Visual characteristics of aspirates from feeding tubes as a method for predicting tube location.
A sample of 880 feeding tube aspirates were classified as being primarily clear or cloudy and as having one of six colors. Gastric aspirates were most frequently cloudy and green, tan or off-white, or bloody or brown. Intestinal fluids were primarily clear and yellow to bile-colored. In the absence of blood, pleural fluid was usually pale yellow and serous, and tracheobronchial secretions were usually tan or off-white mucus. However, respiratory aspirates often contained blood and therefore failed to have the expected characteristics of respiratory fluid. Staff nurses were shown photographs of a sample of 106 aspirates and asked to predict tube position. Their ability to identify 50 gastric aspirates improved significantly after reading a list of suggested characteristics of feeding tube aspirates (81.33% to 90.47%, p < .0001). Similarly, their ability to identify 50 intestinal aspirates improved from 64.07% to 71.53% after reading the list of criteria. However, nurses were often unable to identify respiratory aspirates; the accuracy of their predictions decreased after reading the list of suggested characteristics (from 56.67% to 46.11%). The appearance of aspirates is often helpful in distinguishing between gastric and intestinal placement, but is of little value in ruling out respiratory placement.


[Effect of Arg-Gly-Asp peptide on the secretion of vascular endothelial growth factor from vascular endothelial cells].
To investigate the effect of Arg-Gly-Asp peptides (RGD peptides)on the secretion of vascular endothelial growth factor (VEGF) from vascular endothelial cells (VEC) and the mechanism. Using VEC cultured from the arteries of human greater omentum as a model, and detecting the content of VEGF and the activity of protein kinase C (PKC) under different concentration of RGD. After incubation with 100-300 mg/ml of RGD peptide for 24h, the VEGF content and the activity of PKC in experimental group was significantly higher than that in control group (P < 0.01). The stimulation of RGD peptide to the secretion of VEGF from VEC is in a dose-dependent way, and the stimulation is regulated by activating PKC.


Factors influencing outcome in patients with perforated peptic ulcer disease at a South African tertiary hospital.
Perforated peptic ulcer (PPU) is associated with significant morbidity and mortality, particularly in low to middle income countries. This study aimed to scrutinise the clinical course of patients diagnosed with PPU and identify modifiable factors to improve outcomes. A retrospective review of the hybrid electronic medical record (HEMR) database at Grey's Hospital was performed. All patients diagnosed with PPU between January 2013 and December 2020 were entered into the study. The variables collected include age, ethnicity, comorbid profile, Boey score, type of surgery performed and complications. These factors were analysed to determine the factors responsible for morbidity and mortality. One hundred and ninety four patients were diagnosed with PPU during the study period. Six patients were treated non-operatively, all of whom survived. In the surgically treated group, omental patch repair was performed in 159 (84.5%) patients, and primary closure in 26 (13.8%) patients. The leak rate was 32% in the cohort that underwent relaparotomy and the overall mortality was 14%. There was no significant relationship between the type of repair performed and outcome. All patients had a Boey score of 1 or more. The following factors were found to increase the probability of in-hospital mortality: age > 40 years (OR: 8.49, 95% CI 2.46-29.29 p < 0.01), female gender (OR: 2.509, CI 0.98-6.37, p = 0.048), need for relaparotomy (OR: 0.398, CI 0.17-0.91, p = 0.027) and Boey score > 1 (OR: 46.437, CI 6.13-350.28, p < 0.01). A Boey score > 1 was the only variable that increased the likelihood of finding a leaking repair at relaparotomy (p < 0.01). The Boey score was a significant predictor of mortality and leak rate in our patients with PPU. Adding age as a variable may improve the ability to predict mortality in our setting, while the impact of gender and ethnicity needs further investigation.


Lithium treatment effects on the neuropsychological functioning of patients with bipolar I disorder.
To determine if medication plays a major role in cognitive impairment in bipolar disorder and if regular treatment with lithium influences the cognitive performance of a group of euthymic patients with bipolar I disorder. Cognitive performance was assessed using neuropsychological tests of attention, memory, and executive function on 60 subjects: 20 euthymic bipolar I patients with no medication intake, 20 euthymic bipolar I patients who were following regular treatment with lithium carbonate monotherapy, and a third group of 20 control healthy subjects. The subjects were evaluated from January 2005 to October 2006. Patients were diagnosed using DSM-IV criteria for bipolar disorder. Compared to the healthy group, bipolar I patients had significantly lower performance on episodic verbal and visual-verbal memory regardless of their medication status. No significant cognitive performance differences were found between the two groups of patients with bipolar disorder, suggesting that lithium therapy had no deleterious effects on cognition. Patients with bipolar I disorder have verbal memory deficits that are not explained by medication or by lithium monotherapy, but by the condition itself.


[Echo-flowmetric control 6 years after percutaneous treatment of varicocele].
Several Authors have discussed the long term efficacy of sclerotherapy; somebody supposes that percutaneous angiographic treatment of spermatic vein is not sure at all because the occlusion due to the sclerosing agents is not retained as long lasting. Studies have been done by other Authors about comparison of recurrent varicocele anatomy following surgery and percutaneous balloon occlusion: it is concluded that venous collaterals are identified easily by renal venography, and knowledge of these collaterals is helpful in planning further radiological treatment. Since 1980 we have always treated left varicocele by means of percutaneous sclerotherapy of the spermatic veins following renal phlebography: the treatment is done on an outpatient basis, in local anaesthesia. Sclerosing agents we usually adopt are: sodium-tetradecyl sulphate and alcohol. At our knowledge long-term results of this treatment have never been published; this is the reason for which long-term follow-up of 27 patients that 6 years ago underwent percutaneous sclerotherapy was done. Only 16 of them have accepted to repeat: a) physical examination; b) Doppler flowmetry; c) scrotal ultrasound. The presence of a varicocele was demonstrated in 2 out of 16 patients (12.5% of the case). These data confirms that percutaneous treatment performed following the procedures we adopted in 1986 has a long term efficacy in 87.5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)


Infantile muscle phosphorylase-b-kinase deficiency. A case report.
A Turkish girl is described who showed a severe floppy infant syndrome and respiratory failure at birth. She suffered upper respiratory tract infections and pneumonia. She was ventilated and had hypercapnoea secondary to bradypnoea. Biochemical analysis of skeletal muscle revealed a slightly increased glycogen content, and enzymatic analysis revealed a muscle phosphorylase-b-kinase deficiency. The infant succumbed after 140 days due to persistent apnoea and asystole. Isolated muscle phosphorylase-b-kinase deficiency should be considered as a possible diagnosis in floppy infants.


Effect of Obstructive Sleep Apnea Treatment on Lipids in Obese Children.
Obesity in children is associated with several co-morbidities including dyslipidemia. Obstructive sleep apnea (OSA) is commonly seen in obese children. In adults, diagnosis of OSA independent of obesity is associated with cardiometabolic risk factors including dyslipidemia. There is limited data on the impact of treatment of OSA on lipids in children. The objective of the study was to examine the impact of treatment of OSA on lipids in 24 obese children. Methods: Seventeen children were treated with continuous positive airway pressure (CPAP) and five underwent adenotonsillectomy. Mean apnea hypopnea index prior to treatment was 13.0 + 12.1 and mean body mass index (BMI) was 38.0 + 10.6 kg/m². Results: Treatment of OSA was associated with improvement in total cholesterol (mean change = -11 mg/dL, p < 0.001), and low-density lipoprotein cholesterol (mean change = -8.8 mg/dL, p = 0.021). Conclusion: Obese children should be routinely screened for OSA, as treatment of OSA favorably influences lipids and therefore decreases their cardiovascular risk.


A guide to the histological identification of fungi in tissues.
Infections with fungi and fungus-like organisms have increased in recent years. The presence of a fungus is often unsuspected clinically and it may only come to light in the course of microscopic examination of tissues removed by biopsy or at necropsy. Subsequent culture is desirable but not always possible.A simple scheme for identifying fungi and fungus-like organisms is presented based on general morphology, staining, and other special characteristics with notes on types of tissue reactions and common pitfalls.


Strengthening the admissions process in health care professional education: focus on a premier Pacific Island medical college.
Relying solely on measures of intellectual aptitude and academic performance in university admissions can be disadvantageous to underprivileged students. The Fiji School of Medicine primarily uses such measures to evaluate and select student applicants, and the introduction of supplementary assessments could provide better access for students from disadvantaged backgrounds. This study examined the need for supplementary assessments in the admission process, types of additional assessments needed, and stakeholders' views on a multi-entry multi-exit strategy currently in use at the Fiji School of Medicine. A survey of the key stakeholders was conducted in February and March 2012 using closed and open ended questionnaire. One hundred and twenty-two validated questionnaires were self-administered by key stakeholders from the College of Medicine, Nursing and Health Sciences (CMNHS) and Fiji Ministries of Education and Health, with a response rate of 61%. Returned questionnaires were analysed quantitatively and qualitatively. Sixty-five percent of respondents supported the introduction of supplementary assessments, 49% favoured admissions test, and 16% preferred assessing non-academic factors. Many respondents supported the School's multi-entry multi-exit strategy as a 'good policy' that provided 'flexibility' and opportunity for students, but should be better regulated. These findings demonstrate the need for supplementary assessments in the selection process and for continued support for the use of multi-entry multi-exit strategy at the school.


Wave-induced response of a floating two-dimensional body with a moonpool.
Regular wave-induced behaviour of a floating stationary two-dimensional body with a moonpool is studied. The focus is on resonant piston-mode motion in the moonpool and rigid-body motions. Dedicated two-dimensional experiments have been performed. Two numerical hybrid methods, which have previously been applied to related problems, are further developed. Both numerical methods couple potential and viscous flow. The semi-nonlinear hybrid method uses linear free-surface and body-boundary conditions. The other one uses fully nonlinear free-surface and body-boundary conditions. The harmonic polynomial cell method solves the Laplace equation in the potential flow domain, while the finite volume method solves the Navier-Stokes equations in the viscous flow domain near the body. Results from the two codes are compared with the experimental data. The nonlinear hybrid method compares well with the data, while certain discrepancies are observed for the semi-nonlinear method. In particular, the roll motion is over-predicted by the semi-nonlinear hybrid method. Error sources in the semi-nonlinear hybrid method are discussed. The moonpool strongly affects heave motions in a frequency range around the piston-mode resonance frequency of the moonpool. No resonant water motions occur in the moonpool at the piston-mode resonance frequency. Instead large moonpool motions occur at a heave natural frequency associated with small damping near the piston-mode resonance frequency.


Value Frameworks for the Patient-Provider Interaction: A Comparison of the ASCO Value Framework Versus NCCN Evidence Blocks in Determining Value in Oncology.
To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial. In contrast, the NCCN Evidence Blocks (NEB) derives ratings from an expert panel assessment in the categories of efficacy, safety, quality and consistency of evidence, and affordability. To compare the results of the AVF and NEB by applying each tool to the same clinical scenarios. We evaluated 2 regimens using the AVF and NEB scores: (1) enzalutamide for treatment of metastatic castration-resistant prostate cancer and (2) nivolumab versus docetaxel in treatment of advanced squamous and nonsquamous non-small cell lung cancer (NSCLC). Enzalutamide generated a total NHB score of 44.8 (range 0-180) for use before chemotherapy and 70.8 for use after chemotherapy with a monthly cost of $8,495 in the AVF. The NEB scored enzalutamide 4 (very effective) for efficacy, 4 (occasionally toxic) for safety, and 2 (expensive) for affordability in the no visceral metastases block. It scored 3 (moderately effective) for efficacy, 4 for safety, and 2 for affordability in the visceral metastases block. Nivolumab in advanced nonsquamous NSCLC scored 36.0 and 73.2 in advanced squamous NSCLC, with a monthly cost of $7,010 in the AVF. The NEB gave nivolumab a score of 4 for efficacy and safety and 1 (very expensive) for affordability in the NEB in advanced nonsquamous and advanced squamous NSCLC. The AVF and NEB are novel tools that take different approaches in assessing the value of an oncology treatment regimen. From this study, it is clear that the findings generated by these tools are distinct. The AVF provides a summary score for treatments across all clinical benefit and toxicity categories, whereas the NEB provides component scores for treatment efficacy, safety, quality and consistency of evidence, and affordability. Both tools are novel and come with their own challenges. No outside funding supported this study. Shah-Manek is also employed by Ipsos Healthcare, a consulting firm. The authors have no conflicting interests to report. Study concept and design were contributed by Shah-Manek and Ignoffo. Galanto and Nguyen collected the data, and data interpretation was performed by all the authors. All the authors contributed to writing the manuscript, which was revised primarily by Shah-Manek, along with Galanto, Nguyen, and Ignoffo. This research was previously presented as a poster and podium presentation at the Academy of Managed Care Pharmacy Nexus 2016 held October 3-6 in National Harbor, Maryland.


Scanning precession electron diffraction data analysis approaches for phase mapping of precipitates in aluminium alloys.
Mapping the spatial distribution of crystal phases with nm-scale spatial resolution is an important characterisation task in studies of multi-phase materials. One popular approach is to use scanning precession electron diffraction which enables semi-automatic phase mapping at the nanoscale by collecting a single precession electron diffraction pattern at every probe position over regions spanning up to a few micrometers. For a successful phase mapping each diffraction pattern must be correctly identified. In this work four different approaches for phase mapping of embedded precipitates in an Al-Cu-Li alloy are compared on a sample containing three distinct crystal phases. These approaches are based on: non-negative matrix factorisation, vector matching, template matching and artificial neural networks. To evaluate the success of each approach a ground truth phase map was manually created from virtual images based on characteristic phase morphologies and compared with the deduced phase maps. The percentage accuracy of all methods when compared to the ground truth was satisfactory, with all approaches obtaining scores above 98%. The optimal method depends on the specific task at hand. Non-negative matrix factorisation is suitable with limited prior data knowledge but performs best with few unique diffraction patterns and requires substantial post-processing. It has the advantage of reducing the dimensionality of the dataset and handles weak diffracted intensities well given that they occur repeatedly. The current vector matching implementation is fast, simple, based only on the Bragg spot geometry and requires few parameters. It does however demand that each Bragg spot is accurately detected in each pattern and the current implementation is limited to zone axis patterns. Template matching handles a large range of orientations, including off-axis patterns. However, achieving successful and reliable results often require thorough data pre-processing and do require adequate diffraction simulations. For artificial neural networks a substantial setup effort is demanded but once trained it excels for routine tasks, offering fast predictions. The implemented codes and the data used are available open-source. These resources and the detailed assessment of the methods will allow others to make informed decisions when selecting a data analysis approach for 4D-STEM phase mapping tasks on other material systems.


Pigment-dispersing hormone shifts the phase of the circadian pacemaker of the cockroach Leucophaea maderae.
An antiserum against the crustacean neuropeptide pigment-dispersing hormone stains a small set of neurons in the optic lobes of several hemimetabolous and holometabolous insects. These cells, the primary branches of which in the optic lobe lie in the accessory medulla, fulfill several criteria predicted for neurons of the circadian clock. For example, in fruit flies they express timeless and period, which are two molecular components of the circadian pacemaker. To test whether pigment-dispersing hormone fulfills a circadian function in the cockroach Leucophaea maderae, 150 fmol of synthetic peptide was injected into the vicinity of the accessory medulla. This resulted in a stable phase-dependent resetting of the phase of the circadian locomotor activity rhythm, which depended on the amount of pigment-dispersing hormone injected. The resulting phase-response curve differs from that obtained with light pulses, suggesting that pigment-dispersing hormone-immunoreactive neurons are not part of the visual input pathway to the pacemaker but an integral part of it and/or part of a nonphotic input into the clock. A possible role of these neurons in coupling the bilaterally paired circadian pacemakers is discussed.


Modeling the Reactions Catalyzed by Coenzyme B12 Dependent Enzymes: Accuracy and Cost-Quality Balance.
The reactions catalyzed by coenzyme B12 dependent enzymes are formally initiated by the homolytic cleavage of a carbon-cobalt bond and a subsequent or concerted H-atom-transfer reaction. A reasonable model chemistry for describing those reactions should, therefore, account for an accurate description of both reactions. The inherent limitation due to the necessary system size renders the coenzyme B12 system a suitable candidate for DFT or hybrid QM/MM methods; however, the accurate description of both homolytic Co-C cleavage and H-atom-transfer reactions within this framework is challenging and can lead to controversial results with varying accuracy. We present an assessment study of 16 common density functionals applied to prototypical model systems for both reactions. H-abstraction reactions were modeled on the basis of four reference reactions designed to resemble a broad range of coenzyme B12 reactions. The Co-C cleavage reaction is treated by an ONIOM(QM/MM) setup that is in excellent agreement with solution-phase experimental data and is as accurate as full DFT calculations on the complete model system. We find that the meta-GGAs TPSS-D3 and M06L-D3 and the meta-hybrid M06-D3 give the best overall performance with MUEs for both types of reactions below 10 kJ mol-1. Our recommended model chemistry allows for a fast and accurate description of coenzyme B12 chemistry that is readily applicable to study the reactions in an enzymatic framework.


[Inflammatory heart diseases in childhood: Lebanese epidemiological survey].
To study the frequency, prevalence, clinical presentation, management and outcome of inflammatory heart diseases (IHD) in Lebanese children. Prospective survey of a group of children carriers (or at high risk) of an IHD (n: 156) recorded over a period of six years, between May 1st, 1999, and April 30th, 2005, at the National Register of Paediatric and Congenital Heart Disease, Lebanese Society of Cardiology. The diagnosis was confirmed in all cases by echocardiography. Cases related to cardiac surgery were excluded. Acute rheumatic fever (ARF) is the most frequent pathology : 35.9%, followed by Kawasaki disease (KD) : 24.4%, dilated cardiomyopathy (DCM) : 22.4%, pericardial effusion : 10.9% and finally infective endocarditis (IE) : 64%. There is a seasonal predominance for the ARF and KD during fall and early spring. Consanguineous marriage of first degree doesn't seem to be a factor predisposing for ARF and KD. ARF with carditis benefited from steroids with partial to total regression in 41/45 patients (91%), two patients underwent valve repair or replacement, another patient died from severe pancarditis. All children affected with KD (except 2 cases) received IV immunoglobulins (2 g/kg, single dose), and coronary aneurysms were observed in 2 patients (53%). Patients with DCM in whom there was a strong suspicion of viral myocarditis, were treated medically with complete recuperation of the cardiac function in 88% of cases. Among the patients with pericardial effusion, 3 needed urgent drainage because of a tamponnade. A child with IE was operated of his mitral valve and another one with cerebral palsy had a fatal outcome. No case of cardiac disease associated with HIV infection was found. In Lebanon, ARF remains the main cause of IHD during childhood, before KD. Currently, non-surgical treatments are highly efficient. Delayed diagnosis increased morbidity. Efforts are necessary for early recognition and primary prevention.


Psychological Factors Affecting Outcomes After Elective Shoulder Surgery.
To optimize outcomes following elective shoulder surgery, it is important to address not only the injury or pathology itself, but also the cognitive and emotional factors that may influence a patient's recovery. Depression, anxiety, catastrophic thinking, distress, somatization, and decreased self-efficacy are among the most common psychological factors associated with adverse perioperative events and poor postoperative outcomes. Such factors may manifest at any point during recovery. Validated questionnaires can be used to measure psychological factors preoperatively, thereby enabling earlier intervention that may mitigate any potential negative effect of these factors on the patient's overall outcome. Orthopaedic surgeons must be sensitive to the influence of stress, distress, and limited coping strategies on patients and should learn how best to mitigate the detrimental effects of these factors on outcomes after elective shoulder surgery.


Evolution of Sequence-Diverse Disordered Regions in a Protein Family: Order within the Chaos.
Approaches for studying the evolution of globular proteins are now well established yet are unsuitable for disordered sequences. Our understanding of the evolution of proteins containing disordered regions therefore lags that of globular proteins, limiting our capacity to estimate their evolutionary history, classify paralogs, and identify potential sequence-function relationships. Here, we overcome these limitations by using new analytical approaches that project representations of sequence space to dissect the evolution of proteins with both ordered and disordered regions, and the correlated changes between these. We use the fasciclin-like arabinogalactan proteins (FLAs) as a model family, since they contain a variable number of globular fasciclin domains as well as several distinct types of disordered regions: proline (Pro)-rich arabinogalactan (AG) regions and longer Pro-depleted regions. Sequence space projections of fasciclin domains from 2019 FLAs from 78 species identified distinct clusters corresponding to different types of fasciclin domains. Clusters can be similarly identified in the seemingly random Pro-rich AG and Pro-depleted disordered regions. Sequence features of the globular and disordered regions clearly correlate with one another, implying coevolution of these distinct regions, as well as with the N-linked and O-linked glycosylation motifs. We reconstruct the overall evolutionary history of the FLAs, annotated with the changing domain architectures, glycosylation motifs, number and length of AG regions, and disordered region sequence features. Mapping these features onto the functionally characterized FLAs therefore enables their sequence-function relationships to be interrogated. These findings will inform research on the abundant disordered regions in protein families from all kingdoms of life.


UBC19 is a new interacting protein of ORANGE for its nuclear localization in Arabidopsis thaliana.
ORANGE (OR) is a member of the DnaJ-like zinc finger domain-containing protein family, of which all orthologs share a highly conserved quadruple repeat of the CxxCxxxG signatures at their C-termini. Dual subcellular localization and different interacting partner proteins have been reported for OR. In plastids, OR interacts with phytoene synthase, the entry enzyme for carotenoid biosynthesis, to promote chromoplast biogenesis and carotenoid accumulation in non-pigmented tissues. In the nucleus, OR interacts with the eukaryotic release factor eRF1-2 to regulate cell elongation in the petiole, and with the transcription factor TCP14 to repress the expression of Early Light-Induced Proteins (ELIPs) and chloroplast biogenesis in de-etiolating cotyledons. In this study, we demonstrated the E2 ubiquitin-conjugating enzyme UBC19 as a new interacting partner of OR. The lysine58 of OR was found to be ubiquitinated, and OR lost its nuclear localization and the capability in repressing ELIPs when lysine58 was substituted by alanine. Our findings raised the possibility that the ubiquitination by UBC19 is essential for the nuclear localization of OR.


A rare case of concurrent left ventricular aneurysm and ventricular septal rupture complicating an inferior myocardial infarction: a case report.
Complications following acute myocardial infarction (MI) such as ventricular septal rupture (VSR) and left ventricular (LV) aneurysm are rare and can be dreadful. Their simultaneous presence in the same patient is extremely rare. We aimed to present a rare case of concomitant association of ventricular aneurysm and VSR complicating an inferior myocardial infarction. We report the unusual case of Mr. A. D, a 63-year-old, active smoker, with a history of diabetes mellitus and hypertension, admitted for the management of inferior MI within 6 days. The MI was complicated by an LV aneurysm in the inferoposterior and the inferoseptal walls associated with a VSR in the inferoseptal wall. The patient had only signs of right heart failure on admission. This observation illustrates on the one hand the rarity of the association of VSR and LV aneurysm after an inferior myocardial infarction, and on the other hand the possibility of founding them at an early stage of MI without any signs of cardiogenic shock.


[Medical holocaust. "Euthanasia" in Germany cca. 1935-45].
The method used in the industrialised mass murder of Jews was developed and tested within German psychiatry, where as many as 200,000 people were murdered under the "Euthanasia Programme". The doctors' professional enthusiasm for this programme, their distant contemplation of "life unworthy of life", can be understood as the establishment and legitimisation of certain rules of speech, which caused them to "forget" that they were dealing with people. Thus, German medicine was an important supplier of premises for the Nazi's extermination policy.


Effects of sotalol on arrhythmias and electrophysiology during myocardial ischaemia and reperfusion.
Isolated, buffer perfused guinea pig hearts were used to study the effects of sotalol on arrhythmias and electrophysiology during 30 min of myocardial ischaemia, induced by reducing coronary flow to 10% of control, and subsequent reperfusion. Action potentials were recorded using the floating microelectrode technique and arrhythmias were noted and defined by extracellular electrical records. Sotalol 10(-4) mol X litre-1 reduced the incidence of ventricular arrhythmias during myocardial ischaemia and reperfusion. Prior to the onset of ischaemia sotalol reduced action potential amplitude and Vmax, and prolonged action potential duration, refractory period, and conduction time, and increased pacing threshold. During myocardial ischaemia the effect of sotalol on action potential duration disappeared, and that on refractory period was diminished. The effect of sotalol on action potential amplitude and Vmax was reduced during the early (2 to 12 min) part of ischaemia, but later, at the onset of arrhythmias, tended to reemerge, while the effect on QRS width was exaggerated. Thus the cellular electrophysiological effects of sotalol on normal myocardium provided a poor guide to the mechanism of its antiarrhythmic action in ischaemic tissue.


Quantification of hemodynamic irregularity using oscillatory velocity index in the associations with the rupture status of cerebral aneurysms.
Complex and unstable flow patterns are reported to be associated with the rupture status of cerebral aneurysms, while their evaluation depends on qualitative analysis of streamlines of bloodflow. Oscillatory velocity index (OVI) is a hemodynamic parameter to quantify flow patterns. The aim of this study is to elucidate the associations between OVI and the rupture status of cerebral aneurysms. One hundred and twenty-nine ruptured and unruptured cerebral aneurysms were analyzed with computational fluid dynamics under pulsatile flow conditions. With the use of median value of OVI, all aneurysms were divided into high and low OVI groups. Statistical analysis was performed to compare rupture status, and morphological and hemodynamic parameters between the two groups. The median value of OVI was 0.006. High OVI was more likely observed in ruptured aneurysms (P=0.028) and associated with irregular shape, complex flow patterns, and unstable flow patterns (P<0.001, respectively). In morphological parameters, maximum size, aspect, projection, size, and volume-to-ostium area ratios were significantly higher in the high OVI group (P<0.001, respectively). In hemodynamic parameters, wall shear stress and wall shear stress gradient were significantly lower, and oscillatory shear index and gradient oscillatory number were significantly higher in the high OVI group (P<0.001, respectively). High OVI was associated with rupture status, and morphological and hemodynamic characteristics of ruptured aneurysms. These results indicate that OVI may serve as a valuable hemodynamic parameter for diagnosing rupture status and risks of aneurysms.


Comparison of renal damage by iodinated contrast or gadolinium in an acute renal failure rat model based on serum creatinine levels and apoptosis degree.
This study was undertaken to compare renal damage, as determined by serum creatinine and degree of apoptosis, caused by iodinated contrast or gadolinium in an acute renal failure (ARF) rat model. Rats were divided into three groups; controls (n=3), a CT contrast medium group (n=9), and an MR contrast medium group (n=9). The CT and MR groups were further subdivided into three groups, namely, low, standard, and high dose subgroups. Renal function was evaluated by determining serum creatinine levels; before ARF, and 48 hr after ARF and contrast administration. Apoptosis was assayed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). No significant creatinine level differences were observed between the CT and MR groups (p=0.116). Degrees of apoptosis in the renal cortex and medulla were more severe in the CT contrast medium group than in the control or MR contrast medium group (p<0.05). The study shows that CT contrast medium did not aggravate renal function more so than MR contrast medium in this ARF rat model. However, apoptosis examination in the renal cortex and medulla indicated that CT contrast medium induced more severe apoptosis than MR contrast medium (p<0.05). We conclude that CT contrast medium can be used for renal imaging studies when subjects are well hydrated and preventive medication is administered.


Isolation and Functional Characterization of New Terpene Synthase Genes from Traditional Edible Plants.
Terpene synthase (TPS) genes were isolated and functionally characterized from three traditional edible plants, Acanthopanax sciadophylloides ("Koshiabura") and Acanthopanax sieboldianus ("Himeukogi"), belonging to the family Araliaceae, and Curcuma zedoaria (zedoary, "Gajutsu"), belonging to the family Zingiberaceae. These plants emit characteristic fragrances and are used for traditional foods and folk medicines. From their fragrant tissues, i.e., sprouts of Araliaceae plants and developing rhizomes of zedoary, total RNAs were extracted and reverse transcribed. The resultant cDNAs were used for degenerate PCR followed by rapid amplification of cDNA ends. From the contig sequences obtained, full-length Tps genes were amplified by PCR with newly synthesized primer sets. The isolated full-length genes were introduced into engineered Escherichia coli cells, which can utilize acetoacetate to synthesize farnesyl diphosphate, the substrate for TPSs, through the mevalonate pathway. TPS products synthesized in the transformed E. coli cells were analysed by gas chromatography-mass spectrometry, nuclear magnetic resonance, and optical rotation. Consequently, the isolated Tps genes were found to encode β-caryophyllene synthase, germacrene D synthase, linalool/(3S)-(+)-nerolidol synthase, β-eudesmol synthase, and germacrene B synthase. These results lead us to expect that some of the effective ingredients in folk medicines are volatile terpenes and that intake of traditional foods including these edible plants would have some positive effects on our health.


EXCLUSION OF THE ROLE OF SECONDARY CONTACT IN AN ALLELE FREQUENCY CLINE IN THE MUSSEL MYTILUS EDULIS.
We examined the hypothesis that secondary contact generates an allele-frequency cline at the aminopeptidase-I locus (Lap) in the marine mussel, Mytilus edulis. It has been proposed that variation at the Lap locus is neutral and that the cline results from secondary contact between differentiated oceanic and estuarine populations (Levinton, 1980). We tested this hypothesis by comparing the genotypic distributions in samples from the cline to distributions that incorporate mixing effects. We employed a statistical model that determines the degree of contact using a maximum likelihood estimator and then incorporates the mixing estimates into an expected distribution of genotypes. Wahlund effects resulting from possible admixture are thereby incorporated into the expected distribution. Failure of the model to reconcile the observed with the expected distribution of genotypes indicates that the observed population structure does not result from admixture. The null hypothesis of mixing was unable to explain about 33% of the samples. Combined tests demonstrated the general departure from the mixing model to be highly significant. The distribution of heterozygote discrepancies across the cline was inconsistent with the expectations of a mixing model. Therefore we reject explanations for the structure of the Lap cline that involve secondary contact. Selection directed at the Lap locus appears necessary to explain the genotypic structure of clinal populations.


Obtaining information on patient satisfaction with hospital care: mail versus telephone.
Many objectives of the study examined here were to develop a questionnaire useful in eliciting the perceptions of patients regarding their hospital care, to compare the methodologic and substantive differences between a mail survey and a telephone survey of patients done approximately a week post discharge, and to develop methods allowing the questionnaire to be administered by an organization other than the hospital. Two independent surveys were conducted at the same hospital--a telephone survey with a telephone follow-up, and a mail survey with a telephone follow-up. The study demonstrated that an organization external to the hospital can economically conduct a patient satisfaction survey of a representative patient sample while ensuring confidentiality and producing potentially useful results. The mail survey was preferred over the telephone survey due to lower cost, lower chance of biased responses, and complete assurance of confidentiality. The aspects of hospital care most influencing patient satisfaction related to nursing services.


Fifty Years of Ventricular Tachycardia in a Single Patient.
We report a patient who first presented during childhood in the early 1960's with several episodes of ventricular tachycardia (VT) and we describe her management which reflected the best medical knowledge at the time. She then presented more than 50 years later, again with VT, at which time a definitive diagnosis of the underlying cause was made. Her case illustrates the evolution in the understanding and management of VT over the past 50 years. This in turn reflects the clinical and technological advances in the management of cardiovascular disease over time.


Visual Field Progression in Retinitis Pigmentosa.
To retrospectively study the rate of visual field (VF) progression in patients with retinitis pigmentosa (RP) as it relates to different targets and inheritance patterns. A total of 275 kinetic VF tests were collected from 52 subjects with RP over a period of up to 29 years (mean, 12 years). The VF areas of Goldmann targets V4e, III4e, and I4e were calculated using Photoshop. Differences in the rate of VF loss among different targets and inheritance patterns were compared. There was a significant interocular correlation in both visual acuity (VA) (R2 = 0.739, P < 0.001) and VF area (R2 = 0.815, P < 0.001). The annual rates of decline in VF area for V4e, III4e, and I4e targets were 7.5%, 10.7%, and 12.5%, respectively (all P < 0.001). All of the rates were significantly different from each other (P < 0.001). The mean rate of VF loss was 10.3% (P = 0.009) for autosomal recessive, 2.7% (P = 0.215) for autosomal dominant, and 7.2% (P = 0.009) for X-linked patterns of inheritance. However, the differences among them were not statistically significant (P > 0.05). Based on VF, survival analysis indicated that our patients failed the vision standard for driving and reached legal blindness at the median ages of 37 and 55 years, respectively. The rate of VF loss varies among targets in patients with RP. Fifty percent of patients are not qualified to drive by the age of 37 and become legally blind by the age of 55. These results can be useful for counseling patients with RP as to their potential rate of VF decline.


It's About Time: Advances in Understanding the Circadian Regulation of DNA Damage and Repair in Carcinogenesis and Cancer Treatment Outcomes.
The circadian rhythm is established by a coordinated network of peripheral clocks interlocked and regulated by a central pacemaker. This network is maintained by the rhythmic expression of core clock genes, which in turn generate oscillatory expression patterns of different sets of target proteins in a tissue-specific manner. Precise regulation of biological processes driven by the body's circadian network in response to periodic changes in the environment determines healthy life. The delicate balance in the cycling of enzymes, metabolites, cofactors, and immune regulators is essential to achieve cellular homeostasis. Disruption of this circadian homeostasis has been linked with the development and progression of various diseases including cancer. Over the years, circadian regulation of drug metabolism and processing has been employed in the treatment of diabetes, hypertension, peptic ulcers, and allergic rhinitis. Although time dictated drug administration was demonstrated many decades ago, its application in cancer treatment is limited due to insufficient mechanistic data supporting experimental results and inconsistency between clinical trials. However, timed administration of anti-cancer drugs is rapidly gaining attention as studies with animal and human models unveil molecular intricacies involved in the circadian control of biological pathways. In this regard, striking a balance between maximizing tumor responsiveness and minimizing side effects is crucial to achieve positive patient outcomes. This review focuses on regulation of the circadian clock in carcinogenesis outcomes through DNA damage and repair mechanisms and its application in therapy with specific emphasis on skin and breast cancers.


The neuroprotective effects of the recombinant interleukin-1 receptor antagonist rhIL-1ra after excitotoxic stimulation with kainic acid and its relationship to the amyloid precursor protein gene.
The cytokine interleukin-1 (IL-1) and its endogenous antagonist (IL-1ra) have important functions in the central nervous system. Recent experimental observations have suggested that recombinant IL-1RA (rhIL-1ra) has neuroprotective properties in ischaemia, excitotoxicity, and trauma. We wished to see what effect rhIL-1ra had on kainic acid-induced neuronal death and to investigate how this might relate to changes in expression of the amyloid precursor protein gene (APP) and glial fibrillary acid protein (GFAP) using in situ hybridization. Wistar rats were treated by intracerebroventricular administration with rhIL-1ra at doses of 10, 20 and 40 microg given 10 min before and 10 min after intraperitoneal kainic acid 10 mg/kg. Behaviour was measured and, after 10 days, the brains were removed for histology and in situ hybridization. There were no anticonvulsant effects on kainic acid-induced wet dog shakes or limbic motor seizures. There were no differences in the effects of rhIL-1ra at all doses tested on hippocampal temperature, blood pressure, blood gases, pH, and glucose in comparison to control. With rhIL-1ra 10 microg given twice, there was significant protection of neurons in the CA1 and CA3 field of the hippocampus and dorsal thalamus, but not in the primary olfactory cortex-amygdaloid region. Small, but insignificant, neuroprotective effects were observed in the same anatomical regions with a dose of 20 microg given twice, and no neuroprotective effects were observed with 40 microg. The enhanced neuronal survival in CA1, CA3 and the dorsal thalamus was associated with preservation of APP 695 mRNA (neuronal form) and lack of stimulation of APP 770 (glial form) and GFAP messages. Where there was no neuroprotection APP 695 mRNA was reduced and stimulation of both APP 770 and GFAP mRNAs was observed. In conclusion, rhIL-1ra has dose- and region-dependent effects on neuronal survival after kainic acid and prevents damage-induced changes in APP and GFAP mRNAs.


Cation diffusion in La(0.6)Sr(0.4)CoO(3-δ) below 800 °C and its relevance for Sr segregation.
Cation diffusion was investigated in La0.6Sr0.4CoO3-δ (LSC) thin films on (100) yttria stabilized zirconia in the temperature range 625-800 °C. Isotopic ((86)Sr) and elemental tracers (Fe, Sm) were used to establish diffusion profiles of the cations in bi- and multi-layered thin films. The profiles were analyzed by time of flight-secondary ion mass spectrometry (ToF-SIMS). Grain and grain boundary diffusion coefficients of the cations were determined for LSC thin films with columnar grains - diffusion along grain boundaries is shown to be about three orders of magnitude faster than in grains. This could be verified for thin films with different grain size. A- and B-site cations showed very similar temperature dependencies with activation energies of ∼3.5 eV for bulk and ∼4.1 eV for grain boundary diffusion. The importance of cation diffusivities for surface segregation of Sr and thus for a major degradation mechanism of LSC cathodes in solid oxide fuel cells is discussed.


A new fluorescent chemosensor for cadmium(II) based on a pyrene-appended piperidone derivative and its β-cyclodextrin complex.
We report, in this article, a piperidin-4-one derivative carrying pyrenyl fluorescent reporter groups which acts as a Cd2+ ion sensor. The compound is synthesized and characterized using IR and NMR spectral techniques. The compound forms an inclusion complex with β-cyclodextrin. It selectively binds to Cd2+ ions in water and aqueous β-cyclodextrin media. The stoichiometry of the host-guest complex of the compound with β-cyclodextrin is 1:2. The ligand-metal ion binding stoichiometry is 1:1 both in water and in β-cyclodextrin. The linear concentration range of detection of the metal ion is reported. Cyclodextrin complex formation does not affect the metal ion selectivity of the compound.


Resveratrol protects against asthma-induced airway inflammation and remodeling by inhibiting the HMGB1/TLR4/NF-κB pathway.
The aim of the present study was to explore the protective role of resveratrol (RES) in asthma-induced airway inflammation and remodeling, as well as its underlying mechanism. An asthma rat model was induced by ovalbumin (OVA) treatment. Rats were randomly assigned into sham, asthma, 10 µmol/l RES and 50 µmol/l RES groups. The amount of inflammatory cells in rat bronchoalveolar lavage fluid (BALF) was detected. Pathological lesions in lung tissues were accessed by hematoxylin and eosin (H&E), and Masson's trichrome staining. Levels of inflammatory factors in lung homogenate were detected via ELISA. The blood serum of asthmatic and healthy children was also collected for analysis. Reverse transcription-quantitative polymerase chain reaction was performed to detect high mobility group box 1 (HMGB1), Τoll-like receptor 4 (TLR4), myeloid differentiation primary response gene 88 (MyD88) and NF-κB expression in asthmatic and healthy children, as well as rats of the different groups. H&E staining demonstrated that multiple inflammatory cell infiltration into the rat airway epithelium of the asthma group occurred whilst the 50 µmol/l RES group displayed alleviated pathological lesions. Masson staining indicated that there was an increased airway collagen deposition area in the asthma and 10 µmol/l RES groups compared with the 50 µmol/l RES group. The number of inflammatory cells in BALF extracted from rats of the asthma and 10 µmol/l RES groups was higher compared with the 50 µmol/l RES group. Treatment with 50 µmol/l RES significantly decreased the thicknesses of the airway wall and smooth muscle. ELISA results illustrated that interleukin (IL)-1, IL-10 and tumor necrosis factor-α (TNF-α) levels were elevated, whereas IL-12 level was reduced in lung tissues of the asthma and 10 µmol/l RES groups whilst the 50 µmol/l RES group demonstrated the opposite trend. HMGB1, TLR4, MyD88 and NF-κB mRNA levels were remarkably elevated in rats of the asthma and 10 µmol/l RES groups compared with the 50 µmol/l RES group. Serum levels of IL-1, IL-10 and TNF-α were elevated, whereas IL-12 was reduced in asthmatic children compared with healthy children. The present results demonstrated that a large dose of RES alleviated asthma-induced airway inflammation and airway remodeling by inhibiting the release of inflammatory cytokines via the HMGB1/TLR4/NF-κB pathway.


Determination of halide ions in solution by Total Reflection X-ray Fluorescence (TXRF) spectrometry.
An accurate quantitative determination of halide ions X (X = Cl, Br, I) in aqueous solution by total reflection X-ray fluorescence (TXRF) is not possible using the traditional acidic internal standards. In general, the standard solutions are highly acidic (e.g., Ga(NO3)3 in HNO3) to avoid precipitation of hydroxides of the standard element and to obtain a stable and reliable standard. In acidic solutions, dissolved halide salts can exchange their cation for a proton. The resulting volatile HX compounds can evaporate during the drying procedure of the TXRF sample preparation. In this technical note, we show that an alkaline Cu(NH3)4(NO3)2 standard can be used for the determination of chlorine, bromine and iodine without facing problems of HX evaporation.


Morphology of the greater palatine grooves of the hard palate: a cone beam computed tomography study.
There is increasing frequency of dentoalveolar and palatal implants placed in the posterior maxilla for prosthodontic and orthodontic purposes. The purpose of this study is to provide information on the location and morphology of the greater palatine grooves (GPG) in the hard palate and to promote awareness of this structure. Eighty-nine cone beam computed tomography (CBCT) scans were analysed for the presence of a groove, crest or bridging. This study on the morphology of the GPG in the maxillary first and second molar regions showed three distinct appearances: (1) no palatal groove; (2) one palatal groove; (3) two palatal grooves. The detection frequency of no palatal groove in the first molar region was 60%, 34% had one groove and 6% having two grooves. The detection frequency of no palatal groove in the second molar region was 72%, 26% had one groove and 2% had two grooves. The number of crests in the first and second molar regions ranged from 0 to 3. The present study demonstrates a great variation in morphology of the GPG of the hard palate. Knowledge of the GPG will decrease possible complications of implant surgery, particularly palatal implant surgery and to not confuse the GPG with pathology.


Chronic Myeloid Leukemia in India.
In the last decade, the use of imatinib has brought a paradigm shift in the management of chronic myeloid leukemia (CML). In India, imatinib has been available for more than a decade and has been made accessible to all segments of the population because of patient assistance programs and cheaper generic versions. Despite improvements in survival, there are unique challenges in the Indian context. We reviewed published data pertaining to CML in India for the period of 1990 to 2016, using PubMed advanced search with the terms chronic myeloid leukemia and India, and included studies that reported on epidemiology, monitoring for therapy, treatment outcomes, and resistance. Additionally, the references in retrieved articles were also reviewed. Thirty-seven studies were identified. The incidence of CML may be slightly lower in India than in the West, but there was only a single article reporting population-based data. Indian patients presented with more advanced disease. Most centers have access to imatinib as first-line therapy, but there is limited availability of molecular monitoring and second-line therapy. Most of the outcome data were retrospective but seemed comparable with that reported in Western centers. Drug adherence was impaired in at least one third of patients and contributed to poor survival. Focused prospective studies and cooperative studies might improve the quality of data available. Future studies should focus on adherence, its effects on outcomes, and methods to address this problem.


Autosomal dominant progressive external ophthalmoplegia with multiple deletions of mtDNA: clinical, biochemical, and molecular genetic features of the 10q-linked disease.
Autosomal dominant progressive external ophthalmoplegia (adPEO) is a mitochondrial disease characterized by accumulation of multiple large deletions of mtDNA in patients' tissues. We previously showed that the disease is genetically heterogeneous by assigning two nuclear loci predisposing to mtDNA deletions: one on chromosome 10q 23.3-24.3 in a Finnish family and one on 3p 14.1-21.2 in three Italian families. To reveal any locus-specific disease features, we report here the clinical, biochemical, and molecular genetic characteristics of the 10q-linked disease in the single family reported to date. All seven patients and four asymptomatic subjects had ragged-red fibers and multiple deletions of mtDNA in their muscle. Ptosis and external ophthalmoplegia were the major clinical findings, and depression or avoidant personality traits were frequently, but not consistently, present in the subjects carrying mutant mtDNA. In six of the subjects with mutant mtDNA, the activities of the respiratory chain complexes I or IV, or both, were below or within the low normal range. Two autopsy studies revealed the characteristic distribution of mutant mtDNA in these patients: highest proportion of mutant mtDNA is found in different parts of the brain, followed by the skeletal and ocular muscle, and the heart.


Assessment of Neurobiological Mechanisms of Cortical Thinning During Childhood and Adolescence and Their Implications for Psychiatric Disorders.
Many psychiatric disorders can be conceptualized as disorders of brain maturation during childhood and adolescence. Discovering the neurobiological underpinnings of brain maturation may elucidate molecular pathways of vulnerability and resilience to such disorders. To investigate the underlying neurobiological mechanisms of age-associated cortical thinning during maturation and their implications for psychiatric disorders. This multicohort analysis used data from 3 community-based studies. The Saguenay Youth Study provided data from 1024 adolescents who were recruited at a single site in Quebec, Canada. The IMAGEN cohort provided data from 1823 participants who were recruited in 8 European cities. The Brazil High Risk Cohort Study for the Development of Childhood Psychiatric Disorders provided data from 815 participants who were recruited in 2 Brazilian cities. Cortical thickness was estimated from the results of magnetic resonance imaging (MRI) scans, and age-associated cortical thinning was estimated in 34 cortical regions. Gene expression from the Allen Human Brain Atlas was aligned with the same regions. Similarities in the interregional profiles of gene expression and the profiles of age-associated cortical thinning were measured. The involvement of dendrites, dendritic spines, and myelin was tested using 3 gene panels. Enrichment for genes associated with psychiatric disorders was tested among the genes associated with thinning and their coexpression networks. Data analysis was conducted between March and October 2019. MRI-derived estimates of age-associated cortical thinning and gene expression in 34 cortical regions. A total of 3596 individuals aged 9 to 21 years were included in this study. Of those, 1803 participants (50.1%) were female, and the mean (SD) age was 15.2 (2.6) years. Interregional profiles of age-associated cortical thinning were associated with interregional gradients in the expression of genes associated with dendrites, dendritic spines, and myelin; the variance in thinning explained by the gene panels across different points ranged from 0.45% to 10.55% for the dendrite panel, 0.00% to 9.98% for the spine panel, and 0.19% to 26.39% for the myelin panel. These genes and their coexpression networks were enriched for genes associated with several psychiatric disorders. In this study, genetic similarity between interregional variation in cortical thinning during maturation and multiple psychiatric disorders suggests overlapping molecular underpinnings. This finding adds to the understanding of the neurodevelopmental mechanisms of psychiatric disorders.


Study on the fibre arrangement of the dorsal nerve root and its cellular constituents in the mouse fetus.
The fibre arrangement of the dorsal nerve root was studied in the mouse fetus during early stages of development and was found to consist of two bundles at their exit from the dorsal root ganglion. This separate arrangement of the fibres could be traced along the course of the dorsal nerve root as far as the pial ring. Moreover, neurolemmal cells and neuroblasts were found dispersed along the whole course of the dorsal nerve root. Aggregations of neuroblasts surrounded by a thin fibrous capsule along the dorsal nerve root near the dorsal root ganglia were described as intermediate ganglia.


Retention and turnover among migrant nurses: A scoping review.
To map and explore primary research about factors related to retention, turnover and turnover intention among migrant nurses. Understanding retention and turnover among migrant nurses is essential, especially in the context of nursing shortage. There is a range of factors motivating nurses to emigrate; however, factors related to retention and turnover among migrant nurses in the host country are unclear. This review utilised Arksey and O'Malley's methodological framework for scoping reviews, and is reported with the PRISMA-ScR checklist. Four electronic databases were searched-CINAHL, PsycINFO, ProQuest and PubMed-to identify primary research published between January 2000 and May 2022. Titles and abstracts were reviewed against the inclusion and exclusion criteria, and then full-text versions were reviewed. Data extracted were summarised, and results synthesised. Fifteen studies were included, with studies mainly from the Middle East, the United Kingdom and the United States. Personal, organisational, financial, political and environmental factors were found to influence retention and turnover among migrant nurses. Retention and turnover rates among migrant nurses vary among host countries. The factors identified are related to each other; hence, retention and turnover among migrant nurses are best understood in the context of their source country, host country and individual circumstances. IMPLICATIONS FOR NURSING POLICY, SOCIAL POLICY, AND HEALTH POLICY: Host countries must promote strategies that foster retention, such as reviewing immigration policies to support long-term immigration and family unity. Organisations employing migrant nurses need to consider the presence of a social network to facilitate adaptation and integration. It is also recommended that source countries address the reasons for emigration and initiate policies encouraging return migration, including providing merit to overseas experience. International nursing organisations should call for an examination of the conditions of migrant nurses to ensure equality across all source countries.


S,N-Heteroacene-Based Copolymers for Highly Efficient Organic Field Effect Transistors and Organic Solar Cells: Critical Impact of Aromatic Subunits in the Ladder π-System.
Three novel donor-acceptor alternating polymers containing ladder-type pentacyclic heteroacenes (PBo, PBi, and PT) are synthesized, characterized, and further applied to organic field effect transistors (OFETs) and polymer solar cells. Significant aspects of quinoidal characters, electrochemical properties, optical absorption, frontier orbitals, backbone coplanarity, molecular orientation, charge carrier mobilities, morphology discrepancies, and the corresponding device performances are notably different with various heteroarenes. PT exhibits a stronger quinoidal mesomeric structure, linear and coplanar conformation, smooth surface morphology, and better bimodal crystalline structures, which is beneficial to extend the π-conjugation and promotes charge transport via 3-D transport pathways and in consequence improves overall device performances. Organic photovoltaics based on the PT polymer achieve a power conversion efficiency of 6.04% along with a high short-circuit current density (JSC) of 14.68 mA cm-2, and a high hole mobility of 0.1 cm2 V-1 s-1 is fulfilled in an OFET, which is superior to those of its counterparts, PBi and PBo.


[Impact of the correction of the attenuation in myocardial perfusion image with SPECT].
The aim of this study was to assess the effect of attenuation correction on gender differences in normals and to evaluate its effect on the size and severity of lateral wall perfusion defects in patients with circumflex artery disease. Tomographic myocardial perfusion imaging with and without attenuation correction was performed on 32 patients with circumflex artery stenosis and compared with patients with less than 5% likelihood of coronary disease. Images were acquired with a triple headed scanner and reconstructed using an iterative algorithm and re-sliced in the short axis plane. Regional count densities were measured on selected short axis slices from the base to the apex in both patients and normals. All attenuation corrected images were found to be more uniform than the non attenuation corrected images on the patients with less than 5% likelihood of coronary artery disease. The coefficient of variation was 12.5% for non attenuation corrected images versus 9.9% for attenuation corrected images (p < 0.0001). When female and male segmental count distributions were compared, significant differences were found which were resolved after attenuation correction. In patients with circumflex artery stenosis, the anterolateral and lateral count densities were lower at all levels with attenuation corrected images with an increasing difference from base to apex. The use of attenuation correction results in a greater uniformity in normals and an improved estimation of extent and severity of perfusion defects in the territory of the circumflex artery.


Evolution of Mass Spectrometry Instruments and Techniques for Blood Proteomics.
Mass spectrometry (MS)-based blood proteomics is a crucial research focus in identifying disease biomarkers. Blood serum or plasma is the most commonly used sample for such analysis; however, it presents challenges due to the complexity and dynamic range of protein abundance. Despite these difficulties, the development of high-resolution MS instruments has made comprehensive investigation of blood proteomics possible. The evolution of time-of-flight (TOF) or Orbitrap MS instruments has played a significant role in the field of blood proteomics. These instruments are now among the most prominent techniques for blood proteomics due to their sensitivity, selectivity, fast response, and stability. For optimal results, it is necessary to eliminate high-abundance proteins from the blood sample, to maximize the depth coverage of the blood proteomics analysis. This can be achieved through various methods, including commercial kits, chemically synthesized materials, and MS technologies. This paper reviews recent advancements in MS technology and its remarkable applications in biomarker discovery, particularly in the areas of cancer and COVID-19 studies.


[Preliminary study on differential expression of plasma proteins of patients with Takayasu's arteritis in different stage].
To investigate differential expression of plasma proteins of patients with Takayasu's arteritis to screen disease-related or phase-related proteins or biomarkers. From March, 2005 to January, 2006, Plasma of 20 patients with acute Takayasu's arteritis, 20 patients with chronic Takayasu's arteritis, and 20 healthy people as control were collected. Plasma proteins were profiled by two-dimensional electrophoresis. Spots of differential expression were screened by computerized map analysis and identified by matrix assisted laser desorption/ionization time of flight-mass spectrometry. Circulation levels of parts of differential expression proteins were investigated by Elisa in each subject. Fourteen differential expression proteins were identified, including serum amyloid A, serum amyloid P, fibrinogen, complement C3c, C7, C4 binding protein, factor H related protein-1, immunoglobin, alpha-acid glycoprotein, RAG1 protein, alpha1-microglobin, apolipoprotein A-I, A-IV, transthyretin, haptoglobin. Proteins related to acute and chronic phase were serum amyloid A, fibrinogen, transthyretin, haptoglobin; Circulation levels of Serum amyloid A (SAA) and Complement C4 binding protein (C4BP) were significantly increased in active TA patients comparing to that in inactive TA patients and in controls (SAA: 95.9 vs 49.2, P = 0.009 and 23.9 mg/L, P = 0.001, respectively; C4BP: 88.5 vs 61.7, P = 0.023 and 32.6 mg/L, P < 0.001, respectively). Acute phase proteins and immune proteins may possible be markers for diagnosis and activity of Takayasu's arteritis, Complement activity, complement modulation protein and antibody production may be involved in immune mechanism of Takayasu's arteritis. Further study of these proteins may be helpful to elucidate the pathologic mechanism of Takayasu's arteritis.


Fumarase tumor suppressor gene and MET oncogene cooperate in upholding transformation and tumorigenesis.
Loss of the fumarate hydratase (FH) tumor suppressor gene results in the development of benign tumors that rarely, but regrettably, progress to very aggressive cancers. Using mouse embryo fibroblasts (MEFs) to model transformation, we found that fh knockdown results in increased expression of the met oncogene-encoded tyrosine kinase receptor through hypoxia-inducible factor (hif) stabilization. MET-increased expression was alone able to stabilize hif, thus establishing a feed forward loop that might enforce tumor progression. The fh-defective MEFs showed increased motility and protection from apoptosis. Motility, but not survival, relied on hif-1alpha and was greatly enhanced by MET ligand hepatocyte growth factor. Met cooperated with a weakly oncogenic ras in making MEFs transformed and tumorigenic, as shown by in vitro and in vivo assays. Loss of fh was not equally effective by itself but enhanced the transformed and tumorigenic phenotype induced by ras and MET. Consistently, the rescue of fumarase expression abrogated the motogenic and transformed phenotype of fh-defective MEFs. In conclusion, the data suggest that the progression of tumors where FH is lost might be boosted by activation of the MET oncogene, which is able to drive cell-autonomous tumor progression and is a strong candidate for targeted therapy.


Maintaining Patency of Vascular Access for Haemodialysis.
All types of vascular access, a necessity for haemodialysis, are prone to thrombosis and if untreated this results in failure. Thrombosis results from the combination of impaired blood flow, endothelial and vessel wall injury and a propensity towards pro-coagulative states, either intrinsic or aggravated by dialysis or dehydration. The treatment of access thrombosis relies on removal of the clot (thrombectomy) and treatment of the underlying problem. In most cases this is stenosis secondary to neointimal hyperplasia which can occur early (failure to mature) or later. Pharmacological approaches have largely been shown to be ineffective at prevention of thrombosis. The mainstay of preventing access failure may be in surveillance and detecting stenosis prior to occlusion although the optimal protocol to achieve this remains undefined. Management of thrombosed access is via either surgical and radiological approaches. Multiple techniques and devices are available for thrombectomy and the choice is usually based on local expertise and availability rather than evidence as few trials have been performed to allow robust comparisons. This paper outlines the basis of access thrombosis and discusses the currently available techniques for treatment.


Coagulation and fibrinolysis in human acute lung injury--new therapeutic targets?
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common, life-threatening causes of acute respiratory failure that arise from a variety of local and systemic insults. The need for new specific therapies has led a number of investigators to examine the role of altered coagulation and fibrinolysis in the pathogenesis of ALI/ARDS. This review summarizes our current understanding of coagulation and fibrinolysis in human ALI/ARDS with an emphasis on pathways that could be potential therapeutic targets including the tissue factor pathway, the protein C pathway and modulation of fibrinolysis via plasminogen activator inhibitor-1. The available data suggest that clinical ALI and ARDS are characterized by profound alterations in both systemic and intra-alveolar coagulation and fibrinolysis. Fibrin deposition in the airspaces and lung microvasculature likely results from both activation of the coagulation cascade and impaired fibrinolysis, triggered by inflammation. Modulation of fibrin deposition in the lung through targeting activation and modulation of coagulation as well as fibrinolysis may be an important therapeutic target in clinical ALI/ARDS that deserves further exploration.


Effects of Exercise-Based Interventions on Fall Risk and Balance in Patients With Chronic Obstructive Pulmonary Disease: A SYSTEMATIC REVIEW.
Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease characterized by airflow limitation and is associated with decreased balance and increased fall risk. Since falls are related to increased mortality, interventions targeting balance and fall risk could reduce morbidity and mortality. The objective of this review was to systematically assess the effects of exercise-based interventions on fall risk and balance in patients with COPD. PubMed, Web of Science, EMBASE, and CINAHL were screened for randomized controlled trails and within-group studies evaluating effects of exercise-based interventions on fall risk or balance in patients with COPD. Data were presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Fifteen studies were identified, 6 randomized controlled trails and 9 within-group studies. All interventions reported positive effects on balance outcomes. No studies reported fall risk. Taking current recommendations of balance outcome measures in patients with COPD into account, pulmonary rehabilitation combined with balance training had the highest effect size. Nine papers had concerns regarding bias, mostly due to the lack of blinding outcome assessors. Exercise-based interventions have a positive effect on balance in patients with COPD. Pulmonary rehabilitation with balance training seems to have the most beneficial effect on balance. The effects on fall risk, as well as the long-term intervention effects remain unclear. A standardized balance assessment and research on long-term effects and fall risk are recommended.


Seasonal variation and trends in heart failure morbidity and mortality in a South American community hospital.
Circannual variation in cardiovascular events is well-known. Seasonal variation (SV) in heart failure (HF) has been described in the Northern Hemisphere, but there is scarcity of data in South America. The goals of the present study were to (1) describe the SV of admissions and deaths for HF, and (2) describe trends in HF morbidity and mortality in a community hospital in Argentina from 1992 to 1999. The study sample included 6369 admissions. During this period, the number of HF admissions rose by 188% and the rate HF admissions/all admissions increased from 3.28% to 7.84%. In-hospital mortality decreased from 21% to 13%. HF admissions followed a seasonal pattern with a winter-spring predominance. Male and very old patients were the subgroups with the highest SV. The authors identified clear SV in HF deaths and admissions, which raises a different hypothesis about the rationale of HF admissions and provides information for the organization of care and resource allocation.


Increasing buprenorphine access for patients with chronic pain: A quality improvement initiative.
Buprenorphine is effective for chronic pain and safer than full-agonist opioids; however, limited education and support regarding buprenorphine can result in under-prescribing in primary care and reduced access in specialty pain clinics. The purpose of this quality improvement initiative was to optimize and evaluate procedures for transferring patients stable on buprenorphine for chronic pain from a specialty pain clinic back to primary care. Eight primary care clinics within a Veterans Health Administration Healthcare System. A standard operating procedure for facilitated transfer of prescribing was developed following a needs assessment, and was introduced during an educational session with primary care providers, and providers completed a survey assessing attitudes about buprenorphine prescribing. Success of the initiative was measured through number of patients transferred back to primary care over the course of 18 months. Survey results indicated primary care providers with previous experience prescribing buprenorphine were more likely to view buprenorphine prescribing for pain as within the scope of their practice and endorse feeling comfortable managing a buprenorphine regimen. Providers identified systemic and educational barriers to prescribing, as well as ongoing support from specialty pain care and primary care as facilitators. Metrics suggested the standard operating procedure was generally successful in transferring and retaining eligible patients in primary care. This quality improvement initiative suggests a facilitated transfer procedure can be useful in increasing buprenorphine prescribing for pain in primary care. Future efforts to increase primary care provider comfort and address systemic barriers to buprenorphine prescribing are needed.


Enantioselective α-Benzoyloxylation of β-Keto Esters by N-Oxide Phase-Transfer Catalysts.
An efficient and enantioselective α-benzoyloxylation of β-keto esters has been achieved by phase-transfer catalysis. This simple catalytic procedure is applicable to a range of β-keto esters with cinchona-derived N-oxide asymmetric phase-transfer catalysts and gives the corresponding products in good enantiopurity (up to 95% ee) and yield (up to 99%). This simple and effective oxyfunctionalization is a useful synthetic strategy for introducing an oxygen-containing functional group at the α position of β-dicarbonyl compounds.


PainVision-based evaluation of brain potentials: a novel approach for quantitative pain assessment.
Introduction: The complex and multidimensional nature of pain poses a major challenge in clinical pain assessments. In this study, we aimed to evaluate a novel approach combining quantitative sensory testing (QST) with event-related potential measurements for assessment of experimental pain in healthy individuals. Methods: QST was performed with a commercial device (PainVision, PS-2100), and numeric rating scale (NRS) scores after exposure to different sensory stimuli were reported by the participants. Resting-state electroencephalography (EEG) was simultaneously performed to capture the cortical responses to peripheral stimulation. Results: Pain scores increased with the intensity of stimuli, with mean NRS scores of 2.7 ± 1.0 after mild stimuli and 5.6 ± 1.0 after moderate stimuli. A reproducible, significant P2-N2 complex was evoked by both mild and moderately painful stimuli, but not by non-painful stimuli. The latency of pain-related potentials was not significantly different between stimuli. The amplitudes of both P2 and N2 components significantly increased when intense nociception was applied, and the increments mainly originated from theta oscillations. Conclusion: The combination of QST with EEG was feasible for subjective and objective pain assessment. Distinct patterns of brain potentials were associated with the phenotype of the peripheral stimuli (e.g., noxious versus. innoxious, high versus. low pain intensity).


Survival of Chlamydia trachomatis in different transport media and at different temperatures: diagnostic implications.
We compared the survival of a laboratory strain of Chlamydia trachomatis serovar L-2 in different media and at different temperatures (room temperature, 4 degrees C, and -70 degrees C). At these temperatures the best storage medium was 2SP (0.2 mol/l sucrose in 0.02 mol/l phosphate buffer supplemented with 10% fetal calf serum). We used material obtained from patients to study the sensitivity of the culture method as a function of sample storage time and temperature. Compared with results on direct inoculation, material stored in 2SP for 48 hours gave 11% fewer positive cultures at 4 degrees C and 14% fewer at room temperature. Of samples which gave negative results on direct inoculation, 4% were positive after storage at 4 degrees C for 48 hours and 2% after storage at -70 degrees C for a week. As expected, the number of inclusion forming units in the original material proved to be important for the percentage of positive cultures among the stored samples.


Quality improvement: experience of a sexually transmitted infection clinic in Singapore.
Over the past two years, the Department of Sexually Transmitted Infection Control Clinic (DSC) in Singapore has embarked on a programme to review and enhance its quality improvement programmes. A thorough review of its day-to-day operations was conducted, infection control processes and standard operating procedures. It capitalized on its use of computerized medical records to improve documentation and patient screening. DSC introduced risk-management protocols and revised patient, staff and workplace safety guidelines. These measures have resulted in benefits such as reduced prescription errors, fewer patient complaints and active clinical practice improvement programmes. In January 2008, DSC, along with its parent hospital the National Skin Centre, became the first ambulatory health-care facility in Singapore, and also among the first few outside the United States to be accredited by the Joint Commission International.


[History and psychoanalysis: the stakes of history].
Freud's definition of the relationship between hypnosis and psychoanalysis is a political one that even then pointed to the paradigmatical sciences as defined by Kuhn. Nevertheless, the historian who applies to psychoanalysis the technique of symetry elaborated for such sciences, runs up against a set of singularities that risk bringing him to a position of denouncer of a "fake science". We emphasize that, if the historian does not limit himself to the positivist position or to the history of ideas, he will inevitably find himself engaged in the history that he is analyzing, but with the responsibility of his mode of engagement. We propose to define hypnosis and psychoanalysis as fields inhabited by the question of science in the modern sense of the term, and raising the issue of pertinence, as far as they are concerned, of the theoretical experimental model that guided them.


Developing the discipline and practice of comprehensive men's health.
Men of all ages in the United States experience disproportionately higher rates of morbidity and premature death than females. The reasons for this are complex and include biological, sociological, and health system-related issues, but this is also in part due to the fact that men and boys tend to lead more risky lifestyles and generally avoid preventive care when compared with women and girls. These disparities not only affect males but also their loved ones and can adversely affect their participation in the workforce and in their communities. Better understanding of the drivers of men's health disparities is needed to enable health professionals to more effectively address this problem. One of the fundamental building blocks for changing health care delivery to males is to provide a core curricular framework for education and training of health professionals related to the specific health issues of men and boys. This article will present a study assessing what men's health courses are available in the United States and identifying the content within such courses that will prepare health care professionals to deliver programs and care to this demographic. The study identified that as of 2012, there were only 21 courses in 18 institutions that address gender-appropriate health care for boys and men. The authors conclude that developing and incorporating an expert, consensus-based men's health core curriculum in universities and colleges, particularly in health professional programs, is an extremely important cornerstone in advancing the science and practice of true and balanced gender-based care delivery.


The effect of pantothenic acid on the diet of growing chicks on energy utilization and body composition.
Two experiments were conducted to investigate the effects of varying levels of pantothenic acid on the efficiency of energy utilization and changes in body composition of the growing chick. The results indicate that a pantothenic acid deficiency does not interfere with the chick's ability to obtain metabolizable energy from the diet. The data do show that the efficiency of energy utilization and body composition were markedly affected when chicks were fed diets deficient in pantothenic acid. In both experiments, protein, fat and energy stores were significantly reduced when pantothenic acid-deficient diets were fed. Increased estimates of heat increment per gram of diet were observed when levels of pantothenic acid below the N.R.C. (1971) recommended level of 10 mg. per kg of diet were fed.


[Intermittent versus continuous androgen blockade].
Androgenablation is the therapy of choice for the treatment of advanced and metastatic prostate cancer. However, in more than half of the patients the disease will ultimately progress within 2 years. Intermittent androgenablation through medical castration maintains the apoptotic potential. By periodically changing phases on and off treatment the quality of life of the patients is improved. Apart from reduced toxicity treatment costs are lowered and tumor progression is possibly delayed. In how far survival is influenced is presently not clear and remains to be evaluated in further clinical trials.


[Mortality and hospital admissions in the industrial area of Civitavecchia, 1997-2004].
the industrial area of Civitavecchia (central Italy) has been object of concern because of several sources of environmental contamination potentially affecting the residential communities: a harbor, a cement factory and several power plans are present in the area. A coal power plant is currently under construction. The aim of the study is to evaluate the health of residents in the area, through the analysis of the mortality registry and the hospital discharge records. cause and gender specific indirect Standardized Mortality (1997-2001) and Hospitalization (1997-2000 and 2001-2004) Ratios were computed, with 95% Confidence Intervals, using regional population as reference. mortality and morbidity excesses for cancer were observed, in particular an increased mortality for lung cancer (observed 134, SMR= 120) and for malignant neoplasm of pleura (observed 8, SMR= 516) were detected among men. An increased frequency of hospital admissions for asthma was observed among children aged 0-14 (period 1997-2000: males, observed 73, SHR= 177; females, observed 40, SHR= 157). Finally an significantly increased incidence of renal diseases was recorded by the Lazio Dialysis Registry in the period 2001-2004 (observed 28, SHR= 156). in view of the environmental changes of the area, the excesses observed in this study suggest the need for epidemiologic monitoring found in excess (lung and pleural cancer, respiratory diseases among children, renal diseases) in the area.


The R172W mutation in peripherin/rds causes a cone-rod dystrophy in transgenic mice.
Peripherin/rds (P/rds) is a membrane glycoprotein essential for the photoreceptor outer segment disc morphogenesis and maintenance. More than half of the disease-causing mutations in P/rds have been linked to different forms of macular dystrophy; the most common one is substitution of tryptophan for arginine at position 172 (R172W). Here we confirm the patient phenotype associated with the expression of R172W mutation in transgenic mice. Functional, structural and biochemical analyses showed that, while R172W P/rds is appropriately localized, a direct correlation exists between transgene expression levels and the onset/severity of the phenotype. In the wild-type background, both cone and rod photoreceptors' structure and function were significantly diminished, which indicates a dominant-negative, cone-rod defect. Whereas rds(+/-) mice maintained the normal cone function at early ages, cone responses in R172W/rds(+/-) mice were diminished to 41% of the wild-type level signifying a preferential damaging effect of the mutation on cones. Conversely, R172W/rds(+/-) mice showed a significant rescue of rod function and improvement of rod outer segment structure. Although rds(-/-) mice have no detectable rod or cone responses, R172W/rds(-/-) animals retained 30% of wild-type structure and rod function, but no significant rescue of cone function was detected at 1 month of age. No biochemical abnormalities were observed in complex formation and association with Rom-1; however, R172W protein was more sensitive to tryptic digestion, indicative of a change in protein conformation, possibly contributing to the cone-dominated phenotype. As the first animal model for P/rds-associated cone-rod dystrophy, R172W mice provide a valuable tool for studying the pathophysiology of P/rds-associated human retinal dystrophies and the development of therapeutic strategies to intervene in these diseases.


Microsurgical anatomy of the intracranial part of the vertebral artery.
We studied the intracranial portion of the vertebral artery and its branches in 11 cadaveric specimens. We evaluated the course of vessels and their dimensions (external diameter and length), as well as relationships between each of them. The vertebral artery was larger on the left side in two cases, on the right in five cases, and equal on both sides in four cases. The right and left vertebral arteries joined each other forming the basilar artery at the level of the pontomedullary junction in four cases, 2 mm below it in one case, and 1 to 7 mm above it in six cases. We divided all branches of the intracranial vertebral artery into two groups: the medial branches and the lateral branches. Two major types of medial branches were observed: the anterior spinal artery and the branches of the foramen caecum. The origin of the anterior spinal artery was located 6.5 mm (5-11 mm) proximal to vertebrobasilar junction on the right and 8.5 mm (6-17 mm) on the left. The anterior spinal artery was absent on the right in two cases and on the left in one. Branches arising from the vertebral artery to the foramen caecum were found in four brains. Lateral branches originated from the posterolateral or lateral aspect of vertebral artery. The posterior inferior cerebellar artery, the largest branch of the vertebral artery, was included in this group. Other branches were mostly located between the origin of the posterior inferior cerebellar artery and the vertebrobasilar junction. Forty-six lateral branches originating from the vertebral artery were found in 11 brains (26 on the right and 20 on the left). Lateral branches widely anastomosed with perforators from the basilar artery, posterior inferior cerebral artery, and the anterior inferior cerebellar artery.


Sirtuins in Cancer: a Balancing Act between Genome Stability and Metabolism.
Genomic instability and altered metabolism are key features of most cancers. Recent studies suggest that metabolic reprogramming is part of a systematic response to cellular DNA damage. Thus, defining the molecules that fine-tune metabolism in response to DNA damage will enhance our understanding of molecular mechanisms of tumorigenesis and have profound implications for the development of strategies for cancer therapy. Sirtuins have been established as critical regulators in cellular homeostasis and physiology. Here, we review the emerging data revealing a pivotal function of sirtuins in genome maintenance and cell metabolism, and highlight current advances about the phenotypic consequences of defects in these critical regulators in tumorigenesis. While many questions should be addressed about the regulation and context-dependent functions of sirtuins, it appears clear that sirtuins may provide a promising, exciting new avenue for cancer therapy.


[OBSERVATION OF EFFECTIVENESS OF HIP RESURFACING ARTHROPLASTY IN TREATMENT OF OSTEONECROSIS OF FEMORAL HEAD IN YOUNG AND MIDDLE-AGED PATIENTS].
To evaluate the clinical and radiographic outcomes of hip resurfacing arthroplasty (HRA) for treating osteonecrosis of the femoral head (ONFH) in young and middle-aged patients. Between January 2008 and April 2009, 34 patients with ONFH underwent HRA. There were 19 males and 15 females with an average age of 54 years (range, 33-59 years). Of 34 cases, 16 left hips and 18 right hips were involved, including 9 cases of alcohol-induced ONFH, 8 cases of steroid-induced ONFH, 7 cases of traumatic ONFH, and 10 cases of unexplained ONFH. According to modified Ficat classification system, 26 hips were rated as stage III, and 8 hips as stage IV. The Harris hip score (HHS) and modified University of California, Los Angeles (UCLA) activity score were used to evaluate the clinical results. Migration of prosthesis was assessed on the anteroposterior radiographs. The abduction angle was measured on the acetabular side. On the femoral side, varus-valgus shift was determined by measurement of stem-shaft angle. The axial collapse of femoral component was assessed with the component-lateral cortex ratio. Healing of incision by first intention was achieved in all patients without complications of infection and thrombosis of deep vein of lower extremities. Thirty-two patients were followed up 78 months on average (range, 70-84 months). No implant loosening, infection, femoral neck fracture, dislocation, and inflammatory pseudotumor were observed. At last follow-up, the HHS score was significantly increased to 95.22 +/- 1.47 from preoperative 50.10 +/- 2.27 (t=1.510, P=0.008). Modified UCLA activity score was significantly increased to 7.70 +/- 1.13 from preoperative 3.90 +/- 0.90 (t=0.830, P=0.003). The abduction angle, stem-shaft angle, and compotent-lateral cortex ratio showed no significant difference between at 3 days after operation and last follow-up (P>0.05). If the indication of operation is mastered strictly, HRA may be effective in treatment for ONFH at Ficat stage III or IV in young and middle-aged patients.


A Chinese Medicine Formula "Xian-Jia-Tang" for Treating Bladder Outlet Obstruction by Improving Urodynamics and Inhibiting Oxidative Stress through Potassium Channels.
The aim of this study is to investigate efficacy of a traditional Chinese medicine formula (named Xian-Jia-Tang, XJT) on bladder outlet obstruction (BOO) in rats and explore its mechanisms. Total 80 BOO model rats were established and randomly divided into 4 groups: physiological saline, XJT, Cesium Chloride (CC), and XJT and CC groups. Meanwhile, 12 rats were used as normal control. Bladder weight and urodynamics were measured. Oxidative stress level and mRNA expressions of potassium channels gene were detected in detrusor. The mRNA and protein levels of hypoxia inducible factor-α (HIF-α) in detrusor were detected by RT-PCR and Western blot. BOO model rats showed significantly higher bladder weight and abnormal urodynamics. XJT significantly improved the abnormal urodynamics and inhibited the oxidative stress and changes of mRNA levels of potassium channels genes in detrusor of BOO model rats. Moreover, KATP and SK2/3 mRNA were overexpressed in BOO model rats treated by XJT. Besides, the significantly increased levels of HIF-α mRNA and protein were also inhibited by XJT. However, these inhibition effects of XJT were weakened by CC. XJT could effectively improve the urodynamics and inhibit the oxidative stress caused by hypoxia through suppressing the role of potassium channels in BOO model rats.


Risk of perinatal death associated with labor after previous cesarean delivery in uncomplicated term pregnancies.
Trial of labor after previous cesarean delivery is associated with increased risk of uterine rupture. However, no reliable data exist on the effect of a trial of labor on the risk of perinatal death in otherwise uncomplicated term pregnancies. To determine the risk of intrapartum stillbirth or neonatal death not related to congenital abnormality among women with uncomplicated term pregnancies who had a trial of labor after previous cesarean delivery, compared with women having a planned repeat cesarean delivery, and multiparous and nulliparous women at term not delivered by planned cesarean method. Population-based, retrospective cohort study of data from the linked Scottish Morbidity Record and Stillbirth and Neonatal Death Enquiry encompassing births in Scotland between January 1, 1992, and December 31, 1997. A total of 313 238 singleton births between 37 and 43 weeks' gestational age in which the fetus was in a cephalic presentation. Delivery-related perinatal death, defined as intrapartum stillbirth or neonatal death unrelated to congenital anomaly, compared among the 4 groups. Among women who had a trial of labor following previous cesarean delivery (n = 15 515), the overall rate of delivery-related perinatal death was 12.9 (95% confidence interval [CI], 7.9-19.9) per 10 000 women. This was approximately 11 times greater (odds ratio [OR], 11.6; 95% CI, 1.6-86.7) than the risk associated with planned repeat cesarean delivery (n = 9014), more than twice (OR, 2.2; 95% CI, 1.3-3.5) the risk associated with other multiparous women in labor (n = 151 549), and similar to the risk among nulliparous women in labor (n = 137 160; OR, 1.3; 95% CI, 0.8-2.1). The associations were not explained by differences in maternal height, smoking status, socioeconomic status, age, fetal growth, or week of gestation at delivery. Among women having a trial of labor, the rate of death due to mechanical causes, including uterine rupture, was 4.5 (95% CI, 1.8-9.3) per 10 000 women. This was more than 8 times greater than other multiparous women (OR, 8.5; 95% CI, 3.2-22.3) and nulliparous women (OR, 8.8; 95% CI, 3.2-24.2). The absolute risk of perinatal death associated with trial of labor following previous cesarean delivery is low. However, in our study, the risk was significantly higher than that associated with planned repeat cesarean delivery, and there was a marked excess of deaths due to uterine rupture compared with other women in labor.


Increased specimen minimum volume reduces turnaround time and hemolysis.
Quantity not sufficient (QNS) specimens with minimal blood volume for testing are common in clinical laboratories. However, there is no universal definition of minimum volume for a QNS specimen and little data is available addressing the impact of QNS / low volume specimens on turnaround time (TAT) and sample hemolysis. We compared the TAT and hemolysis index from samples ≤1.0 mL to all specimens received and quantified the number of specimens with reduced blood volume. A new QNS policy requiring ≥1.5 mL of sample in a blood tube for laboratory analysis was implemented and the results were assessed by sample hemolysis and TAT. The median laboratory TAT for samples with ≤1.0 mL of blood was 61 min (Interquartile Range, IQR: 50-82), in contrast to 28 min (26-34) for all samples. The hemolysis index for samples ≤1.0 mL was 112 (65-253) and 15 (8-29) for all samples. Requirement of a minimum volume of 1.5 mL of blood resulted in the proportion of samples with TAT ≥ 60 min to decrease from 10.4% to 4.24% in the ED, and for specimens cancelled due to hemolysis to decrease from 4.24% to 3.38%. This policy was introduced hospital wide with similar effects. Together, we correlate limited specimen volume with an increase in laboratory TAT and hemolysis. Implementation of a QNS policy of ≥1.5 mL and provider education provided a significant and durable reduction in TAT and specimen hemolysis.


Evaluation of intrathoracic goiter with I-123 scintigraphy and nuclear magnetic resonance imaging.
Iodine-123 thyroid scintigraphy allows the diagnosis of a functioning retrosternal goiter in a patient with a mediastinal mass. The case report of a 60-yr-old lady demonstrates this. The correlative values of nuclear magnetic resonance imaging and thyroid scintigraphy in the initial evaluation and continued management of patients with thyroid mediastinal mass are presented. In addition, this observation demonstrates the ability of nuclear magnetic resonance to identify retrosternal thyroid tissue. This may obviate the need for TCT evaluation, which involves both ionizing radiation and iodinated contrast enhancement.


Increase in Dye:Dendrimer Ratio Decreases Cellular Uptake of Neutral Dendrimers in RAW Cells.
Neutral generation 3 poly(amidoamine) dendrimers were labeled with Oregon Green 488 (G3-OGn) to obtain materials with controlled fluorophore:dendrimer ratios (n = 1-2), a mixture containing mostly 3 dyes per dendrimer, a mixture containing primarily 4 or more dyes per dendrimer (n = 4+), and a stochastic mixture (n = 4avg). The UV absorbance of the dye conjugates increased linearly as n increased and the fluorescence emission decreased linearly as n increased. Cellular uptake was studied in RAW cells and HEK 293A cells as a function of the fluorophore:dendrimer ratio (n). The cellular uptake of G3-OG n (n = 3, 4+, 4avg) into RAW cells was significantly lower than G3-OG n (n = 1, 2). The uptake of G3-OG n (n = 3, 4+, 4avg) into HEK 293A cells was not significantly different from G3-OG1. Thus, the fluorophore:dendrimer ratio was observed to change the extent of uptake in the macrophage uptake mechanism but not in the HEK 293A cell. This difference in endocytosis indicates the presence of a pathway in the macrophage that is sensitive to hydrophobicity of the particle.