Ultrasonography methods for predicting malignancy in canine mammary tumors.
The aim of this study was to evaluate and compare the efficacy of B-mode, Doppler, contrast-enhanced ultrasonography (CEUS), and Acoustic Radiation Force Impulse (ARFI) elastography in predicting malignancy in canine mammary masses. This was a prospective cohort study from 2014 to 2016, which included 153 bitches with one or more mammary masses. A total of 300 masses were evaluated by ultrasonography (B-mode, Doppler, CEUS, and ARFI) and subsequently classified as benign or malignant by histopathology. Each ultrasound parameters studied were compared between benign and malignant masses by Chi-square or Student tests and differences were considered significant when P < 0.01. For the variables that proved significant differences were estimated the cut-off point, sensitivity, specificity, accuracy, and area under curve (AUC) by receiver-operating characteristic curve (ROC) analysis in a logistic regression model using histopathological classification as reference, to assess and compare diagnostic performance of each technique. Out of 300 mammary masses evaluated 246 were classified as malignant and 54 as benign. B-mode measurements showed sensitivity 67.9%, and specificity 67.6% as malignancy predictors on canine mammary masses; Doppler indexes systolic (>21.2 m/s) and diastolic velocity (>4.8 m/s) sensitivity 79.2% and specificity 70.8%; CEUS wash-out time (<80.5 s) sensitivity 80.2% and specificity 16.7%; and ARFI elastography shear velocity (SWV > 2.57 m/s) sensitivity 94.7% and specificity 97.2% In conclusion B-mode and Doppler ultrasound evaluations may assist in malignancy prediction of canine mammary masses with moderate sensitivity and specificity, already the SWV was an great accurate predictor. Therefore, ARFI elastography exam inclusion in veterinary clinic oncology and research is highly recommended, since it allows fast, non-invasive, and complication-free malignancy prediction of canine mammary masses.


Thoracic splenosis.
Intrathoracic splenosis is a rare condition that results after rupture of the spleen or diaphragmatic injury. We present herein a case of intrathoracic splenosis of a 48-years-old woman whom splenectomy had been performed 5 years ago after a traffic accident. The patient was operated on with suspicion of malignancy and total resection of the lesion was performed with video-assisted thoracic surgery (VATS). Histopathologic examination confirmed the splenosis diagnosis. Thoracic splenosis should be suspected for the patients with thoracic lesions whom had medical history of thoracoabdominal injury including splenectomy or diaphragmatic injury.


Doing many things at a time: Lack of power decreases the ability to multitask.
Three studies investigated the effects of power on the ability to pursue multiple, concomitant goals, also known as multitasking. It was predicted that powerless participants will show lower multitasking ability than control and powerful participants. Study 1 focused on self-reported ability to multitask in a sample of executives and subordinate employees. Studies 2 and 3 investigated the ability to dual-task and to switch between tasks, respectively, using dual-task and task-switching paradigms. Across the studies, powerless individuals were less able to effectively multitask compared with control and powerful participants, suggesting that the detrimental effects of lack of power extend beyond single-task environments, shown in past research, into multitasking environments. Underlying mechanisms are discussed.


Gld and lpr mice: single gene mutant models for failed self tolerance.
Mice homozygous for the gld or lpr mutations develop autoimmunity, and a lymphoproliferative disorder involving accumulation of huge numbers of unusual CD4-CD8-TCR alpha beta lo T cells. Here we review our past work with gld mice, and attempt to explain lymphoproliferation in terms of current models of T cell maturation and self-tolerance induction. The availability of molecular probes to the gene products of lpr and gld should shortly lead to a better understanding of the acquisition of self tolerance during T cell maturation and of autoimmunity.


Disclosure Management When Returning to Work After a Leave of Absence Due to Mental Illness.
People with mental illness must often decide the extent to which they want to disclose their mental illness publicly. Especially in the context of work, this is a complex and individual decision. This Open Forum discusses the importance of well-reasoned disclosure management to increase the chances of successful workplace reintegration after a leave of absence due to a mental illness. The authors posit that despite the risks of stigma and discrimination, disclosing a mental illness to an employer can benefit employees. However, proper support is often essential in establishing how to best manage disclosure or nondisclosure.


Adjuvant therapy for melanoma.
The search for effective adjuvant therapy for melanoma has resulted in the testing of a remarkably broad spectrum of therapeutic agents. Until recently, there was little evidence to suggest a benefit for any adjuvant therapy. The demonstration of activity for adjuvant high-dose interferon alfa in a cooperative group trial resulted in Food and Drug Administration approval and has dramatically changed the melanoma landscape. This article reviews all the randomized adjuvant trials conducted to date in melanoma, discusses pertinent studies still in progress or awaiting analysis, and offers recommendations for the adjuvant treatment of melanoma patients rendered clinically disease-free by surgery.


Dietary K intake regulates the response of apical K channels to adenosine in the thick ascending limb.
We used the patch-clamp technique to study the effect of adenosine on the apical 70-pS K channel in the thick ascending limb (TAL) of the rat kidney. Application of 1 microM cyclohexyladenosine (CHA), an adenosine analog, stimulated apical 70-pS K channel activity and increased the product of channel open probability and channel number (NP(o)) from 0.34 to 0.7. Also, addition of CGS-21680, a specific A(2a) adenosine receptor agonist, mimicked the effect of CHA and increased NP(o) from 0.33 to 0.77. The stimulatory effect of CHA and CGS-21680 was completely blocked by H89, an inhibitor of protein kinase A (PKA), or by inhibition of adenylate cyclase with SQ-22536. This suggests that the stimulatory effect of adenosine analogs is mediated by a PKA-dependent pathway. The effect of adenosine analog was almost absent in the TAL from rats on a K-deficient (KD) diet for 7 days. Application of DDMS, an agent that inhibits cytochrome P-450 hydrolase, not only significantly increased the activity of the 70-pS K channel but also restored the stimulatory effect of CHA on the 70-pS K channel in the TAL from rats on a KD diet. Also, the effect of CHA was absent in the presence of 20-HETE. Inhibition of PKA blocked the stimulatory effect of CHA on the apical 70-pS K channel in the presence of DDMS in the TAL from rats on a KD diet. We conclude that stimulation of adenosine receptor increases the apical 70-pS K channel activity via a PKA-dependent pathway and that the effect of adenosine on the apical 70-pS K channel is suppressed by low-K intake. Moreover, the diminished response to adenosine is the result of increase in 20-HETE formation, which inhibits the cAMP-dependent pathway in the TAL from rats on a KD diet.


Avian influenza virus directly infects human natural killer cells and inhibits cell activity.
Natural killer (NK) cell is a key component of innate immunity and plays an important role in host defense against virus infection by directly destroying infected cells. Influenza is a respiratory disease transmitted in the early phase of virus infection. Evasion of host innate immunity including NK cells is critical for the virus to expand and establish a successful acute infection. Previously, we showed that human influenza H1N1 virus infects NK cells and induces cell apoptosis, as well as inhibits NK cell activity. In this study, we further demonstrated that avian influenza virus also directly targeted NK cells as an immunoevasion strategy. The avian virus infected human NK cells and induced cell apoptosis. In addition, avian influenza virion and HA protein inhibited NK cell cytotoxicity. This novel strategy has obvious advantages for avian influenza virus, allowing the virus sufficient time to expand and subsequent spread before the onset of the specific immune response. Our findings provide an important clue for the immunopathogenesis of avian influenza, and also suggest that direct targeting NK cells may be a common strategy used by both human and avian influenza viruses to evade NK cell immunity.


Graphics processing unit-assisted density profile calculations in the KSTAR reflectometer.
Wavelet transform (WT) is widely used in signal processing. The frequency modulation reflectometer in the KSTAR applies this technique to get the phase information from the mixer output measurements. Since WT is a time consuming process, it is difficult to calculate the density profile in real time. The data analysis time, however, can be significantly reduced by the use of the Graphics Processing Unit (GPU), with its powerful computing capability, in WT. A bottle neck in the KSTAR data processing exists in the data input and output (IO) process between the CPU and its peripheral devices. In this paper, the details of the WT implementation assisted by a GPU in the KSTAR reflectometer are presented and the consequent performance improvement is reported. The real time density profile calculation from the reflectometer measurements is also discussed.


Ice Generation and the Heat and Mass Transfer Phenomena of Introducing Water to a Cold Bath of Brine.
We demonstrate a method for the study of the heat and mass transfer and of the freezing phenomena in a subcooled brine environment. Our experiment showed that, under the proper conditions, ice can be produced when water is introduced to a bath of cold brine. To make ice form, in addition to having the brine and water mix, the rate of heat transfer must bypass that of mass transfer. When water is introduced in the form of tiny droplets to the brine surface, the mode of heat and mass transfer is by diffusion. The buoyancy stops water from mixing with the brine underneath, but as the ice grows thicker, it slows down the rate of heat transfer, making ice more difficult to grow as a result. When water is introduced inside the brine in the form of a flow, a number of factors are found to influence how much ice can form. Brine temperature and concentration, which are the driving forces of heat and mass transfer, respectively, can affect the water-to-ice conversion ratio; lower bath temperatures and brine concentrations encourage more ice to form. The flow rheology, which can directly affect both the heat and mass transfer coefficients, is also a key factor. In addition, the flow rheology changes the area of contact of the flow with the bulk fluid.


Impact of Genetic Variation in TLR4 3'UTR on NSCLC Genetic Susceptibility.
Toll-like receptors (TLRs) are expressed not only in immune cells but also in a variety of tumor cells. Single-nucleotide polymorphisms (SNPs) located in the TLRs' promoter or the 3' untranslated region may affect gene expression by affecting the activity of the promoter or regulating the binding of mRNA to miRNA. This study aimed to investigate the association of the SNPs in TLR genes with the susceptibility to NSCLC. This case-control study involved 700 lung cancer patients and 700 healthy controls. All individuals were genotyped for all selected SNPs in TLR genes using polymerase chain reaction (PCR) test-based restriction fragment length polymorphism (PCR-RFLP) and TaqMan SNP genotyping assay. The association of genetic variations in TLRs with the susceptibility to NSCLC was evaluated by unconditional logistic regression with OR (95% CI). After evaluating transcriptional factor or miRNA binding capability by bioinformatics methods, six TLRs were identified for further analysis. We did not find that TLR3 rs5743303, TLR4 rs1927914, TLR4 rs11536891, TLR5 rs1640816, and TLR7 rs3853839 were associated with NSCLC risk (P > 0.05). Our data showed that TLR4 rs7869402 C > T polymorphism reduced the risk of NSCLC with OR (95% CI) of 0.63 (0.45-0.89). When stratified by gender and age, the individuals carrying at least one rs7869402T allele significantly decreased the NSCLC risk among males (OR = 0.58, 95% CI = 0.38-0.87) and among youngsters (OR = 0.43, 95% CI = 0.27-0.69). Smoking stratification analysis showed that the rs7869402T allele-containing genotype reduced the risk of NSCLC with OR (95% CI) of 0.50 (0.29-0.87) among smokers but not among nonsmokers (P > 0.05). When the individuals were classed by the pathological type, we found that the rs7869402T-containing genotype was associated with the risk of adenocarcinoma (OR = 0.62, 95% CI = 0.41-0.92) but not with that of squamous cell carcinoma (OR = 0.71, 95% CI = 0.44-1.13) and other types (OR = 0.23, 95% CI = 0.03-1.70). Compared with the TLR4 Ars1927914-Crs7869402-Trs11536891 haplotype, the Grs1927914-Trs7869402-Trs11536891 haplotype was associated with a decreased risk for developing NSCLC with OR (95% CI) of 0.57 (0.41-0.80). These results indicated that the TLR4 rs7869402 variation affects the genetic susceptibility to NSCLC.


Mucoepidermoid carcinoma of salivary glands: a study of 69 cases with special attention to histologic grading.
Sixty-nine cases of mucoepidermoid carcinoma with a minimum of five years follow-up are presented. Major salivary glands were involved in 46 cases (44 parotid, two submandibular), and intraoral minor glands in 23. The tumor was considered histologically high grade (20 cases) when 90% or more of its area was made up of tumor cells and 10% or less of intracystic space and low grade (49 cases) when this ratio was lower. The proportion of cell types was not considered in grading: although intermediate, epidermoid, and clear cells usually predominated in high-grade tumors, several such examples contained numerous mucous cells. Grade was highly significant prognostically; all but 2 of the 14 deaths due to tumor and all six instances of distant metastasis occurred in cases with high-grade tumors. High histologic grade also was associated with an increased incidence of local recurrence (particularly recurrence not subsequently controlled) and cervical lymph node metastasis; in the case of recurrence this was due in part to the fact that inadequate surgical margins were more common with high-grade tumors. Tumors measuring less than 2.5 cm were rarely fatal regardless of grade, there being only two such deaths (one high grade, one low grade). Nuclear anisochromia and pleomorphism of more than slight degree, frequent mitoses, and tumor necrosis of more than focal extent were found to be untypical of mucoepidermoid carcinoma regardless of grade; these findings should occasion consideration of other diagnoses such as poorly differentiated adenocarcinoma with a solid growth pattern and adenosquamous carcinoma.


The organic-inorganic relationship in calcified mitochondria.
Experimentally induced calcification within mitochondria has been studied electron rnicroscopically. Cells investigated comprise hepatic cells damaged by CCl(4) intoxication, myocardial cells damaged by prolonged dihydrotachysterol (DHT) administration, and cells from skeletal muscle (gastrocnemius) damaged by DHT sensibilization and local injury. Cells from a human bowel carcinoma were studied too. Two types of intramitochondrial inorganic inclusion have been found. The first consists of clusters of apatite-like, needle-shaped crystals (crystalline aggregates), the second of clusters of very fine granules (granular aggregates). The former have been found mainly in mitochondria in apparently normal myocardial and muscular cells, the latter in mitochondria of degenerated hepatic, neoplastic, and myocardial cells. Crystalline aggregates are closely related to the membranes of cristae at first, but they later spread to occupy the whole mitochondrial matrix. Granular aggregates are initially found in the mitochondrial matrix near, but perhaps not touching, cristae; by growing they come into close contact with cristal membranes. Both types of aggregate show intrinsic electron opacity, which disappears after formic acid decalcification. Only the crystalline aggregates give an electron diffraction pattern of crystallinity. Uranium and lead staining of decalcified sections shows that both types of aggregate are intimately connected with an organic substrate. The substrate of crystalline aggregates consists of very thin, elongated structures shaped like the inorganic crystals. The substrate of granular aggregates consists of amorphous material gathered in clusters, with the same roundish shape and intercristal position as the inorganic granules. Both types of substrate are stained by phosphotungstic acid at low pH and by silver nitrate-methenamine after periodic acid oxidation. These results show that the organic content of the substrates includes glycoproteins; they have been confirmed by the periodic acid-Schiff (PAS) method under the optical microscope. These findings have been discussed in relation to the recent discovery of organic Ca(2+)-binding sites in mitochondria and to the general problems of soft tissue calcification.


A compact, portable pulse forming line.
Some research has been done on making a compact, portable pulse forming line. A kind of ceramic based on SrTiO(3) is used as the dielectric of the planar pulse forming line. The ceramic's dielectric constant is around 300 and can store more energy than water with the same volume. However, it is not easy to manufacture the large ceramic bulk but we did successfully manufacture 80 x 10 x 6 cm(3) ceramic bulks. Using this kind of ceramic bulk as the dielectric, we successfully made a compact, portable line that generated a voltage pulse up to 150 kV with a duration of about 92 ns.


Nitrous oxide inhalation as a cause of cervical myelopathy.
Current evidence suggests that the incidence of recreational nitrous oxide inhalation is on the rise. Due to the possibility of clinically significant myelopathy, as well as potential response to treatment, it is important to consider this diagnosis when appropriate. We present a case of acquired ataxia and myelopathy due to nitrous oxide abuse and discuss diagnosis, pathophysiology, and response to treatment.


Hunger and microbiology: is a low gastric acid-induced bacterial overgrowth in the small intestine a contributor to malnutrition in developing countries?
Underproduction of hydrochloric acid into the stomach is frequently encountered in subjects from developing countries. We explore the hypothesis that hypochlorhydria compromises the gastric barrier and favours bacterial overgrowth in the proximal parts of the small intestine where nutrient absorption takes place. Food calories are thus deviated into bacterial metabolism. In addition to an adequate caloric supply, correcting hypochlorhydria might be needed to decrease childhood malnutrition.


On Transform Domain Communication Systems under Spectrum Sensing Mismatch: A Deterministic Analysis.
Towards the era of mobile Internet and the Internet of Things (IoT), numerous sensors and devices are being introduced and interconnected. To support such an amount of data traffic, traditional wireless communication technologies are facing challenges both in terms of the increasing shortage of spectrum resources and massive multiple access. The transform-domain communication system (TDCS) is considered as an alternative multiple access system, where 5G and mobile IoT are mainly focused. However, previous studies about TDCS are under the assumption that the transceiver has the global spectrum information, without the consideration of spectrum sensing mismatch (SSM). In this paper, we present the deterministic analysis of TDCS systems under arbitrary given spectrum sensing scenarios, especially the influence of the SSM pattern to the signal to noise ratio (SNR) performance. Simulation results show that arbitrary SSM pattern can lead to inferior bit error rate (BER) performance.


Comprehensive Evolutionary Analysis of Lamprey TNFR-Associated Factors (TRAFs) and Receptor-Interacting Protein Kinase (RIPKs) and Insights Into the Functional Characterization of TRAF3/6 and RIPK1.
TNFR-associated factors (TRAFs) and receptor-interacting protein kinases (RIPKs) are important immunological linker molecules in mammals and play important roles in the TNFα, TLR and IFN signaling pathways. However, the evolutionary origins of these genes in vertebrates have not previously been described in lampreys. In this study, we searched the genomes of Lampetra japonicum, Lethenteron reissneri, and Petromyzon marinus for genes encoding trafs and ripks and performed homologous sequence alignment, phylogenetic tree, functional domain, conserved motif, gene structure, and synteny analyses to determine their evolutionary relationships. The distribution of the lamprey traf and ripk families and the immune response of the gene families in lampreys stimulated by different pathogens were also demonstrated, suggesting a role of structural changes in expression and functional diversification. Additionally, the dual luciferase reporter gene assay showed that the addition of exogenous immunomodulator (TNFα or IFN) to the overexpression of LjLRIPK1a or LjTRAF3/6 significantly downregulated NF-κB or ISRE activation. LjRIPK1a can significantly enhance caspase-8 activity, and overexpression of LjRIPK1a or LjTRAF3a/6 in HEK293T cells results in cell apoptosis. In summary, this study makes an important contribution to the understanding of the traf and ripk gene families in different vertebrates. Our results also provide new evidence for the evolution of vertebrate TRAFs and RIPKs and their impacts on immune regulation.


Covalent adlayer growth on a diamond thin film surface.
The surface of boron-doped diamond thin films can be modified by exposure to a strong oxidizing agent, resulting in the formation of -OH and =O terminated diamond. The -OH groups are reacted with an acid chloride to produce a covalently bound, modified diamond thin film surface. The demonstration of these reactions allows for the facile modification of diamond surfaces using techniques well established for oxide surfaces. Characterization of the covalently bound species shows submonolayer coverage, and time-resolved fluorescence measurements are reflective of the highly featured nature of the diamond film.


Evidence for partner choice in toddlers: considering the breadth of other-oriented behaviours.
When do humans become moral beings? This commentary draws on developmental psychology theory to expand the understanding of early moral behaviours. We argue that by looking at a broader range of other-oriented acts than what has been considered by Baumard et al., we can find support for the mutualistic approach to morality even in early instances of other-oriented behaviours.


Circulating HBV RNA: From biology to clinical applications.
Chronic HBV infection can hardly be cured due to the persistence of an intrahepatic pool of viral covalently closed circular DNA (cccDNA) transcription template, which is refractory to current antivirals. The direct analyses of cccDNA quantity and transcriptional activity require an invasive biopsy. Recently, circulating HBV RNA has been identified as a promising noninvasive surrogate marker of cccDNA and can be used for monitoring disease progression and predicting prognosis of patients with chronic HBV infection. To better understand this surrogate biomarker of cccDNA, we reviewed the current knowledge about the molecular characteristics and potential clinical applications of circulating HBV RNA. Specifically, we summarized the reported species and existing forms of circulating HBV RNA and discussed their biogenesis and the capacity of de novo infection by RNA virions. Moreover, we described the potential applications of circulating HBV RNA in different clinical scenarios, such as classifying the phases of chronic HBV infection, analyzing sustained on-treatment and off-treatment outcomes of treated patients, as well as predicting HCC development. Perspectives on future research of circulating HBV RNA were also proposed in this review.


[Surgical laparoscopic therapy of small bowel tumors: review of the literature and report of two cases].
The Authors, after a short review of small bowel tumors, point out that recently a laparoscopic approach for these tumors has been suggested and some cases have been reported. The Authors present two cases of patients operated for small bowel tumor using a laparoscopic technique: the first case for a stromal tumor (GIST), the second case for an adenocarcinoma in advanced stage with multilobar lung metastases. The first patient is alive and disease free after one year, the second died after six months for tumor progression. The Authors believe that laparoscopic technique can be employed with satisfying results also in the treatment of small bowel tumors with moderate trauma and invasiveness.


Inappropriate Medications Use and Polypharmacy among Older Adults with Anxiety Disorder.
Elderly with mental health conditions usually use multiple medications, which predisposes them to inappropriate use of medications, which is defined as medications that should be avoided due to their risk; this outweighs their benefit given that safer alternatives are available. This study aimed to examine potentially inappropriate medication use among older patients with anxiety disorder. This study used a cross-sectional retrospective study design using twelve months of data extracted from the Electronic Health Record (EHR) database for older adults diagnosed with anxiety disorder and treated in the ambulatory care setting. Potentially inappropriate medications (PIMs) use was evaluated using the 2019 Beers criteria. Descriptive statistics were used to describe the sample. Pearson's chi-square tests (for categorical variables) and t-tests (for continuous variables) were utilized to measure the differences in independent variables between patients with and without PIMs. Binary logistic regression was used to examine the associations between PIMs use and identify potential factors for PIMs use among older adults with anxiety disorder. Analyses were performed using the Statistical Analysis Software version 9.4 (SAS® 9.4). The study sample includes 371 older adults (age ≥ 65 years) with anxiety disorder; their average age was (72.1 ± 5.8) years. PIMs use was highly prevalent among older adults with anxiety (66.6%). About 35.6% of the study sample used one PIM, 22.6% used two PIMs, and 8.4% used three PIMs. The most frequently prescribed PIMs were NSAIDs and gastrointestinal agents. The adjusted regression analysis found that PIMs use was less likely among men than women. In addition, PIMs use was more likely among women with diabetes, cancer, and polypharmacy. Future studies on strategies and interventions rationing PIMs use in older adults with anxiety disorder are necessary given the high prevalence of PIMs and polypharmacy within this population.


The sigh of the oppressed: The palliative effects of ideology are stronger for people living in highly unequal neighbourhoods.
Ideologies that legitimize status hierarchies are associated with increased well-being. However, which ideologies have 'palliative effects', why they have these effects, and whether these effects extend to low-status groups remain unresolved issues. This study aimed to address these issues by testing the effects of the ideology of Symbolic Prejudice on well-being among low- and high-status ethnic groups (4,519 Europeans and 1,091 Māori) nested within 1,437 regions in New Zealand. Results showed that Symbolic Prejudice predicted increased well-being for both groups, but that this relationship was stronger for those living in highly unequal neighbourhoods. This suggests that it is precisely those who have the strongest need to justify inequality that accrue the most psychological benefit from subscribing to legitimizing ideologies.


Use of capillary tube leukocyte adherence inhibition for the detection of tumor-specific immune responses.
The tumor-specific immune response of A/J mice was determined at various times after subcutaneous injection with a transplantable spindle-cell sarcoma (SaI) using a leukocyte adherence inhibition (LAI) assay carried out in capillary tubes. Solubilized antigens prepared by 3M KC1 extraction of the specific tumor, other transplantable tumors and normal A/J liver were used in the evaluation of LAI reactivity. The assay was found to be capable of detecting a significant antitumor response before the subcutaneous tumors became detectable by palpation. The response remained significant until the tumors were greater than 25 mm in diameter. Responsive cell populations did produce an active supernatant, indicating the possible presence of a lymphokine and/or specific cytophilic antibody.


Motivational Enhancement: What Ancient Technologies of the Self and Recent Biotechnologies Have in Common.
Motivational enhancement of any kind can be conceived of either as a way to reduce the need for effort, or as a change in the subjective perception of effort. However, in both cases, effort is not all that matters. In the evaluation of praiseworthy conduct, the practical goals pursued by the subject, their dedication, and the discernment they exercise are equally important. I further argue that not only in terms of the general purpose, but also in terms of the means employed for human enhancement, we cannot, in fact, establish significant differences between the traditional technology of the self and biomedical technologies for enhancing motivation. There are two key features they all share. The traditional techniques of the self also aim at the gradual reduction of effort through their steady practice, and they are all mental conditioning and self-conditioning techniques based on repetition and training.


Linoleic acid-induced expression of inducible nitric oxide synthase and cyclooxygenase II via p42/44 mitogen-activated protein kinase and nuclear factor-kappaB pathway in retinal pigment epithelial cells.
High linoleic acid (LA) intake is known to correlate with age-related macular degeneration (AMD), but the molecular mechanisms remain unclear. This study was conducted to investigate the effects of LA on expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase II (COX-2) and their associated signaling pathways in human retinal pigment epithelial (RPE) cells. ARPE-19 cells were treated with different concentrations of LA. Expressions of iNOS and COX-2 were examined using semiquantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis. Concentrations of nitric oxide (NO) and prostaglandin E(2) (PGE(2)) in the culture medium were determined by enzyme-link immunosorbent assay (ELISA). Activation of p42/44, p38, JNK mitogen-activated protein kinase (MAPK) and nuclear factors (NF)-kappaB were evaluated by Western blot analysis and electrophoretic mobility shift assay (EMSA). We found that LA induced expression of iNOS and COX-2 in RPE cells at the mRNA and protein levels in a time-and dose-dependent manner. Upregulation of iNOS and COX-2 resulted in increased production of NO and PGE(2). Moreover, LA caused degradation of IkappaB and increased NF-kappaB DNA binding activity. Effects of LA-induced iNOS and COX-2 expression were inhibited by a NF-kappaB inhibitor, pyrrolidine dithiocarbamate (PDTC). LA activated p42/44, but not p38 or JNK MAPK. Inhibition of p42/44 activity by PD98059 significantly reduced LA-induced activation of NF-kappaB. Linoleic acid-induced expression of iNOS and COX-2 as well as PGE(2) and NO release in RPE cells were sequentially mediated through activation of p42/p44, MAPK, then NF-kappaB. These results may provide new insights into both mechanisms of LA action on RPE cells and pathogenesis of age-related macular degeneration.


Perceptions of Asthma Quality of Life in Children and Parent Dyads in Two Rural Counties in West Virginia.
This study examines perceived quality of life (QOL) in a convenience sample of children (aged 7-11) with asthma and their parents from two schools in rural West Virginia. Forty-nine child-parent dyads representing 25 males and 24 females completed the study. The PedsQL™ 3.0 Asthma Module was utilized to separately measure child and parent perceptions of various dimensions of pediatric, asthma-specific, health-related QOL. Dimensions of the tool were scored separately and included symptoms, treatment, worry, and communication. The mean module dimension scores for children ranged from 63.27 to 80.47 and for parents, the range was from 61.26 to 79.79, with higher scores indicating higher QOL. Parents of male children perceived their son's QOL to be higher than that of female children in the symptoms and treatment dimensions. Strong relationships occurred between the child's worry and the other three dimensions as well as between the symptoms and the treatment dimensions. For the dyads, the only significant relationship was between the child and the adult treatment dimensions. With the well-documented burden of asthma in school-aged populations, information regarding the QOL of child and parent dyads will enhance school nurses' ability to improve health and educational outcomes in schools.


A 'target' skin lesion.
A boy, 12 years of age, was being treated for pneumonia. The cold haemagglutination test was positive for Mycoplasma pneumoniae. He developed an isolated asymptomatic skin lesion on his lower limb which disappeared completely after 1 week.


[Biochemical and immunological properties of the fractions of tubercle bacilli].
In 1954, Dr. Yuichi Yamamura and his coassociates, National Sanatorium Toneyama Hospital, has reported the formation of experimental tuberculous cavity in rabbits. This work was a milestone of the researches in the field of cellular immunology. In 1960, I have started my scientific carrier in Kyushu University Medical School as the post-graduate student under the guidance of Prof. Yamamura. Since then, I have worked on the field of biochemical and immunological properties of tubercle bacilli. The arabinose mycolate, polysaccharides, cell-wall skeleton (CWS) and trehalose dimycolate (TDM) were purified from tubercle bacilli and their Chemical structures and biological activities were investigated in detail in our laboratory. In 1971, we have reported that adjuvant active principle of tubercle bacilli was a CWS fraction, and the details of chemical structure and adjuvantity of mycobacterial CWS were investigated in our research group. The application of BCG-CWS to cancer immunotherapy was also studied. In 1974, Prof. E. Lederer and his coworkers, University of Paris, have reported that N-acetyl muramyl-L-alanyl-D-isoglutamine (MDP) was the minimum adjuvant-active structure of bacterial cell wall. We have synthesized several hundreds of MDP derivatives and selected, MDP-Lys(L18), romurtide, as the candidate of cytokine inducer for the clinical application. Romurtide is applied in cancer patients for the recovery of the number and functions of monocytes, neutrophils and platelets. These results suggest that the tubercle bacilli, especially, CWS and related synthetic MDP derivatives, are effective for the potentiation of host resistance against infectious diseases and cancer.


Transcellular ion currents in the water mold Achlya. Amino acid proton symport as a mechanism of current entry.
Achlya, like other tip-growing organisms, generates an endogenous electrical current such that positive charge flows into the hyphal apex and exits from the trunk. The present study is concerned with the mechanism of current generation by hyphae growing in a defined, complete medium. The intensity of the current, measured in the extracellular medium with a vibrating probe, was unaffected by the removal of all the inorganic constituents of the growth medium. However, an increase in the external pH or the deletion of amino acids abolished the current. Removal of methionine alone diminished the current by two thirds. Hyphae also generated a longitudinal pH gradient in the extracellular medium; the region surrounding the tip was more alkaline than the bulk medium, whereas the region around the trunk was relatively acidic. These findings suggest that a flux of protons, dependent upon amino acids in the medium, carries current into the tip and creates the surrounding alkaline zone. The proton current appears to result from the transport of amino acids rather than their metabolism. Conditions that abolished the current also inhibited methionine uptake but had little effect on the respiratory rate. The findings imply a connection between the proton current and chemiosmotic energy transduction. We propose that protons flow into the hyphal tip through amino acid/proton symporters that are preferentially localized there. The proton flux energizes the uptake of amino acids into the growing zone and may also contribute to the polarization of hyphal growth.


[Abdominal pain in children caused by lactose intolerance. Prospective use of the hydrogen breath test].
We performed the breath hydrogen test in children consulting for abdominal pain in order to determine the minimal quantity of lactose required to prove malabsorption with least patient incomfort and to evaluate the effect of an adapted diet in children with a positive test. The breath hydrogen test after lactose intake was performed in 109 children (51 boys, 58 girls, mean age 8.2 + 3.2 years, range 3 to 15) seen for unexplained abdominal pain. All these children had complained of abdominal pain daily for at least 6 months and no other cause could be identified. Children with acute or chronic diarrhoea or constipation were excluded. Nineteen children had been transferred from the surgery unit and 6 had been followed by the psychiatry unit. All these children drank milk regularly. The diagnosis of lactose intolerance was established in 83 children (76.1%) on the basis of a hydrogen peak in the breath after lactose ingestion. One-fourth of the children were of French origin and the others had at least one grandparent who was of Mediterranean or African origin. A lactose-free diet was proposed and led to the disappearance of abdominal pain in 24% and a clear improvement in 32%. The breath hydrogen test is a simple non-invasive test which allows a selection of children who could benefit from a lactose-free diet although it cannot be used to predict the effect of diet.


A model to estimate the outcome of prostate cancer photodynamic therapy with TOOKAD Soluble WST11.
Interstitial photodynamic therapy is becoming an interesting modality to treat some early stage prostate cancers. A light-sensitive drug is injected to the patient and activated by light using optical fibres inserted inside the prostate. In this work, we were interested in the characterization of the light action model for the WST11 (Tookad® Soluble) drug. A retrospective analysis was performed on results from 28 patients enrolled in phase I and II trials with the WST11 drug. A drug dose of 4 mg/kg patient, dose light of 200 J cm(-1) and wavelength of 753 nm were used. Correlation between the illuminated volume and the obtained necrosis, measured at day 7 MR images, was clearly established. This result suggests that photodynamic therapy planning is possible based on this model.


Curcumin ameliorates mitochondrial dysfunction associated with inhibition of gluconeogenesis in free fatty acid-mediated hepatic lipoapoptosis.
Insulin resistance occurs in almost all patients with non-alcoholic fatty liver disease (NAFLD), and mitochondrial dysfunction likely plays a pivotal role in the progression of fatty liver into non-alcoholic steatohepatitis (NASH). Curcumin is a compound derived from the spice turmeric, a spice that is a potent antioxidant, anti-carcinogenic, and anti-hepatotoxic agent. The aim of this study was to analyze the ability of curcumin to protect against the mitochondrial impairment induced by high free fatty acids (HFFAs) and to determine the underlying mechanism for this cytoprotection. Curcumin treatment inhibited the lipoapoptosis, ROS production and ATP depletion elicited by HFFA in primary hepatocytes. We demonstrate that curcumin effectively suppressed HFFA-induced production of phosphoenol pyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase) in hepatocytes. Not only did curcumin treatment increase mitochondrial DNA (mtDNA) copy number in hepatocytes, but it also increased levels of transcriptional factors that regulate mitochondrial biogenesis, including peroxisome proliferator-activated receptor-γ coactivator 1α (PGC1α), nuclear respiratory factor 1 (NRF1) and mitochondrial transcription factor A (Tfam). In addition, curcumin contributed to cell survival, as indicated by the restoration of the mitochondrial membrane potential (MMP) and the inhibition of the mitochondrial biogenesis induced by HFFA. Furthermore, this cytoprotection resulted from curcumin-mediated downregulation of the NF-κB p65 subunit, thereby inhibiting lipoapoptosis. Together, these data suggest that curcumin protects hepatocytes from HFFA-induced lipoapoptosis and mitochondrial dysfunction, which partially occurs through the regulation of mitochondrial biogenesis.


Oral environment and cancer.
Cancer is now the leading cause of death in Japan. A rapid increase in cancer mortality is expected as Japan is facing a super-aged society. Many causes of cancer are known to be closely linked to life style factors, such as smoking, drinking, and diet. The oral environment is known to be involved in the pathogenesis and development of various diseases such as bronchitis, pneumonia, diabetes, heart disease, and dementia. Because the oral cavity acts as the bodily entrance for air and food, it is constantly exposed to foreign substances, including bacteria and viruses. A large number of bacteria are endemic to the oral cavity, and indigenous oral flora act to prevent the settlement of foreign bacteria. The oral environment is influenced by local factors, including dental plaque, tartar, teeth alignment, occlusion, an incompatible prosthesis, and bad lifestyle habits, and systemic factors, including smoking, consumption of alcohol, irregular lifestyle and eating habits, obesity, stress, hormones, and heredity. It has recently been revealed that the oral environment is associated with cancer. In particular, commensal bacteria in the oral cavity are involved in the development of cancer. Moreover, Candida, human papilloma virus and Epstein-Barr virus as well as commensal bacteria have been reported to be associated with the pathogenesis of cancer. In this review, we introduce recent findings of the correlation between the oral environment and cancer.


Probing Nanoparticle Geometry down to Subnanometer Size: The Benefits of Vibrational Spectroscopy.
Understanding the role of nanoparticle size and shape in the binding of molecules is very relevant for heterogeneous catalysis and molecular electronics. The geometry of Pd nanoparticles (NPs) has been studied from very small clusters containing 4 atoms up to large (>500 atoms), well-faceted NPs. Their geometry was retrieved by combining scanning tunneling microscopy and vibrational sum frequency generation (SFG) spectroscopy of adsorbed CO. SFG has been revealed to be highly sensitive to the geometry of NPs smaller than 100 atoms by identifying the nature of CO adsorption sites. NP growth could be followed layer by layer in the critical size range corresponding to the transition from a nonmetallic to a metallic state and to oscillations of CO adsorption energy. NP height remained at two Pd planes up to 30 atoms, and adsorption energy minima correspond to the completion of successive layers.


Bupropion sustained release and smoking cessation.
The identification of nicotine dependence as a psychiatric disorder and increased knowledge of nicotine's neuropharmacologic effects have stimulated researchers to search for new pharmacologic interventions for smoking cessation. After reviewing the efficacy and safety of bupropion sustained release (SR) as an agent for treating smoking cessation, the Food and Drug Administration recently approved the use of bupropion SR for this indication. This paper reviews nicotine's pharmacologic effects and the factors contributing to the development of nicotine dependence, the general principles and strategies for treating nicotine dependence, and the evidence for the efficacy of bupropion SR as a treatment for smoking cessation. The release of bupropion SR as a treatment for smoking cessation may provide clinicians with additional opportunities to address smoking cessation with their patients.


Publication Integrity, Accessibility, and Women Authors.
An implicit assumption of considerable importance is that manuscripts published in professional journals should reflect integrity on the part of authors, peer reviewers, and publishers. Unfortunately, some evidence continues to emerge that calls into question a view that all responsible parties are willing to play by the rules.


[Indicator Function of Ragworm (Nereididae) on Sediment Microplastic in Haizhou Bay Intertidal Zone].
Sediment samples were collected from nine sites of three sections, in the intertidal zone of Haizhou bay in July 2018. The abundance and characteristics of microplastics in the sediments (and ragworms within the sediments) were then determined to identify the source of microplastics in ragworms, and to explore the effects of ragworms on microplastics in sediment. The average abundance of microplastics in tidal flat sediments was (0.49±0.17) n·g-1, which was at a high level in domestic offshore environmental studies. Among all the microplastics detected, the most common form and color were fiber and black-gray, respectively, and the materials were mainly polyethylene (PE), polyester (PET), and polystyrene (PS). The detection rate of microplastics in ragworm was 77.78%-86.67%, with an average abundance of (6.68±2.21) n·ind-1; the abundance was significantly correlated with individual mass (r=0.42, P=0.002). The microplastic abundance was significantly higher in ragworms with individual mass over 1.5 g than in those with a mass of<0.5 g or 0.5-1 g (F3=141.029, P=0.000). In ragworms, microplastics were dominated by small black or blue fibers, and the main materials were PE and PET. By analyzing the various characteristics of microplastics with a particle size of 0-3 mm, it was found that the abundance of microplastics in sediments was strongly correlated with that in ragworms (r=0.79,P=0.01); the main form (r=0.90, P=0.035) and the material composition (r=0.73, P=0.024) also showed significant correlation between sediments and ragworms. This indicates that ragworms ingest microplastics in the sedimentary environment and exchange the microplastics with the sediments. Therefore, ragworms can be used as an indicator species of microplastic pollution in sediments.


Sequential enhanced cleaning eliminates multidrug-resistant organisms in general intensive care unit of a traditional Chinese medicine hospital.
Effective cleaning of surfaces within hospital wards is necessary to reduce pathogen transmission. We investigated the roles of sequential enhanced cleaning by culturing pathogens from high-touch surfaces in a general intensive care unit. A before-after controlled study was conducted during a 17-month period in the 25-bed general intensive care unit. The study comprised a baseline period (period 1) and 4 sequential tiered interventions: each patient zone was wiped with a single clean microfiber cloth daily (period 2), fluorescent markers and adenosine triphosphate assay were used to monitor and provide feedback on the effectiveness of cleaning (period 3), wiping a single patient zone with 3 clean microfiber cloths daily (period 4), and withdrawal of the feedback (period 5). Compared with period 1, the cultures of multidrug-resistant organisms from high-touch surfaces were reduced by 41.0% (prevalence ratio [OR] = 0.59, P < .001), 70.8% (OR = 0.29, P < .001), 82.6% (OR = 0.17, P < .001), and 70.8% (OR = 0.29, P < .0001) in the subsequent sequential interventions, respectively. Adoption of fluorescent markers and adenosine triphosphate bioluminescence reduced environmental contamination. Use of 3 cleaning cloths for 1 patient zone was more effective compared with a single cloth.


[Intracytoplasmic sperm injection].
The first results of intracytoplasmic sperm injection (ICSI) in Norway are presented. Acceptable fertilization rates were obtained for all indications; severe male infertility, as well as moderately reduced sperm quality where in vitro fertilization (IVF) and embryo transfer had previously failed. Furthermore, in cases where IVF had failed despite normal sperm quality, fertilization rates of 50-60% were achieved. The overall pregnancy rate was 24.9% per embryo transfer, and the live pregnancy rate per started cycle was 13.4%. As expected, the results improved with experience. The results were greatly influenced by the age of the female. In the age group 34 years or less, the total pregnancy rate per cycle was 32.4%, with a miscarriage rate of 24.2%. In the age group 35 years or more, (42% of the study group), the total pregnancy rate per embryo transfer was 15.2%, with a miscarriage rate of 75%. The corresponding implantation rates were 17.4% and 7.9% respectively. 23 children have been born so far, none with major malformations or chromosome abnormality symptoms.


An N-Heterocyclic Boryloxy Ligand Isoelectronic with N-Heterocyclic Imines: Access to an Acyclic Dioxysilylene and its Heavier Congeners.
Introduced here is a new type of strongly donating N-heterocyclic boryloxy (NHBO) ligand, [(HCDippN)2 BO]- (Dipp=2,6-diisopropylphenyl), which is isoelectronic with the well-known N-heterocyclic iminato (NHI) donor class. This 1,3,2-diazaborole functionalized oxy ligand has been used to stabilize the first acyclic two-coordinate dioxysilylene and its Ge, Sn, and Pb congeners, thereby presenting the first complete series of heavier group 14 dioxycarbene analogues. All four compounds have been characterized by X-ray crystallography and density-functional theory, enabling analysis of periodic trends: the potential for the [(HCDippN)2 BO]- ligand to subtly vary its electronic-donor capabilities is revealed by snapshots showing the gradual evolution of arene π coordination on going from Si to Pb.


Elucidating the Molecular Structure of Hydrophobically Modified Polyethylenimine Nanoparticles and Its Potential Implications for DNA Binding.
The structural properties of the polyethylenimine (PEI) polymer are generally tuned and selectively modified to reinforce its potential in a broad spectrum of applied domains of medicine, healthcare, material design, sensing, and electronic optimization. The selective modification of the polymer brings about changes in its interfacial characteristics and behavior. The current work involves the synthesis of naphthalimide conjugated polyethylenimine organic nanoparticles (NPEI-ONPs). The interfacial molecular structure of NPEI-ONPs is explored in an aqueous medium at pH 7.4 using surface tensiometry and sum-frequency generation vibrational spectroscopy (SFG-VS). The hydrophobic functionalization rendered a concentration-dependent surface coverage of NPEI-ONPs, where the SFG-VS analysis exhibited the molecular rearrangement of its hydrophobic groups at the interface. The interaction of NPEI-ONPs with double-stranded DNA (dsDNA) is carried out to observe the relevance of the synthesized nanocomposites in the biomedical domain. The bulk-specific studies (i.e., thermal denaturation, viscometry, zeta (ζ) potential, and ATR-FTIR) reveal the condensation of dsDNA in the presence of NPEI-ONPs, making its structure more compact. The interface-sensitive SFG-VS showcased the impact of the dsDNA and NPEI-ONP interaction on the interfacial molecular behavior of NPEI-ONPs at the air-aqueous interface. Our results exhibit the potential of such hydrophobically functionalized ONPs as promising candidates for developing biomedical sealants, substrate coatings, and other biomedical domains.


[The role of adrenoreceptors in the mechanism of pharmacological action of cavinton].
Having studied the functional state of beta-adrenoreceptors in vitro by the radioligand (3H-dihydroalprenalol) method it has been shown that cavinton in the concentration of 2.5 X 10(-6) M considerably increases the affinity of beta-adrenoreceptors for the ligand. In the in vivo experiments on rats the intraperitoneal injection of cavinton in the dose of 2 mg/kg causes an increase in the affinity of synaptosomal beta-adrenoreceptors for the ligand 10 days after chronic administration without altering the concentration of the receptors (Bmax) themselves. 20 days after the injection of the drug the affinity still grows and this effect of cavinton is retained even 30 days after the injection.


Case reports of robot-assisted laparoscopic radical nephrectomy and inferior vena cava tumor thrombectomy: A retrospective analysis.
Renal cell carcinoma is one common type of urologic cancers. It has tendencies to invade into the inferior vena cava (IVC) and usually requires an open surgery procedure. High rates of operative complications and mortality are usually associated with an open surgery procedure. The recently emerged robot-assisted laparoscopic radical nephrectomy (RAL-RN) and IVC tumor thrombectomy have shown to reduce operative related complications in patients with renal cell carcinoma.This case series study aimed to summarize technical utilization, perioperative outcomes, and efficacies of RAL-RN and IVC tumor thrombectomy in our hospital. A retrospective analysis was performed on clinical data from 20 patients who underwent RAL-RN and IVC tumor thrombectomy from January 2017 to December 2019 in our department.Patients had a median age of 59 years (interquartile range [IQR], 46-68). Four patients had renal neoplasm on left side and 16 on right side. Nineteen patients underwent RAL-RN (level 0: n = 2) or RAL-RN with IVC thrombectomy (n = 17) (level I: n = 3; level II: n = 12; and level III: n = 3) and 1 patient was converted into an open surgery. The median operative time was 328 minutes (IQR, 221-453). The estimated median blood loss was 500 mL (IQR, 200-1200). The median size of removed renal carcinoma was 67 cm2 (IQR, 40-91); the length of IVC tumor thrombus was 5 cm (IQR, 3-7). The postsurgery hospital length of stay was 6 days (IQR, 5-7). The complications included intestinal obstruction (n = 1), lymphatic fistula (n = 1), heart failure (n = 1), and low hemoglobin level (n = 1). The outcomes for patients after 16 months (IQR, 11-21) follow-up were tumor-free (n = 10), tumor progression (n = 4), loss of contact (n = 1), and death (n = 5).We concluded that RAL-RN and IVC thrombectomy renders good safety profiles including minimal invasiveness, low estimated median blood loss, short hospitalization, low morbidity, and quick renal function recovery. The long-term efficacy needs a further investigation.


Separation and enhanced detection of anesthetic compounds using solid phase micro-extraction (SPME)-Raman spectroscopy.
Polydimethylsiloxane (PDMS)-based solid-phase micro-extraction (SPME) was used along with Raman spectroscopy (RS) to separate and enhance the detection of five anesthetic compounds (halothane, propofol, isoflurane, enflurane, and etomidate) from aqueous and serum phases. Raman signals in the spectral ranges 250-450 cm(-1) and 950-1050 cm(-1) allowed the unique characterization of all five compounds when extracted into the PDMS phase. The SPME-RS detection of clinically relevant concentrations of aqueous propofol (6.5 μM) and halothane (200 μM) is shown. We quantify the partition coefficient for aqueous halothane in PDMS as log K = 1.9 ± 0.2. Solid-phase micro-extraction of the anesthetics makes their detection possible without the strong autofluorescent interference of serum proteins. Because of low solubility and/or weak Raman scattering, we found it challenging to detect enflurane, isoflurane, and etomidate directly from the aqueous phase, but could we do so with SPME enhancement. These studies show the potential of SPME-RS as a method for the direct detection of anesthetics in blood.


[Mental disorders in women: Natural course during premenstrual phases, peripartum period and perimenopause].
Epidemiological studies indicate sex-specific differences in prevalence rates and the natural course of mental disorders. Affective, anxiety, somatoform and eating disorders are more prevalent in women than men, whereas substance use disorders occur more commonly in men, and some disorders are equally distributed in both sexes (e. g. psychotic disorders). The aim of this review is to depict the natural course of mental disorders during the reproductive stages (premenstrual phases, peripartum period, perimenopause) in women, including also neuroendocrine features associated with the menstrual cycle, pregnancy, puerperium and perimenopause. Recommendations for sex-specific diagnostic and therapeutic procedures are provided.


The Elderly Voice: Mechanisms, Disorders and Treatment Methods.
The elderly population is increasing globally. In Turkey, the population aged 65+ is predicted to grow to more than 15% of the whole population by 2050. Just like the rest of the body, the voice also changes with age. Voice changes throughout life have been reported in up to 52.4% of aged individuals and may have a negative impact on their quality of life. Voice is affected by various factors, including age, disease, hormones, medications, and physiological, psychological, and social conditions. A multidisciplinary approach is therefore needed to achieve the best voice outcomes. In this review, we summarize the mechanisms involved in voice changes in the elderly together with the applicable diagnostic and treatment methods.


Automated bladder scan urine volumes are not reliable in complex neonatal cases.
We investigate the accuracy of urine volumes obtained by an automated bladder scan in complex neonatal cases. Automated bladder scan determinations of urine volumes were obtained by neonatal intensive care unit nursing staff in 10 patients with myelodysplasia and cloacal exstrophy. Urine volumes were then immediately obtained by straight catheterization. Correlation between the scan and catheter volumes was then evaluated across and within cases. There was low correlation between automated bladder scan volume and catheter volume across and within cases (0.037 +/- 0.37) and (0.188 +/- 0.12), respectively. Using a cutoff of 20 cc 25% of significant volumes were missed. The 95% confidence interval from these data indicates that a significant volume is missed 7% to 25% of the time. We urge clinicians to exercise caution in the use of automated bladder scanners for determination of urine volumes in complex neonatal intensive care unit cases.


Diverse Research Teams and Underrepresented Groups in Clinical Studies.
Several ophthalmic diseases disproportionately affect racial and ethnic minority patients, yet most clinical trials struggle to enroll cohorts that are demographically representative of disease burden; some barriers to recruitment include time and transportation, language and cultural differences, and fear and mistrust of research due to historical abuses. Incorporating diversity within the research team has been proposed as a method to increase trust and improve engagement among potential study participants. To examine how demographic factors of potential research participants and personnel may be associated with patient consent rates to participate in prospective ophthalmic clinical studies. This retrospective cohort study included patients from an urban, academic hospital who were approached for consent to participate in prospective ophthalmic clinical studies conducted between January 2015 and December 2021. Multivariable logistic regression assessing associations between patient and research personnel demographics and rates of affirmative consent to participate was used. In total, 1380 patients (mean [SD] age, 58.6 [14.9] years; 50.3% male) who were approached for consent to participate in 10 prospective ophthalmic clinical studies were included. Of prospective patients, 566 (43.5%) were Black; 327 (25.1%), Hispanic or Latino; 373 (28.6%), White; 36 (2.8%), other race and ethnicity; and 78 (5.8%) declined to answer. Black patients (odds ratio [OR], 0.32; 95% CI, 0.24-0.44; P < .001) and Hispanic or Latino patients (OR, 0.31; 95% CI, 0.20-0.47; P < .001) were less likely to consent compared with White patients. Patients with lower socioeconomic status were less likely to consent than patients with higher socioeconomic status (OR, 0.43; 95% CI, 0.33-0.53; P < .001). Concordance between patient and research staff race and ethnicity was associated with increased odds of affirmative consent (OR, 2.72; 95% CI, 1.99-3.73; P < .001). In this cohort study, patients from underrepresented racial and ethnic groups and those with lower socioeconomic status were less likely to participate in ophthalmic clinical studies. Concordance of race and ethnicity between patients and research staff was associated with improved participant enrollment. These findings underscore the importance of increasing diversity in clinical research teams to improve racial and ethnic representation in clinical studies.


Structural and functional analyses of the promoter of the murine multidrug resistance gene mdr3/mdr1a reveal a negative element containing the AP-1 binding site.
We have previously shown that the multidrug-resistance/P-glycoprotein gene, mdr3/mdr1a, is activated in mouse hepatocellular carcinomas (HCC). In this study, we show that in a number of HCC-derived cell lines (Hepa1c1c, Hepa1c1c-BprC1, and Hepa1-6) mdr3 is expressed at high levels. To investigate transcriptional regulation of mdr3 in these cells, we have isolated a DNA fragment containing the 5' portion of the mouse mdr3 gene and performed a functional analysis of its promoter. Transient transfection assays using various lengths of the promoter sequence to direct expression of the chloramphenicol acetyltransferase (CAT) reporter gene revealed that the sequence located -94 nucleotides upstream from mouse mdr3 transcription start site functions as a negative element in mouse hepatoma cells. A canonical AP-1 binding sequence TGA-GTCA located at -117 is at least in part responsible for the negative effect from the following observations: (i) Alteration of this AP-1 sequence by site-directed mutagenesis enhanced CAT expression. (ii) Expression of CAT reporter gene was elevated when double-stranded DNA containing the AP-1 sequence, but not mutated sequences, was used as a competitor in cotransfection experiment. (iii) Enhancement of the CAT expression was also seen in cotransfection experiments using recombinant plasmid DNA expressing the c-jun/c-fos proteins, which interact with AP-1 sequences. Interestingly, the proximal region of the hamster pgp1 promoter shares striking sequence similarity with that of the mouse mdr3 gene, including the AP-1 site, but the AP-1 site in the hamster promoter serves as a positive regulator. Although previous studies have demonstrated that positive and negative transcription factors can modulate gene expression through interactions with c-jun/c-fos, this is the first study to show that an AP-1 site functions as a negative cis-element in the regulation of gene expression.


Variations of stereotypies in individuals with Rett syndrome: A nationwide cross-sectional study in Taiwan.
Individuals with Rett syndrome (RTT) can have variable manifestations of stereotypies. In this nation-wide cross-sectional study, we recruited all individuals with RTT in Taiwan diagnosed as RTT by neurologists based on genetic findings and diagnostic criteria. The data were collected using questionnaire. A total 43 cases of typical RTT and 15 cases of atypical RTT, aged from 2.1 to 40.1 years, were enrolled. They included 3 (5.2%) in stage II, 42 (72.4%) in stage III, and 13 (22.4%) in stage IV. All individuals presented with at least one stereotypy. Individuals with atypical RTT had more varied stereotypies (mean: 14 ± 6) compared to those with typical RTT (mean: 9 ± 5) (P = 0.003). Flapping (73.3%) and wringing (58.1%) were the most common hand stereotypies in atypical and typical RTT, respectively. Compared with typical RTT, hair pulling, bruxism, retropulsion, and protrusion of lips were more common in atypical RTT (P = 0.003, P = 0.006, P = 0.003 and <0.001, respectively). The number of stereotypies did not differ among different stages, clinical severities, and hand functions. Although there were no age-related changes in stereotypies in atypical RTT, flapping (P = 0.012), clapping (P = 0.044), and mouthing with single hand (P = 0.009) were significantly more prevalent in individuals aged <10 years with typical RTT, and they decreased after 10 years. In conclusion, our study showed that the stereotypical movements varied in typical and atypical RTT, implying the heterogeneous nature of the disease and the pathogenic mechanisms of RTT with atypical features. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1204-1214. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.


MicroRNA-146a and -21 cooperate to regulate vascular smooth muscle cell proliferation via modulation of the Notch signaling pathway.
A number of microRNAs (miRs) have been shown to participate in the regulation of vascular smooth muscle cell (VSMC) proliferation, a key step in the formation of atherosclerotic plaque, by targeting certain genes. The aim of the present study was to investigate the roles of miR‑146a and miR‑21 in VSMC growth and to study the underlying mechanisms. The expression levels of four previously reported, differentially expressed microRNAs in atherosclerotic plaque (miR‑146a/b, miR‑21, miR‑34a and miR‑210) were measured in two groups: An atherosclerotic plaque group (n=10) and a normal control group (n=10). Polymerase chain reaction (PCR) analysis revealed that the relative expression levels of miR‑146a and miR‑21 in atherosclerotic plaque samples were significantly upregulated to ~260 and 250%, respectively, compared with those in normal controls. Notch2 and Jag1 were confirmed to be target genes of miR‑146a and miR‑21 through the use of a luciferase assay, PCR and western blot analysis. Additionally, VSMCs transfected with miR‑146a expressed significantly lower levels of Notch2 protein and presented an accelerated cell proliferation, which could be attributed to a reduction in the levels of cell cycle arrest. Cotransfection of miR‑146a and miR‑21 further promoted cell cycle progression in addition to VSMC proliferation. In conclusion, the present study revealed that miR‑146a and miR‑21 were significantly upregulated in atherosclerotic plaque, and cooperated to accelerate VSMC growth and cell cycle progression by targeting Notch2 and Jag1.


Polychlorobiphenyl levels in the serum of cats from residential flats in Italy: Role of the indoor environment.
The domestic cat (Felis catus) was used as a sentinel of exposure to polychlorobiphenyls (PCBs) in indoor urban environments y. Sera from 120 cats were pooled to form 30 different groups selected by age (<2 years; > 2 ≤ 8 years; > 8 years), sex, municipality (Bologna and Turin) and environment (indoor vs. outdoor). Test portions of 1 mL were analyzed by means of gas chromatography coupled to high-resolution mass spectrometry (GC-HRMS) for six selected indicators non-dioxin-like PCBs (∑6 PCBs: congeners #28, #52, #101, #132, #153 and #180) and the results were computed in the upper-bound mode. The internal dose of PCBs attributable to the cats' alimentary lipid intake ranged from 32.4 to 1,446 ng/g (P50 165; mean 258). The Wilcoxon test revealed significantly lower PCB burden in "outdoor" groups than in "indoor" groups. Age correlated well with the heptachlorinated and most bio-accumulative congener, PCB #180, and slightly with hexachlorinated PCBs #138 and #153. Contamination attributable to house dust collected in 15 living-rooms ranged from 10.0 to 279 ng/g dry weight (P50 97.4; mean 94.4). Exposure estimates indicated a 0.6-16 ng/kg bw range of daily ∑6 PCB intake from a default value of 200 mg/cat of dust ingestion. The intake of PCBs due to dust ingestion fell within the same order of magnitude as that computed from a 60 g daily intake of commercial dry pet foods, while inhalation accounted for 0.21-8.2 ng/kg bw/day, on setting the nominal ∑6 PCB contamination in outdoor and indoor air at 0.37 and 15 ng/m3, respectively. Italian indoor cats could be exposed to higher levels of ∑6 PCBs than the Reference Dose (RfD) of 10 ng/kg/bw/day; this supports the World Health Organization's statement that the quality of the indoor environment is a major determinant of health.


Anesthetic considerations in the patient with a heart transplant.
As programs to increase the awareness of organ donation grow, more patients undergo cardiac transplantation. Because immunosuppressive therapy and postoperative care are improved, the 1-year survival rate of these patients has increased to more than 80%. Not surprisingly, these patients may, either coincidentally or as a result of medications, require other procedures using anesthesia, frequently at hospitals other than the highly specialized institution that performed the transplant. Because the denervated heart responds differently than the normal heart to many perioperative drugs, physicians, including cardiologists who are frequently consulted preoperatively, must have a special awareness of the particular problems in this group of patients.


Episodic boundaries affect neural features of representational drift in humans.
A core feature of episodic memory is representational drift, the gradual change in aggregate oscillatory features that supports temporal association of memory items. However, models of drift overlook the role of episodic boundaries, which indicate a shift from prior to current context states. Our study focuses on the impact of task boundaries on representational drift in the parietal and temporal lobes in 99 subjects during a free recall task. Using intracranial EEG recordings, we show boundary representations reset gamma band drift in the medial parietal lobe, selectively enhancing the recall of early list (primacy) items. Conversely, the lateral temporal cortex shows increased drift for recalled items but lacked sensitivity to task boundaries. Our results suggest regional sensitivity to varied contextual features: the lateral temporal cortex uses drift to differentiate items, while the medial parietal lobe uses drift-resets to associate items with the current context. We propose drift represents relational information tailored to a region's sensitivity to unique contextual elements. Our findings offer a mechanism to integrate models of temporal association by drift with event segmentation by episodic boundaries.


The evolution of radiological measurements and the association with clinician and patient reported outcome following distal radius fractures in non-osteoporotic patients: what is clinically relevant?
Following distal radius fractures in young non-osteoporotic patients, clinical relevancy of outcome has been scarcely reported. Outcome can be put in perspective by using measurement errors of radiological measurements and Minimal Important Change when reporting on clinician and patient reported outcome. Aim of this study was to assess the clinical relevance of radiological measurements, clinician and patient reported outcomes following distal radius fractures in young non-osteoporotic patients. Retrospective cohort study. Non-osteoporotic patients following a distal radius fracture were selected. Radiographs of both wrists were obtained at baseline, 6 weeks and at follow-up. Active range of motion and grip strength measurements were obtained at the follow-up visit and 4 questionnaires were answered to assess pain, upper extremity functioning, and health status. Seventy-three patients (32 women, 41 men) with a mean age of 33.5 (SD 9.2) years at the time of injury were included. Median follow up was 62 months (IQR 53.0-84.5). Several radiological measurements evolved statistically significantly over time, however none exceeded measurement errors. Flexion/extension difference of injured compared to uninjured wrist (mean difference 11.2°, t = -7.5, df = 72, p < 0.001), exceeded Minimal Important Change, while grip strength differences did not. When comparing patients with DRFs to healthy controls, only the differences on Patient Reported Wrist Evaluation subscales "pain", "function" and total scores exceeded minimal important change (8, 10 and 13 points, respectively). Multivariable regression analysis revealed statistically significant relationships between residual step-off and respectively diminished flexion/extension (B = -36.8, 95% CI -62; -11.1, p = 0.006), diminished radial/ulnar deviation (B = -17.9, 95% CI -32.0; -3.9, p = 0.013) and worse ShortForm-36 "mental component score" (B = -15.4, 95% CI -26.6; -4.2, p < 0.001). Radiological measurements following distal radius fractures seem to evolve over time, but differences were small and were probably not clinically relevant. Range of motion, in particular flexion/extension, was impaired to such extend that it was noticeable for a patient, whereas grip strength was not impaired. The Patient Reported Wrist Evaluation was clinically relevantly diminished. Residual articular incongruency seems to influence range of motion.Implications for rehabilitationReporting Minimal Important Change regarding clinician and patient reported outcome following distal radius fractures is of more clinical value than reporting on statistical significance.Following distal radius fractures, the changes in radiological measurements do not seem to reflect a clinical relevant change.Range of motion, in particular flexion/extension, should be measured following distal radius fractures, as this might be impaired in a clinically relevant way.Measuring grip strength is of less importance following distal radius fractures, because grip strength does not seem to be affected.Residual articular incongruency seems to influence range of motion and therefore should be reduced to a minimum when treating non-osteoporotic patients.


Transformation of Schizosaccharomyces japonicus.
This protocol describes the use of electroporation to transform Schizosaccharomyces japonicus with plasmids or linear DNA. Plasmids are helpful for the complementation testing of mutations and for the expression of specific genes. Linear DNA fragments integrated into chromosomal DNA by homologous recombination are useful for gene deletion or to fuse a gene with a tag sequence (e.g., encoding a fluorescent protein). To introduce DNA into S. japonicus, electroporation methods are recommended because S. japonicus is sensitive to lithium acetate (LiOAc).


Hearing preservation in acoustic neuroma surgery.
Hearing conservation in acoustic tumour surgery remains controversial. There have been few previous reports in the British literature. The senior author has managed 24 patients by retrosigmoid surgery with the intention of preserving hearing during the last 9 years. The clinical features, surgical technique and results are discussed with respect to pre-operative selection criteria, and post-operative quality of hearing. Hearing preservation has been achieved in 11 (78.6%) of 14 patients with small or intracanalicular tumours and a mean minimum auditory threshold of 35 dB and 70% speech discrimination, the majority (81.8%) above the 50 dB/50% level. Tumour filing the fundus of the internal auditory canal was found to be a significant adverse prognostic factor as regards successful hearing preservation. Tumour excision was complete in all patients. Nearly 90% of patients had normal facial function, and the remaining 10% grade II function. Associated morbidity was minimal. It is suggested that the potential for hearing conservation should be considered as a factor in the management of patients with small acoustic neuromas.


Repression of oxidant-induced nuclear factor-kappaB activity mediates placental cytokine responses in gestational diabetes.
Although oxidative stress has been implicated in the pathogenesis of type 2 diabetes, limited data are available regarding its role in gestational diabetes mellitus (GDM), a disease of similar pathophysiology. The proinflammatory cytokines TNFalpha, IL-6, and IL-8 are released from the placenta at term and have been implicated in and/or associated with various metabolic events, including decreased insulin sensitivity. Previously we reported differences in the ex situ release of proinflammatory cytokines from placental and adipose tissues obtained from women with and without GDM. We proposed that these differences reflect preexposure and/or adaptation to oxidative stress by GDM tissues. In this study, we tested the hypothesis that placental tissue from women with GDM is less responsive to oxidative stress than tissue from normal women. Under basal conditions, release of TNFalpha, IL-6, and IL-8 was similar in both control and GDM groups. However, 8-isoprostane release was 2-fold greater in the GDM group (P < 0.01). In response to oxidative stress, TNFalpha and 8-isoprostane release and nuclear factor-kappaB (NF-kappaB) DNA-binding activity were significantly increased in normal tissues (20-fold, 2-fold, and 35%, respectively, P < 0.01). In contrast, the response of GDM tissues to oxidant stress was blunted, with no change in 8-isoprostane release, a 4-fold increase in TNFalpha release, and a 40% reduction in NF-kappaB DNA-binding activity. These data support the hypothesis that placentae from women with GDM display a reduced capacity, mediated by repression of NF-kappaB activity, to respond to oxidative stress.


Outbreaks of renal failure associated with melamine and cyanuric acid in dogs and cats in 2004 and 2007.
Sixteen animals affected in 2 outbreaks of pet food-associated renal failure (2 dogs in 2004; 10 cats and 4 dogs in 2007) were evaluated for histopathologic, toxicologic, and clinicopathologic changes. All 16 animals had clinical and laboratory evidence of uremia, including anorexia, vomiting, lethargy, polyuria, azotemia, and hyperphosphatemia. Where measured, serum hepatic enzyme concentrations were normal in animals from both outbreaks. All animals died or were euthanized because of severe uremia. Distal tubular lesions were present in all 16 animals, and unique polarizable crystals with striations were present in distal tubules or collecting ducts in all animals. The proximal tubules were largely unaffected. Crystals and histologic appearance were identical in both outbreaks. A chronic pattern of histologic change, characterized by interstitial fibrosis and inflammation, was observed in some affected animals. Melamine and cyanuric acid were present in renal tissue from both outbreaks. These results indicate that the pet food-associated renal failure outbreaks in 2004 and 2007 share identical clinical, histologic, and toxicologic findings, providing compelling evidence that they share the same causation.


Shaping robust system through evolution.
Biological functions are generated as a result of developmental dynamics that form phenotypes governed by genotypes. The dynamical system for development is shaped through genetic evolution following natural selection based on the fitness of the phenotype. Here we study how this dynamical system is robust to noise during development and to genetic change by mutation. We adopt a simplified transcription regulation network model to govern gene expression, which gives a fitness function. Through simulations of the network that undergoes mutation and selection, we show that a certain level of noise in gene expression is required for the network to acquire both types of robustness. The results reveal how the noise that cells encounter during development shapes any network's robustness, not only to noise but also to mutations. We also establish a relationship between developmental and mutational robustness through phenotypic variances caused by genetic variation and epigenetic noise. A universal relationship between the two variances is derived, akin to the fluctuation-dissipation relationship known in physics.


A role for activated Cdc42 in glioblastoma multiforme invasion.
Cdc42 is a Rho-GTPase which plays a major role in regulating cell polarity and migration by specifying the localization of filopodia. However, the role of Cdc42 in GBM invasion has not been thoroughly investigated. We generated stable doxycycline-inducible clones expressing wild type (WT)-, constitutively active (CA)-, and dominant negative (DN)-Cdc42 in three different human glioma cell lines. Expression of CA-Cdc42 significantly increased the migration and invasive properties of malignant glioma cells compared to WT and DN-Cdc42 cell clones, and this was accompanied by a greater number of filopodia and focal adhesion structures which co-localize with phosphorylated focal adhesion kinase (FAK). By mass spectrometry and immunoprecipitation studies, we demonstrated that activated Cdc42 binds to IQGAP1. When implanted orthotopically in mice, the CA-Cdc42 expressing glioma cells exhibited enhanced local migration and invasion, and led to larger tumors, which significantly reduced survival. Using the Cancer Genome Atlas dataset, we determined that high Cdc42 expression is associated with poorer progression free survival, and that Cdc42 expression is highest in the proneural and neural subgroups of GBM. In summary, our studies demonstrate that activated Cdc42 is a critical determinant of the migratory and invasive phenotype of malignant gliomas, and that its effect may be mediated, at least in part, through its interaction with IQGAP1 and phosphorylated FAK.


A validated stability-indicating gas chromatography method for determination of divalproex sodium impurities in pharmaceutical preparation.
A stability-indicating gas chromatography (GC) method has been developed and validated for the quantitative determination of divalproex sodium impurities in pharmaceutical preparation. A technique has been developed whereby the peak purity of a compound with poor UV detection can be determined using a gas chromatograph coupled with a mass spectrometer. The drug products were subjected to hydrolysis, oxidation, photolysis, and heat to apply stress conditions. The stability-indicating nature of the method has been proven by establishing peak purity of all stressed samples. The chromatographic separation was performed on a fused silica capillary (Quadrex-FFAP, 30 meter, 0.32 mm and 1 microm film thickness) column. The method validation results indicate that the method is specific, accurate, linear, reproducible, rugged, and robust. The effectiveness of the technique was demonstrated with stability sample analysis of divalproex sodium in its pharmaceutical preparation.


Lipoprotein effects of different thiazolidinediones in clinical practice.
To investigate and compare the effects of troglitazone and rosiglitazone on plasma lipoproteins in patients with type 2 diabetes mellitus and dyslipidemia. This cohort study was conducted in the Diabetes Clinic of the University of Alabama. We identified and studied 18 patients with type 2 diabetes and dyslipidemia first treated with troglitazone (600 mg/day) and then transferred to rosiglitazone therapy (8 mg/day). By lowering insulin resistance, thiazolidinediones have common effects on lipoproteins; however, these drugs may have important differences in their effects on individual lipid particles. In our patients, both troglitazone and rosiglitazone increased low-density lipoprotein (LDL) levels; however, only rosiglitazone significantly changed the LDL particle size to the larger, less atherogenic LDL particle. Similarly, both troglitazone and rosiglitazone increased high-density lipoprotein (HDL) concentrations; however, although troglitazone increased only HDL(3), rosiglitazone also significantly increased the larger, more cardioprotective HDL(2) particle. Furthermore, only troglitazone increased Lp(a) significantly. In contrast, rosiglitazone and not troglitazone significantly increased triglycerides. Small but significant differences exist in the effects of different thiazolidinediones on lipoproteins in patients with type 2 diabetes. Overall, the changes in lipoprotein profile induced by rosiglitazone therapy seem to have less atherogenic potential than those resulting from the use of troglitazone.


Immunization with the Malaria Diversity-Covering Blood-Stage Vaccine Candidate Plasmodium falciparum Apical Membrane Antigen 1 DiCo in Complex with Its Natural Ligand PfRon2 Does Not Improve the In Vitro Efficacy.
The blood-stage malaria vaccine candidate Plasmodium falciparum apical membrane antigen 1 (PfAMA1) can induce strong parasite growth-inhibitory antibody responses in animals but has not achieved the anticipated efficacy in clinical trials. Possible explanations in humans are the insufficient potency of the elicited antibody responses, as well as the high degree of sequence polymorphisms found in the field. Several strategies have been developed to improve the cross-strain coverage of PfAMA1-based vaccines, whereas innovative concepts to increase the potency of PfAMA1-specific IgG responses have received little attention even though this may be an essential requirement for protective efficacy. A previous study has demonstrated that immunization with a complex of PyAMA1 and PyRON2, a ligand with an essential functional role in erythrocyte invasion, leads to protection from lethal Plasmodium yoelli challenge in an animal model and suggested to extend this strategy toward improved strain coverage by using multiple PfAMA1 alleles in combination with PfRon2L. As an alternative approach along this line, we decided to use PfRon2L in combination with three PfAMA1 diversity covering variants (DiCo) to investigate the potential of this complex to induce more potent parasite growth inhibitory immune response in combination with better cross-strain-specific efficacy. Within the limits of the study design, the ability of the PfAMA1 DiCo-Mix to induce cross-strain-specific antibodies was not affected in all immunization groups, but the DiCo-PfRon2L complexes did not improve the potency of PfAMA1-specific IgG responses.


Chamber music hall acoustics: Measurements and perceptual differences.
This study investigates the room acoustics of seven chamber music halls of various modern and historical architecture by means of objective room acoustic measures and a subjective listening experiment. The acoustic measurements were performed with heavy cloth covering the audience areas to simulate occupancy in the halls. A loudspeaker quartet was used for auralizations, which were reproduced in a surrounding loudspeaker array. The perceptual differences between the halls were evaluated in terms of envelopment, warmth, clarity, proximity, and preference by using a paired comparison paradigm. The subjective evaluations were conducted in two different laboratories and latent class analysis was used to study the agreement between laboratories and the emergence of different listener groups in the ratings of each attribute. Concerning preference, the emergence of two groups found in the study of large symphony halls was confirmed, where one group prefers rich, enveloping sound and one group prefers high clarity. The perceptual ratings were not clearly associated with a specific hall shape, but rather depended on the distribution of early and late sound energy. Thus, the distinction between rectangular and non-rectangular floor plans previously found for large symphony halls was not observed with these smaller halls.


A prospective randomized trial of intravenous ketorolac vs. acetaminophen administered with opioid patient-controlled analgesia in gynecologic surgery.
To determine which non-narcotic analgesic, acetaminophen (Ofirmev®) or ketorolac (Toradol®), provides better post-operative pain control when combined with an opioid patient-controlled analgesia (PCA) pump. Secondary objectives include comparisons of the rates of ileus, post-operative bleeding, transfusions, and length-of-hospitalization (LOH). A prospective, randomized trial of acetaminophen (A) 1-g intravenous (IV) every 6-h or ketorolac (K) 15-mg IV every 6-h from post-operative day 1-3 in addition to an opioid PCA for patients undergoing benign or malignant gynecologic laparotomy procedures was performed. Abstracted data included pain levels via visual analogue pain scales (VAS), amount of narcotic used, hepatic enzyme levels, hemoglobin, urine output, blood transfusions, time to return of flatus and LOH. One-hundred patients were accrued and underwent 55 benign gynecologic laparotomies and 45 cancer-related laparotomies. VAS pain levels (3.3 K, 3.5 A) and morphine PCA use (79.1 oral morphine equivalents [OME] K vs. 84.5 A) were not different, however dilaudid PCA usage was less by K patients (84.4 OME K and 136.8 OME A, p < 0.001). There was a significant hemoglobin change between the two groups (2.6 g K vs. 2 g A, p = 0.015), however blood transfusions were equal (28% K, 22% A, p > 0.05). Return of flatus was 2.7-days for K vs. 3.4-days for A (p = 0.011) and LOH was not different (4.4-days K vs. 5.1-days A, p = 0.094). Both intravenous ketorolac and acetaminophen provide similar post-operative analgesia through VAS pain scales and total usage of morphine via PCA pumps. Use of ketorolac with dilaudid PCA was associated with less dependence on dilaudid and a quicker return of bowel function than acetaminophen, however length of stay and transfusion rates were not different.


[A case-control study of the risk factors for lung cancer among Chinese women who have never smoked].
To investigate the risk factors for lung cancer among women who had never smoked. Methods A 1:2 matched case-control study was carried out. The cases are the no-smoking female patients with the primary lung cancer diagnosed by pathology mothed from hospitals in Beijing, Shanghai and Chengdu between September 2001 and February 2004. One hospital control and one population control matched for age, sex and no-smoking et al., were enrolled. The case and control were interviewed about the exposure information of related factors using the uniform questionnaire. Statistical analysis of single-factor and multivariate conditional Logistic regression were performed to screen the risk factors of lung cancer. During the single-factoranalysis, 28 exposure factors were identified as risk factors for lung cancer. The multivariate conditional Logistic regression show that passive smoking index > or = 50 person * year (OR = 1.77,95% CI, 1.07 - 2.92), consumption of internal organs of animals (OR = 1.85,95% CI, 1.06 - 3.22), and occupational exposure to dust (OR = 2.47,95% CI, 1.21 - 5.03) and bad ventilation in workplace( OR = 4.02,95% CI, 1.74 - 9.29) are risk factors for lung cancer, but consumption of vegetables( OR = 0.26, 95% CI, 0.12 - 0.59), taking vitamins often (OR = 0.53, 95% CI, 0.30 - 0.93), average month income per person after married > or = 500 yuan ( OR = 0.50, 95% CI, 0.28 - 0.91) and the first procreation occurred between 24 and 30 years old (OR = 0.53, 95% CI, 0.32 - 0.90) are the protective factors for lung cancer. The dose-response were observed between passive smoking and risk rate of lung cancer by trend test. Some factors such as passive smoking, consumption of internal organs of animals, occupational exposure to dust and bad ventilation in workplace can increase the risk of lung cancer for women who had never smoked. Other factors such as consumption of vegetables, taking vitamins, and so on, can reduce the risk of lung cancer for women who had never smoked.


Evaluation of formal quality of Spanish psychiatry journals.
Standardization of scientific journals is a fundamental factor for a successful scientific communication, since it has repercussions on the role accomplishment of journals as research dissemination agents and expressive and representative channels of the different scientific communities. The formal characteristics of the seven psychiatric journals included in the IME (Spanish Medical Index) database in 2006 were evaluated. A specific form was designed to evaluate the 64 different characteristics of each journal, based on the IME qualitative criteria for being included. Journals having the highest overall scores were Actas Españolas de Psiquiatría with 68/82 points, followed by European Journal of Psychiatry (65/82 points), Anales de Psiquiatría (58/82 points), Psiquiatría Biológica (57/82 points) and Informaciones Psiquiátricas (45/82 points). Spanish psychiatric journals fulfill most of the requirements, although some of them could be improved, such as failures in the regularity of the publication, the English presentation of the abstracts and the paper typology specification, indication of the reception and acceptance date and lack of a clear description of the publishing process for the selection of the manuscripts and peer review.


Plasmon-enhanced strong exciton-polariton coupling in single microwire-based heterojunction light-emitting diodes.
Manipulating the strong light-matter coupling interaction in optical microresonators that are naturally formed by semiconductor micro- or nanostructures is crucial for fabricating high-performance exciton-polariton devices. Such devices can function as coherent light sources having considerably lower emission threshold. In this study, an exciton-polariton light-emitting diode (LED), made of a single ZnO microwire (MW) and a p-GaN substrate, serving as the hole injector, was fabricated, and its working characteristics, in the near-ultraviolet region, were demonstrated. To further improve the quality of the single ZnO MW-based optical microresonator, Ag nanowires (AgNWs) with ultraviolet plasmonic response were deposited on the MW. Apart from the improvement of the electrical and optical properties of the hexagonal ZnO MW, the optically pumped whispering-gallery-mode lasing characteristics were significantly enhanced. Furthermore, a single ZnO MW not covered, and covered by AgNWs, was used to construct a heterojunction LED. Compared with single bare ZnO MW-based LED, significant enhancement of the device performance was achieved, including a significant enhancement in the light output and a small emission band blueshift. Specifically, the exciton-polariton emission was observably enhanced, and the corresponding Rabi splitting energy (∼ 495 meV) was significantly higher than that of the bare ZnO MW-based LED (∼ 370 meV). That ultraviolet plasmons of AgNWs enhanced the exciton-polariton coupling strength was further confirmed via angle-resolved electroluminescence measurements of the single MW-based polaritonic devices, which clearly illustrated the presence of Rabi splitting and subband anti-crossing characteristics. The experimental results provide new avenues to achieve extremely high coupling strengths, which can accelerate the advancements in electrically driven high-efficiency polaritonic coherent emitters and nonlinear devices.


Analysis of the coliphage T5 DNA ejection process with free and liposome-associated TonA protein.
Outer membrane protein TonA, the receptor for coliphage T5, has been partially purified and incorporated into the phospholipid bilayer of liposomes. Adsorption of the phage to its receptor in either a free or liposome-associated form is fast and sufficient to trigger the ejection of encapsidated DNA. In both in vitro systems the exit of DNA from the phage capsid is a very slow process. Ejected DNA can partially accumulate inside the liposome aqueous compartment, but the transfer from the phage head to the liposome internal space is never complete, perhaps because the liposome volume is too small. The presence of polyamines or divalent cations (magnesium) or both in the incubation medium diminished the extent of DNA ejection, possibly by stabilizing DNA inside the head. DNA movement was slowed as the temperature was decreased from 37 to 18 degrees C. Furthermore, incubation at 4 degrees C totally prevented this DNA movement, even if a large part of the DNA had already exited the capsid.


Current targeted therapeutics against COVID-19: Based on first-line experience in China.
SARS-CoV-2 is a novel strain, causing a global pandemic since the end of 2019. The majority of patients showed nonspecific symptoms such as fever, dry cough, and fatigue. Most patients have a good prognosis while some with severe conditions could rapidly progress to acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulation dysfunction, and even die. The exacerbation of the patient's condition may be due to a cytokine storm in the body. Effective targeted therapies including antiviral and immunization are urgently needed. Although many clinical trials are already underway and the majority of patients have received antiviral therapy based on medication experience with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and preliminary results from some clinical trials, there are no antiviral drugs proven to be effective currently. We summarize the current therapeutic medicines used in the clinic, hope to be able to provide some implications for clinical medication.


Primary synovial sarcoma of the kidney with rhabdoid features.
Synovial sarcoma is a soft tissue sarcoma with clearly defined histologic, immunophenotypic, and molecular features. It occurs predominantly in the extremities of young adults but has been reported in many other anatomic sites. Histologically, it is classified as biphasic, monophasic, and poorly differentiated. The latter category, which includes tumors with a rhabdoid morphology, has been associated with a more aggressive behavior. Generally, the biphasic variant does not pose any diagnostic problem because of its typical histologic appearance; in contrast, the monophasic and poorly differentiated variants may represent a diagnostic challenge because their microscopic features can be confused with those of other spindle cell tumors with rhabdoid features. The application of molecular techniques, such as reverse transcriptase polymerase chain reaction to detect the fusion transcript associated with the characteristic t(X;18) translocation of synovial sarcoma, has enabled the confirmation of this diagnosis, even in cases of unusual localization, such as the one we present here.