Lead exposure and increased food allergic sensitization in U.S. children and adults.
Whether blood lead levels are associated with sensitization to food allergens in adults and children is unclear. Prior studies have shown that exposure to lead is associated with atopic sensitization and modulation of several cytokines (eg, interleukin [IL]-12, IL-10, interferon [IFN]-γ, and IL-4 production) and with T-cell dysregulation and bias toward T helper 2 (Th2) activity. The objective of this work was to assess whether exposure to lead is independently associated with allergic symptoms and sensitizations in a large nationally representative sample of children and adults. We studied 2712 children and 4333 adults enrolled in the 2005-2006 cycle of the National Health and Nutritional Examination Surveys (NHANES). Participants were tested for serum-specific immunoglobulin E (IgE) levels to food allergens as well as blood lead levels. Food allergens tested included shrimp, egg, peanut, and milk. Logistic regression models adjusted for demographic factors, body mass index, history of asthma, smoking, housing characteristics, and current exposure to animals in the home, to assess the association of blood lead levels with sensitization to food allergens. Median (interquartile range [IQR]) for serum blood was 0.87 μg/L (0.61 to 1.31) in children and 1.48 μg/L (0.92 to 2.34) in adults. At baseline, 672 (24.7%) of children participants and 719 (16.6%) of adult participants tested positive for increased sensitization to food allergens. A 2-fold increase in blood lead levels in adult participants was associated with increased sensitization to food allergens (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02 to 1.22). Blood lead was not associated with sensitization to food allergens among pediatric participants (OR, 0.95; 95% CI, 0.82 to 1.10). Exposure to lead was associated with increased odds of sensitization to food allergens in adult but not children participants.


Safety and effectiveness of vessel sealing for dissection during pancreaticoduodenectomy.
Traditional pancreaticoduodenectomy dissection techniques are tedious and time-consuming. The LigaSure(®) Vessel Sealing System is an alternative to standard dissection methods. LigaSure(®) can be used in replace of ligatures, clips, and sutures in most of the pancreaticoduodenectomy procedure. The objective of this study was to examine our experience with LigaSure(®) in pancreaticoduodenectomies and to show the safety and time-effectiveness. Forty-three pancreaticoduodenectomies were performed by a single surgeon using the LigaSure(®) device in place of traditional dissection techniques. A retrospective chart review was conducted to evaluate patient management and outcome. Demographics, preoperative, intraoperative, and postoperative data were analyzed. The average patient age was 61 years. Primary pathologic diagnoses were: periampullary carcinoma (56%), chronic pancreatitis (5%), cystic lesion (26%), neuroendocrine tumor (7%), and other (5%). Our patient population demonstrated American Society of Anesthesiologists Class I (2%), Class II (14%), III (75%), and IV (9%). Average operative time was 4:11 hours. The study group required an average of 0.49 ± 1.35 units of blood. Eight patients (19%) received blood transfusion, receiving an average of 2.63 ± 2.13 units. Patients had a median hospital stay of 10 days (range, 5 to 41 days). An oral diet was ordered for most patients by Day 4. Fourteen patients (32.5%) had a complication, including two patients requiring additional surgery for drainage of abscess. There were no postoperative deaths. The use of LigaSure(®) is a practical and safe alternative to standard dissection techniques. Operative time, blood loss, and complication rate are favorable compared with published series.


[Microbial air monitoring in operating theatre: active and passive samplings].
Microbial air contamination was evaluated in 11 operating theatres using active and passive samplings. SAS (Surface Air System) air sampling was used to evaluate cfu/m3 and settle plates were used to measure the index of microbial air contamination (IMA). Samplings were performed at the same time on three different days, at three different times (before, during and after the surgical activity). Two points were monitored (patient area and perimeter of the operating theatre). Moreover, the cfu/m3 were evaluated at the air inlet of the conditioner system. 74.7% of samplings performed at the air inlet and 66.7% of the samplings performed at the patient area before the beginning of the surgical activity (at rest) exceeded the 35 cfu/m3 used as threshold value. 100% of IMA values exceeded the threshold value of 5. Using both active and passive sampling, the microbial contamination was shown to increase significantly during activity. The cfu values were higher at the patient area than at the perimeter of the operating theatre. Mean values of the cfu/m3 during activity at the patient area ranged from a minimum of 61+/-41 cfu/m3 to a maximum of 242+/-136 cfu/m3; IMA values ranged from a minimum of 19+/-10 to a maximum of 129+/-60. 15.2% of samplings performed at the patient area using SAS and 75.8% of samplings performed using settle plates exceeded the threshold values of 180 cfu/m3 and 25 respectively, with a significant difference of the percentages. The highest values were found in the operating theatre with inadequate structural and managerial conditions. These findings confirm that the microbiological quality of air may be considered a mirror of the hygienic conditions of the operating theatre. Settle plates proved to be more sensitive in detecting the increase of microbial air contamination related to conditions that could compromise the quality of the air in operating theatres.


Wealth exchange models and machine learning: Finding optimal risk strategies in multiagent economic systems.
The Yard-Sale Model, a well known wealth exchange model whose observed macroscopic behavior hides many underlying aspects of particular complexity, was studied at the microscopic level. The performance of the agents during the successive transactions allows for the definition of successful or disadvantageous strategies according to the profit they achieve at the end of the process. Optimal strategies were found that maximize the individual wealth of each agent by performing their training through a genetic algorithm. The addition of different levels of rationality given by the amount of available information from their environment showed promising results, at both the microscopic and macroscopic levels. Remarkably, after the training process, the rational agents were able to determine when it would be convenient to interact with their opponents. Additionally, a region of parameters was found for which the distribution of wealth is a power law throughout the whole wealth range. As a general result, the incorporation of rational agents in this type of systems leads to greater inequality at the collective level.


[Surgery of mitral valve insufficiency. Results of 10 years].
From 1987 to 1996 we operated on 263 patients for mitral insufficiency. Multiple valve operations were excluded, with the exception of tricuspid reconstruction for functional regurgitation. The perioperative mortality was 3%, while the late mortality rate during a mean follow-up period of 3.5 years amounted to 2% per patient year and 1.7% if only cardiac causes were considered. The prognosis for patients with rheumatic, endocarditic and ischemic valvular disease was much worse compared to that for a degenerative cause. The latter group consisted of 209 patients with an operative mortality of 1.4% and a late mortality rate per patient year of 1.4% and 0.9% for cardiac causes only. Further analysis showed a significant prognostic improvement for patients with a preoperative ejection fraction of more than 60% and a repairable valve.


Role of uric acid in the link between arterial stiffness and cardiac hypertrophy: a cross-sectional study.
Hyperuricaemia has been linked to atherosclerosis; however, there is limited evidence about its association with arterial stiffness and cardiac hypertrophy, which are associated with adverse cardiovascular outcomes. We studied the association of hyperuricaemia with an increased risk of arterial stiffness and cardiac hypertrophy in a population participating in a health-screening programme. In subjects who underwent health screening from 2005 to 2007, arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV), whereas cardiac hypertrophy was determined by plain chest radiography and electrocardiography. Polychotomous logistic regression was used to identify associations of hyperuricaemia with arterial stiffness and cardiac hypertrophy, after adjusting for the presence of metabolic syndrome. Of the total 9375 subjects enrolled, 1324 (14.5%) had hyperuricaemia. Subjects with hyperuricaemia had a significantly higher baPWV [1618.8 (379.3) cm/s] than those without it [1501.8 (334.9) cm/s]. Cardiac hypertropy was observed in 1047 (11.2%) subjects. Hyperuricaemia was associated with cardiac hypertrophy with an odds ratio (OR) of 1.53 (95% CI 1.32, 1.77). Polychotomous logistic regression showed that hyperuricaemia was associated with ORs (95% CI) for coexisting abnormal baPWV and cardiac hypertrophy of 1.75 (95% CI 1.24, 2.47) and 1.41 (95% CI 1.04, 1.91) in men and women, respectively, after adjusting for age, proteinuria, high high-sensitive CRP, abnormal ankle-brachial index or a number of metabolic syndrome components present. Hyperuricaemia was associated with arterial stiffness and cardiac hypertrophy. Hyperuricaemia, along with other risk factors related to atherosclerosis, could play a role in the development of cardiac hypertrophy by increasing arterial stiffness.


In situ detection of cellular and abnormal isoforms of prion protein in brains of cattle with bovine spongiform encephalopathy and sheep with scrapie by use of a histoblot technique.
To detect prion protein, brains from 5 cattle naturally affected with bovine spongiform encephalopathy (BSE) and 3 sheep naturally affected with scrapie were examined and compared with brains of normal cattle and sheep using a histoblot technique. The technique enabled the in situ distinctive detection of the cellular (PrP(C)) and abnormal (PrP(Sc)) isoforms of the prion protein. In BSE- or scrapie-affected brains, the Prp(C) signal decreased, especially in those areas where the PrP(Sc) signal was detected.


Identification of useful biomolecular markers in kidney renal clear cell carcinoma: an in silico and in vitro analysis-based study.
Kidney renal clear cell carcinoma (KIRC) is the most prevalent type of renal cell carcinoma (RCC), with a high incidence and mortality rate. There is a lack of sensitive biomarkers. Therefore, the discovery of accurate biomarkers for KIRC patients is critical to improve prognosis. We determined hub genes and their associated pathways involved in the pathogenesis of KIRC from the GSE66272 dataset consisting of KIRC (n = 26) and corresponding control (n = 26) samples and later validated the expression and methylation level of the identified hub genes on The Cancer Genomic Atlas (TCGA) datasets and Human RCC 786-O and normal HK-2 cell lines through RNA sequencing (RNA-seq), Reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and targeted bisulfite sequencing (bisulfite-seq) analyses. The identified up-regulated four hub genes include TYROBP (Transmembrane Immune Signaling Adaptor TYROBP), PTPRC (Protein tyrosine phosphatase, receptor type, C), LCP2 (Lymphocyte cytosolic protein 2), and ITGB2 (Integrin Subunit Beta 2). Moreover, the higher expression of TYROBP, PTPRC, LCP2, and ITGB2 in KIRC patients insignificantly correlates with a poor prognosis in KIRC patients. In addition, hub genes were involved in the "Fc epsilon RI signaling pathway, asthma, natural cell killer mediated cytotoxicity, T cell receptor signaling pathway, primary immunodeficiency, Fc gamma R-mediated phagocytosis, malaria, leukocyte transendothelial migration, and legionellosis" pathways and associated with the infiltration level of CD8+ T, CD4+ T, and macrophage cells. Our integrated in silico and in vitro analysis identified important hub genes (TYROBP, PTPRC, LCP2, and ITGB2) involved in the pathogenesis of KIRC as possible diagnostic biomarkers.


Influences of current density on tribological characteristics of ceramic coatings on ZK60 Mg alloy by plasma electrolytic oxidation.
Current density is a key factor of plasma electrolytic oxidation process. Its influences on structure, mechanical, and tribological characteristics of ceramic coatings on ZK60 Mg alloy by pulsed bipolar microplasma oxidation in Na(3)PO(4) solution were studied in this paper. Thickness, structure, composition, mechanical property, and tribological characteristics of the coatings were studied by eddy current coating thickness gauge, scanning electron microscope (SEM), X-ray diffraction (XRD), nanoindentation measurements, and ball-on-disk friction testing. The results show that all the coatings prepared under different current densities are composed of MgO phase. The amount of MgO phase, thickness and friction coefficient of the coatings increased with the increasing current density. Among three ceramic coatings produced under three current densities, the coating produced under the current density of 7 A/dm(2) got the highest nanohardness and lowest wear rate with the value of 1.7 GPa and 1.27 x 10(-5) mm(3)/Nm.


[Investigations on the endoparasitic fauna of domestic cats in eastern Brandenburg].
The internal organs of 155 cats originating from 3 different territories in the eastern part of Brandenburg state were examined for parasites between 1993 and 1995. Parasites were found in 85% of cats. Parasites with the highest prevalence were Toxocara mystax (45%), Hydatigera taeniaeformis (22%), Ancylostoma tubaeforme (17%) and Opisthorchis felineus (16%). Metorchis bilis, Mesocestoides spp., Taenia pisiformis, Capillaria plica, Capillaria sp., Ollulanus tricuspis, Aelurostrongylus abstrusus, Cystoisospora spp. and Sarcocystis spp. were diagnosed with a lower frequency. The occurrence of H. taeniaeforme, A. tubaeformis und O. felineus was depending on the origin of the cats.


Microsomal enzyme induction, lipoproteins and atherosclerosis.
The liver is the principal site for the synthesis and elimination of lipoproteins circulating in plasma, and alterations in hepatic function influence plasma lipoprotein levels. High HDL-C/T-C and apo A-I/apo B ratios, which are characteristic of a low coronary risk, have been typical of healthy subjects with high microsomal enzyme activity in the liver. Microsomal enzyme inducing drugs such as phenytoin, phenobarbital and carbamazepine, and also alcohol, influence serum lipid and apoprotein concentrations. The inducers increase the concentrations of hepatic microsomal enzyme and apo A-I mRNA, and also proteins and phospholipids. They similarly increase serum HDL-C and apo A-I levels and the HDL-C/LDL-C ratio, powerful protective factors against coronary heart disease. These parameters parallel hepatic protein and phospholipid concentrations, and microsomal enzyme activity as assessed by liver cytochrome P-450 or antipyrine kinetics. Serum LDL-C levels are inversely proportional to hepatic cytochrome P-450 concentrations. Experimental studies indicate that phenobarbital retards cholesterol accumulation in the arterial wall and the formation of atherosclerotic plaque. A decreased mortality rate from coronary heart disease has been reported for subjects who take enzyme inducers, drugs or alcohol, whereas impairment of hepatic microsomal function may promote atherogenesis. In addition to drugs non-pharmacological factors such as dietary constituents and physical exercise may influence hepatic microsomal function and hence improve the serum lipoprotein profile. These observations, which connect microsomal inducers, liver lipids and proteins, serum lipids and apoproteins characteristic of a low risk of atherosclerotic disease and low incidence of coronary deaths, lead to the conclusion that the activation of liver microsomal function can prevent atherogenesis in man.


Do mother's interests in weight control influence preschoolers' obesity and weight related concerns?
The purpose of this study was to assess the relationship between the mother's interest in weight control and its association with the preschooler's obesity and weight related concerns. This was a cross-sectional study based on 470 parents' self-reports. To score interests in weight control, mothers rated each of 6 items on a five-point Likert scale ranging from disagree (1) to agree (5). The perceptions of mothers' weights and their children's weights, mothers' Body Mass Index (BMI), preschoolers' Weight-Length Index (WLI) (%), and weight-related concerns were determined. The mothers' BMI was significantly correlated with interest scores of weight control in mothers (r=0.632, p<0.001) while their children's obesity was weakly correlated with the mothers' interest scores (r=0.133, p=0.025). Mothers with a high interest of weight control reported higher percentages of family history of obesity than mothers with lower interests (63.2% vs. 36.8%, p<0.001). Two-thirds of the mothers (65.4%) were accurate in their perceptions about their weights. Similarly, 63.7% of mothers knew exactly their children's weight-statuses. Compared with mothers with low interest in weight controls, mothers with high interest in weight control had lower correct-perceptions about their weights (p<0.05) but higher correct-perceptions about their children's weights. More than two-thirds of mothers (85%) reported not worrying about their children's obesity in the future. Only 14.3% of the mothers were satisfied with their current weight statuses. Three-fourths of mothers preferred exercise as an effective weight-control method for their children, 20% preferred diet therapy and 5.5% preferred behavior modification. More girls were overweight / obese, than boys (overweight: 16.1% (girl) vs. 12.8% (boy), obese: 5.4% (girl) vs. 4.5% (boy)). About 40% of overweight girls' mothers had low interests in their weight controls with low correct-perceptions in their children's weights, which suggests possible elevated risk of obesity, especially in girls, in the future.


The association between thyroid-stimulating hormone and thyroid nodules, goiter and thyroid antibody positivity.
The relationship between normal thyroid-stimulating hormone (TSH) levels and thyroid disease in adults remains controversial. This study aimed to investigate the correlation between serum TSH levels, particularly those falling within the normal range, and thyroid diseases in Chinese adults, including thyroid nodules (TN), goiter (GR), and thyroid antibody positivity. This research was a cross-sectional study conducted in an adult population in Tianjin, China. Thyroid volume (Tvol) and TN were assessed using thyroid ultrasonography. Fasting venous blood and spot urine samples were collected to evaluate thyroid function and iodine status. A total of 2460 subjects participated in the survey. The prevalence of thyroid dysfunction was 9.76%, and abnormal TSH levels were found to potentially increase the risk of GR and thyroid antibody positivity in adults. A total of 2220 subjects with TSH within the normal reference range were included in the further study. In these patients, Tvol decreased as TSH levels increased, in both men and women (P < 0.0001). Low TSH levels (0.27-1.41 IU/mL) were identified as a risk factor for TN (odds ratio [OR], 1.46; 95% CI: 1.14-1.87) and GR (OR 5.90, 95% CI 2.27-15.3). Upon stratification by sex and age, the risk of TN was found to be higher in women and elderly individuals (≥60 years old), while the risk of GR was found to be higher in men and younger individuals (<60 years old). High TSH levels (2.55-4.2 IU/mL) were identified as a risk factor for thyroid antibody positivity (OR, 1.53; 95% CI: 1.11-2.10). Men and younger individuals with high TSH levels exhibited a higher risk of thyroid antibody positivity. In adults with normal TSH levels, low TSH levels were associated with an increased risk of TN and GR, whereas high TSH levels were associated with thyroid antibody positivity. The research also suggests that adults whose TSH levels at upper or lower limits of the normal range should be reviewed regularly.


RAPID COMMUNICATION: Generation of FGF5 knockout sheep via the CRISPR/Cas9 system.
Sheep are an important source of fiber production. Fibroblast growth factor 5 (FGF5) is a dominant inhibitor of length of the anagen phase of the hair cycle. Knockout or silencing of the gene results in a wooly coat in mice, donkeys, dogs, and rabbits. In sheep breeding, wool length is one of the most important wool quality traits. However, traditional breeding cannot accurately and efficiently mediate an advanced genotype into the sheep genome. In this study, we generated 3 knockout sheep via the 1-step clustered regularly interspaced short palindromic repeat (CRISPR)/Cas9 system. Sequencing analysis confirmed that mutations in the gene existed in all germ lines of 3 founders: besides the intact sequence, 3 kinds of deletions in the gene (including 5, 13, and 33 bp) were detected. The changes in the primary and senior structure of the FGF5 protein due to the 3 deletions in founders suggested that the FGF5 protein was dysfunctional. In addition, the expression level of intact mRNA in heterozygous individuals decreased compared with the wild types ( < 0.01). Functionally, we discovered that wool length in founders was significantly longer than in wild types ( < 0.05). Collectively, the knockout sheep with the longer wool length phenotype will provide an efficient way for fast genetic improvement of sheep breeding and promote the development of wool industry.


Formulation and evaluation of nano lipid formulation containing CNS acting drug: molecular docking, in-vitro assessment and bioactivity detail in rats.
The study performed molecular docking, formulated, characterized thymoquinone (TQ) loaded solid lipid nano particles (TQSLN) and exhibited comparative antidepressant activity. TQ loaded nano lipid formulations were prepared by solvent injection methods and characterize for different in-vitro parameters. The optimized formulation was evaluated for depression using unpredictable chronic mild stress (UCMS) model for a period of six weeks. TQSLN was assessed in modified forced swim test (MFST), tail suspension test (TST), locomotor activity followed by biochemical parameters such as monoaminesand brain derived neurotrophic factor (BDNF). The results of molecular docking study revealed that TQ has shown greater affinity and tighter binding capacity for the active site of neurotransmitter receptors. TQSLN showed nanometric size, optimum zeta potential with high percent encapsulation and lower poly dispersity index (PDI). Transmission electron microscopy (TEM) images showed spherical shape without aggregation and agglomeration of particles. The in-vivo study result revealed that the higher amount of TQ reaches to the target region by showing higher levels of monoamines 5 hydroxytryptamine (5-HT), dopamine (DA) and norepinephrine (NE) as compared to thymoquinone suspension (TQS) in brain. In conclusion, the nano lipid formulation remarkably improved the bio-efficacy of TQ and demonstrated a promising perspective for oral delivery of poorly water-soluble drugs.


Atypical Optic Neuritis.
Classic demyelinative optic neuritis is associated with multiple sclerosis and typically carries a good prognosis for visual recovery. This disorder is well characterized with respect to its presentation and clinical features by baseline data obtained through the optic neuritis treatment trial and numerous other studies. Atypical optic neuritis entails clinical manifestations that deviate from this classic pattern of features. Clinical signs and symptoms that deviate from the typical presentation should prompt consideration of less common etiologies. Atypical features to consider include lack of pain, simultaneous or near-simultaneous onset, lack of response to or relapse upon tapering from corticosteroids, or optic nerve head or peripapillary hemorrhages. The most important alternative etiologies to consider and the steps towards their respective diagnostic evaluations are suggested for these atypical features.


Structural insight into DNA joining: from conserved mechanisms to diverse scaffolds.
DNA ligases are diverse enzymes with essential functions in replication and repair of DNA; here we review recent advances in their structure and distribution and discuss how this contributes to understanding their biological roles and technological potential. Recent high-resolution crystal structures of DNA ligases from different organisms, including DNA-bound states and reaction intermediates, have provided considerable insight into their enzymatic mechanism and substrate interactions. All cellular organisms possess at least one DNA ligase, but many species encode multiple forms some of which are modular multifunctional enzymes. New experimental evidence for participation of DNA ligases in pathways with additional DNA modifying enzymes is defining their participation in non-redundant repair processes enabling elucidation of their biological functions. Coupled with identification of a wealth of DNA ligase sequences through genomic data, our increased appreciation of the structural diversity and phylogenetic distribution of DNA ligases has the potential to uncover new biotechnological tools and provide new treatment options for bacterial pathogens.


Metastable Marcasite-FeS2 as a New Anode Material for Lithium Ion Batteries: CNFs-Improved Lithiation/Delithiation Reversibility and Li-Storage Properties.
Marcasite (m-FeS2) exhibits higher electronic conductivity than that of pyrite (p-FeS2) because of its lower semiconducting gap (0.4 vs 0.7 eV). Meanwhile, as demonstrates stronger Fe-S bonds and less S-S interactions, the m-FeS2 seems to be a better choice for electrode materials compared to p-FeS2. However, the m-FeS2 has been seldom studied due to its sophisticated synthetic methods until now. Herein, a hierarchical m-FeS2 and carbon nanofibers composite (m-FeS2/CNFs) with grape-cluster structure was designed and successfully prepared by a straightforward hydrothermal method. When evaluated as an electrode material for lithium ion batteries, the m-FeS2/CNFs exhibited superior lithium storage properties with a high reversible capacity of 1399.5 mAh g-1 after 100 cycles at 100 mA g-1 and good rate capability of 782.2 mAh g-1 up to 10 A g-1. The Li-storage mechanism for the lithiation/delithiation processes of m-FeS2/CNFs was systematically investigated by ex situ powder X-ray diffraction patterns and scanning electron microscopy. Interestingly, the hierarchical m-FeS2 microspheres assembled by small FeS2 nanoparticles in the m-FeS2/CNFs composite converted into a mimosa with leaves open shape during Li+ insertion process and vice versa. Accordingly, a "CNFs accelerated decrystallization-recrystallization" mechanism was proposed to explain such morphology variations and the decent electrochemical performance of m-FeS2/CNFs.


Clinical value of F-FDG PET/CT in assessing suspicious relapse after rectal cancer resection.
To evaluate the value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the restaging of resected rectal cancer. From January 2007 to Sep 2008, 21 patients who had undergone curative surgery resection for rectal carcinoma with suspicious relapse in conventional imaging or clinical findings were retrospectively enrolled in our study. The patients underwent 28 PET/CT scans (two patients had two scans, one patient had three and one had four scans). Locoregional recurrences and/or distant metastases were confirmed by histological analysis or clinical and imaging follow-up. Final diagnosis was confirmed by histopathological diagnosis in 12 patients (57.1%) and by clinical and imaging follow-up in nine patients (42.9%). Eight patients had extrapelvic metastases with no evidence of pelvic recurrence. Seven patients had both pelvic recurrence and extrapelvic metastases, and two patients had pelvic recurrence only. (18)F-FDG PET/CT was negative in two patients and positive in 19 patients. (18)F-FDG PET/CT was true positive in 17 patients and false positive in two. The accuracy of (18)F-FDG PET/CT was 90.5%, negative predictive value was 100%, and positive predictive value was 89.5%. Five patients with perirectal recurrence underwent (18)F-FDG PET/CT image guided tissue core biopsy. (18)F-FDG PET/CT also guided surgical resection of pulmonary metastases in three patients and monitored the response to salvage chemotherapy and/or radiotherapy in four patients. (18)F-FDG PET/CT is useful for evaluating suspicious locoregional recurrence and distant metastases in the restaging of rectal cancer after curative resection.


Evaluation of corneal elevation in eyes with subclinical keratoconus and keratoconus using Galilei double Scheimpflug analyzer.
To measure corneal elevations in eyes with subclinical keratoconus and those with keratoconus using the Galilei Scheimpflug analyzer and to determine the optimal corneal elevation cutoff points to maximize sensitivity and specificity in discriminating keratoconus and subclinical keratoconus from normal corneas. A total of 136 normal eyes, 23 eyes with subclinical keratoconus, and 51 eyes with keratoconus were enrolled. Maximum anterior and posterior corneal elevation was measured in the central 3-, 5-, and 7-mm zones using the Galilei double Scheimpflug camera. Receiver operating characteristic curves were used to compare the sensitivity and specificity of the measured parameters and to identify optimal cutoff points for discriminating keratoconus and subclinical keratoconus from normal corneas. Mean anterior and posterior corneal elevations in all zones were statistically higher in keratoconus and subclinical keratoconus versus normal corneas. The posterior elevation measurement in the 3-mm zone had the strongest power to distinguish keratoconus from normal. The corresponding figure for the 7-mm zone, however, had the strongest power to distinguish eyes with subclinical keratoconus (area under the curve, 0.98 and 0.92, respectively). Optimal cutoff point for posterior elevation in the 3-mm zone was 18.5 µm for keratoconus (sensitivity, 92%; specificity, 95%). The corresponding figure in the 7-mm zone was 50.5 µm for subclinical keratoconus (sensitivity, 79.9%; specificity, 94.0%). Anterior and posterior elevations measured by the Galilei analyzer in the 3-mm zone can effectively discriminate keratoconus from normal corneas. These measurements in the 7-mm zone can be considered to distinguish subclinical keratoconus.


Mechanical properties of giant liposomes compressed between two parallel plates: impact of artificial actin shells.
The mechanical response of giant liposomes to compression between two parallel plates is investigated in the context of an artificial actin cortex adjacent to the inner leaflet of the bilayer. We found that nonlinear membrane theory neglecting the impact of bending sufficiently describes the mechanical response of liposomes consisting of fluid lipids to compression whereas the formation of an actin cortex or the use of gel-phase lipids generally leads to substantial stiffening of the shell. Giant vesicles are gently adsorbed on glassy surfaces and are compressed with tipless cantilevers using an atomic force microscope. Force-compression curves display a nonlinear response that allows us to determine the membrane tension σ0 and the area compressibility modulus K(A) by computing the contour of the vesicle as a function of the compression depth. The values for KA of fluid membranes correspond well to what is known from micropipet-suction experiments and computed from monitoring membrane undulations. The presence of a thick actin shell adjacent to the inner leaflet of the liposome membrane stiffens the system considerably, as mirrored in a significantly higher apparent area compressibility modulus.


Colonization with Multidrug-Resistant Bacteria - On the Efficiency of Local Decolonization Procedures.
The effectiveness of a disinfectant-based decolonization strategy for multidrug-resistant bacteria like extended spectrum β-lactamase (ESBL)-positive Gram-negative bacteria with or without additional fluoroquinolon and carbapenem resistance as well as vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus was assessed. Between 2011 and 2015, 25 patients from Libya, Syria, and the Ukraine with war traumata were treated at the Bundeswehr hospital Hamburg. The patients were heavily colonized and infected with multidrug-resistant bacteria, altogether comprising 371 distinct combinations of pathogens and isolation sites. Local disinfection was assessed for effectiveness regarding successful decolonization of multidrug-resistant bacteria. Altogether, 170 cases of successful decolonization were observed, comprising 95 (55.8%) such events at sampling sites that were accessible to disinfecting procedures. The remaining 75 (44.2%) decolonization events had to be considered as spontaneous. In contrast, 95 out of 172 (55.2%) colonized isolation sites that were accessible to disinfection procedures were successfully decolonized. Patient compliance with the enforced hygiene procedures was associated with decolonization success. Systemic antibiotic therapy did not relevantly affect isolation time. Disinfecting washing moderately supports local decolonization of multidrug-resistant pathogens in comparison with spontaneous decolonization rates if the patients' compliance with the applied hygiene procedures is ensured.


Logarithmic corrections to scaling in critical percolation and random resistor networks.
We study the critical behavior of various geometrical and transport properties of percolation in six dimensions. By employing field theory and renormalization group methods we analyze fluctuation induced logarithmic corrections to scaling up to and including the next-to-leading order correction. Our study comprehends the percolation correlation function, i.e., the probability that two given points are connected, and some of the fractal masses describing percolation clusters. To be specific, we calculate the mass of the backbone, the red bonds, and the shortest path. Moreover, we study key transport properties of percolation as represented by the random resistor network. We investigate the average two-point resistance as well as the entire family of multifractal moments of the current distribution.


The pepper late embryogenesis abundant protein CaLEA1 acts in regulating abscisic acid signaling, drought and salt stress response.
As sessile organisms, plants are constantly challenged by environmental stresses, including drought and high salinity. Among the various abiotic stresses, osmotic stress is one of the most important factors for growth and significantly reduces crop productivity in agriculture. Here, we report a function of the CaLEA1 protein in the defense responses of plants to osmotic stress. Our analyses showed that the CaLEA1 gene was strongly induced in pepper leaves exposed to drought and increased salinity. Furthermore, we determined that the CaLEA1 protein has a late embryogenesis abundant (LEA)_3 homolog domain highly conserved among other known group 5 LEA proteins and is localized in the processing body. We generated CaLEA1-silenced peppers and CaLEA1-overexpressing (OX) transgenic Arabidopsis plants to evaluate their responses to dehydration and high salinity. Virus-induced gene silencing of CaLEA1 in pepper plants conferred enhanced sensitivity to drought and salt stresses, which was accompanied by high levels of lipid peroxidation in dehydrated and NaCl-treated leaves. CaLEA1-OX plants exhibited enhanced sensitivity to abscisic acid (ABA) during seed germination and in the seedling stage; furthermore, these plants were more tolerant to drought and salt stress than the wild-type plants because of enhanced stomatal closure and increased expression of stress-responsive genes. Collectively, our data suggest that CaLEA1 positively regulates drought and salinity tolerance through ABA-mediated cell signaling.


Reductive catalytic fractionation: state of the art of the lignin-first biorefinery.
Reductive catalytic fractionation (RCF) of lignocellulose is an emerging biorefinery scheme that combines biomass fractionation with lignin depolymerisation. Central to this scheme is the integration of heterogeneous catalysis, which overcomes the tendency of lignin to repolymerise. Ultimately, this leads to a low-Mw lignin oil comprising a handful of lignin-derived monophenolics in close-to-theoretical yield, as well as a carbohydrate pulp. Both product streams are considered to be valuable resources for the bio-based chemical industry. This Opinion article sheds light on recently achieved milestones and consequent research opportunities. More specifically, mechanistic studies have established a general understanding of the elementary RCF steps, which include (i) lignin extraction, (ii) solvolytic and catalytic depolymerisation and (iii) stabilisation. This insight forms the foundation for recently developed flow-through RCF. Compared to traditional batch, flow-through RCF has the advantage of (i) separating the solvolytic steps from the catalytic steps and (ii) being a semi-continuous process; both of which are beneficial for research purposes and for industrial operation. Although RCF has originally been developed for 'virgin' biomass, researchers have just begun to explore alternative feedstocks. Low-value biomass sources such as agricultural residues, waste wood and bark, are cheap and abundant but are also often more complex. On the other side of the feedstock spectrum are high-value bio-engineered crops, specifically tailored for biorefinery purposes. Advantageous for RCF are feedstocks designed to (i) increase the total monomer yield, (ii) extract lignin more easily, and/or (iii) yield unconventional, high-value products (e.g. alkylated catechols derived from C-lignin). Taking a look at the bigger picture, this Opinion article highlights the multidisciplinary nature of RCF. Collaborative efforts involving chemists, reactor engineers, bioengineers and biologists working closer together are, therefore, strongly encouraged.


Artificial neural network predictive model for allergic disease using single nucleotide polymorphisms data.
The purpose of this study was to develop a novel diagnostic prediction method for allergic diseases from the data of single nucleotide polymorphisms (SNPs) using an artificial neural network (ANN). We applied the prediction method to four allergic diseases, such as atopic dermatitis (AD), allergic conjunctivitis (AC), allergic rhinitis (AR) and bronchial asthma (BA), and verified its predictive ability. Almost all the learning data were precisely predicted. Regarding the evaluation data, the learned ANN model could correctly predict a diagnosis with more than 78% accuracy. We also analyzed the SNP data using multiple regression analysis (MRA). Using the MRA model, less than 10% of patients with the above allergic diseases were correctly diagnosed, while this figure was more than 75% for persons without allergic diseases. From these results, it was shown that the ANN model was superior to the MRA model with respect to predictive ability of allergic diseases. Moreover, we used two different methods to convert the genetic polymorphism data into numerical data. Using both methods, diagnostic predictions were quite precise and almost the same predictive abilities were observed. This is the first study showing the application and usefulness of an ANN for the prediction of allergic diseases based on SNP data.


GOLD-Induced Cytokine (GOLDIC): A Game-Changer Orthobiologic in Regenerative Medicine.
Due to the Industry 4.0 and Industry 5.0 revolutions, researchers, clinicians, and regenerative medicine experts are exploring the plausibility of regenerating diseased or degenerated tissues to regain their near-normal biomechanical properties. In the past three decades, research on "Tissue Engineering and Regenerative Medicine" (TERM) has attained various milestones in clinical translation from bench to bedside. The regulatory bodies of various countries and states are working on the ethical use and guidelines for the production and storage of various cellular and acellular products. Platelets and platelet-derived by-products play a significant role in TERM. The growth factors and cytokines present in platelets regenerate the tissue of interest. In this connotation, a newer orthobiologic called "GOLD-induced cytokine" (GOLDIC) has become a product of interest among various regenerative medicine experts and researchers around the globe. Due to its potent anti-inflammatory action and potential systemic side effects, gold has been withdrawn from the management panel for rheumatoid arthritis. With the knowledge of its anti-inflammatory properties, researchers explored the utility of gold for tissue regeneration.


Septal elicitation of hippocampal theta rhythm did not repair cognitive and emotional deficits resulting from vestibular lesions.
Bilateral vestibular lesions cause atrophy of the hippocampus in humans and subsequent deficits in spatial memory and the processing of emotional stimuli in both rats and humans. Vestibular lesions also impair hippocampal theta rhythm in rats. The aim of the present study was to investigate whether restoring theta rhythm to the hippocampus of a rat, via stimulation of the medial septum, would repair the deficits caused by vestibular lesions. It was hypothesized that the restoration of theta would repair the deficits and the vestibular rats would exhibit behavior and EEG similar to that of the sham rats. Rats were given either sham surgery or bilateral vestibular deafferentation (BVD) followed in a later operation by electrode implants. Half of the lesioned rats received stimulation. Subjects were tested in open field, elevated T-maze and spatial nonmatching to sample tests. BVD caused a deficit in hippocampal theta rhythm. Stimulation restored theta power at a higher frequency in the vestibular-lesioned rats, however, the stimulation did not repair the cognitive and emotional deficits caused by the lesions. It was concluded that stimulation, at least in the form used here, would not be a viable treatment option for vestibular damaged humans.


The Reduction of Credit Risk in the Health Care Industry in China: Are We Returning to the Pre-COVID-19 Era?
This study aims to evaluate the changes in the credit risk of the health care industry in China due to the COVID-19 epidemic by the modified KMV (named by Kealhofer, Mcquown, and Vasicek) model to calculate the default distances. We observe that the overall default distance mainly first decreased and then increased before and after the COVID-19 epidemic control in China; after the epidemic was controlled, the overall credit risk was reduced by 22.8%. Specifically, as shown in subdivided industries, health care equipment and health care facilities have larger credit risk fluctuations, while health care suppliers, health care distributors, and health care services have smaller fluctuations. These results can contribute to our understanding of why the COVID-19 epidemic in China could be controlled earlier, and software facilities are more important than hardware facilities in public health safety. Our methodological innovation is to use the GARCH (generalized autoregressive conditional heteroskedasticity) model and threshold regression model to modify the important parameters of the KMV model. This method has good accuracy in the Chinese environment.


A Combined NMR and SAXS Analysis of the Partially Folded Cataract-Associated V75D γD-Crystallin.
A cataract is a pathological condition characterized by the clouding of the normally clear eye lens brought about by deposition of crystallin proteins in the lens fiber cells. These protein aggregates reduce visual acuity by scattering or blocking incoming light. Chemical damage to proteins of the crystallin family, accumulated over a lifetime, leads to age-related cataract, whereas inherited mutations are associated with congenital or early-onset cataract. The V75D mutant of γD-crystallin is associated with congenital cataract in mice and was previously shown to un/fold via a partially folded intermediate. Here, we structurally characterized the stable equilibrium urea unfolding intermediate of V75D at the ensemble level using solution NMR and small-angle x-ray scattering. Our data show that, in the intermediate, the C-terminal domain retains a folded conformation that is similar to the native wild-type protein, whereas the N-terminal domain is unfolded and comprises an ensemble of random conformers, without any detectable residual structural propensities.


Psychosocial protective interventions associated with a better quality of life and psychological wellbeing for African American/Black female breast cancer survivors: an integrative review.
This integrative review provides an overview of current psychosocial interventions and qualitative studies exploring African American Breast Cancer Survivors (AABCS)' psychosocial wellbeing. We conducted a search of five databases: PubMed, Academic Search Ultimate, CINAHL, PsycINFO, and Web of Science. Peer-reviewed articles written in English and published from 2011 to May 26, 2021 were included. We critically appraised intervention studies and qualitative studies using established frameworks. Of the 633 unique studies identified, seven interventions and twenty-one qualitative studies were included. Analysis of the interventions revealed the importance of alleviating structural barriers and facilitating peer support for AABCS. Analysis of the qualitative studies revealed seven themes: (1) spirituality/religion, (2) social support, (3) cultural perceptions of BC, (4) lack of representation, (5) negative impacts of treatment, (6) healthcare system experience, and (7) barriers to psychosocial care. This review highlights the dearth of psychosocial interventions created specifically for AABCS. The qualitative literature in this review elucidates the unique psychosocial challenges that AABCS experience, providing rich data to inform the creation of future culturally competent interventions in this population. This review found spirituality and social support to be protective factors for AABCS' psychosocial wellbeing. Further research using rigorous methodologies is needed to further evaluate how to most effectively alleviate structural barriers that AABCS face in obtaining long-term support.


[Geography of cancer of the esophagus].
A review of available data on the epidemiology of oesophageal cancer from different parts of the world as well as an analysis of new findings, suggests the following conclusions: 1. A peculiar incidence pattern of the disease exists worldwide with roughly 500-fold differences in rates (truncated) between the highest and lowest risk areas. 2. Males are generally affected more than females, with a few exceptions such as the very high risk regions of northern Iran. The highest male: female sex ratios (based on truncated incidence rates) have been reported from Normandy and Brittany (25:1) and the lowest ratios from South Gorgan in northern Iran (0.5:1). 3. There is evidence that the frequency of oesophageal cancer is rising over time in many regions, particularly among the black population of the United States and in England and France. 4. Most of the areas reflecting a very high incidence of this disease are located in poorer parts of the world. 5. The frequency of this disease varies among the native and migrated population in different countries.


Myelosuppression in patients treated with 177Lutetium-lilotomab satetraxetan can be predicted with absorbed dose to the red marrow as the only variable.
The aim of this study was to investigate dosimetry data and clinical variables to predict hematological toxicity in non-Hodgkin lymphoma (NHL) patients treated with [177Lutetium]Lu-lilotomab satetraxetan. A total of 17 patients treated with [177Lu]Lu-lilotomab satetraxetan in a first-in-human phase 1/2a study were included. Absorbed dose to the red marrow was explored using SPECT/CT-imaging of the lumbar vertebrae L2-L4 over multiple time points. Percentage reduction of thrombocytes and neutrophils at nadir compared to baseline (PBN) and time to nadir (TTN) were chosen as indicators of myelosuppression and included as dependent variables. Two models were applied in the analysis, a multivariate linear model and a sigmoidal description of toxicity as a function of absorbed dose. A total of 10 independent patient variables were investigated in the multivariate analysis. Absorbed dose to the red marrow ranged from 1 to 4 Gy. Absorbed dose to the red marrow was found to be the only significant variable for PBN for both thrombocytes and neutrophils. The sigmoid function gave similar results in terms of accuracy when compared to the linear model. Myelosuppression in the form of thrombocytopenia and neutropenia in patients treated with [177Lu]Lu-lilotomab satetraxetan can be predicted from the SPECT/CT-derived absorbed dose estimate to the red marrow.


Experimental and numerical analysis of high-resolution injection technique for capillary electrophoresis microchip.
This study presents an experimental and numerical investigation on the use of high-resolution injection techniques to deliver sample plugs within a capillary electrophoresis (CE) microchip. The CE microfluidic device was integrated into a U-shaped injection system and an expansion chamber located at the inlet of the separation channel, which can miniize the sample leakage effect and deliver a high-quality sample plug into the separation channel so that the detection performance of the device is enhanced. The proposed 45° U-shaped injection system was investigated using a sample of Rhodamine B dye. Meanwhile, the analysis of the current CE microfluidic chip was studied by considering the separation of Hae III digested ϕx-174 DNA samples. The experimental and numerical results indicate that the included 45° U-shaped injector completely eliminates the sample leakage and an expansion separation channel with an expansion ratio of 2.5 delivers a sample plug with a perfect detection shape and highest concentration intensity, hence enabling an optimal injection and separation performance.


Solution Growth of Ultralong Gold Nanohelices.
Metallic nanohelices are extremely rare and, to date, have never been synthesized by a direct solution method. In this work, we report ultralong Au nanohelices grown in solution under ambient conditions. They are ultralong with several tens of micrometers in length, with extraordinary aspect ratio (length/diameter greater than 22 300) and the number of pitches (more than 22 000 pitches). The pitch and width are uniform within each helix but vary widely among the helices. Crystal analyses showed that the facets, twin boundaries, grain sizes, and orientations are aperiodic along the helices. The apparent smooth curving is only possible with a large number of surface steps, suggesting that these structural features are the mere consequence of the helix formation rather than the cause. We propose that the nanowires are formed by the active surface growth mechanism and that the helicity originates from the random and asymmetrical blocking of nuclei embedded within the floccules of ligand complexes, in the form of either asymmetric binding of ligands or asymmetric diffusion of growth materials through the floccules. The separate growth environment of these nuclei causes constant helicity within each helix but differing helicity among the individuals. The embedding also provides a robust environment for the sustained growth of the nanohelices, leading to their record length and consistency.


Family history of cancer and colon cancer risk: the Utah Population Database.
Family history of colon cancer has been shown to be related to the risk of developing colon cancer. The impact that a comprehensive family history of colon or other cancers has on the risk of colon cancer has not been thoroughly studied. The purpose of this study was to assess the risk of developing colon cancer associated with having a family history of colon, rectal, breast, ovarian, endometrial, or prostate cancer. A case-control study was conducted using data from the Utah Population Database. Case patients had first primary colon cancers (n = 2543). Three control subjects per case were individually matched to case patients on year of birth, place of birth, marital status, and sex. Those case patients with the highest familial standardized incidence ratio were at an increased risk of developing colon cancer (for men, odds ratio [OR] = 2.51 and 95% confidence interval [CI] = 1.88-3.29; for women, OR = 2.90 and 95% CI = 2.17-3.82). A second- or third-degree relative with colon cancer increased risk from 25% to 52%. Risk associated with family history was greater in those patients diagnosed before age 50 (for men, OR = 3.61 and for women, OR = 7.18) than in those diagnosed at 50 or more years of age (for men, OR = 2.44 and for women, OR = 2.73). The risk associated with a family history of colon cancer was greatest for the distal segment of the colon. Women were at an increased risk of colon cancer if they had a first-degree relative with breast (OR = 1.59; 95% CI = 1.25-2.03), uterine (OR = 1.50; 95% CI = 0.99-2.26), ovarian (OR = 1.63; 95% CI = 1.41-1.89), or prostate (OR = 1.49; 95% CI = 1.21-1.82) cancer; men were at increased risk of colon cancer if they had a first-degree relative with breast (OR = 1.30; 95% CI = 1.02-1.66), uterine (OR = 1.96; 95% CI = 1.34-2.87), or ovarian (OR = 1.59; 95% CI = 0.90-2.81) cancer. These findings support previous observations that people with a family history of colon cancer are at increased risk of colon cancer. Those with a second- or third-degree relative with colon cancer or a first-degree relative with breast, ovarian, uterine, or prostate cancer also have an increased risk of developing colon cancer. These data support the recommendations that individuals who have a first-degree, and possibly a second- or third-degree, relative with colon cancer should have regular screening for colon cancer.


The extended catalysis of glutathione transferase.
Glutathione transferase reaches 0.5-0.8 mM concentration in the cell so it works in vivo under the unusual conditions of, [S]≪[E]. As glutathione transferase lowers the pK(a) of glutathione (GSH) bound to the active site, it increases the cytosolic concentration of deprotonated GSH about five times and speeds its conjugation with toxic compounds that are non-typical substrates of this enzyme. This acceleration becomes more efficient in case of GSH depletion and/or cell acidification. Interestingly, the enzymatic conjugation of GSH to these toxic compounds does not require the assumption of a substrate-enzyme complex; it can be explained by a simple bimolecular collision between enzyme and substrate. Even with typical substrates, the astonishing concentration of glutathione transferase present in hepatocytes, causes an unusual "inverted" kinetics whereby the classical trends of v versus E and v versus S are reversed.


Effect of partial occlusion on newborns' face preference and recognition.
Many studies have shown that newborns prefer (e.g. Goren, Sarty & Wu, 1975; Valenza, Simion, Macchi Cassia & Umiltà, 1996) and recognize (e.g. Bushnell, Say & Mullin, 1989; Pascalis & de Schonen, 1994) faces. However, it is not known whether, at birth, faces are still preferred and recognized when some of their parts are not visible because hindered by other configurations, that is when faces are partly occluded. Also, it is not known whether newborns' preference for an upright over an inverted face and newborns' face recognition are differentially affected depending on the salience of the occluded face features. Seventy-seven newborns (mean age of 43.5 hrs) were tested using the preferential looking (Experiment 1) and the habituation techniques (Experiment 2). Results demonstrated that newborns prefer and recognize occluded faces even if some portions of them are not available, at least when the hindered features are not salient. On the contrary, these abilities are affected by obscuring high salience facial features (i.e. eyes). However, while in the case of face detection, eyes occlusion completely prevented newborns' face detection, in the case of face recognition an analogous stimulus manipulation heavily impaired, but did not totally preclude, newborns' recognition performance. The data collected improve our comprehension of newborns' way of processing and encoding information to detect and recognize faces.


A molecular mechanism for mRNA trafficking in neuronal dendrites.
Specific neuronal mRNAs are localized in dendrites, often concentrated in dendritic spines and spine synapses, where they are translated. The molecular mechanism of localization is mostly unknown. Here we have explored the roles of A2 response element (A2RE), a cis-acting signal for oligodendrocyte RNA trafficking, and its cognate trans-acting factor, heterogeneous nuclear ribonucleoprotein (hnRNP) A2, in neurons. Fluorescently labeled chimeric RNAs containing A2RE were microinjected into hippocampal neurons, and RNA transport followed using confocal laser scanning microscopy. These RNA molecules, but not RNA lacking the A2RE sequence, were transported in granules to the distal neurites. hnRNP A2 protein was implicated as the cognate trans-acting factor: it was colocalized with RNA in cytoplasmic granules, and RNA trafficking in neurites was compromised by A2RE mutations that abrogate hnRNP A2 binding. Coinjection of antibodies to hnRNP A2 halved the number of trafficking cells, and treatment of neurons with antisense oligonucleotides also disrupted A2RE-RNA transport. Colchicine inhibited trafficking, whereas cells treated with cytochalasin were unaffected, implicating involvement of microtubules rather than microfilaments. A2RE-like sequences are found in a subset of dendritically localized mRNAs, which, together with these results, suggests that a molecular mechanism based on this cis-acting sequence may contribute to dendritic RNA localization.


Full length migration of plastic biliary stent into the left lobe of liver and its endoscopic retrieval.
An elderly female was admitted with obstructive jaundice, secondary to an impacted 1.7 cm size stone in distal CBD. Cholangiogram obtained during ERCP revealed dilated biliary system with large, immobile stone at the lower end of CBD. A large size sphincterotomy was performed and stone extraction using biliary balloon / dormia basket attempted which was unsuccessful as the stone was impacted in distal CBD. Therefore, a plastic biliary stent of 9 cm/8.5 french size was inserted successfully to secure the biliary drainage. Patient improved clinically and discharged home on ursodeoxycholic acid. Four weeks later, she presented to emergency department with signs of cholangitis. An emergency ERCP was performed. The stent had migrated up completely into the left intra hepatic duct. In this session, the stone was extracted and biliary drainage secured. Migrated stent was removed later on by another ERCP procedure.


A 42-Year-Old Woman With Anemia, Shock, and Ischemic Stroke After Lung Transplantation.
A 42-year-old woman with mixed connective tissue disease-associated interstitial lung disease underwent bilateral lung transplantation. She had an uneventful surgery and was extubated 3 h later. Induction immunosuppression therapy included methylprednisolone 500 mg intraoperatively, basiliximab (anti-IL-2 monoclonal antibody) on days 0 and 4 after transplantation, and methylprednisolone 125 mg intravenously bid for 2 days following surgery. Maintenance immunosuppression therapy consisted of prednisone 20 mg daily, mycophenolate mofetil 750 mg bid, and enteral tacrolimus 0.5 mg bid. Both the donor and the recipient were seropositive for cytomegalovirus. Infectious disease prophylaxis consisted of valganciclovir, trimethoprim-sulfamethoxazole, and voriconazole.


Regulating the stereoselectivity of medium-chain dehydrogenase/reductase by creating an additional active pocket accommodating prochiral heterocyclic ketones.
Medium chain dehydrogenase/reductase (MDR) is a robust catalyst for the asymmetric synthesis of chiral heterocyclic alcohols, essential building blocks in pharmaceuticals. However, the regulatory mechanism of stereoselective complementary reduction of heterocyclic ketones by carbonyl reductase (CR) is unclear. Structure-guided creation of an additional substrate-binding active pocket inversed the stereoselectivity of SpCR from Spathaspora passalidarum. The mutant m48 showed improved catalytic activity towards the 12 tested heterocyclic ketones (conversion rate >99%, ee value > 99%). Hence, we regulated the stereoselectivity of MDR by creating an active pocket suitable for substrate localisation. This strategy has a guiding significance in addition to the conventional method for stereoselectivity modification of MDR.


Proxy-based accelerated discovery of Fischer-Tropsch catalysts.
Development of heterogeneous catalysts for complex reactions such as Fischer-Tropsch synthesis of fuels is hampered by difficult reaction conditions, slow characterisation techniques such as chemisorption and temperature-programmed reduction and the need for long term stability. High-throughput (HT) methods may help, but their use has until now focused on bespoke micro-reactors for direct measurements of activity and selectivity. These are specific to individual reactions and do not provide more fundamental information on the materials. Here we report using simpler HT characterisation techniques (XRD and TGA) along with ageing under Fischer-Tropsch reaction conditions to provide information analogous to metal surface area, degree of reduction and thousands of hours of stability testing time for hundreds of samples per month. The use of this method allowed the identification of a series of highly stable, high surface area catalysts promoted by Mg and Ru. In an advance over traditional multichannel HT reactors, the chemical and structural information we obtain on the materials allows us to identify the structural effects of the promoters and their effects on the modes of deactivation observed.


Effects of strain on the carrier mobility in silicon nanowires.
We investigate electron and hole mobilities in strained silicon nanowires (Si NWs) within an atomistic tight-binding framework. We show that the carrier mobilities in Si NWs are very responsive to strain and can be enhanced or reduced by a factor >2 (up to 5×) for moderate strains in the ± 2% range. The effects of strain on the transport properties are, however, very dependent on the orientation of the nanowires. Stretched 100 Si NWs are found to be the best compromise for the transport of both electrons and holes in ≈10 nm diameter Si NWs. Our results demonstrate that strain engineering can be used as a very efficient booster for NW technologies and that due care must be given to process-induced strains in NW devices to achieve reproducible performances.


Regulation of Respiratory Pathway and Electron Transport Chain in Relation to Senescence of Postharvest White Mushroom (Agaricus bisporus) under High O2/CO2 Controlled Atmospheres.
In order to study the respiration metabolism mechanism based on the generation of adenosine triphosphate (ATP) and reactive oxygen species (ROS) and nitric oxide (NO) by the electron transport chain (ETC) of the white mushroom under high O2/CO2 controlled atmospheres, the treatments of 100% O2, 80% O2 + 20% CO2, 60% O2 + 40% CO2, and 40% O2 + 60% CO2 at 2 ± 1 °C were employed and natural air was used as the control. ATP and energy charge can maintain the membrane integrity and function, life activities, and physicochemical reactions of higher plants. The results showed that the 80% O2 + 20% CO2 treatment inhibited the respiration rate, embden-meyerhof-parnas or glycolysis pathway, and ROS and NO contents. It significantly delayed the reduction of the ATP content and energy charge level, tricarboxyfic-acid-cycle and cytochrome pathway proportion, and their key enzymes activity and gene expression. It also maintained a high phosphopentose pathway and moderate alternative pathway. Results indicated that the 80% O2 + 20% CO2 prolonged the storage time of mushrooms to 24 days and retarded the senescence through retaining the higher energy, suppressing the ROS contents, enhancing the endurance capability in adversity, and regulating the respiration pathways and ETC metabolism.


Enhanced production of interleukin 6 in peripheral blood monocytes stimulated with mucins secreted into the bloodstream.
It has been reported that tumor progression is correlated with the serum level of interleukin 6 (IL-6). The purpose of this study was to investigate by what mechanism, other than production from tumor cell, the serum level of IL-6 is elevated in the tumor-bearing state. Monocytes from healthy donors were cultured in the presence of sera from colon cancer patients, and the activity to elevate IL-6 production was estimated. This activity of serum was also examined after various biochemical treatments. When monocytes from healthy donors were cultured in the presence of sera from patients with colon cancer, secretion of IL-6 from the cells was markedly elevated. Serum proteins were fractionated on Sepharose 4B and the activity to elevate IL-6 production was found in the excluded fractions. Sialyl Tn antigen was detected in these same fractions. By excluding some mucins from the serum, the inducing activity was reduced to 40% of the original level. Furthermore, we purified mucins from the conditioned medium of colon cancer cells. Production of IL-6 was effectively elevated by a small amount of purified mucins in a dose-dependent manner. When the inducing activity was examined in the presence of binding or competitive inhibitors to the scavenger receptor, the effect was remarkably reduced. Mucins secreted from colon cancer cells into the bloodstream induce production of IL-6 in peripheral blood monocytes through the scavenger receptor, which may be responsible for the high level of serum IL-6 in colon cancer patients.


Annealing Effect on Mechanical and Tribological Behaviors of Nanoscale Mechanics of Zr60Cu25Al5Ag5Ni5 Thin-Layer Metallic Glasses for Engineering Materials Applications.
A new and unique alloy formulation design strategy has been developed in order to fabricate thin-layered metallic glasses (TLMGs) with superior fracture resistance and low coefficient of friction (COF) during the nanoscratching test. Due to the outstanding properties, TFMG could be applied for different uses, such as for surface coating, biomedical, bioimprinting, electronic devices, spacecraft, and railway, all of which need surface fracture resistance. The fabricated Zr-based metallic glass was prepared from Zr, Al, Cu, Ni, and Ag above 99.9 Wt % in purity by arch melting techniques. TFMGs were coated on silicon wafer by sputtering the vapor deposition method from bulk metallic glass then annealed below glass transition temperature Tg ∼ 450 °C for 10, 30, and 60 min. Nanoindentation and nanoscratch tests were used to investigate nanomechanical and nanotribological properties, and atomic force microscopy (AFM) was used to examine the surface morphology and microstructures of TLMG. The nanoindentation data indicated that the average hardness of metallic glasses increased from 9.75 (as-cast MG) to 13.4 GPa (annealed for 60 min). Coefficients of friction for the cast sample, annealed for unannealed, 10, 30, and 60 min, were 0.062, 0.049, 0.039, and 0.03, respectively, as well as the wear depths were 201.56, 148.43, 37.32, and 25.27 nm, respectively. These studies show that the coefficient of friction and wear rate decreases when the annealing time increases as a result of atomic reordering and structural relaxation that occurred at longer annealing times. Furthermore, continuous wear process, wear depth, wear track volume, and contact area decrease with increasing annealing time. This study can be used to design protocols to prepare novel TLMGs, which have outstanding mechanical and tribological properties for engineering materials applications.


Role of AMPK in Myocardial Ischemia-Reperfusion Injury-Induced Cell Death in the Presence and Absence of Diabetes.
Recent studies indicate cell death is the hallmark of cardiac pathology in myocardial infarction and diabetes. The AMP-activated protein kinase (AMPK) signalling pathway is considered a putative salvaging phenomenon, plays a decisive role in almost all cellular, metabolic, and survival functions, and therefore entails precise regulation of its activity. AMPK regulates various programmed cell death depending on the stimuli and context, including autophagy, apoptosis, necroptosis, and ferroptosis. There is substantial evidence suggesting that AMPK is down-regulated in cardiac tissues of animals and humans with type 2 diabetes or metabolic syndrome compared to non-diabetic control and that stimulation of AMPK (physiological or pharmacological) can ameliorate diabetes-associated cardiovascular complications, such as myocardial ischemia-reperfusion injury. Furthermore, AMPK is an exciting therapeutic target for developing novel drug candidates to treat cell death in diabetes-associated myocardial ischemia-reperfusion injury. Therefore, in this review, we summarized how AMPK regulates autophagic, apoptotic, necroptotic, and ferroptosis pathways in the context of myocardial ischemia-reperfusion injury in the presence and absence of diabetes.


Nitrate concentration effects on NO3-N uptake and reduction, growth, and fruit yield in strawberry.
Strawberries (Fragaria xananassa Duch. 'Osogrande') were grown hydroponically with three NO3-N concentrations (3.75, 7.5, or 15.0 mM) to determine effects of varying concentration on NO3-N uptake and reduction rates, and to relate these processes to growth and fruit yield. Plants were grown for 32 weeks, and NO3-N uptake and nitrate reductase (NR) activities in roots and shoots were measured during vegetative and reproductive growth. In general, NO3-N uptake rates increased as NO3-N concentration in the hydroponics system increased. Tissue NO3- concentration also increased as external NO3-N concentration increased, reflecting the differences in uptake rates. There was no effect of external NO3-N concentration on NR activities in leaves or roots during either stage of development. Leaf NR activity averaged approximately 360 nmol NO2 formed/g fresh weight (FW)/h over both developmental stages, while NR activity in roots was much lower, averaging approximately 115 nmol NO2 formed/g FW/h. Vegetative organ FW, dry weight (DW), and total fruit yield were unaffected by NO3-N concentration. These data suggest that the inability of strawberry to increase growth and fruit yield in response to increasing NO3-N concentrations is not due to limitations in NO3-N uptake rates, but rather to limitations in NO3- reduction and/or assimilation in both roots and leaves.


Record events in growing populations: universality, correlation, and aging.
This paper studies the occurrence of record events in score populations which grow stochastically in time. In Rényi's basic record model, a population of independent and identically distributed (i.i.d.) random scores grows deterministically--a single new score being added at each time step. Rényi's record theorem asserts that the resulting record events are independent, and that their occurrence probabilities decrease harmonically in time. Moreover, Rényi's result is universal--being independent of the distribution of the i.i.d. random scores. This paper considers an arbitrary stochastic growth of the score population--allowing the number of the i.i.d. random scores added at each time step to follow arbitrary stochastic dynamics. Exploring the stochastic growth model we: (i) establish a general analog of Rényi's record theorem; (ii) show that universality with respect to the distribution of the i.i.d. random scores is maintained; (iii) compute the distribution of the waiting times for record events; (iv) analyze the dependencies/independencies of the record events; and (v) analyze the aging/stationarity of the record events.


Online Removal of Baseline Shift with a Polynomial Function for Hemodynamic Monitoring Using Near-Infrared Spectroscopy.
Near-infrared spectroscopy (NIRS) has become widely accepted as a valuable tool for noninvasively monitoring hemodynamics for clinical and diagnostic purposes. Baseline shift has attracted great attention in the field, but there has been little quantitative study on baseline removal. Here, we aimed to study the baseline characteristics of an in-house-built portable medical NIRS device over a long time (>3.5 h). We found that the measured baselines all formed perfect polynomial functions on phantom tests mimicking human bodies, which were identified by recent NIRS studies. More importantly, our study shows that the fourth-order polynomial function acted to distinguish performance with stable and low-computation-burden fitting calibration (R-square >0.99 for all probes) among second- to sixth-order polynomials, evaluated by the parameters R-square, sum of squares due to error, and residual. This study provides a straightforward, efficient, and quantitatively evaluated solution for online baseline removal for hemodynamic monitoring using NIRS devices.


Tau and the fractionated default mode network in atypical Alzheimer's disease.
Alzheimer's disease-related atrophy in the posterior cingulate cortex, a key node of the default mode network, is present in the early stages of disease progression across clinical phenotypic variants of the disease. In the typical amnestic variant, posterior cingulate cortex neuropathology has been linked with disrupted connectivity of the posterior default mode network, but it remains unclear if this relationship is observed across atypical variants of Alzheimer's disease. In the present study, we first sought to determine if tau pathology is consistently present in the posterior cingulate cortex and other posterior nodes of the default mode network across the atypical Alzheimer's disease syndromic spectrum. Second, we examined functional connectivity disruptions within the default mode network and sought to determine if tau pathology is related to functional disconnection within this network. We studied a sample of 25 amyloid-positive atypical Alzheimer's disease participants examined with high-resolution MRI, tau (18F-AV-1451) PET, and resting-state functional MRI. In these patients, high levels of tau pathology in the posteromedial cortex and hypoconnectivity between temporal and parietal nodes of the default mode network were observed relative to healthy older controls. Furthermore, higher tau signal and reduced grey matter density in the posterior cingulate cortex and angular gyrus were associated with reduced parietal functional connectivity across individual patients, related to poorer cognitive scores. Our findings converge with what has been reported in amnestic Alzheimer's disease, and together these observations offer a unifying mechanistic feature that relates posterior cingulate cortex tau deposition to aberrant default mode network connectivity across heterogeneous clinical phenotypes of Alzheimer's disease.


Assessing the nexus between COVID-19 pandemic-driven economic crisis and economic policy: lesson learned and challenges.
This study examines China's budgetary policy during the COVID-19 pandemic as a result of China's insufficient ability to deal with a new crisis when the epidemic struck in March 2020 and as a result of the economic crisis that began in China in March 2020. In order to better comprehend China's economic status during COVID-19, the study relies on secondary data. The fiscal response of emerging market economies like India is less than in advanced economies. However, it is generally considered to be in line with the average for emerging market economies. As a result of the Disaster Management authority imposing a rigorous lockdown, unemployment rose, the trade cycle was interrupted, and manufacturing and service activities were affected. According to the study's findings, China's economic policies, namely its fiscal policy, responded in the years leading up to 2019 by increasing health expenditure, income transfer, welfare payments, subsidies, and reducing short-term unemployment. As a result of the COVID-19 pandemic, China's government has adopted a number of measures to minimize the damage to the economy. This article also focuses on China's numerous budgetary actions with COVID-19.


CSF hypocretin-1 levels in schizophrenics and controls: relationship to sleep architecture.
Hypocretins/orexins are newly identified peptides of hypothalamic origin. Hypocretin deficiency is involved in the sleep disorder narcolepsy, suggesting the importance of hypocretin neurotransmission for the regulation of sleep. Hypocretin is known to excite midbrain dopaminergic neurons and to induce hyperactivity and stereotypy in animals. Altered hypocretin neurotransmission might therefore be involved in schizophrenia, since an involvement of dopaminergic mechanisms and an association with sleep disturbance are well demonstrated in patients with schizophrenia. Hypocretin is also known to affect the hypothalamic-pituitary-adrenal axis by stimulating the release of corticotropin releasing hormone (CRH). In the current study, we measured CSF hypocretin levels in 12 controls and 13 patients with chronic schizophrenia associated with moderate sleep disturbance, such as longer sleep onset latency, decreased total sleep time and decreased sleep efficacy. No difference in CSF hypocretin levels between schizophrenia and control subjects was found. CSF hypocretin levels were positively correlated with CSF CRH levels in the patient, control and combined subject populations, but the correlation did not reach statistical significance in any population. The hypocretin levels in schizophrenic patients were, however, positively and significantly correlated with sleep latency, one of the most consistent sleep abnormalities seen in schizophrenia. This correlation was not significant in controls, and no other significant correlation between CSF hypocretin levels and any measure of sleep architecture in either patients or controls was observed. Further studies of whether CNS hypocretin neurotransmission is involved in sleep and neuroendocrine abnormalities seen in patients with schizophrenia and other psychiatric conditions are warranted.


Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone.
Troglitazone decreases insulin resistance and hyperglycemia in patients with non-insulin-dependent diabetes mellitus (NIDDM), but its effects on subjects without diabetes are not known. We performed oral and intravenous glucose-tolerance tests, studies with the euglycemic-hyperinsulinemic clamp, meal-tolerance tests, and 24-hour blood-pressure measurements at base line and after the administration of troglitazone, 200 mg orally twice daily, or placebo for 12 weeks in 18 nondiabetic obese subjects, 9 of whom had impaired glucose tolerance. The mean (+/- SD) rates of glucose disposal increased from 4.7 +/- 1.7 to 6.0 +/- 1.7 mg per kilogram of body weight per minute (P = 0.004) and from 9.0 +/- 1.8 to 9.9 +/- 1.3 mg per kilogram per minute (P = 0.02) during insulin infusions of 40 and 300 mU per square meter of body-surface area per minute, respectively, in the troglitazone group. The insulin-sensitivity index, calculated from the results of intravenous glucose-tolerance tests, increased from 0.7 +/- 0.6 x 10(-4) to 1.6 +/- 0.9 x 10(-4) in subjects given troglitazone, and their glycemic response to oral glucose and to mixed meals decreased. The mean fasting plasma insulin concentration decreased by 48 percent (P = 0.002), and the plasma insulin response to oral glucose and mixed meals decreased by 40 and 41 percent, respectively. The changes were similar in the subjects with normal glucose tolerance and those with impaired glucose tolerance. Systolic and diastolic blood pressure decreased by 5 +/- 2 mm Hg (P = 0.05) and 4 +/- 2 mm Hg (P = 0.04), respectively, after treatment with troglitazone. There were virtually no changes in the placebo group. Troglitazone decreases insulin resistance and improves glucose tolerance in obese subjects with either impaired or normal glucose tolerance. The ability of troglitazone to reduce insulin resistance could be useful in preventing NIDDM:


Detecting climate-related trends in streamflow data.
This paper reviews the results of a number of studies that have investigated streamflow data for the existence of trend. These studies provide evidence that trends in various, but not all, streamflow regimes are occurring at rates that are higher than one might attribute to chance alone. Results of different studies using different approaches were compared and were shown, at times, to have dramatic differences. These differences might potentially be due to pre-conditioning of data prior to trend detection in attempts to minimize the impacts of serial correlation on testing procedures. It was also evident that patterns of trend can vary over small spatial scales and that a relatively high-density network is required to effectively comprehend trend and how it might be altering across an area. A global network of streamflow sites representing pristine or stable conditions is needed to assess patterns of change. Selection criteria for sites within such a network are provided, and it is highlighted that local knowledge is required to perform this selection.


New methods to titrate EIAV-based lentiviral vectors.
Ideally, gene transfer vectors used in clinical protocols should only express the gene of interest. So far most vectors have contained marker genes to aid their titration. We have used quantitative real-time PCR to titrate equine infectious anemia virus (EIAV) vectors for gene therapy applications. Viral RNA was isolated from vector preparations and analyzed in a one-step RT-PCR reaction in which reverse transcription and amplification were combined in one tube. The PCR assay of vector stocks was quantitative and linear over four orders of magnitude. In tandem, the integration efficiency of these vectors has also been determined by real-time PCR, measuring the number of vector genomes in the target cells. We have found that these methods permit reliable and sensitive titration of lentiviral vectors independent from the expression of a transgene. They also allow us to determine the integration efficiency of different vector genomes. This technology has proved very useful, especially in the absence of marker genes and where vectors express multiple genes.


Simultaneous peritoneal dialysis catheter insertion and removal in catheter-related infections without interruption of peritoneal dialysis.
Catheter-related infections result in high patient morbidity, the need for temporary haemodialysis, and high costs. These infections are the main cause of limited technique survival in peritoneal dialysis. We introduced a protocol for the simultaneous peritoneoscopic insertion and removal of peritoneal catheters in patients with catheter-related infections. Peritoneal dialysis was continued the day after surgery using low-volume dwells and a dry abdomen during the daytime. The dialysate leukocyte count had to be below 100/mm3 before exchanging catheters, which was performed under antibiotic therapy based on culture sensitivity. The old catheter was removed after the new catheter had been inserted in the opposite abdominal region. CAPD patients were switched to APD for 1 week, which made prolonged hospitalization necessary. Simultaneous catheter insertion and removal was performed 25 times in 22 patients on CCPD and 15 times in 14 patients on CAPD. In CCPD patients, peritoneal dialysis was restarted after 1.0+/-0.1 days in 24 cases. One patient had sufficient residual renal function and discontinued CCPD until day 10. In 10 CAPD patients (11 procedures) APD was started 1.3+/-0.2 days after the procedure with CAPD beginning 7.1+/-0.6 days thereafter. Three CAPD patients preferred haemodialysis and restarted CAPD 10.0+/-2.1 days after surgery. One patient continued CAPD the day after surgery. In addition to minor complications (e.g. position-dependent outflow problems), dialysate leakage occurred in two patients. Two patients developed peritonitis within the first 30 days after surgery, one of which was procedure related. One patient had severe lower gastrointestinal bleeding 2 weeks after the procedure, which was not related to the catheter replacement. Ultimately, in 38 of 40 procedures the patients could successfully continue peritoneal dialysis. We conclude that simultaneous insertion and removal of a peritoneal dialysis catheter without interruption of peritoneal dialysis is a safe procedure in patients with catheter-related infections.


Combined Application of Malic Acid and Lycopene Maintains Content of Phenols, Antioxidant Activity, and Membrane Integrity to Delay the Pericarp Browning of Litchi Fruit During Storage.
Litchi fruit contains abundant polyphenols and is susceptible to browning after harvest. Herein the combined treatments of malic acid (MA) and lycopene (LYC) to delay the development of browning in litchi fruit stored at room temperature (25°C) and low temperature (4°C) was investigated. The results showed that the pericarp browning could be alleviated, and the increase of malondialdehyde (MDA) content and relative leakage rate was retarded by the combined MA and LYC during storage. As compared to control, the content of pericarp anthocyanins, flavonoids, and the total phenols maintained higher levels; and the decrease of antioxidant activity of 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging capacity and reducing power were slowed down in treated fruit. The enzyme activity of polyphenol oxidase (PPO) and peroxidase (POD) related to oxidation of polyphenols were depressed by the combined treatments. Furthermore, correlation analysis revealed that the content of phenols in the pericarp negatively affected the changes in the browning index, and was positively related to the DPPH radical scavenging capacity. Taken together, the combined treatments of MA and LYC exhibited potential effects in delaying the pericarp browning of litchi fruit by maintaining the content of polyphenols, antioxidant activity, and membrane integrity.


Enhanced Moisture-Reactive Hydrophilic-PTFE-Based Flexible Humidity Sensor for Real-Time Monitoring.
Flexible sensors connected to cell phones are a promising technology that can aid in continuously monitoring signals in our daily lives, such as an individual's health status and information from buildings, farms, and industry. Among such signals, real-time humidity monitoring is crucial to a comfortable life, as human bodies, plants, and industrial environments require appropriate humidity to be maintained. We propose a hydrophilic polytetrafluoroethylene (H-PTFE)-based flexible humidity sensor integrated with readout circuitry, wireless communication, and a mobile battery. To enhance its sensitivity, linearity, and reliability, treatment with sodium hydroxide implements additional hydroxyl (OH) groups, which further enhance the sensitivity, create a strong linearity with respect to variations in relative humidity, and produce a relatively free hysteresis. Furthermore, to create robust mechanical stability, cyclic upward bending was performed for up to 3000 cycles. The overall electrical and mechanical results demonstrate that the flexible real-time H-PTFE humidity sensor system is suitable for applications such as wearable smart devices.


Gender differences in ophthalmologists' annual incomes.
To understand the association between provider gender and ophthalmologists' annual incomes. Retrospective analysis of survey data collected from ophthalmologists by the American Medical Association (AMA) between 1992 and 2001. Six hundred thirty white male and 62 white female actively practicing ophthalmologists who responded to the AMA's survey of physicians between 1992 and 2001 and who worked in an office-based practice. A linear regression model was generated to determine the association between provider gender and ophthalmologists' annual incomes after controlling for work effort, provider characteristics, and practice characteristics. Annual incomes of male and female ophthalmologists in 2004 dollars after controlling for work effort, provider characteristics, and practice characteristics. White female ophthalmologists reported having 24% fewer visits and working 5% fewer annual hours than their white male counterparts. White female ophthalmologists had practiced medicine for fewer years than white males and were more likely to be employees, as opposed to having an ownership interest in the practice, but less likely to be board certified. After adjustment for work effort, provider characteristics, and practice characteristics, white females' mean annual income was $219,194, or $55,091 (20%) lower than white males' (95% confidence interval, -$93,611 to -$16,572; P = 0.005). During the 1990s, female gender was associated with lower annual incomes among ophthalmologists. Observed differences may be attributable to factors that we were not able to measure, such as whether the clinician practice was predominantly medical or surgical. However, just as policymakers are exploring gender differences in access to and outcomes of health care, they should further explore gender-based income differences among physicians.


Free and total prostate-specific antigen in a screened population.
To determine whether the ratio of free to total (F/T) prostate-specific antigen (PSA) can differentiate between men with prostate carcinoma or benign conditions in a screened population. Total and free serum PSA (measured using Delfia PSA assays, Abbott IMx and Hybritech Tandem E methods) were determined retrospectively in 1726 men aged 55-77 years, in whom 67 prostate carcinomas were detected by screening with a digital rectal examination, transrectal ultrasonography, and total serum PSA level. Predictors for a positive biopsy result were estimated as a function of total PSA, free PSA and the combination of both. There was an excellent correlation between the Delfia ProStatus, the Abbott IMx and the Hybritech Tandem E assays. Compared with the total serum PSA level, the F/T ratio improved the specificity significantly only in those men with a total PSA of > or = 7 ng/mL. Using the information given by the total and free PSA values, a maximum sensitivity of 75% at a specificity of 74% was obtained for the whole PSA range from 4 to 10 ng/mL; the maximum sensitivity was 79% with a specificity of 71%. The optimal mathematical combination of free and total serum PSA improves the specificity of total serum PSA level in detecting prostate carcinoma more than the does the F/T PSA ratio.


Dispensable chromosomes in Fusarium oxysporum f. sp. lycopersici.
The genomes of many filamentous fungi consist of a 'core' part containing conserved genes essential for normal development as well as conditionally dispensable (CD) or lineage-specific (LS) chromosomes. In the plant-pathogenic fungus Fusarium oxysporum f. sp. lycopersici, one LS chromosome harbours effector genes that contribute to pathogenicity. We employed flow cytometry to select for events of spontaneous (partial) loss of either the two smallest LS chromosomes or two different core chromosomes. We determined the rate of spontaneous loss of the 'effector' LS chromosome in vitro at around 1 in 35 000 spores. In addition, a viable strain was obtained lacking chromosome 12, which is considered to be a part of the core genome. We also isolated strains carrying approximately 1-Mb deletions in the LS chromosomes and in the dispensable core chromosome. The large core chromosome 1 was never observed to sustain deletions over 200 kb. Whole-genome sequencing revealed that some of the sites at which the deletions occurred were the same in several independent strains obtained for the two chromosomes tested, indicating the existence of deletion hotspots. For the core chromosome, this deletion hotspot was the site of insertion of the marker used to select for loss events. Loss of the core chromosome did not affect pathogenicity, whereas loss of the effector chromosome led to a complete loss of pathogenicity.


Withholding response in the face of a smile: age-related differences in prefrontal sensitivity to Nogo cues following happy and angry faces.
The modulation of control processes by stimulus salience, as well as associated neural activation, changes over development. We investigated age-related differences in the influence of facial emotion on brain activation when an action had to be withheld, focusing on a developmental period characterized by rapid social-emotional and cognitive change. Groups of kindergarten and young school-aged children and a group of young adults performed a modified Go/Nogo task. Response cues were preceded by happy or angry faces. After controlling for task performance, left orbitofrontal regions discriminated trials with happy vs. angry faces in children but not in adults when a response was withheld, and this effect decreased parametrically with age group. Age-related changes in prefrontal responsiveness to facial expression were not observed when an action was required, nor did this region show age-related activation changes with the demand to withhold a response in general. Such results reveal age-related differences in prefrontal activation that are specific to stimulus valence and depend on the action required.


Perioperative myocardial infarction: diagnostic clues and prevention.
The diagnosis of perioperative myocardial infarction can be missed if the pain is masked by postoperative analgesia and the possibility is not considered. This report is the case of a patient with a missed diagnosis of perioperative myocardial infarction. Myocardial injury and infarction from noncardiac surgery is currently the subject of intense interest and research. This report illustrates the importance of the diagnosis and suggests clues that can be used to make the diagnosis.


EFFICACY OF INSULIN, HEPARIN AND FENOFIBRATE COMBINATION TREATMENT IN SEVERE HYPERTRIGLYCERIDEMIA: DOUBLE CENTER EXPERIENCE.
Severe hypertriglyceridemia (SH), which calls for a triglyceride (TG) level above 1000 mg/dL, remains an important health issue. While some data exist to offer combination of heparin, insulin and fenofibrate as a reasonable treatment option, safety and benefits of this therapy have not been accurately weighted, largely due to the limited sample size of the relevant studies. Assess the efficacy and safety of the heparin, insulin and fenofibrate combination in the treatment of patients with SH. Patients aged ≥18 years with TG level above 1000 mg/dL and adequate organ function were included. Triglyceride levels were measured immediately before the treatment and on the 3rd and 6th days of the treatment. Treatment dosage, duration, response and side effects were assessed. Patients with hypertriglyceridemia presenting with acute pancreatitis were treated additionally with lipid apheresis. A total of 42 patients were included. Of these, 85.8% came to medical attention with some kind of secondary hypertriglyceridemia causes. The baseline median TG value of the cases was 2141.0 mg/ dL (1026-12250). There were 6 patients (14.3%) with acute pancreatitis at presentation. In patients without pancreatitis, with administration of insulin infusion, unfractionated heparin infusion and fenofibrate capsule, median TG values decreased to 921 mg/ dL (190-6400) on the 3rd day and to 437 mg/ dL (112-1950) on the 6th day of the treatment (p<0.0001, Friedman test). Potential toxicities related to insulin, heparin and fenofibrate combination treatment including hypoglycemia, hemorrhage, rise in creatine kinase levels, hepato - and nephrotoxicity were not observed. In this trial involving patients with SH, our data suggest that insulin, heparin and fenofibrate combination therapy was safe and effective.


A taxonomic synopsis of Altingiaceae with nine new combinations.
A taxonomic synopsis of the Altingiaceae is presented, including the taxonomic enumeration and distribution of 15 recognized species based on studies of 1,500 specimens from 24 herbaria throughout the distributional range of the taxa. Previous phylogenetic analyses based on several molecular markers have shown that Altingia and Semiliquidambar are nested within Liquidambar. All Altingia and Semiliquidambar species are now formally transferred to Liquidambar, which has the nomenclatural priority. The following nine new combinations are herein made: Liquidambar cambodiana(Lecomte) Ickert-Bond & J. Wen, Liquidambar caudata (H. T. Chang) Ickert-Bond & J. Wen, Liquidambar chingii (Metcalf) Ickert-Bond & J. Wen, Liquidambar gracilipes (Hemsl.) Ickert-Bond & J. Wen, Liquidambar multinervis(Cheng) Ickert-Bond & J. Wen, Liquidambar obovata (Merrill & Chun) Ickert-Bond & J. Wen, Liquidambar poilanei (Tardieu) Ickert-Bond & J. Wen, Liquidambar siamensis (Craib) Ickert-Bond & J. Wen, and Liquidambar yunnanensis (Rehder & Wilson) Ickert-Bond & J. Wen.