This report analyzes detection rates of chromosome aberrations as a function of stainig technique. Of 1,717 peripheral lymphocyte cultures processed by a midsize service cytogenetics laboratory, 23 chromosomal aberrations (1.3%) would not have been detected without the use of either R-banding or G-banding. These 23 cases comprise 21 of 64 non-Robertsonian structural autosomal changes and two of 68 gonosomal aberrations. In contrast, in 1,634 amniotic fluid cell cultures only one balanced rearrangement (0.06% of all cases) would not have been detected without banding. Combined with incidence rates from newborn cytogenetic screenings, these figures suggest that among 10,000 prenatal diagnoses for advanced maternal age, at most one chromosomally unbalanced fetus would be missed if banding were not routinely applied. Because of savings in time and possible automation, it is estimated that discretionary rather than routine use of chromosome banding in prenatal cytogenetics would allow for detection of at least twice as many age-related aneuploidies. In view of sharply rising demand for prenatal cytogenetic services, a discretionary approach might therefore assure a more equitable distribution of limited cytogenetic resources.


Diurnal effects of motor activity and fatigue in Parkinson's disease.
Wrist motor activity was monitored continuously in 65 patients with Parkinson's disease (PD) to assess the influence of disease severity and excessive fatigue on the diurnal motor activity pattern. Mildly or moderately affected PD patients had a similar diurnal pattern to that of 68 healthy controls, with a late morning peak; however, mean levels of motor activity were lower. The most severely affected patients showed an overall flattened diurnal pattern. Results refute the existence of end of day deterioration, but instead suggest a "depressed morning start" in the most severely affected patients with PD. Excessive fatigue was not reported at a particular time of day and did not influence the diurnal motor activity pattern.


Ultrasound processing of liquid system(s) and its antimicrobial mechanism of action.
Ultrasound creates cavitation phenomena, resulting in the formation of several free radicals, namely OH˙ and H˙, due to the breakdown of the H2 O molecule. These radicals affect the cellular integrity of the bacteria, causing the inactivation of several processes, and thus it is important to unravel the mechanism of action of this technology. This research looks into the application and mechanism of action of ultrasound technology as a means of disinfection by acoustic cavitation. Sterile water and synthetic waste water were inoculated with different mutants of Escherichia coli K12 strains containing deletions in genes affecting specific functional properties of E. coli. These were: dnak soxR, soxS, oxyR, rpoS, gadA/gadB, gadC and yneL. Escherichia coli K-12 ΔoxyR appeared to be more resistant to the treatment together with gadW, gadX, gabT and gabD, whereas the mutant K-12 ΔdnaK was more sensitive with c. 2·5 log (CFU per ml) reduction in comparison to their isogenic wild-type E. coli K-12. This indicates that the dnaK gene participates in general stress response and more specifically to hyperosmotic stress. The other E. coli deleted genes tested (soxS, rpoS, gadB, gadC, yneL) did not appear to be involved in protection of microbial cells against ultrasound. This study looks at the mechanism of action of ultrasound technology for the disinfection of wastewater. Different mutants with deleted genes were used to study the respective sensitivity or resistance to this treatment. This is essential to characterize changes at the molecular level, which might be occurring during treatment, resulting in bacterial adaptation.


Fruit Photosynthesis: More to Know about Where, How and Why.
Not only leaves but also other plant organs and structures typically considered as carbon sinks, including stems, roots, flowers, fruits and seeds, may exhibit photosynthetic activity. There is still a lack of a coherent and systematized body of knowledge and consensus on the role(s) of photosynthesis in these "sink" organs. With regard to fruits, their actual photosynthetic activity is influenced by a range of properties, including fruit anatomy, histology, physiology, development and the surrounding microclimate. At early stages of development fruits generally contain high levels of chlorophylls, a high density of functional stomata and thin cuticles. While some plant species retain functional chloroplasts in their fruits upon subsequent development or ripening, most species undergo a disintegration of the fruit chloroplast grana and reduction in stomata functionality, thus limiting gas exchange. In addition, the increase in fruit volume hinders light penetration and access to CO2, also reducing photosynthetic activity. This review aimed to compile information on aspects related to fruit photosynthesis, from fruit characteristics to ecological drivers, and to address the following challenging biological questions: why does a fruit show photosynthetic activity and what could be its functions? Overall, there is a body of evidence to support the hypothesis that photosynthesis in fruits is key to locally providing: ATP and NADPH, which are both fundamental for several demanding biosynthetic pathways (e.g., synthesis of fatty acids); O2, to prevent hypoxia in its inner tissues including seeds; and carbon skeletons, which can fuel the biosynthesis of primary and secondary metabolites important for the growth of fruits and for spreading, survival and germination of their seed (e.g., sugars, flavonoids, tannins, lipids). At the same time, both primary and secondary metabolites present in fruits and seeds are key to human life, for instance as sources for nutrition, bioactives, oils and other economically important compounds or components. Understanding the functions of photosynthesis in fruits is pivotal to crop management, providing a rationale for manipulating microenvironmental conditions and the expression of key photosynthetic genes, which may help growers or breeders to optimize development, composition, yield or other economically important fruit quality aspects.


Distribution of prolactin in selected rat organs and tissues.
A single dose of 25 microg prolactin (PRL)/kg of rat body weight was administered to rats subcutaneously. At 1, 2, 3, 4 and 5 h after the injection, selected organs and tissues were taken for analysis. It was found that 1 h after administration, the highest amount of PRL accumulated in the milk (lactiferous) gland, the blood, the ovaries, the pituitary and the liver. Over time, the prolactin content in the selected organs and tissues decreased. PRL is selectively captured by the milk gland, the pituitary, the ovaries, the liver and the heart. Based on the value of the organ or tissue capacity index for PRL, the following order was established for the organs and tissues to which the hormone binds: milk gland > blood > pituitary > ovaries > lungs > liver > cranial bone > spleen > heart > kidneys > muscular tissue > adrenals > adipose tissue > brain.


The pharmacology of sedation.
There is no single "miracle drug" for sedation. However, the range of available agents is broad and provides many safe and effective sedation options for medical procedures and studies. Providers of pediatric sedation should be thoroughly familiar with these agents.


A substantial oxygen isotope effect at O2 in the OMP decarboxylase reaction: mechanistic implications.
Orotidine-5'-monophosphate decarboxylase (OMP decarboxylase, ODCase) catalyzes the decarboxylation of orotidine-5'-monophosphate (OMP) to uridine-5'-monophosphate (UMP). Despite extensive enzymological, structural, and computational studies, the mechanism of ODCase remains incompletely characterized. Herein, carbon kinetic isotope effects were measured for both the natural abundance substrate and a substrate mixture synthesized for the purpose of carrying out the remote double label isotope effect procedure, with O2 of the substrate as the remote position. The carbon kinetic isotope effect on enzymatic decarboxylation of this substrate mix was measured to be 1.0199 +/- 0.0007, compared to the value of 1.0289 +/- 0.0009 for natural abundance OMP, revealing an (18)O2 isotope effect of 0.991 +/- 0.001. This value equates to an intrinsic isotope effect of approximately 0.983, using a calculated commitment factor derived from previous isotope effect data. The measured (18)O2 isotope effect requires a mechanism with one or more enzymatic processes, including binding and/or chemistry, that contribute to this substantial inverse isotope effect. (18)O2 kinetic isotope effects were calculated for four proposed mechanisms: decarboxylation preceded by proton transfer to 1) O2; 2) O4; and 3) C5; and 4) decarboxylation without a preceding protonation step. A mechanism involving no pre-decarboxylation step does not appear to have any steps with the necessary substantial inverse (18)O2 effect, thus calling into question any mechanism involving simple direct decarboxylation. Protonation at O2, O4, or C5 are all calculated to proceed with inverse (18)O2 effects, and could contribute to the experimentally measured value. Recent crystal structures indicate that O2 of the substrate appears to be involved in an intricate bonding arrangement involving the substrate phosphoryl group, an enzyme Gln side chain, and a bound water molecule; this interaction likely contributes to the observed isotope effect.


A simple and effective noise whitening method for underwater acoustic orthogonal frequency division multiplexing.
Underwater acoustic orthogonal frequency division multiplexing (OFDM) enables simple frequency domain equalization, but its performance is often limited by intercarrier interference (ICI) that is induced by channel variation, in addition to the ambient noise. As the signal itself, the variance of the ICI is frequency dependent as (i) the transmitter often has a nonideal transmit voltage response (TVR) and (ii) underwater acoustic propagation introduces frequency dependent attenuation. In this paper, a simple method to account for the frequency dependent spectrum of the ICI plus noise is proposed. Specifically, the power spectrum of the ICI plus noise is approximated using a low-order polynomial in the log domain, by fitting the measurements on the null subcarriers embedded in each OFDM symbol. Prewhitening is then applied to each OFDM symbol before channel estimation and data demodulation. The proposed method is tested using experimental data collected from the SPACE08 and RACE08 experiments, where signals with and without transmitter precompensation are compared side by side in the former. Impressive performance gains are found whenever the signal is significantly colored. This is the case when either the TVR is not compensated or the transmission distance and bandwidth are large.


Paternal age as an independent factor does not affect embryo quality and pregnancy outcomes of testicular sperm extraction-intracytoplasmic sperm injection in azoospermia.
This study was performed to evaluate the independent influence of paternal age affecting embryo development and pregnancy using testicular sperm extraction (TESE)-intracytoplasmic sperm injection (ICSI) in obstructive azoospermia (OA) and nonobstructive azoospermia (NOA). Paternal patients were divided into the following groups: ≤30 years, 31-35 years, 36-40 years, 41-45 years and ≥46 years. There were no differences in the rates of fertilisation or embryo quality according to paternal and maternal age. However, clinical pregnancy and implantation rates were significantly lower between those ≥46 years of paternal age compared with other age groups. Fertilisation rate was higher in the OA than the NOA, while embryo quality, pregnancy and delivery results were similar. Clinical pregnancy and implantation rates were significantly lower for patients ≥46 years of paternal age compared with younger age groups. In conclusion, fertilisation using TESE in azoospermia was not affected by the independent influence of paternal age; however, as maternal age increased concomitantly with paternal age, rates of pregnancy and delivery differed between those with paternal age <41 years and ≥46 years. Therefore, paternal age ≥46 years old should be considered when applying TESE-ICSI in cases of azoospermia, and patients should be advised of the associated low pregnancy rates.


The safe treatment, monitoring and management of severe traumatic brain injury patients in a monoplace chamber.
This report describes how 27 patients with severe traumatic brain injury were safely treated, monitored and managed in a monoplace chamber that was compressed with air to 1.5 atmospheres absolute (152 kPa). A total of 75 hyperbaric oxygen treatments were delivered using the monoplace system described, with all patients receiving 100% oxygen via mechanical ventilation. Specific pieces of equipment, components and features were selected, and modifications were interfaced to safely and effectively treat these critically ill patients in a monoplace chamber. Patient monitoring included cardiovascular and ventilatory parameters as well as intracranial pressure, brain tissue oxygen levels, brain temperature and cerebral microdialysis. The chamber and all the supporting equipment for ventilating, monitoring and managing the patient functioned well.


Percutaneous nephrostomies.
A review was made of 127 percutaneous nephrostomies (PCN) in 106 patients with benign (74 patients) and malignant (32 patients) urinary tract obstruction. Data on underlying aetiology, complications, subsequent management and long-term management are presented. The study confirms that PCN is an effective and safe method of providing temporary or prolonged urinary diversion in obstruction. Its use in pelvic malignancy should be determined by the likelihood of obtaining worthwhile prolonged palliation in individual patients.


Store-operated Ca2+ current and TRPV6 channels in lymph node prostate cancer cells.
The contribution of endogenous and recombinant transient receptor potential vanilloid type 6 (TRPV6) channels to Ca2+ entry across the plasma membrane was studied in the human lymph node prostate cancer cell line (LNCaP). LNCaP cells do express the TRPV6 gene, and Ca2+ entry currents in these cells were detected after active and passive Ca2+ store depletion by intracellular application of inositol 1,4,5-trisphosphate, Ca2+ chelators, and the sarcoplasmic/endoplasmic reticulum Ca2+-ATPase inhibitor thapsigargin. This store-operated Ca2+ current (ISOC) had biophysical properties similar to those of the Ca2+ release-activated Ca2+ current (ICRAC) in rat basophilic leukemia cells such as the activation mechanism, inward rectification, and Ca2+ selectivity. These properties are also shared by the Ca2+-sensing Ca2+ current (ITRPV6) recorded after heterologous expression of TRPV6 cDNA in human embryonic kidney and rat basophilic leukemia cells (Bödding, M., Wissenbach, U., Flockerzi, V. (2002) J. Biol. Chem. 277, 36656-36664). TRPV6 cDNA transfection of LNCaP cells restored recombinant ITRPV6, which can be distinguished from ISOC by the mechanism of activation, the voltage dependence of monovalent currents in the absence of external divalent cations, and the changes in Ca2+ current densities due to different membrane potentials. In addition, ISOC was not affected by antiandrogen or 1,25-dihydroxyvitamin D3 treatment of LNCaP cells, which up-regulates TRPV6 gene expression, or by androgen treatment, which has the opposite effect. Therefore, native channels responsible for ISOC are different from those for recombinant ITRPV6 and do not appear to be affected if one of their assumed subunits, TRPV6, is up- or down-regulated, suggesting a rather rigid subunit composition in vivo.


Serum miR-122 may serve as a biomarker for response to direct acting antivirals: effect of paritaprevir/R with dasabuvir or ombitasvir on miR-122 in HCV-infected subjects.
Circulating microRNAs (miRNA) have been intensely investigated as biomarkers in disease and therapy. Several studies have identified miR-122 as an important regulator of HCV replication. The effect of new therapies that directly target the HCV replication life cycle on circulating microRNA levels has not been elucidated. We performed expression profiling of circulating miRNA in serum in subjects treated with HCV direct-acting antiviral agents (DAAs). Serum miRNA levels were evaluated from two studies in HCV GT1-infected treatment-naïve subjects and prior nonresponders to pegylated interferon (pegIFN) and ribavirin (RBV) who received paritaprevir/ritonavir + dasabuvir + RBV for 12 weeks, and in treatment-naïve genotype (GT)1-3-infected subjects who received paritaprevir/ritonavir + ombitasvir ± RBV for 12 weeks. Over 100 different miRNA species were detected in serum. Of these, levels of miR-122 showed the most consistent change in response to treatment across all HCV genotypes. In all subjects, miR-122 showed an average four-fold reduction between baseline and week 2, and remained below baseline through post-treatment week 12 in subjects who achieved sustained virological response. In contrast, in subjects who did not achieve SVR, miR-122 levels began to return to baseline levels after the second week of treatment. The change in miR-122 levels was similar across genotypes, and was comparable with or without RBV. This is the first report comparing expression levels of circulating miRNA in HCV GT1-3 subjects treated with IFN-free combinations of DAAs. The results suggest that serum levels of miR-122 are reduced following treatment in subjects who achieve SVR, and correlate with HCV RNA levels across genotypes.


Ensuring adequate health financing to prevent and control the COVID-19 in Iran.
On February 19th 2020, the Iranian Ministry of Health and Medical Education (MoHME) has announced the first 2 cases of SARS-CoV-2, a novel emerging coronavirus which causes an infection termed as COVID-19, in Qom city. As such, the Iranian government, through the establishment of the "National Headquarters for the management and control of the novel Coronavirus", has started implementing policies and programs for the prevention and control of the virus. These measures include schools and universities closure, reduced working hours, and increased production and delivery of equipment such as masks, gloves and hygienic materials for sterile environments. The government has also made efforts to divulge high-quality information concerning the COVID-19 and to provide laboratories and hospitals with diagnostic kits and adequate resources to treat patients. However, despite such efforts, the number of cases and deaths has progressively increased with rising trends in total confirmed cases and deaths, as well as in new daily cases and deaths associated with the COVID-19. Iran is a developing country and its economic infrastructure has been hit hardly by embargo and sanctions. While developed countries have allocated appropriate funding and are responding adequately to the COVID-19 pandemics, Iran has experienced a serious surge of cases and deaths and should strive to provide additional resources to the health system to make healthcare services more accessible and to increase the fairness of that access. All relevant actors and stakeholders should work together to fight this disease.


All reversible dynamics in maximally nonlocal theories are trivial.
A remarkable feature of quantum theory is nonlocality (Bell inequality violations). However, quantum correlations are not maximally nonlocal, and it is natural to ask whether there are compelling reasons for rejecting theories in which stronger violations are possible. To shed light on this question, we consider post-quantum theories in which maximally nonlocal states (nonlocal boxes) occur. We show that reversible transformations in such theories are trivial: they consist solely of local operations and permutations of systems. In particular, no correlations can be created; nonlocal boxes cannot be prepared from product states and classical computers can efficiently simulate all such processes.


Risk Factors for Intra-operative Bleeding in Percutaneous Nephrolithotomy in an Academic Center: A Retrospective Study.
Percutaneous nephrolithotomy (PNL) is the treatment of choice for renal stones as a safe, effective, and minimally invasive method. However, bleeding remains a major concern in the procedure. This study aimed to investigate the risk factors of bleeding in PNL. This retrospective descriptive cross-sectional study was conducted in the Urology department of Razi hospital. The data of patients with urinary calculi staghorn type who underwent PNL in a prone position under general anesthesia were recorded. A checklist including patients' demographics, surgical characteristics, and outcomes was filled out for each patient. The data from 151 complete files were gathered. The mean age of the cases was 47.89 ± 12.41 years. The mean hemoglobin (Hb) drop was 1.92 ± 1.56 mg/dL. At least 1 mg/dL Hb drop was observed in all cases. The highest Hb drop was 3 mg/dL.). There was no significant relationship between stone bulk, age, BMI, GFR, surgery duration, and the number of tracts, and Hb drop during PNL (P > 0.05). But there was a positive correlation between Urinary Tract Infection (UTI) history (P = 0.01) and transfusion (P = 0.0001) and Hb drop during PNL. Also, the history of open kidney surgery (P = 0.031), nephrostomy insertion (P = 0.003), and extracorporeal shock wave lithotripsy therapy (ESWL) (P = 0.041) were correlated with the increased risk of Hb drop. Urinary tract infection, history of open surgery, nephrostomy implantation, and ESWL were significantly associated with more bleeding in PNL.


Renal, efficacy and safety outcomes following late conversion of kidney transplant patients from calcineurin inhibitor therapy to everolimus: the randomized APOLLO study.
The primary objective of this trial was to demonstrate, based on the estimated glomerular filtration rate (eGFR), superior renal function at month 12 after conversion of maintenance kidney transplant patients from calcineurin inhibitor (CNI) therapy to everolimus, compared to continuing a standard CNI regimen. APOLLO was an open-label, 12-month, prospective, multicenter study in which 93 maintenance kidney transplant patients were randomized to convert from CNI to everolimus (n = 46) or remain on standard CNI-based immunosuppression (n = 47). The primary efficacy variable was eGFR (Nankivell formula) 12 months after randomization. The study was terminated prematurely due to slow recruitment and was thus underpowered. Mean time post-transplant was 83.5 months with everolimus and 70.1 months with CNI. Adjusted values for eGFR (Nankivell) at month 12 were 61.6 (95% CI 58.1, 65.1) mL/ min/1.73 m² with everolimus and 58.8 (95% CI 55.2, 62.3) mL/min/1.73 m² with CNI, a difference of 2.8 (95% CI -1.0, 6.7) mL/ min/1.73 m² (p = 0.145) i.e., the primary objective was not met. Using the modification of diet in renal disease (MDRD) formula, adjusted eGFR at month 12 was significantly higher with everolimus (p = 0.030). In the subpopulation who remained on the study drug (n = 52), the difference in the adjusted change from randomization was 6.6 (95% CI 1.5, 11.6) mL/min/1.73 m² (p = 0.013) in favor of everolimus. There was no biopsyproven acute rejection and no graft losses. Adverse events led to discontinuation of everolimus and CNI in 32.6% and 10.6% of patients, respectively. Conversion from CNI to everolimus to preserve renal function can be considered several years after kidney transplantation and does not compromise immunosuppressive efficacy.


Hereditary cerebral small vessel disease and stroke.
Cerebral small vessel disease is considered hereditary in about 5% of patients and is characterized by lacunar infarcts and white matter hyperintensities on MRI. Several monogenic hereditary diseases causing cerebral small vessel disease and stroke have been identified. The purpose of this systematic review is to provide a guide for determining when to consider molecular genetic testing in patients presenting with small vessel disease and stroke. CADASIL, CARASIL, collagen type IV mutations (including PADMAL), retinal vasculopathy with cerebral leukodystrophy, Fabry disease, hereditary cerebral hemorrhage with amyloidosis, and forkhead box C1 mutations are described in terms of genetics, pathology, clinical manifestation, imaging, and diagnosis. These monogenic disorders are often characterized by early-age stroke, but also by migraine, mood disturbances, vascular dementia and often gait disturbances. Some also present with extra-cerebral manifestations such as microangiopathy of the eyes and kidneys. Many present with clinically recognizable syndromes. Investigations include a thorough family medical history, medical history, neurological examination, neuroimaging, often supplemented by specific examinations e.g of the of vision, retinal changes, as well as kidney and heart function. However molecular genetic analysis is the final gold standard of diagnosis. There are increasing numbers of reports on new monogenic syndromes causing cerebral small vessel disease. Genetic counseling is important. Enzyme replacement therapy is possible in Fabry disease, but treatment options remain overall very limited.


Site-directed mutagenesis of the conserved Asp-443 and Asp-498 carboxy-terminal residues of HIV-1 reverse transcriptase.
Substitution of the conserved Asp-443 residue of HIV-1 reverse transcriptase by asparagine specifically suppressed the ribonuclease H activity of the enzyme without affecting the reverse transcriptase activity, suggesting involvement of this ionizable residue at the ribonuclease H active site. An analogous asparagine substitution of the Asp-498 residue yielded an unstable enzyme that was difficult to enzymatically characterize. However, the instability caused by the Asn-498 mutation was relieved by the introduction of a second distal Asn-443 substitution, yielding an enzyme with wild type reverse transcriptase activity, but lacking ribonuclease H activity.


Candida utilis and Chlorella vulgaris counteract intestinal inflammation in Atlantic salmon (Salmo salar L.).
Intestinal inflammation, caused by impaired intestinal homeostasis, is a serious condition in both animals and humans. The use of conventional extracted soybean meal (SBM) in diets for Atlantic salmon and several other fish species is known to induce enteropathy in the distal intestine, a condition often referred to as SBM induced enteropathy (SBMIE). In the present study, we investigated the potential of different microbial ingredients to alleviate SBMIE in Atlantic salmon, as a model of feed-induced inflammation. The dietary treatments consisted of a negative control based on fish meal (FM), a positive control based on 20% SBM, and four experimental diets combining 20% SBM with either one of the three yeasts Candida utilis (CU), Kluyveromyces marxianus (KM), Saccharomyces cerevisiae (SC) or the microalgae Chlorella vulgaris (CV). Histopathological examination of the distal intestine showed that all fish fed the SC or SBM diets developed characteristic signs of SBMIE, while those fed the FM, CV or CU diets showed a healthy intestine. Fish fed the KM diet showed intermediate signs of SBMIE. Corroborating results were obtained when measuring the relative length of PCNA positive cells in the crypts of the distal intestine. Gene set enrichment analysis revealed decreased expression of amino acid, fat and drug metabolism pathways as well as increased expression of the pathways for NOD-like receptor signalling and chemokine signalling in both the SC and SBM groups while CV and CU were similar to FM and KM was intermediate. Gene expression of antimicrobial peptides was reduced in the groups showing SBMIE. The characterisation of microbial communities using PCR-DGGE showed a relative increased abundance of Firmicutes bacteria in fish fed the SC or SBM diets. Overall, our results show that both CU and CV were highly effective to counteract SBMIE, while KM had less effect and SC had no functional effects.


Acute hypoxia decreases plasma VEGF concentration in healthy humans.
Vascular endothelial growth factor (VEGF) is known to be upregulated by hypoxia in vitro. However, in vivo data about VEGF regulation in chronic hypoxic diseases are conflicting. We investigated the effects of hypoxia on plasma VEGF concentration in healthy subjects. To control known confounders, such as insulin, glucose concentrations, or exercise, hypoxic effects on VEGF were studied during experimentally clamping glucose concentrations at rest. In a double-blind crossover study design, we induced hypoxia for 30 min by decreasing oxygen saturation to 75% (vs. normoxic control) in 14 healthy men. Plasma VEGF concentration was determined at baseline, immediately after hypoxia had ended, and after a further 150 min. Levels of its soluble (s)Flt-1 receptor were assessed at baseline and at the end of the clamp. In parallel, catecholamine and cortisol levels were monitored. To investigate potential effects of glucose administration on the release of VEGF, we performed a third session, reducing glucose infusion for 30 min while serum insulin was held stable thereby inducing hypoglycemia. Hypoxia decreased VEGF levels compared with the normoxic control (P<0.05). VEGF concentrations increased during hypoglycemia (P<0.02) but were comparable to the normoglycemic control at the end of the clamp (P>0.80). sFlt-1 receptor concentration remained unchanged during hypoxia and hypoglycemia compared with control (both P>0.4). Epinephrine concentration (P<0.01) increased upon hypoxia, whereas norepinephrine and cortisol did not change. Contrary to in vitro studies, in healthy humans hypoxia decreases plasma VEGF concentration, suggesting that systemic VEGF concentration may be differently regulated than the expression on cellular basis.


Health outcomes associated with phytosterols: An umbrella review of systematic reviews and meta-analyses of randomized controlled trials.
Phytosterols (PS), as a kind of plant active ingredients, have many benefits to human health. However, there is currently no comprehensive overview of the clinical evidence and an assessment of the evidence quality. We conducted an umbrella review, which incorporated verification spanning a number of meta-analyses and systematic reviews to clarify the link that existed between PS consuming and health outcomes. The databases PubMed, Embase, Web of Science and The Cochrane Library were searched for appropriate research and ultimately included 23 articles involving 79 results. Methodological quality and the validity of evidence received designation in the included meta-analyses leveraging the Assessment of Multiple Systematic Reviews (AMSTAR-2) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The consumption of PS makes a contribution to the alleviation of metabolic conditions such as hypercholesterolemia, diabetes, obesity, and hypertension. Its most essential function is to decrease cholesterol absorption, leading to dramatically reductions in total cholesterol and low density lipoprotein cholesterol. Furthermore, utilizing PS products can have a favorable impact on managing apolipoprotein levels along with decreasing the probability of obtaining atherosclerotic cardiovascular disease. This umbrella review summarized a range of beneficial functions of PS to humans, highlighting the promising potential for the development of PS into functional foods.


Proteinuria and glomerular disease in Jamaica.
Clinical, laboratory and renal biopsy data on 50 adult patients investigated in Jamaica because of proteinuria of more than 1 g/day were reviewed. Primary glomerular disease was present in 23 cases and the most common histological pattern was mesangial proliferation. Proteinuria was part of a systemic disease in 27 patients of whom 19 had systemic lupus erythematosus (SLE). Urinary protein excretion was less in patients with systemic diseases than in those with primary glomerulonephritis, but hypoalbuminemia, renal function and presence of edema were not helpful in distinguishing types and causes of renal disease. By comparison with other countries SLE and mesangial proliferative glomerulonephritis are common causes of proteinuria and nephrotic syndrome in Jamaica whereas idiopathic membranous glomerulonephropathy appears to be rare.


Anatomic study of submandibular gland transfer in an attempt to prevent postradiation xerostomia.
Xerostomia is the most common negative sequela after radiotherapy for head and neck cancer and results from destruction of normal salivary gland tissue by radiation. We hypothesized that transferring a single submandibular gland outside the radiation field to the submental region may preserve its function, thus preventing xerostomia and its consequences. This anatomic study was designed to evaluate different methods of submandibular gland transfer to the submental region. Eight submandibular glands were dissected in four fresh human cadavers. The anatomy and blood supply of the region were documented. Each gland was transferred to the submental region by either free microvascular transfer or based on retrograde flow through the distal facial vessels. Both methods of transfer resulted in complete relocation of the submandibular gland into the submental region.


Coriandrum sativum L. seed extract mitigates lipotoxicity in RAW 264.7 cells and prevents atherogenic changes in rats.
This study was designed to assess the efficacy of Coriandrum sativum L. (CS) in preventing in vitro low density lipoprotein (LDL) oxidation mediated macrophage modification. Further, an in vivo study was also conducted to confirm upon the efficacy of CS seed extract in alleviating pathophysiological alterations of high cholesterol diet induced atherosclerosis in rats. Copper mediated cell free oxidation of LDL accounted for elevated indices of malondialdehyde (MDA), lipid hydroperoxide (LHP)and protein carbonyl (PC) and a progressive increment in conjugate diene (CD) levels whereas, reverse set of changes were recorded in presence of CS extract. Cell mediated LDL oxidation (using RAW 264.7 cells) accounted for lowered MDA production and oxidized LDL (Ox-LDL) mediated cell death in presence of CS extract and the same was attributed to its potent antioxidant and free radical scavenging potentials. High cholesterol fed atherogenic rats showed elevated lipid indices, evidences of LDL oxidation, plaque formation in thoracic aorta. The same was further validated with immunostaining of cell adhesion molecules and hematoxylin and eosin (HXE) staining. However, co-supplementation of CS to atherogenic rats recorded significant lowering of the above mentioned parameters further strengthening the claim that CS extract is instrumental in preventing onset and progression of atherosclerosis.


Modeling Approach to Determine Static Rivulet Height in Regular Polygonal Capillary Tubes.
The rise of partially wetting liquids along the corners of noncircular capillary tubes is observed in many practical science and engineering applications such as wastewater treatment using membranes, remediation, oil recovery from petroleum reservoirs, and blood flow. In this paper, rivulet rise at the corners of polygonal capillary tubes is studied for partially wetting liquids with contact angles below the critical value. The presence of corners changes the distribution of a liquid in an incomplete wetting condition. In this study, geometrical models are proposed to better understand the capillary rise and flow behavior at the corners. A geometrical solution for the capillary rivulet height and profile is derived under gravity in triangular, square, and pentagonal capillary tubes. The effects of several factors including contact angle, number of polygon sides, and liquid properties on the capillary rivulet height are examined. It was found that the ratio of liquid surface tension to density directly affects the corner rise, while it has an inverse relationship with other factors. The maximum rivulet height of 91.6 mm is obtained in the triangular capillary tube with a side length of 1 mm and a contact angle of 30° for polydimethylsiloxane (PDMS-20)-air fluid pair. The minimum capillary rivulet height of 6.2 mm, on the other hand, is achieved in the pentagonal capillary tube, with a side length of 3 mm and a contact angle of 30°. To validate the developed analytical approach, comparisons are made between the model results, literature predictions, and experimental data. In addition, the geometrical model for a square capillary tube is compared with previous published studies, revealing a good agreement. This study provides quantitative results for the influence of capillary tube shape on the flow behavior of fluids in noncircular tubes that can be useful for control and optimization of transport phenomena in corresponding systems.


Multimode Optical Interconnects on Silicon Interposer Enable Confidential Hardware-to-Hardware Communication.
Following Moore's law, the density of integrated circuits is increasing in all dimensions, for instance, in 3D stacked chip networks. Amongst other electro-optic solutions, multimode optical interconnects on a silicon interposer promise to enable high throughput for modern hardware platforms in a restricted space. Such integrated architectures require confidential communication between multiple chips as a key factor for high-performance infrastructures in the 5G era and beyond. Physical layer security is an approach providing information theoretic security among network participants, exploiting the uniqueness of the data channel. We experimentally project orthogonal and non-orthogonal symbols through 380 μm long multimode on-chip interconnects by wavefront shaping. These interconnects are investigated for their uniqueness by repeating these experiments across multiple channels and samples. We show that the detected speckle patterns resulting from modal crosstalk can be recognized by training a deep neural network, which is used to transform these patterns into a corresponding readable output. The results showcase the feasibility of applying physical layer security to multimode interconnects on silicon interposers for confidential optical 3D chip networks.


Stereotypes of old persons in Singapore.
The research investigated the stereotypic perceptions of older adults in Singaporean society. One hundred and two university students completed the 300 item Adjective Check List (ACL) differentially assigning traits to young or old adults. Item level analysis of ACL data demonstrated a depiction of old adults as intellectually impaired, cantankerous, and conservative but also serene, nurturant and responsible. The affective meaning analysis indicated that the stereotypes of old adults were characterized as less potent and less active than the stereotypes of young adults but that there were no significant differences in the favorability indices. Singaporean data were compared with research on stereotypes in India and the United States and discussed in terms of cross-cultural theories of modernization and aging.