Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention.
Intravascular lithotripsy (IVL) has been shown to be safe and effective for calcium modification in nonocclusive coronary artery disease (CAD), but there are only case reports of its use in calcified chronic total occlusions (CTO). We report data from an international multicenter registry of IVL use during CTO percutaneous coronary intervention (PCI) and provide provisional data regarding its efficacy and safety. During the study period, IVL was used in 55 of 1053 (5.2%) CTO PCI procedures. IVL was used within the occluded segment after successful CTO crossing in 53 procedures and during incomplete CTO crossing in 2 cases. The mean J-CTO score was 3.1. CTO PCI technical and procedural success was achieved in 53 (96%) and 51 (93%) cases. Six patients had a procedural complication, with 3 main vessel perforations (5%). Two had covered stent implantation, one required pericardiocentesis, and one was managed conservatively. All had combination therapy with another calcium modification device. Two patients had a procedural myocardial infarction (PMI) (4%), and two others had a major adverse cardiovascular event (MACE) (4%) at a median follow-up of 13 (4-21) months. IVL can effectively facilitate calcium modification during CTO PCI. More data are required to establish the efficacy and safety of IVL and other calcium modification devices when used extraplaque or in combination during CTO PCI.


Implementation of the Admission Process of Patients Under the Public Crisis Situation of COVID-19 Pandemic: A Real-World Case Study.
To clarify the implementation of the admission process under the public crisis of COVID-19 pandemic. A real-world study was conducted to collect data on the normal and public crisis situations at a tertiary hospital in China and understand the views of 18 head nurses on the necessity of the admission process in public crisis situations. Independent t-test and chi-square test were used to analyze the work data in two situations; Spearman correlation analysis was performed to determine the correlation of work data with two situations of process implementation, and differences between the head nurses' views of necessity of the admission process and actual implementation under public crisis situations were analyzed. Significant differences were observed in the working data between the normal and public crisis situations (P < 0.05), and the implementation of the admission process was not in place. The number of nurses on duty was positively correlated with each item of admission process (P < 0.05), the rest of work data were negatively correlated with each item in the admission process (P < 0.05), and there was a significant difference between the necessity of each item in the admission process and the actual implementation results (P < 0.05). Public crisis leads to the lack of implementation of admission process, and the original admission process and quality control standards are not applicable during the public crisis situation.


Characteristics Associated With Telemonitoring Use Among Patients With Chronic Heart Failure: Retrospective Cohort Study.
Chronic heart failure (HF) is a chronic disease affecting more than 64 million people worldwide, with an increasing prevalence and a high burden on individual patients and society. Telemonitoring may be able to mitigate some of this burden by increasing self-management and preventing use of the health care system. However, it is unknown to what degree telemonitoring has been adopted by hospitals and if the use of telemonitoring is associated with certain patient characteristics. Insight into the dissemination of this technology among hospitals and patients may inform strategies for further adoption. We aimed to explore the use of telemonitoring among hospitals in the Netherlands and to identify patient characteristics associated with the use of telemonitoring for HF. We performed a retrospective cohort study based on routinely collected health care claim data in the Netherlands. Descriptive analyses were used to gain insight in the adoption of telemonitoring for HF among hospitals in 2019. We used logistic multiple regression analyses to explore the associations between patient characteristics and telemonitoring use. Less than half (31/84, 37%) of all included hospitals had claims for telemonitoring, and 20% (17/84) of hospitals had more than 10 patients with telemonitoring claims. Within these 17 hospitals, a total of 7040 patients were treated for HF in 2019, of whom 5.8% (409/7040) incurred a telemonitoring claim. Odds ratios (ORs) for using telemonitoring were higher for male patients (adjusted OR 1.90, 95% CI 1.50-2.41) and patients with previous hospital treatment for HF (adjusted OR 1.76, 95% CI 1.39-2.24). ORs were lower for higher age categories and were lowest for the highest age category, that is, patients older than 80 years (OR 0.30, 95% CI 0.21-0.44) compared to the reference age category (18-59 years). Socioeconomic status, degree of multimorbidity, and excessive polypharmacy were not associated with the use of telemonitoring. The use of reimbursed telemonitoring for HF was limited up to 2019, and our results suggest that large variation exists among hospitals. A lack of adoption is therefore not only due to a lack of diffusion among hospitals but also due to a lack of scaling up within hospitals that already deploy telemonitoring. Future studies should therefore focus on both kinds of adoption and how to facilitate these processes. Older patients, female patients, and patients with no previous hospital treatment for HF were less likely to use telemonitoring for HF. This shows that some patient groups are not served as much by telemonitoring as other patient groups. The underlying mechanism of the reported associations should be identified in order to gain a deeper understanding of telemonitoring use among different patient groups.


Population pharmacokinetics of escalating doses of caspofungin in a phase II study of patients with invasive aspergillosis.
Caspofungin (CAS) is approved for second-line management of proven or probable invasive aspergillosis at a dose of 50 mg once daily (QD). Preclinical and limited clinical data support the concept of the dose-dependent antifungal efficacy of CAS with preservation of its favorable safety profile. Little is known, however, about the pharmacokinetics (PKs) of higher doses of CAS in patients. In a formal multicenter phase II dose-escalation study, CAS was administered as a 2-h infusion at doses ranging from 70 to 200 mg QD. CAS PK sampling (n = 468 samples) was performed on day 1 and at peak and trough time points on days 4, 7, 14, and 28 (70 mg, n = 9 patients; 100 mg, n = 8 patients; 150 mg, n = 9 patients; 200 mg, n = 20 patients; total, n = 46 patients). Drug concentrations in plasma were measured by liquid chromatography tandem mass spectroscopy. Population pharmacokinetic analysis (PopPK) was performed using NONMEM (version 7) software. Model evaluation was performed using bootstrap analysis, prediction-corrected visual predictive check (pcVPC), as well as standardized visual predictive check (SVPC). The four investigated dose levels showed no difference in log-transformed dose-normalized trough levels of CAS (analysis of variance). CAS concentration data fitted best to a two-compartment model with a proportional-error model, interindividual variability (IIV) fitted best on clearance (CL), central and peripheral volume of distribution (V(1) and V(2), respectively) covariance fitted best on CL and V(1), interoccasion variability (IOV) fitted best on CL, and body weight fitted best as a covariate on CL and V(1) (CL, 0.411 liters/h ± 29% IIV; IOV on CL, 16%; V(1), 5.785 liters ± 29% IIV; intercompartmental clearance, 0.843 liters/h; V2, 6.53 liters ± 67% IIV). None of the other examined covariates (dose level, gender, age, serum bilirubin concentration, creatinine clearance) improved the model further. Bootstrap results showed the robustness of the final PopPK model. pcVPC and SVPC showed the predictability of the model and further confirmed the linear PKs of CAS over the dosage range of 70 to 200 mg QD. On the basis of the final model, geometric mean simulated peak plasma levels at steady state ranged from 13.8 to 39.4 mg/liter (geometric coefficient of variation, 31%), geometric mean trough levels ranged from 4.2 to 12.0 mg/liter (49%), and geometric mean areas under the concentration-time curves ranged from 170 to 487 mg · h/liter (34%) for the dosage range of 70 to 200 mg QD. CAS showed linear PKs across the investigated dosage range of 70 to 200 mg QD. Drug exposure in the present study population was comparable to that in other populations. (This study has been registered with the European Union Drug Regulating Authorities Clinical Trials website under registration no. 2006-001936-30 and at ClinicalTrials.gov under registration no. NCT00404092.).


Iridal-Type Triterpenoids with a Cyclopentane Unit from the Rhizomes of Belamcanda chinensis.
Ten new iridal-type triterpenoid derivatives, polycycloiridals K-T (1-10), with a cyclopentane moiety originating from the cyclization of the homofarnesyl side chain were isolated from the rhizomes of Belamcanda chinensis. Their structures were established by spectroscopic data, a single-crystal X-ray diffraction analysis, TDDFT quantum mechanical calculations, and chemical derivatization. Compounds 2 and 10 exhibited 33.4% and 32.9% inhibitory activities, respectively, against PTP1b (protein tyrosine phosphatase) at a concentration of 10 μM. A putative biosynthetic pathway is proposed.


Spotless rickettsiosis caused by Rickettsia slovaca and associated with Dermacentor ticks.
The pathogenic role of Rickettsia slovaca was first demonstrated in 1997 in a patient who presented with a single inoculation lesion of the scalp and enlarged cervical lymph nodes after receiving a bite from a Dermacentor tick. Subsequently, we evaluated the occurrence of R. slovaca infections among patients living in France and Hungary who presented with these symptoms. R. slovaca infections were confirmed by polymerase chain reaction (PCR) in 17 of 67 enrolled patients. Infections were most likely to occur in patients aged <10 years and in patients who were bitten during the colder months of the year. The median duration of incubation for the disease was 7 days. Fever was present in only 2 patients, and only 1 patient developed a rash. Sequelae included persistent asthenia (3 cases) and localized alopecia (4 cases). Immunofluorescence and/or Western blot analysis detected antibodies in 50% of tested patients. Three Dermacentor ticks obtained from patients revealed R. slovaca by PCR.


The Contribution of Thoracic Radiation Dose Volumes to Subsequent Development of Cardiovascular Disease in Cancer Survivors.
Although radiation therapy (RT) has been recognized for contributing to cardiovascular disease (CVD), it is unknown whether specific doses received by cardiovascular tissues influence development. In this pilot study, we examined the contribution of RT dose distribution on the development of CVD events in patients with cancer within 5 years of RT. A retrospective case-controlled design was used matching 28 cases receiving thoracic RT who subsequently developed an adverse CVD event with 28 controls based upon age, gender, and cancer type. Dose volume histograms of nongated computed tomography scans received during RT characterized the dose delivered to the heart. Heart chambers were segmented using an atlas approach, and radiomics features for the segmentation as well as planning dose in each chamber were tabulated for analysis. No significant differences were observed in the RT dose statistics between groups, preexisting CVD, nor significant differences of RT doses delivered to distinct chambers of the heart. Cases were found to have greater CVD risk factors at the time of cancer diagnosis. Morphological significant differences for perimeter on border ( P = .043), equivalent spherical radius ( P = .050), and elongation ( P = .038) were observed, with preexisting CVD having the highest values (ie, larger hearts). Traditional CVD risk factors were more prevalent in the cases who developed CVD. No differences were observed in doses of RT. Of note, we observed significant differences in heart morphology and mass in known diseased hearts on the pretreatment scans. These new metrics may have implications for the measurement and quantification of CVD.


Antibody and cytokine responses to house dust mite allergens and Toxoplasma gondii antigens in atopic and non-atopic Brazilian subjects.
According to hygiene hypothesis, a lower exposure to infection is associated with increased prevalence of allergic diseases. This study aimed to investigate the association between atopy and Toxoplasma gondii (Tg) infection by analyzing the antibody and cytokine responses to house dust mite allergens and T. gondii antigens in Brazilian subjects. A total of 275 individuals were assessed and divided into atopics (n=129) and non-atopics (n=146) based on markers of allergy (positive skin prick test and ELISA-IgE to mite allergens) or Tg-seropositive (n=116) and Tg-seronegative (n=159) groups according to infection markers (positive ELISA-IgG to T. gondii). Tg-seropositive individuals presented lower allergenic sensitization (37%) to mite allergens than Tg-seronegative subjects (54%). A significant association was found between atopy and negative serology to T. gondii (OR: 2.0; 95% CI: 1.23-3.26; P<0.05). Proliferative responses and cytokine production after antigenic stimulation showed predominant synthesis of Th1-cytokines as IFN-gamma in Tg-seropositive patients, whether atopics or non-atopics. Conversely, Th2-cytokines as IL-5 prevailed in atopics compared to non-atopics, regardless the seropositivity to T. gondii. Levels of IL-10, IL-13, IL-17, and TGF-beta were not able to discriminate the groups. Hence, a negative association between atopy and infection by T. gondii was demonstrated for the first time in Brazilian subjects, focusing on the antibody and cytokine responses and indicating that the immunomodulation induced by the parasite may play a protective role in the development of allergic diseases.


High resolution IR diode laser study of collisional energy transfer between highly vibrationally excited monofluorobenzene and CO2: the effect of donor fluorination on strong collision energy transfer.
Collisional energy transfer between vibrational ground state CO2 and highly vibrationally excited monofluorobenzene (MFB) was studied using narrow bandwidth (0.0003 cm(-1)) IR diode laser absorption spectroscopy. Highly vibrationally excited MFB with E' = ∼41,000 cm(-1) was prepared by 248 nm UV excitation followed by rapid radiationless internal conversion to the electronic ground state (S1→S0*). The amount of vibrational energy transferred from hot MFB into rotations and translations of CO2 via collisions was measured by probing the scattered CO2 using the IR diode laser. The absolute state specific energy transfer rate constants and scattering probabilities for single collisions between hot MFB and CO2 were measured and used to determine the energy transfer probability distribution function, P(E,E'), in the large ΔE region. P(E,E') was then fit to a bi-exponential function and extrapolated to the low ΔE region. P(E,E') and the biexponential fit data were used to determine the partitioning between weak and strong collisions as well as investigate molecular properties responsible for large collisional energy transfer events. Fermi's Golden rule was used to model the shape of P(E,E') and identify which donor vibrational motions are primarily responsible for energy transfer. In general, the results suggest that low-frequency MFB vibrational modes are primarily responsible for strong collisions, and govern the shape and magnitude of P(E,E'). Where deviations from this general trend occur, vibrational modes with large negative anharmonicity constants are more efficient energy gateways than modes with similar frequency, while vibrational modes with large positive anharmonicity constants are less efficient at energy transfer than modes of similar frequency.


Collective sensing and collective responses in quorum-sensing bacteria.
Bacteria often face fluctuating environments, and in response many species have evolved complex decision-making mechanisms to match their behaviour to the prevailing conditions. Some environmental cues provide direct and reliable information (such as nutrient concentrations) and can be responded to individually. Other environmental parameters are harder to infer and require a collective mechanism of sensing. In addition, some environmental challenges are best faced by a group of cells rather than an individual. In this review, we discuss how bacteria sense and overcome environmental challenges as a group using collective mechanisms of sensing, known as 'quorum sensing' (QS). QS is characterized by the release and detection of small molecules, potentially allowing individuals to infer environmental parameters such as density and mass transfer. While a great deal of the molecular mechanisms of QS have been described, there is still controversy over its functional role. We discuss what QS senses and how, what it controls and why, and how social dilemmas shape its evolution. Finally, there is a growing focus on the use of QS inhibitors as antibacterial chemotherapy. We discuss the claim that such a strategy could overcome the evolution of resistance. By linking existing theoretical approaches to data, we hope this review will spur greater collaboration between experimental and theoretical researchers.


Effect of exercise on hemodynamics and urinary protein excretion in patients with early-stage diabetic nephropathy.
We investigated the effects of exercise on hemodynamics and urinary protein excretion in 15 patients with early-stage diabetic nephropathy (DN) as compared the findings with these of 16 healthy volunteers. Patients were divided into two groups according to their renal histopathologic findings; Group D0 consisted of 8 patients in whom light microscopy showed minor glomerular abnormalities and Group DI consisted of 7 patients with early stage diffuse lesions. The subjects exercised on a treadmill at a workload of 4.7 METS for 20 minutes. Systolic blood pressure, heart rate and the pressure rate product were significantly higher in the DI group than in the D0 and control groups during exercise. Diastolic blood pressure was similar among the three groups. Creatinine clearance was unchanged during exercise. Urinary albumin excretion, urinary acid soluble protein excretion and urinary alpha 1-microglobulin excretion were all significantly increased in group DI compared with the D0 and control groups. Excretion of beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase activity were unchanged during exercise. Our findings suggest that this provocative exercise test is useful for diagnosing early-stage diabetic nephropathy.


Demarcating Z-line and Gastric Folds Boundary Based on the Segmentation of the Lower Esophageal Sphincter Images.
The endoscopic diagnosis of pathological changes in the gastroesophageal junction including esophagitis and Barrett's mucosa is based on the visual detection of two boundaries: mucosal color change between esophagus and stomach, and top endpoint of gastric folds. The presence and pattern of mucosal breaks in the gastroesophageal mucosal junction (Z line) classify esophagitis in patients and the distance between the two boundaries points to the possible columnar lined epithelium. Since visual detection may suffer from intra- and interobserver variability, our objective was to define the boundaries automatically based on image processing algorithms, which may enable us to measure the detentions of changes in future studies. To demarcate the Z-line, first the artifacts of endoscopy images are eliminated. In the second step, using SUSAN edge detector, Mahalanobis distance criteria, and Gabor filter bank, an initial contour is estimated for the Z-line. Using region-based active contours, this initial contour converges to the Z-line. Finally, by applying morphological operators and Gabor Filter Bank to the region inside of the Z-line, gastric folds are segmented. To evaluate the results, a database consisting of 50 images and their ground truths were collected. The average dice coefficient and mean square error of Z-line segmentation were 0.93 and 3.3, respectively. Furthermore, the average boundary distance criteria are 12.3 pixels. In addition, two other criteria that compare the segmentation of folds with several ground truths, i.e., Sweet-Spot Coverage and Jaccard Index for Golden Standard, are 0.90 and 0.84, respectively. Considering the results, automatic segmentation of Z-line and gastric folds are matched to the ground truths with appropriate accuracy.


Genome Assembly of Salicaceae Populus deltoides (Eastern Cottonwood) I-69 Based on Nanopore Sequencing and Hi-C Technologies.
Populus deltoides has important ecological and economic values, widely used in poplar breeding programs due to its superior characteristics such as rapid growth and resistance to disease. Although the genome sequence of P. deltoides WV94 is available, the assembly is fragmented. Here, we reported an improved chromosome-level assembly of the P. deltoides cultivar I-69 by combining Nanopore sequencing and chromosome conformation capture (Hi-C) technologies. The assembly was 429.3 Mb in size and contained 657 contigs with a contig N50 length of 2.62 Mb. Hi-C scaffolding of the contigs generated 19 chromosome-level sequences, which covered 97.4% (418 Mb) of the total assembly size. Moreover, repetitive sequences annotation showed that 39.28% of the P. deltoides genome was composed of interspersed elements, including retroelements (23.66%), DNA transposons (6.83%), and unclassified elements (8.79%). We also identified a total of 44 362 protein-coding genes in the current P. deltoides assembly. Compared with the previous genome assembly of P. deltoides WV94, the current assembly had some significantly improved qualities: the contig N50 increased 3.5-fold and the proportion of gaps decreased from 3.2% to 0.08%. This high-quality, well-annotated genome assembly provides a reliable genomic resource for identifying genome variants among individuals, mining candidate genes that control growth and wood quality traits, and facilitating further application of genomics-assisted breeding in populations related to P. deltoides.


Risk of postoperative scalp necrosis in the occipital artery region after posterior cranial fossa surgery.
Ischemia-induced postoperative scalp necrosis in the superficial temporal artery (STA) region is known to occur after STA-middle cerebral artery anastomoses. However, no reports have evaluated the risk of postoperative scalp necrosis in the occipital artery (OA) region. This study examined the surgical procedures that pose a risk for postoperative scalp necrosis in the OA region following posterior cranial fossa surgery. Patients who underwent initial posterior fossa craniotomy at our institution from 2015 to 2022 were included. Clinical information was collected using medical records. Regarding surgical procedures, we evaluated the incision design and whether a supramuscular scalp flap was prepared. The supramuscular scalp flap was defined as a scalp flap dissected from the sternocleidomastoid and/or splenius capitis muscles. A total of 392 patients were included. Postoperative scalp necrosis occurred in 19 patients (4.8%). There were 296 patients with supramuscular scalp flaps, and supramuscular scalp flaps prepared in all 19 patients with postoperative necrosis. Comparing incision designs among patients with supramuscular scalp flap, a hockey stick-shaped scalp incision caused postoperative necrosis in 14 of 73 patients (19.1%), and the odds of postoperative scalp necrosis were higher with the hockey stick shape than with the retro-auricular C shape (adjusted odds ratio: 12.2, 95% confidence interval: 3.86-38.3, p = 0.00002). In all the cases, ischemia was considered to be the cause of postoperative necrosis. The incidence of postoperative necrosis is particularly high when a hockey stick-shaped scalp incision is combined with a supramuscular scalp flap.


The effects of flumazenil on the antinociceptive actions of morphine in rats.
The 8-fluoro-5,6-dihydro-5-methyl-6-oxo-4H-imidazol[1,5-a][1,4]benzodiazepine-3-carboxylic acid ethyl ester (Flumazenil)-morphine interaction on analgesia (acute pain model, tail-flick test) was tested after intraperitoneal (IP) and intrathecal (IT) routes of administration in female rats. Analgesia was enhanced by the concurrent administration of Flumazenil with morphine (IP), in a dose-related way. Flumazenil alone (IP) did not produce analgesia. In contrast, morphine analgesia was not enhanced by Flumazenil by the IT route. These data demonstrate that Flumazenil enhances morphine-mediated antinociception by mechanisms that are likely to involve benzodiazepine receptors at sites other than the spinal cord.


2006 Visualization Challenge winners.
Science and the National Science Foundation announce the winners and honorable mentions in the categories of photography, illustration, informational graphics, noninteractive multimedia, and interactive multimedia in this year's Science and Engineering Visualization Challenge.


Implementation of local area network extension for instrumentation standard trigger capabilities in advanced data acquisition platforms.
Synchronization mechanisms are an essential part of the real-time distributed data acquisition systems (DASs) used in fusion experiments. Traditionally, they have been based on the use of digital signals. The approach known as local area network extension for instrumentation (LXI) provides a set of very powerful synchronization and trigger mechanisms. The Intelligent Test Measurement System (ITMS) is a new platform designed to implement distributed data acquisition and fast data processing for fusion experiments. It is based on COMPATPCI technology and its extension to instrumentation (PXI). Hardware and software elements have been developed to include LXI trigger and synchronization mechanisms in this platform in order to obtain a class A LXI instrument. This paper describes the implementation of such a system, involving the following components: commercial hardware running a Linux operating system; a real-time extension to an operating system and network (RTAI and RTNET), which implements a software precision time protocol (PTP) using IEEE1588; an ad hoc PXI module to support hardware implementation of PTP-IEEE 1588; and the multipoint, low-voltage differential signaling hardware LXI trigger bus.


Transcriptional analysis of host responses to Marek's disease viral infection.
This study was aimed at investigating the genes that control host responses to Marek's disease virus (MDV). Spleen tissues from infected and age-matched uninfected control chickens were examined 4, 7, 14, and 21 d postinfection for gene expression differences, using both microarray and quantitative real-time polymerase chain reaction (PCR) methodologies. Up to 51% of genes assayed during microarray analysis showed a significant change (p < or = 0.05) in expression after MDV infection, of which cell surface molecules, transcription and signal transduction molecules, housekeeping and metabolism mediators, and cytokines and cytokine receptors were most commonly differentially expressed. Setting a fold change threshold (> or =2), 14 of 84 genes showed differential expression over time. In addition, some genes showed differential expression at more than one time point. For example, the granzyme-A homolog gene remained upregulated in infected chickens, with fold changes of 7.98, 13.91, and 9.07 at 7, 14, and 21 d postinfection, respectively. Other genes that were differentially expressed at more than one time point were invariant chain, IgM, and CD3. Quantitative real-time PCR analysis was used to validate microarray results for a subset of genes showing a :2-fold change in expression. Expression of all but one gene (CD28) was confirmed. Identification of genetic mechanisms initiated by in vivo infection with MDV expands the current understanding of immune response to the virus in addition to host response elements associated with viral pathogenesis.


Ocular Decompression Retinopathy with Macular Edema after Deep Sclerectomy with Intrascleral Implantation.
We report a case of ocular decompression retinopathy (ODR) with macular edema, diagnosed by optical coherence tomography, after a deep sclerectomy (DS) with an intrascleral implant, resolved with medical therapy 6 months later. The medical literature reports that in 14% of patients suffering from ODR, a pars plana vitrectomy was required, and 15% of patients had a poor final visual acuity. An otherwise healthy 75-year-old man with high myopia and a primary open-angle glaucoma, with previous intraocular pressure (IOP) of 24 mm Hg, underwent a DS with intrascleral implant without complications. The patient suffered postoperatively from ODR with macular edema that required medical therapy with nonsteroidal anti-inflammatory eye drops (Nepafenac® 0.3%) for a period of 6 months. ODR is an infrequent complication that may occur after any surgical or medical procedure that causes a sudden IOP decrease. The presence of macular edema is only reported in 5% of cases and can occur in patients who report a decreased visual acuity, commonly associated with a retinal hemorrhage. We have described a case of ODR with macular edema after DS with intrascleral implant. Although ODR is considered to cause a low level of morbidity, in some patients this may not be the case.


Development of an experimental model of brain tissue heterotopia in the lung.
The presence of heterotopic brain tissue in the lung is a rare abnormality. The cases reported thus far are usually associated with neural tube defects (NTD). As there are no reports of experimental models of NTD that present this abnormality, the objective of the present study was to develop a surgical method of brain tissue heterotopia in the lung. We used 24 pregnant Swiss mice divided into two groups of 12 animals each, denoted 17GD and 18GD according to the gestational day (GD) when caesarean section was performed to collect the fetuses. Surgery was performed on the 15th GD, one fetus was removed by hysterectomy and its brain tissue was cut into small fragments and implanted in the lung of its litter mates. Thirty-four live fetuses were obtained from the 17GD group. Of these, eight (23.5%) were used as control (C), eight (23.5%) were sham operated (S) and 18 (52.9%) were used for pulmonary brain tissue implantation (PBI). Thirty live fetuses were obtained from the females of the 18GD group. Of these, eight (26.6%) were C, eight (26.6%) S and 14 (46.6%) were used for PBI. Histological examination of the fetal trunks showed implantation of GFAP-positive brain tissue in 85% of the fetuses of the 17GD group and in 100% of those of the 18GD group, with no significant difference between groups for any of the parameters analysed. The experimental model proved to be efficient and of relatively simple execution, showing complete integration of the brain tissue with pulmonary and pleural tissue and thus representing a model that will permit the study of different aspects of cell implantation and interaction.


Bilateral massive conchae bullosa mimicking intranasal tumors.
We describe a case of bilateral massive conchae bullosa in a 76-year-old woman. She presented with a 2-year history of nasal obstruction and frontal headache. In light of these and other findings on anterior rhinoscopic and endoscopic examinations, we initially suspected nasal tumors. However, after a prebiopsy evaluation by computed tomography, we diagnosed bilateral massive conchae bullosa that did not impair sinus ventilation. Endoscopic surgery was performed, and the patient's symptoms abated.


Neurovascular injuries to the shoulder.
The throwing athlete is at risk for neurovascular injuries of the shoulder because of the excessive demands placed upon the shoulder by repetitive throwing motions. The most commonly recognized neurovascular compression syndromes are axillary artery occlusion, effort thrombosis, quadrilateral space syndrome, and thoracic outlet syndrome. Diagnosis is aided by the use of the Adson's test, costoclavicular maneuver, and hyperabduction maneuver. Initial treatment usually is nonoperative. Anticoagulation or thrombolytic therapy can be used for vascular occlusion. Surgery usually is reserved for patients suffering acute or chronic symptoms despite nonoperative treatment. With proper treatment, most patients are able to resume their previous athletic activities in a timely manner with minimal disability.


The simian virus 40 large T antigen. A lot packed into a little.
Simian virus 40 (SV40) large T antigen is an 81,000 Mr, multifunctional viral phosphoprotein. Certain of its functions are essential to the viral replication process in monkey cells. Others, as yet undefined in biochemical terms, contribute to its neoplastic transforming activity. This review focuses on the known structure-function relationships of this protein and reflects upon the potential significance of its transforming properties in the natural host species of this virus.


Suicides among family members of elderly suicide victims: an exploratory study.
This exploratory study compares elderly suicides with (n=13) and without (n=72) family member suicide. Previous episodes of suicidal behavior were more common among suicides who lost first-degree relatives by suicide (100% vs. 65%, p = .009). Six persons had lost an offspring by suicide prior to their own deaths. Substance use disorder was more prevalent among those with offspring suicide than those without (100% vs. 25%, p = .000). While informants reported that offspring suicides played a central role in the suicide of the elderly study case, sibbling suicides were not considered precipitating factors.


The many facets of Raman spectroscopy for biomedical analysis.
A critical review is presented on the use of linear and nonlinear Raman microspectroscopy in biomedical diagnostics of bacteria, cells, and tissues. This contribution is combined with an overview of the achievements of our research group. Linear Raman spectroscopy offers a wealth of chemical and molecular information. Its routine clinical application poses a challenge due to relatively weak signal intensities and confounding overlapping effects. Nonlinear variants of Raman spectroscopy such as coherent anti-Stokes Raman scattering (CARS) and stimulated Raman scattering (SRS) have been recognized as tools for rapid image acquisition. Imaging applications benefit from the fact that contrast is based on the chemical composition and molecular structures in a label-free and nondestructive manner. Although not label-free, surface enhanced Raman scattering (SERS) has also been recognized as a complementary biomedical tool to increase sensitivity. The current state of the art is evaluated, illustrative examples are given, future developments are pointed out, and important reviews and references from the current literature are selected. The topics are identification of bacteria and single cells, imaging of single cells, Raman activated cell sorting, diagnosis of tissue sections, fiber optic Raman spectroscopy, and progress in coherent Raman scattering in tissue diagnosis. The roles of networks-such as Raman4clinics and CLIRSPEC on a European level-and early adopters in the translation, dissemination, and validation of new methods are discussed.


Surgical palliative care disparities.
Surgical palliative care is an interdisciplinary treatment modality that aims to decrease suffering and improve the quality of life of seriously ill surgical patients. Although surgical palliative care is increasingly being found to positively impact patient quality of life, disparities in surgical palliative care remain poorly defined. While the field of medical palliative care has demonstrated certain racial/ethnic, socioeconomic, and geographic groups are at higher risks for receiving worse palliative care, there is no analogous consensus in the field of surgical palliative care. This is largely secondary to a paucity of research focus in this field. Given that the aforementioned disparities experienced by minoritized patient populations has led to significant morbidity, it is important to understand and call attention to disparities existing within the field of surgical palliative care as well. To advance the knowledge of current healthcare shortcomings and progress towards equitable surgical palliative care, this paper reviews the current state of surgical palliative care disparities evidence, details gaps in knowledge, and highlights priorities for future surgical palliative care research. The articles identified in this review noted disparate surgical palliative care access and outcomes across various racial/ethnic groups, age ranges, socioeconomic classes, hospital populations, and regions. However, evidence scarcity necessitates more robust research be performed to adequately identify at risk groups and understand the factors supporting disparity development.


MicroRNA-365 inhibits proliferation, migration and invasion of glioma by targeting PIK3R3.
A growing body of evidence suggests that microRNA-365 (miR-365) played crucial role in the initiation and development of many types of cancers. However, the biological role of miR-365 in human glioma remains unclear. Herein, the aims of this study were to investigate the role and underlying mechanisms of miR-365 in glioma by a series of in vitro and in vivo experiments. We found that miR-365 was strongly downregulated in malignant glioma tissues and cell lines. Restoration of the expression of miR-365 in glioma cells significantly inhibited cell proliferation, migration and invasion in vitro and tumor growth in vivo. Notably, phosphoinositide-3-kinase regulatory subunit 3 (PIK3R3) was proved to be a direct target of miR-365 in glioma cells, and its mRNA expression was inversely correlated with miR-365 expression in clinical glioma tissues. PIK3R3 overexpression in miR-365 expressing cells could rescue proliferation, migration and invasion inhibition of miR-365. In addition, miR-365 was able to inhibit the phosphorylation of AKT and mTOR in vitro and in vivo, which are key participants in the AKT/mTOR pathway. These results suggest that miR-365 functioned as a tumor suppressor in glioma by targeting PIK3R3, suggesting that miR-365 has potential as therapeutic targets for glioma.


The Effect of the Dental Operating Microscope on the Outcome of Nonsurgical Root Canal Treatment: A Retrospective Case-control Study.
The aim of the current investigation was to assess the effect of the use of a dental operating microscope on the outcome of nonsurgical root canal treatment (NS RCT) while treating the mesiobuccal (MB) root of the maxillary first molar. This retrospective investigation included endodontically treated maxillary first molars (ETMs) with apparent adequate previous NS RCT and restorations referred for endodontic retreatment at the endodontic graduate clinic. Inclusion criteria were ETMs that were diagnosed with irreversible pulpitis and normal periapical tissues before the initial NS RCT and ETMs that presented with a minimum of 1 identifiable periapical lesion (PAR) at 1 of the roots at the time of retreatment. One hundred ninety-five ETMs were included and divided into 2 groups: (1) the initial NS RCT had been performed using a microscope (n = 83) and (2) NS RCT had been performed without the use of a microscope (n = 112). Data extracted were whether the second MB (MB2) canal was located initially and the presence of an MB PAR at the time of retreatment. Data were statistically analyzed using binary logistic regression (α = 0.05). The MB root was 3 times more likely to present with a PAR at the time of retreatment if the initial NS RCT was performed without the use of a microscope (P < .05, odds ratio = 3.1). There was a significant association between a missed MB2 canal and an MB PAR in the group in which the initial NS RCT was performed without the use of a microscope (P < .05, odds ratio = 5.1). However, in cases in which the initial NS RCT was performed using a microscope, a missed MB2 canal was not associated with the presence of an MB PAR. With proper education, dentists can gain further insight into recognizing limitations in treating cases that require advanced training and advanced optics such as a microscope. Based on this strategy, it would appear that the outcome of NS RCT can be improved.


Expression of the ERBB2 protein in benign and malignant salivary gland tumors.
Fifty-two primary human salivary gland tumors were analyzed for expression of the p185ERBB2 protein using immunohistochemical and immunoblotting techniques. About 63% (33/52) of the tumors expressed the ERBB2 protein. The highest expression levels were detected among the carcinomas, where 32% of the tumors showed intense membrane staining in 25-100% of the tumor cells. In benign pleomorphic adenomas, the corresponding figure was only 12%. Clinical follow-up data available for 18 of the 19 patients with carcinomas suggested an association between high ERBB2 protein levels and poor prognosis as measured by recurrence of disease and/or the appearance of metastases. These results indicate that ERBB2 activation and overexpression could be an important genetic event with possible prognostic implications in a subset of malignant salivary gland tumors.


Spouse contracting to increase antabuse compliance in alcoholic veterans.
Developed and evaluated a home-based contracting program to determine its effect on the compliance rates of discharged alcohol patients to a disulfiram (antabuse) regimen. The three comparison groups included (a) no contract/no recording; (b) contract/recording; and (c) contract/recording plus instructions for positive reinforcement. Twenty-five patients who had been treated in a behaviorally oriented inpatient alcohol dependence treatment program and who lived with a significant other (i.e., spouse, sibling, parent) participated in the study. At the end of the 3-month period for which the disulfiram was prescribed, those Ss who were involved in contracting and recording reached criterion more frequently than those who were in the minimal treatment group. Furthermore, 84% of this S sample were abstinent at the 3-month follow-up according to collateral reports. The discussion centers on the use of home-based contracting as an inexpensive alternative to other, more costly disulfiram programs. Additional methods for obtaining measures of reliability on self-report of disulfiram usage also are discussed.


A Particle Swarm Optimization-Based Approach with Local Search for Predicting Protein Folding.
The hydrophobic-polar (HP) model is commonly used for predicting protein folding structures and hydrophobic interactions. This study developed a particle swarm optimization (PSO)-based algorithm combined with local search algorithms; specifically, the high exploration PSO (HEPSO) algorithm (which can execute global search processes) was combined with three local search algorithms (hill-climbing algorithm, greedy algorithm, and Tabu table), yielding the proposed HE-L-PSO algorithm. By using 20 known protein structures, we evaluated the performance of the HE-L-PSO algorithm in predicting protein folding in the HP model. The proposed HE-L-PSO algorithm exhibited favorable performance in predicting both short and long amino acid sequences with high reproducibility and stability, compared with seven reported algorithms. The HE-L-PSO algorithm yielded optimal solutions for all predicted protein folding structures. All HE-L-PSO-predicted protein folding structures possessed a hydrophobic core that is similar to normal protein folding.


Hyperamylasemia Post Living Donor Nephrectomy Does Not Relate to Pain.
Introduction The aetiology of pain after laparoscopic donor nephrectomy remains unclear. Given the proximity of the left kidney to the tail of the pancreas, we aimed to assess whether mobilisation and retrieval of the left kidney might inflame the pancreas, leading to pain and hyperamylasaemia in the post-operative period. Patient and methods In the present study, 16 consecutive live kidney donors were analysed in the same three months period. Amylase levels were measured on days 1 and 2. For each 24-hour period post-operatively analgesia consumption was recorded, as well as pain scores at rest on a visual analogue scale (VAS). Results Three out of 16 donors presented hyperamylasemia. A multiple regression analysis found levobupivacaine dose, propofol dose, transversus abdominis plane block and day 1 amylase did not significantly predict pain scores. Interestingly, body mass index significantly correlated with increased pain scores (p = 0.041). Also, increasing CO2 insufflation pressure and use of local anaesthetic infusion catheters predicted a decreased deep pain score (p = 0.036 and p = 0.037). Conclusion There was no correlation of amylase levels and pain scores. Pancreatitis is a rare complication of nephrectomy and no overt cases were seen in the case of donor nephrectomy.


Association between knee extensor strength and pulmonary function in the female elderly.
[Purpose] The purpose of this study is to study the impact of knee extensor strength, which is an index of the degree of physical activity on lung capacity in older women. [Subjects and Methods] Thirty-three older women who participated in the exercise program hosted by a senior citizen center and S University located in Busan. Force vital capacity (FVC) was measured with digital spirometry (Pony FX, COSMED Inc., Italy). Three rounds of measurements were taken for each participant, with one-minute rests between the tests. The means were computed for analysis. Knee extensor strength was measured with a hand-held dynamometer (HHD, MicroFET2®, Hogan Health Industries, Inc., UT, USA). Three rounds of measurements were taken for each knee extensor muscle, after which the mean of the measurements was taken for each side. The higher knee extensor muscle strength value was used for the analysis. [Results] Knee extensor muscle strength had significant positive correlations with Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), Peak expiratory flow (PEF), and Forced expiratory flow (FEF 25-75%). Association between knee extensor muscle strength and pulmonary function suggested that weakening of the elderly's knee extensor muscle strength has an adverse effect on pulmonary function, although the explanatory power was weak. [Conclusion] Knee extensor muscle weakness in elderly females restricts their physical activity and mobility, thereby serving as a key factor in decreasing their lung capacity.


Losartan may inhibit the progression of liver fibrosis in chronic HCV patients.
Abundant experimental evidence indicates overproduction of angiotensin II in the injured liver, and a role in stimulation of hepatic stellate cell (HSC) activation and fibrogenesis thereby, representing an attractive antifibrotic target. The aim of this study was to examine the antifibrotic effect of losartan on histopathologic level in chronic HCV patients. A prospective study on fifty patients with chronic HCV and liver fibrosis proved by liver biopsy was conducted. They included patients who did not respond (n=36) or comply (n=2) or receive therapy due to established cirrhosis (n=10), or refused to receive (n=2) combined interferon and ribavirin therapy. They were divided randomly into 2 groups. The 1(st) group (n=25) was given losartan 50 mg OD for 1 year and the 2(nd) group (25 patients) was given silymarin, 140 mg t.i.d., (silymarin group). Liver biopsy was done at baseline and 1 year from the onset of treatment (end of study). In the second liver biopsy after 1 year, the decrease in fibrosis stage was significantly different between losartan group and silymarin group (a decrease of 1.88±0.96 (50.9%) vs. 0.45±0.93 (11.7%), respectively; P<0.01). In patients treated with losartan, regression in fibrosis stage was observed in 14/16 patients vs. 2/11 in silymarin group (P<0.01). No differences were observed in inflammation grades in both groups. A significant increase in albumin and prothrombin levels and a decrease in systolic blood pressure were found in losartan but not in silymarin group (P=0.009, 0.001 & 0.018 respectively and P=0.158, 0.603 & 0.288, respectively). Histopathological scores showed that losartan had an inhibitory effect on progression and even led to regression of fibrosis stage but had no effect on the grade of inflammation.


Immunochemical properties of streptococcal M protein purified by isoelectric focusing.
Electrofucusing of an alkaline extract of type 24 streptococcal M protein yielded an antigenic fraction that was type specific and apparently homogeneous. The haptenic nature of this fraction was suggested by its inability to precipitate type-specific antiserum or to induce opsonic antibodies in rabbits, despite its ability to strongly inhibit opsonization of homologous-type streptococci by M antibody. The fraction migrated as a single band upon electrophoresis in sodium dodecyl sulfate (SDS) acrylamide gel. The mobility of the protein band was consistent with a molecular weight of 36,500 daltons. In some experiments using larger quantities of protein, a second faint protein band with an average molecular weight of 70,000 was observed, suggesting the presence of dimers of the 36,500-dalton protein. Amino acid analysis showed the predominant amino acid to be glycine followed by aspartic acid and glutamic acid. Moreover, this M protein fraction was free of non-type-specific immunotoxic properties in guinea pigs and in man. Although apparently not immunogenic, this nontoxic fraction may provide a useful tool to study the relationship of the type-specific protective moiety to potentially harmful "impurities" in M protein vaccines.


Identification of novel glucocerebrosidase chaperones by unexpected skeletal rearrangement reaction.
Compound 5 was identified from a high-throughput screening campaign as a small molecule pharmacological chaperone of glucocerebrocidase (GCase), a lysosomal hydrolase encoded by the GBA1 gene, variants of which are associated with Gaucher disease and Parkinson's disease. Further investigations revealed that compound 5 was slowly transformed into a regio-isomeric compound (6) in PBS buffer, plausibly via a ring-opening at hemiaminal moiety accompanied by subsequent intramolecular CC bond formation. Utilising this unexpected skeletal rearrangement reaction, a series of compound 6 analogues was synthesized which yielded multiple potent GCase pharmacological chaperones with sub-micromolar EC50 values as exemplified by compound 38 (EC50 = 0.14 μM).


Weakly Supervised Part Proposal Segmentation From Multiple Images.
Weakly supervised local part segmentation is challenging, due to the difficulty of modeling multiple local parts from image level prior. In this paper, we propose a new weakly supervised local part proposal segmentation method based on the observation that local parts will keep fixed along the object pose variations. Hence, the local part can be segmented by capturing object pose variations. Based on such observation, a new local part proposal segmentation model is proposed. Three aspects, such as shape similarity-based cosegmentation, shape matching-based part detection and segmentation, and graph matching-based part assignment are considered. A part segmentation energy function is first proposed. Four terms, such as MRF-based single image segmentation term, shape feature-based foreground consistency term, NCuts-based part segmentation term, and two-order graphs matching based part consistency term, are contained. Then, a three sub-minimization-based energy minimization method is proposed to accomplish approximation solution. Finally, we verify our method based on three image data sets (PASCAL VOC 2008 Part data set, UCB Bird data set, and Cat-Dog data set), and one video data set (UCF Sports) data set. The experimental results demonstrate a better segmentation performance compared with the existing object cosegmentation and part proposal generation methods.


Novel polyamine-dialkyl phosphate conjugates for gene carriers. Facile synthetic route via an unprecedented dialkyl phosphate.
To develop a novel nonviral gene carrier, three types of polyamine-dialkyl phosphates conjugates were synthesized via an unprecedented synthetic intermediate, dimerized dicetyl phosphate (DCP) anhydride, and the transfection efficiency and the complexation properties of the conjugate-DNA were evaluated. Condensation of DCP by 1,3,5-triisopropylbenzenesulfonyl chloride, TPSCl, gives the dimerized anhydride, which is stable enough to isolate by column chromatography in approximately 90% yield. The anhydride is reactive with various amines, i.e., spermidine, spermine, and polyethylenimine (PEI(1800)), providing corresponding polyamine-DCP conjugates via phosphoramidate linkage. The polyamine-DCP conjugates exhibited moderate transfection efficacy evaluated by beta-galactosidase assay. The conjugate-DNA complex was observed by using an atomic force microscope (AFM), revealing that the PEI(1800)-DCP conjugate, which showed the most efficient transfection, enables the formation of the more compact complex with DNA.


Acridine orange-methyl green fluorescent staining of nucleoli.
The staining of nucleoli with the fluorescent dye acridine orange following by counter-staining with methyl green differentially stained nucleoli in both plant and animal cells. The nucleoli fluoresced as bright structures highlighted against the quenched fluorescence of the chromatin. This technique provides a simple and highly reproducible method for differential staining of nucleoli.


Physiological time model of Scirpophaga incertulas (Lepidoptera: Pyralidae) in rice in Guandong Province, People's Republic of China.
Scirpophaga incertulas (Walker) (Lepidoptera: Pyralidae) is autochthonous and monophagous on rice, Oryza spp., which favors the development of a physiological time model using degree-days (degrees C) to establish a well defined window during which adults will be present in fields. Model development of S. incertulas adult flight phenology used climatic data and historical field observations of S. incertulas from 1962 through 1988. Analysis of variance was used to evaluate 5,203 prospective models with starting dates ranging from 1 January (day 1) to 30 April (day 121) and base temperatures ranging from -3 through 18.5 degrees C. From six candidate models, which shared the lowest standard deviation of prediction error, a model with a base temperature of 10 degrees C starting on 19 January was selected for validation. Validation with linear regression evaluated the differences between predicted and observed events and showed the model consistently predicted phenological events of 10 to 90% cumulative flight activity within a 3.5-d prediction interval regarded as acceptable for pest management decision making. The degree-day phenology model developed here is expected to find field application in Guandong Province. Expansion to other areas of rice production will require field validation. We expect the degree-day characterization of the activity period will remain essentially intact, but the start day may vary based on climate and geographic location. The development and validation of the phenology model of the S. incertulas by using procedures originally developed for pecan nut casebearer, Acrobasis nuxvorella Neunzig, shows the fungibility of this approach to developing prediction models for other insects.


Antigen provoking gamma interferon production in response to Mycobacterium bovis BCG and functional difference in T-cell responses to this antigen between viable and killed BCG-immunized mice.
It has been shown that gamma interferon (IFN-gamma)-producing CD4+ T cells, which are generated only by immunization with viable bacteria, exert a significant role in protective immunity against mycobacteria in mice. In this study, we have tried to determine the antigen recognized by the T cells in search of a possible protective antigen. T cells from viable Mycobacterium bovis BCG-immunized mice were stimulated with several antigens, and IFN-gamma production was measured. Purified protein derivative and viable and killed BCG lysates caused significant IFN-gamma production, and almost the same level of IFN-gamma activity was detected in both groups stimulated with viable and killed BCG lysates. However, heat shock protein (HSP) 65 and HSP 70 were not a major antigen for IFN-gamma production. The antigen provoking IFN-gamma production is localized mainly in the membrane fraction of BCG cells, and the approximate molecular size was 18 kDa. On the other hand, T cells from killed BCG-immunized mice never responded to this antigen for IFN-gamma production, whereas they could mount a delayed-type hypersensitivity response. These results showed that the antigen provoking IFN-gamma production was present in killed as well as viable BCG. In addition to the antigen presentation by antigen-presenting cells, some kinds of differentiation factor (such as monokines) that are produced only by stimulation with viable cells seemed to be necessary for the development of IFN-gamma-producing T cells.


Clopidogrel attenuates coated-platelet production in patients undergoing elective coronary catheterization.
Coated-platelets are a subclass of highly thrombotic activated platelets with an enhanced ability to generate thrombin. Excessive numbers of coated-platelets are believed to increase thrombotic risk. A previous report demonstrated that P2Y12 inhibition in vitro attenuates coated-platelet formation. The aim of this study was to determine the effect clopidogrel has on coated-platelet formation. We enrolled 27 patients undergoing elective coronary angiography. A total of 3 blood samples were taken from eligible patients: baseline, 24-hour postclopidogrel (preangiography), and 6-hour postangiography. Coated-platelet levels, expressed as percentage of total platelets, were determined with convulxin and thrombin with or without 1.5 or 6 microM adenosine diphosphate (ADP). Baseline levels of coated-platelets were 40.0% +/- 14.3% (mean +/- 1 SD). After clopidogrel exposure, the coated-platelet level was 32.8% +/- 13.6%, representing a significant 7.2% absolute reduction (AR) (17.8% relative reduction (RR); P < 0.0001). Clopidogrel significantly lowered the convulxin, thrombin plus ADP coated-platelet production (11.0% AR; 20.1% RR for 1.5 microM and 11.2% AR; 19.1% RR for 6 microM). This is the first report on the impact of in vivo administration of a P2Y12 antagonist on coated-platelet formation. The significance of a partial attenuation in coated-platelet potential has yet to be determined, but this could represent a new antithrombotic mechanism of clopidogrel beyond inhibition of ADP-induced aggregation.


Becoming incapacitated? Long-term sickness benefit recipients and the construction of stigma and identity narratives.
The transition to becoming 'incapacitated' and receiving sickness benefits represents a significant shift in an individual's narrative. Drawing on in-depth interviews with 25 long-term sickness benefits recipients in North-East England, this article focuses upon how individuals perceived and managed becoming 'incapacitated', particularly in relation to stigma and identity. The findings show that participants negotiated changes to their identity in varying ways - constructing new dimensions of self, validating their illness and pursuing aspirations. Importantly, the transition onto sickness benefits does not inevitably result in a shift to a negative identity. The term incapacity can include many realities, challenging the notion of sickness benefit recipients as being passively dependent. Instead, an active, sometimes very functional sense of self can be accompanied by a positive identity for recipients, which is especially important, in a context of the rhetoric surrounding ongoing welfare reform and sickness benefits recipients in the UK.


Improving the clinical recognition, prognosis, and treatment of melioidosis through epidemiology and clinical findings: The Sabah perspective.
Melioidosis is a deadly endemic disease in northern Australia and Southeast Asia, including Sabah, Malaysia, which is caused by the bacterium Burkholderia pseudomallei. It contributes to high fatality rates, mainly due to misdiagnosis leading to the wrong treatment being administered to the patients. Local epidemiology and data on clinical features could assist clinicians during diagnosis and treatment. However, these details are still scarce, particularly in Sabah. A retrospective study of 246 culture-confirmed melioidosis cases in Queen Elizabeth Hospital, Sabah, Malaysia was performed between 2016 and 2018. The epidemiological data and clinical and laboratory findings were extracted and analysed. The annual incidence of culture-confirmed melioidosis cases was estimated to be 4.97 per 100,000 people. The mean age of the patients was 50±15 years. Males and members of the Kadazan-Dusun ethnic group accounted for the majority of the melioidosis cases. The odds ratio analysis indicated that bacteraemic melioidosis in this region was significantly associated with fever (76%), and patients having at least one underlying illness (43%), including diabetes mellitus (32%). Sixty-eight patients (28%) succumbed to melioidosis. Contrary to what is known regarding factors that promote bacteraemic melioidosis, neither patients with fever nor patients with at least one comorbid disease, including diabetes mellitus, were significantly associated with death from melioidosis. There was no statistically significant difference between patients without comorbidities (24, 27%) and those with at least one comorbid disease (26, 25%), including diabetes mellitus (18, 23%). The odds ratios indicate that melioidosis mortality in this region is related to patients showing respiratory organ-associated symptoms (29%), bacteraemia (30%), and septic shock (47%). Burkholderia pseudomallei isolates in this study were highly susceptible to ceftazidime (100%), imipenem (100%), and trimethoprim-sulfamethoxazole (98%). Information obtained from this study can be used by clinicians to recognise individuals with the highest risk of acquiring melioidosis, estimate an accurate prognosis, and provide effective treatment for melioidosis patients to reduce death from melioidosis.


[Duchenne muscular dystrophy: electrocardiographic analysis of 131 patients].
Cardiac involvement is known to occur in patients with Duchenne muscular dystrophy (DMD). The electrocardiogram (ECG) shows some typical changes in DMD, which makes it a useful test for the diagnosis of cardiac lesion in this disease. To evaluate the electrocardiographic changes in patients with DMD and to correlate these changes with the age of the population studied. ECG of 131 patients diagnosed with DMD were examined. Several electrocardiographic variables were analyzed, and the patients were divided into two groups - one with and one without changes, for each variable studied. The correlation between the two groups and the age of the patients was analyzed. Garson's criteria were used to establish the electrocardiographic parameters of normality. ECG was abnormal in 78.6% of the patients. All showed normal sinus rhythm. The following percentages were found for the main variables studied: short PR interval = 18.3%; abnormal R waves in V1 = 29.7%; abnormal Q waves in V6 = 21.3%; abnormal ventricular repolarization = 54.9%; abnormal QS waves in inferior and/or upper lateral wall = 37.4%; conduction disturbances in right bundle branch = 55.7%; prolonged QT C interval = 35.8%, and wide QRS = 23.6%. Unpaired t test was used to establish the correlation between age and the electrocardiographic variables studied in the two groups. Statistically significant differences were found only for the abnormal repolarization variable. Electrocardiographic abnormalities are common in DMD, revealing early cardiac involvement. Only the abnormal ventricular repolarization variable was more frequent, however at a lower age range (p < 0.05).


Study on development of Agaricus bisporus by fluorescent microscopy and scanning electron microscopy.
Two strains of Agaricus bisporus have been investigated by fluorescent microscopy and scanning electron microscopy. Somatic nuclei, stained with auramin O and examined by fluorescent microscopy, appear to be randomly distributed, divide asynchronously, and assume a nonclassical or "two-track" configuration during mitotic metaphase. A similar configuration has been observed for nuclei during meiosis, but early meiosis in A. bisporus appears to be classical, usually with nine pairs of chromosomes evident during prophase I. Scanning electron microscopy has been used to document developmental stages in the formation and germination of basidiospores. Two-spored basidia were predominant, but occasionally one- or three-spored forms were observed. Four-spored basidia were absent, and uninucleated basidiospores were exceedingly rare to absent.


[Biomechanical effects of different bone cement diffusion patterns after vertebroplasty:finite element analysis].
To investigate the biomechanical effects of different bone cement diffusion patterns in the treatment of osteoporotic vertebral compression fractures. One volunteer with L1 osteoporotic vertebral compression fracture was selected, male, aged 68 years old, heighed 172 cm, weighted 60 kg, and healthy before. CT scans were used from T10-L5, CT data was extracted with Mimics software, and Geomagic wrap and Solidworks were used to model, and the three-dimensional finite element model (T12-L2) of preoperative osteoporotic vertebral compression fractures in the thoracolumbar segment was established. Similarly, the situations of bone cement dispersion in vertebroplasty were simulated (the situations of bone cement dispersion had the three kinds, including the bone cement not contacts with upper and lower endplates, the bone cement only contacts with upper endplates, and the bone cement contacts with upper and lower endplates). According to different diffusion situations, five types of loads were applied to the model:upright, upright plus forward flexion, upright plus backward extension, upright plus left bending, upright plus right rotation. Meanwhile, the model was compared with the cementless lumbar spine model, and the deformation and stress distribution of each model under load were recorded and compared. After the establishing the finite element model of osteoporotic vertebral compression fracture in the thoracolumbar segment, it was found that the deformation of three different bone cement distribution models above was not significantly different. In L1 cancellous bone, the Von Mises stress of the cementless lumbar spine group was significantly higher than that of the cemented group. Among the three groups of different bone cement injection situations, the Von Mises stress in the group of bone cement contacts with upper and lower endplates was the lowest, followed by the group of bone cement only contacts with upper endplates, and the highest Von Mises stress was the group that bone cement contacts neither the upper or lower endplates. In the comparison of bone cement stress, the Von Mises stress in the group of bone cement contacts with upper and lower endplates was significantly higher than the other two groups (upright 12.375 MPa, upright plus forward flexion 16.411 MPa, upright plus backward extension 16.801 MPa, upright plus left bending 13.425 MPa, upright plus right rotation 13.014 MPa), and the Von Mises stress in the group of bone cement does not contact with upper and lower endplates was the lowest. The bone cement contact with both upper and lower endplates can effectively absorb and transfer the stress level brought by the load, reduce the stress level of cancellous bone, and reduce the possibility of refracture of the operative vertebral body.


Examination of the correlation of first-week mortality with the gastrointestinal syndrome following chemotherapy.
The equation frequently made between mortality of mammals within the first week after treatment by cytotoxic drugs and the "gastrointestinal syndrome" has been critically examined. Six clinically used drugs were employed. Only for carmustine and 5-FU was a plateau in survival time observed, for increasing single doses. With cyclophosphamide or dactinomycin, mean survival time in the period of interest decreased sharply with dose, in marked contrast to the constancy observed over a large range of doses of radiation. The dynamics of expression of intestinal injury, as judged by mitotic activity in the crypts, was the same for all drugs and for radiation. However, the clonogenic response of the intestine (crypt microcolony assay) differed widely between agents. Cyclophosphamide and dactinomycin did not destroy any crypts at dose ranges containing the 50% lethality dose for mice. Of the remaining four drugs (carmustine, 5-FU, mechlorethamine hydrochloride, and doxorubicin), the surviving fraction of crypts corresponding to 50% lethality of mice varied 17-fold. Altering the route of administration of mechlorethamine hydrochloride from ip to iv increased the lethality dose and the dose for a given level of crypt survival, but not by the same factor. Survival of primitive, clonogenic cells of the bone marrow was also altered, but in the opposite direction. It is concluded that even where mean survival times are closely similar to radiation, the interpretation of the gastrointestinal syndrome following radiation cannot be applied quantitatively in a similar manner after many cytotoxic drugs.


Comparison of Reading Speed after Bilateral Bifocal and Trifocal Intraocular Lens Implantation.
To evaluate and compare visual acuity and reading speed for Korean language between a diffractive bifocal and trifocal intraocular lens (IOL) of the same material and haptic design. We reviewed the medical records of the patients who had undergone bilateral cataract surgery with bifocal IOLs (AT LISA 801) on the both eyes (bifocal group) and trifocal IOLs (AT LISA tri 839 MP, trifocal group). The main outcome measures were the uncorrected distance, intermediate, and near visual acuity (uncorrected distance visual acuity [UCDVA], uncorrected intermediate visual acuity [UCIVA], and uncorrected near visual acuity [UCNVA]) and corrected distance, near, and distance-corrected intermediate visual acuity (corrected distance visual acuity [CDVA], corrected near visual acuity [CNVA], and distance-corrected intermediate visual acuity [DCIVA]) at last postoperative follow-up month. Reading speeds for Korean language were measured to check near visual function. Fourteen eyes (7 patients) were included in the bifocal group and 32 eyes of 16 patients in the trifocal group. There were no statistical differences between the two groups with respect to UCDVA, UCNVA, CDVA, and CNVA. However, UCIVA (0.35 vs. 0.22 logarithm of the minimum angle of resolution [logMAR], p < 0.01) and DCIVA (0.34 vs. 0.20 logMAR, p < 0.01) were significantly better in the trifocal group than in the bifocal group. The mean reading speed for logMAR 0.5 optotype (point 10) was 86.50 words per minute (wpm) in the bifocal group and 81.48 wpm in the trifocal group without a significant difference (p = 0.70). Trifocal IOLs provided the same level of distance and near visual acuity and reading speed as that of bifocal IOLs with better intermediate visual acuity.


[Pierre-François Tingry (1743-1821), a Geneva pharmacist: his research in plant chemistry].
Tingry spent his entire professional and scientific career in Geneva, after completing his pharmacy studies in Paris. An important part of his writings, unpublished and conserved in Geneva, concerns plant chemistry. His work was principally devoted to the composition and varied parts of the flower Lilium album. Although he is classified as a minerologist and inorganic chemist, it is fitting to think of him also as a botanist and innovative talent in pharmacognosis.


Clinical Evaluation of Coronally Advanced Flap With or Without Advance-Platelet Rich Fibrin Membrane in the Treatment of Miller's Class-II Localized Gingival Recession: A Clinical Study.
Periodontal treatment focuses on maintaining a patient's natural teeth and gums. The gingival margin recedes to a point apical to the tooth in 20%-100% of people. Coronally advanced flap (CAF) is one of several effective treatments for this condition. This surgery covers the tooth root with gingiva. The predictability of this surgery depends on the blood supply, donor tissue, and surgical skills. Platelet concentrates, which include platelet-rich fibrin (PRF), majority of the time is used for various regenerative therapies. Since no bovine thrombin or anticoagulant is needed, its manufacturing is simpler, cheaper, and less biochemically modified than PRP. Platelet-rich fibrin (PRF) is a fibrin matrix that progressively releases platelet cells and cytokines. The present study aimed to evaluate the efficacy of CAF with and without A-PRF in the treatment of Miller's class-II localized gingival recession. Twenty patients were chosen who had Miller's class-II localized gingival recession. A random number generator was used to place patients into either the "test" or "control" group. Treatment for both Groups A and B included a coronally advanced flap, but only Group A additionally got autologous platelet-rich fibrin (A-PRF). After receiving a detailed explanation of the treatment process, the patient signed an informed consent form. Complete medical and dental histories were taken to see whether there were any absolute or relative contraindications. Following treatment with either method in the current study, gingival thickness improved considerably. The percentage of root coverage did not change considerably between the two groups. The clinical result might likely have been different if other factors, such as platelet concentration and PRF consistency, had been examined in the current investigation. Furthermore, there was no histological examination of the healing process. As a result, we are unsure of the extent to which PRF affects how effectively connective tissue attaches. The additional use of A-PRF membrane did not provide additional benefits in terms of root coverage outcomes compared with CAF alone. The use of A-PRF membranes significantly reduced the recession depth.


Post traumatic osteoma of tibial insertion of medial collateral ligament of knee joint.
Two cases are presented of post traumatic para-articular osteoma developing at the site of tibial attachment of the medial collateral ligament of knee joint. These occurred after injuries sustained while playing football and in one case the ossified mass was treated with surgical excision for unresolved symptoms after conservative measures. A comparison is made with Pellegrini Stieda disease, which is a similar affection of the femoral insertion of the medial ligament of the knee joint.


Sex differences in children's response to parental divorce: 1. Research methodology and postdivorce family forms.
This two-part review documents inconsistencies in the empirical basis for the hypothesis that boys are more negatively affected than are girls by parental divorce. An attempt is made to move beyond a global hypothesis to one specifying circumstances for the pattern. Part 1 asks whether methodological adequacy or postdivorce family forms in the studies help explain the discrepancy across studies that examine sex differences in children's response to parental divorce. Part 2, reviewing other possible sources for the discrepancy, will appear in a forthcoming issue of this Journal.


Enhancer-Promoter Interaction of SELF PRUNING 5G Shapes Photoperiod Adaptation.
Tomato (Solanum lycopersicum) is a major vegetable fruit grown and consumed worldwide. Modern cultivated tomatoes are derived from their wild relative, Solanum pimpinellifolium, a short-day plant that originated from the Andean region of South America. The molecular underpinnings of the regional adaptation and expansion of domesticated tomato remain largely unclear. In this study, we examined flowering time in wild and cultivated tomatoes under both long-day and short-day conditions. Using quantitative trait locus mapping in a recombinant inbred line population, we identified SELF PRUNING 5G (SP5G) as a major locus influencing daylength adaptation in tomato. Genetic diversity analysis revealed that the genomic region harboring SP5G shows signatures of a domestication sweep. We found that a 52-bp sequence within the 3' untranslated region of SP5G is essential for the enhanced expression of this gene, leading to delayed flowering time in tomatoes through a promoter-enhancer interaction that occurs only under long-day conditions. We further demonstrate that the absence of the 52-bp sequence attenuates the promoter-enhancer interaction and reduces SP5G expression in cultivated tomatoes, making their flowering time insensitive to daylength. Our findings demonstrate that cis-regulatory variation at the enhancer region of the SP5G 3' untranslated region confers reduced photoperiodic response in cultivated tomatoes, uncovering a regulatory mechanism that could potentially be used to manipulate flowering time in tomato through novel biotechnological approaches.


[Contemporary threat of influenza virus infection].
Swine-origine H1N1 influenza virus (S-OIV) caused a great mobilization of health medical service over the world. Now it is well known that a vaccine against novel virus is expected as a key point in that battle. In the situation when recommended treatment with neuraminidase inhibitors is not sufficient to control influenza A/H1N1 viral infection the quick and precisely diagnostic procedures should be applied to save and protect our patients.


Pathophysiology and medical management of systemic hypertension in pregnancy.
Hypertension in pregnancy includes a group of distinct disorders that require special consideration in both prevention and pharmacologic treatment. In recent years, there have been few advances regarding the pathophysiology and prevention of preeclampsia or in the recommendations for first-line drug therapy for its hypertensive complications. Similarly, the recommendations for pharmacologic treatment of women with chronic hypertension antedating pregnancy have changed little primarily because first-line medications have the advantage of having had more extensive research experience. Recent clinical trials have demonstrated the efficacy and safety of various second-line drugs for the hypertensive disorders of pregnancy; whether these therapies can eventually replace the standard recommended medications will require more extensive long-term investigation.


Does a Multimodal No-Compression Suture Technique of the Intercostal Space Reduce Chronic Postthoracotomy Pain? A Prospective Randomized Study.
Chronic postthoracotomy pain is a significant adverse outcome of thoracic surgery. We evaluated with a prospective randomized trial the effect of a multimodal no-compression suture technique of the intercostal space on postoperative pain occurrence in patients undergoing minithoracotomy. Patients undergoing a muscle-sparing lateral minithoracotomy for different thoracic diseases were randomly divided into two groups: 146 patients received intercostal muscle flap harvesting and pericostal no-compression "edge" suture (the IMF group), and 151 patients received a standard suture technique associated with an intrapleural intercostal nerve block (the IINB group). Pain scores and interference of pain with daily activities were assessed by using the Italian version of the Brief Pain Inventory on day 1, and at 1 to 6 months postoperatively. The results of pulmonary function tests (spirometry and the 6-minute walking test ) were evaluated preoperatively and at 1 and 6 months postoperatively. Postthoracotomy pain scores throughout the first postoperative day were significantly lower in the IMF group. After 1 and 6 months, patients in the IMF group had a significantly lower average pain score (p = 0.001). There were no significant differences in pain interference scores at each evaluation time point in either group. However, differences were shown in lung function test results at 1 and 6 months postoperatively (the forced expiratory volume in 1 second in the IINB group averaged 68.8 ± 17.4% of predicted value and 72.8 ± 10.5%, respectively, and in the IMF group it averaged 83.1 ± 7.4% and 86.4 ± 12.8%, respectively [p = 0.023 and 0.013, respectively]; the 6-minute walking test results in the IINB group averaged 311.1 ± 51.0 and 329.9 ± 54.8 m, respectively, and those in the IMF group averaged 371.2 ± 54.8 and 395.7 ± 56.4 m, respectively [p = 0.0001]). The multimodal no-compression suture technique is a rapid and feasible procedure that reduces the intensity of early and chronic postthoracotomy pain.


Does methylene blue reduce adhesion during the healing process after tendon repair?
This study aims to biomechanically and histopathologically investigate the effects of methylene blue (MB) on preventing postoperative adhesion in chickens undergoing full- thickness flexor tendon incision. This study was performed between June 2017 and June 2018 on Hubbard JA 57 type chickens (age, 6 months; weight, 2.2±0.3 kg). Sixty-four tendons were studied in 32 chickens, including 16 in the control group and 16 in the experimental group. The second and third finger flexor digitorum profundus tendons of the left foot of each chicken were repaired primarily after a full-thickness incision approximately 1 cm proximal to the distal adhesion area. In the control (n=32) and experimental groups (n=32), 0.25 mL of normal saline and 0.25 mL of 1% MB solutions were applied locally to the surgical site, respectively. The operated limb was immobilized using a circular cast. 16 chickens were randomly selected in each group and examined at the fourth week, and the remaining 16 chickens were examined at the sixth week. Thirty-two of these tendons were evaluated using the Tang histopathological adhesion classification system, and the other 32 were evaluated with a biomechanical pull system. Adhesion was found to be less in the experimental group compared to the control group at the end of the fourth and sixth weeks both histopathologically and biomechanically. Furthermore, adhesion was significantly less in the experimental group at the end of the sixth week compared to the fourth week both histopathologically and biomechanically. Histopathological and biomechanical results show that MB, which has anti-inflammatory, antiseptic, antimicrobial and antioxidant effects, reduces adhesion during the healing process after tendon repair. We think that local MB application, particularly in surgeries performed after this type of injury, will be beneficial on early rehabilitation and functional results.


Adamantinoma-Like Ewing's Family Tumor of the Sino Nasal Region: A Case Report and a Brief Review of Literature.
Ewing's sarcoma family of tumors (EFTs) are malignant mesenchymal tumors with a predilection for bone and soft tissue. They are characterized by their monomorphic small blue round cell morphology. However rare morphologic variants of EFTs can also show overt epithelial differentiation in the form of squamoid differentiation along with strong cytokeratin expression. This particular subset of EFTs are known as adamantinoma-like EFTs which can be difficult to differentiate from epithelial head and neck malignancies. Here we report a case of sinonasal adamantinoma-like EFT in an 18-year-old male patient. The lesion differed from a typical EFT by means of overt squamoid differentiation which showed a basaloid appearance with peripheral palisading. The immunohistochemistry was positive for pan-cytokeratin, p40, p63, ERG, FLI1, and CK5/6. It was negative for actin, desmin, and WT-1. Initial diagnosis of a basaloid squamous cell carcinoma was made. Further molecular studies were also done due to the complex presentation of the tumor. EWSR testing with break-apart analysis confirmed EWSR1 and FLI1 rearrangements. Further confirmation was done with RT-PCR. The case was found to be positive for EWS-FLI-1 translocation. The revised immunohistochemistry panel showed CD99, ERG, FLI1, and synaptophysin positivity. The lesion was reclassified as an adamantinoma-like ES. Our case reinforces the fact that a subset of EFTs can show histomorphologic and immunohistochemical features of aberrant epithelial differentiation. These cases are difficult to differentiate from usual epithelial malignancies which occur in this region. This diagnostic pitfall can be avoided by the inclusion of CD99 and/or FLI1 in the immunohistochemical assessment of any round cell malignancy at any anatomic location. A strong and diffuse CD99 positivity should prompt molecular testing for the presence of EWSR1 gene rearrangements.


The relationship between cerebrospinal fluid markers of Alzheimer pathology and positron emission tomography tau imaging.
The two primary molecular pathologies in Alzheimer's disease are amyloid-β plaques and tau-immunoreactive neurofibrillary tangles. Investigations into these pathologies have been restricted to cerebrospinal fluid assays, and positron emission tomography tracers that can image amyloid-β plaques. Tau tracers have recently been introduced into the field, although the utility of the tracer and its relationship to other Alzheimer biomarkers are still unknown. Here we examined tau deposition in 41 cognitively normal and 11 cognitively impaired older adults using the radioactive tau ligand (18)F-AV-1451 (previously known as T807) who also underwent a lumbar puncture to assess cerebrospinal fluid levels of total tau (t-tau), phosphorylated tau181 (p-tau181) and amyloid-β42 Voxel-wise statistical analyses examined spatial patterns of tau deposition associated with cognitive impairment. We then related the amount of tau tracer uptake to levels of cerebrospinal fluid biomarkers. All analyses controlled for age and gender and, when appropriate, the time between imaging and lumbar puncture assessments. Symptomatic individuals (Clinical Dementia Rating > 0) demonstrated markedly increased levels of tau tracer uptake. This elevation was most prominent in the temporal lobe and temporoparietal junction, but extended more broadly into parietal and frontal cortices. In the entire cohort, there were significant relationships among all cerebrospinal fluid biomarkers and tracer uptake, notably for tau-related cerebrospinal fluid markers. After controlling for levels of amyloid-β42, the correlations with tau uptake were r = 0.490 (P < 0.001) for t-tau and r = 0.492 (P < 0.001) for p-tau181 Within the cognitively normal cohort, levels of amyloid-β42, but not t-tau or p-tau181, were associated with elevated tracer binding that was confined primarily to the medial temporal lobe and adjacent neocortical regions. AV-1451 tau binding in the medial temporal, parietal, and frontal cortices is correlated with tau-related cerebrospinal fluid measures. In preclinical Alzheimer's disease, there is focal tauopathy in the medial temporal lobes and adjacent cortices.


The differential expression of Yersinia pseudotuberculosis adhesins determines the requirement for FAK and/or Pyk2 during bacterial phagocytosis by macrophages.
Phagocytosis of Yersinia pseudotuberculosis by macrophages is initiated by interactions between host cell integrin receptors and the bacterial adhesins, invasin and YadA. Two non-receptor protein tyrosine kinases, FAK and Pyk2, have been implicated in this process. In this study, we investigated the mechanisms of activation and functional requirements for these kinases during phagocytosis. A panel of Yersinia strains that differentially express invasin and YadA were used to infect cells in which FAK and/or Pyk2 expression was reduced by RNA interference. Bacterial strains that simultaneously express invasin and YadA activated FAK and Pyk2 signalling pathways that perform non-redundant functions required for Yersinia internalization. In contrast, FAK activation was found to be sufficient for phagocytosis of bacteria expressing invasin alone, and Pyk2 activation was sufficient when YadA was expressed in the absence of invasin. Based on these data, we suggest that the activation states of FAK and Pyk2, as well as the subsequent signalling events that lead to phagocytosis, are differentially regulated through the unique mechanisms of integrin engagement utilized by invasin and YadA. These findings lend insight into the molecular events that control bacterial phagocytosis as well as other integrin-based processes such as cell adhesion and migration.


Isolation of a human major histocompatibility complex class I gene encoding a nonubiquitous molecule expressed on activated lymphocytes.
The human major histocompatibility complex is a multigene family containing at least 20 class I genes. Included within this family are the loci encoding the highly polymorphic HLA-A, -B, and -C antigens present at the surface of most nucleated cells. The large number of genes detected with class I probes by Southern blot analysis and the existence of serological reagents defining nonubiquitous, non-HLA-A,B,C class I antigens suggest that products other than HLA-A,B,C antigens are encoded within the class I gene family. These products might be the human counterparts of the murine Qa and TL antigens. In order to identify non-HLA-A,B,C genes, we have developed a probe, JF11, located in noncoding regions flanking the HLA-A locus. This probe detects only a limited number of class I genes and does not detect HLA-A,B,C-associated restriction fragments on Southern blots. This probe was used to screen a human cosmid library. Some of the cosmids isolated with this probe were then transferred into mouse fibroblasts expressing human beta 2-microglobulin. One of the transfectants specifically reacts with one alloantiserum (HA2) that detects HLA class I molecules specific to HLA-A2-positive, phytohemagglutinin-activated T cells and not found on resting T or B cells. Data presented in this paper provide evidence for the isolation and expression of a class I gene encoding a nonubiquitous class I antigen that could be a human analogue of the murine Qa antigens.


High value of rapid diagnostic tests to diagnose malaria within children: A systematic review and meta-analysis.
Children aged under five years accounted for 61% of all malaria deaths worldwide in 2017, and quicker differential diagnosis of malaria fever is vital for them. Rapid diagnostic tests (RDTs) are strips to detect. specific antigens promptly and are helpful in resource-limited areas. Thus, our aim is to assess the diagnostic accuracy of RDTs for malaria in children against the gold standard. MEDLINE, Web of Science, EMBASE, Cochrane Library, the China National Knowledge Infrastructure, Wanfang, and Sinomed databases were systematically searched on August 23, 2019. Studies that compared RDTs with microscopy or polymerase chain reaction in malaria diagnoses for children were eligible. Relevant data were extracted. The quality of studies was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies instrument. Meta-analyses were carried out to calculate the pooled estimates and 95% confidence intervals of sensitivity and specificity. 51 articles were included. For diagnostic accuracy, the pooled estimates of the sensitivity and specificity of RDTs were 0.93 (95% confidence interval (CI) = 0.90, 0.95) and 0.93 (95% CI = 0.90, 0.96) respectively. Studies were highly heterogeneous, and subgroup analyses showed that the application of RDTs in high malaria transmission areas had higher sensitivity but lower specificity than those in low-to-moderate areas. RDTs have high accuracy for malaria diagnosis in children, and this characteristic is more prominent in high transmission areas. As they also have the advantages of rapid-detection, are easy-to-use, and can be cost-effective, it is recommended that the wider usage of RDTs should be promoted, especially in resource-limited areas. Further research is required to assess their performance in WHO South-East Asia and Americas Region.


Chemical Characteristics, Motivation and Strategies in choice of Materials used as Liver Phantom: A Literature Review.
Liver phantoms have been developed as an alternative to human tissue and have been used for different purposes. In this article, the items used for liver phantoms fabrication are mentioned same as in the previous literature reviews. Summary and characteristics of these materials are presented. The main factors that need to be available in the materials used for fabrication in computed tomography, ultrasound, magnetic resonance imaging, and nuclear medicine were analyzed. Finally, the discussion focuses on some purposes and aims of the liver phantom fabrication for use in several areas such as training, diagnoses of different diseases, and treatment planning for therapeutic strategies - for example, in selective internal radiation therapy, stereotactic body radiation therapy, laser-induced thermotherapy, radiofrequency ablation, and microwave coagulation therapy. It was found that different liver substitutes can be developed to fulfill the different requirements.


A new method to compute mechanical properties of a standing skyline for cable yarding.
Cable-based technologies are the backbone for logistics of timber or construction material on impassable terrain. In Central Europe, the use of standing skylines with pre-stressed, both-sided fixed-anchor cables and multi-span configurations with internal intermediate supports is common. To ensure a safe and cost-effective set-up for cable road operations, it is essential to identify and compute the properties of the skyline (e.g. load path, tensile forces). This task is challenging because it requires dealing with the non-linear behaviour of the cable structure under the load and has to include all significant physical effects. Several approaches have previously been proposed as practical solutions, however not all physical effects were covered by those approaches, such as the inclination-dependent elastic prolongation of the cable or the longitudinal deflection of the sagging carriage. With our new proposed approach, we aim to close this gap of knowledge, and consider all relevant physical effects. We present a non-linear approach that is able to compute the properties of a wide range of standing skyline configurations, including those with additional cables. This approach offers an extensive solution and a flexible framework for considering individual configurations or particularities by adding equations to the equation system.


[Celiac disease: clinical and subclinical forms].
Coeliac disease is an intolerance to gluten that classically produces a chronic diarrhoea with a picture of malabsorption and a total villous atrophy. These elements regress completely in a sequential way under a prolonged strict gluten-free diet. The progress registered in the understanding of this affection depends on the individualization of the atypical forms (delayed isolated stature, constipation...) of asymptomatic forms thanks to the study of specific antibodies (anti-gliadin, anti-endomysium, and more recently anti-transglutaminase). The auto-immune nature of coeliac disease is well established. The diagnostic criteria are simplified allowing the commencement of a gluten-free diet which must be perfectly detailed. Finally, allergy to wheat flour merits individualization in the framework of coeliac disease (cf. article).


A constitutive 65 kDa chondrocyte protein as a target antigen in adjuvant arthritis in Lewis rats.
The autoantigen in adjuvant arthritis in Lewis rats is still unknown despite the knowledge that the 65 kDa mycobacterial heat-shock protein (hsp) is involved in the disease process. T cells and antibodies obtained from rats with adjuvant arthritis respond to chondrocyte membrane antigen(s). In Western blots a 65 kDa chondrocyte membrane protein (CH65) is stained by sera from arthritic rats. In addition, spleen cells from rats with adjuvant arthritis proliferate in vitro to chondrocyte membranes and CH65 as antigens. Furthermore, pretreatment of rats with CH65 or mycobacterial hsp65 but not human hsp60, induces a significant retardation of the onset of adjuvant arthritis in Lewis rats. The data suggest that CH65 is a potential autoantigen involved in the pathogenesis of adjuvant arthritis in Lewis rats.


[Physical, chemical and microbiological quality of concentrated orange juices made in Venezuela].
Concentrated fruit juices are a very attractive type of product because of the many advantages they offer for reductions in packing, transportation and storage costs, and in addition, they offer the possibility of consumption outside harvesting time. Due to their potential in the international market, it is necessary to evaluate if they are accomplishing the quality requirements, and to know the different factors that can affect their stability. For this purpose, samples of national products were analyzed for physical, chemical and microbiological characteristics; the diacetyl test was performed as a measure of the sanitary conditions under processing. The samples analyzed comply with the national standards established by the Comision Venezolana de Normas Industriales (COVENIN N(o) 2395-86 Concentrados de frutas para consumo directo). It is advisable to determine the zero tolerant yeasts population because this type of microorganisms are responsible for spoilage whenever cold storage is interrupted, and because they can not be detected by the official procedures used to detect yeasts.