The influence of implant body and thread design of mini dental implants on the loading of surrounding bone: a finite element analysis.
Mini dental implants (MDI) were once thought of as transitional implants for treatment in selected clinical situations. Their reduced diameter makes them a very attractive option for patients with poor tolerance to maxillary and mandibular prostheses. Using the method of finite element analysis, a series of different designed MDI prototypes have been investigated. The prototypes differed in the geometry of implant body and/or design of implant head. The load transfer of the implant prototypes to the idealised alveolar bone has been regarded and the prototypes have been compared to each other and to a number of standard commercial implants. The prototype models have been virtually placed in the idealised bone with a cortical thickness of 1.5 mm and loaded laterally 30° from the implant's long axis. The condition of immediate loading was assumed for the numerical analyses through defining a contact interface between the implant and bone bed. The numerical analysis in this study showed that the design of the investigated prototype MDI of group 3 (mini-ball head) is the most advantageous design.


[Hormonal replacement therapy in women after surgery for thyroid cancer treated with suppressive doses of L-thyroxine].
Total thyroidectomy followed by 131I ablation and thyroxine suppressive therapy is recommended for the treatment of differentiated thyroid carcinomas. Thyroxine should be given at a dose sufficient to suppress TSH to low or undetectable levels. These patients are categorized as subclinical hyperthyroidism subjects. Some cardiovascular effects of subclinical hyperthyroidism, such as an increase in left ventricular mass and accelerated bone loss, should be taken into consideration. Estrogens reduce the loss of bone mass in thyrotoxic postmenopausal patients and have cardioprotective effects. The relatively high incidence of thyroid carcinoma in women suggests that estrogen and/or progesterone may be important for the development of these neoplasms. Immunohistochemical study has established that steroid receptors are present in thyroid tissue. Many authors suggest that estrogens by itself do not appear to affect the natural history of thyroid cancer. Besides the thyroid, active iodide transports catalysed by the sodium/iodide symporter occurs in the lactating mammary gland. An increased risk of breast carcinoma in women with thyroid carcinoma due to carcinogenicity of radioiodine has been reported by some but not all investigators. Hormone replacement therapy in the thyroxine treated postmenopausal women consists in conventional oral or transdermal estrogen combined with progesterone. In some cases the daily dose of thyroxine should be increased to achieve TSH suppression.


Optimising neurosurgical outpatient care: a paradigm shift?
The Wellington Regional Hospital (WRH) neurosurgical service has noted a substantial increase in patient volumes over the last decade, with referrals to the neurosurgical outpatient clinic appearing to have increased even more substantially. To quantify the increase in referrals to the WRH neurosurgical outpatient service and to determine whether this has translated into an increase in the number of neurosurgical procedures performed. All referrals to the WRH neurosurgical department from the lower North and upper South Islands of New Zealand spanning 10 years were collected. Key outcome data were the number of interventions performed. In addition to GP referrals, all specialist referrals to the WRH neurosurgical outpatient service were also analysed as a comparison. In total, 19 201 patients were referred to the WRH neurosurgical service over the 10 years of the study. Within this timeframe, 7105 patients were referred by GPs and 12 096 were referred by specialist teams. Only 348 patients (4.9%) referred by GPs underwent some form of therapeutic intervention, compared to 3489 patients (28.8%) referred by specialist teams. Our data shows that specialist referrals result in a proportionally greater number of therapeutic interventions than GP referrals. This is in part due to the wider array of diagnostic tests available to specialists compared to GPs. The development of relevant guidelines for primary care referral to a neurosurgical service appears warranted and could facilitate initiation of appropriate investigations in primary care.


Tumor infiltrating lymphocytes in acral lentiginous melanoma: a study of a large cohort of cases from Latin America.
Acral lentiginous melanoma (ALM) is a poor prognosis subtype and is the most prevalent in non-Caucasian populations. The presence of tumor infiltrating lymphocytes (TILs) has been associated with poor prognosis in melanoma. A large cohort of ALM cases was studied to determine status of TIL and its association with outcome. All patients with cutaneous melanoma presenting from 2005 to 2012 at Instituto Nacional de Enfermedades Neoplasicas in Peru were retrospectively identified. Clinicopathological information was obtained from the medical charts. A prospective evaluation of TIL was performed. Analysis of association between ALM and clinicopathological features including TIL as well as survival analysis compared the outcome of ALM to whole group and extremity NALM was performed. 537 ALM from a total of 824 cutaneous melanoma cases were studied. Older age (p = 0.022), higher Breslow (p = 0.008) and ulceration (p < 0.001) were found to be more frequent in ALM. Acral had worse overall survival (OS) compared with the whole group (p = 0.04). Clinical stage (CS) I-II patients had a median OS of 5.3 (95% CI 4.3-6.2) for ALM and 9.2 (95% CI 5.0-7.0) for extremity NALM (p = 0.016). Grade 0 (absence of TIL), I, II and III were found in 7.5, 34.5, 32.1, and 25.9%, respectively. Lower TIL grade was associated with larger tumor size (p = 0.003), higher Breslow (p = 0.001), higher Clark level (p = 0.007), higher CS (p = 0.002), extremity location (p = 0.048), histological subtype ALM (p = 0.024) and better OS (p = 0.001). ALM is highly prevalent in Peru and carries poor outcome. Lower TIL levels were associated with poor outcome and ALM.


Effects of plyometric training on technical skill performance among athletes: A systematic review and meta-analysis.
The literature has proven that plyometric training (PT) improves various physical performance outcomes in sports. Even though PT is one of the most often employed strength training methods, a thorough analysis of PT and how it affects technical skill performance in sports needs to be improved. This study aimed to compile and synthesize the existing studies on the effects of PT on healthy athletes' technical skill performance. A comprehensive search of SCOPUS, PubMed, Web of Science Core Collection, and SPORTDiscus databases was performed on 3rd May 2023. PICOS was employed to establish the inclusion criteria: 1) healthy athletes; 2) a PT program; 3) compared a plyometric intervention to an active control group; 4) tested at least one measure of athletes' technical skill performance; and 5) randomized control designs. The methodological quality of each individual study was evaluated using the PEDro scale. The random-effects model was used to compute the meta-analyses. Subgroup analyses were performed (participant age, gender, PT length, session duration, frequency, and number of sessions). Certainty or confidence in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Thirty-two moderate-high-quality studies involving 1078 athletes aged 10-40 years met the inclusion criteria. The PT intervention lasted for 4 to 16 weeks, with one to three exercise sessions per week. Small-to-moderate effect sizes were found for performance of throwing velocity (i.e., handball, baseball, water polo) (ES = 0.78; p < 0.001), kicking velocity and distance (i.e., soccer) (ES = 0.37-0.44; all p < 0.005), and speed dribbling (i.e., handball, basketball, soccer) (ES = 0.85; p = 0.014), while no significant effects on stride rate (i.e., running) were noted (ES = 0.32; p = 0.137). Sub-analyses of moderator factors included 16 data sets. Only training length significantly modulated PT effects on throwing velocity (> 7 weeks, ES = 1.05; ≤ 7 weeks, ES = 0.29; p = 0.011). The level of certainty of the evidence for the meta-analyzed outcomes ranged from low to moderate. Our findings have shown that PT can be effective in enhancing technical skills measures in youth and adult athletes. Sub-group analyses suggest that PT longer (> 7 weeks) lengths appear to be more effective for improving throwing velocity. However, to fully determine the effectiveness of PT in improving sport-specific technical skill outcomes and ultimately enhancing competition performance, further high-quality research covering a wider range of sports is required.


Overweight, obesity, oxidative stress and the risk of breast cancer.
There is growing scientific evidence linking excess body weight to breast cancer risk. However, there is no common consensus on this relation due partly to methodologies used, populations studied and the cancer subtype. We report here a summary of the present state of knowledge on the role of overweight and obesity in pathogenesis of breast cancer and possible mechanisms through which excess body weight might influence the risk, focusing on the role of oxidative stress in breast cancer etiology. The findings demonstrate duality of excess body weight action in dependence on menopausal status: a statistically significant increased risk in postmenopausal overweight/ obese women and non-significant preventive effect among premenopausal women. Due to several gaps in the literature on this topic, additional studies are needed. Future research should address factors influencing the excess body weight - breast cancer relationship, such as race/ethnicity, tumor subtype, receptor status, the most appropriate measure of adiposity, reproductive characteristics, and lifestyle components.


Broadly increased sensitivity to cytotoxic T lymphocytes resulting from Nef epitope escape mutations.
Nef is an HIV-1 protein that is absent in most retroviruses, yet its reading frame is highly maintained despite frequent targeting by CD8(+) CTL in vivo. Because Nef is not necessarily required for viral replication, this consistent maintenance suggests that Nef plays an important role(s) and substantial fitness constraints prevent its loss in vivo. The ability of Nef to down-regulate cell surface MHC class I (MHC-I) molecules and render infected cells resistant to CTL in general is likely to be an important contributing function. We demonstrate that mutational escape of HIV-1 from Nef-specific CTL in vitro leads to progeny virions that are increased in their susceptibility to CTL of specificities for proteins other than Nef. The escape mutants contain multiple nef mutations that impair the ability of the virus to down-regulate MHC-I through disruption of its reading frame as well as epitope point mutations. Given the rarity of nef frameshifts in vivo, these data support the concept that the ability to down-regulate MHC-I could be a key constraint for preservation of Nef in vivo.


[Volatile anaesthesias' molecular biological course of action].
Anaesthesia is extensively used worldwide and in Denmark alone more than 400,000 anaesthesias are performed each year. In spite of that the molecularly mechanism of anaesthesia has not been proven. Hypotheses have been suggested (lipid versus protein theory), but none has yet been able to explain the whole mechanism. Molecular targets for volatile anaesthetics (e.g. potassium and calcium channels) affected areas in the central nervous system and the impact on the cerebral metabolism versus the cerebral blood flow are discussed.


[Factor structure and validity of a german version of the barratt impulsiveness scale].
Impulsive traits are key characteristics in a number of psychiatric disorders and are part of the normal behavior spectrum. The BIS-5 is an instrument developed to assess impulsivity. The aim of this study is to evaluate the BIS-5 in two German psychiatric inpatient samples and healthy controls proving the originally proposed four-factor structure as well as convergent and discriminate validity. 159 alcohol-dependent subjects and 77 suicidal inpatients were recruited in an University psychiatric hospital. 182 healthy subjects were recruited from town community. BIS-5 items were translated and back-translated. Principal component analysis with oblique rotation was conducted in the whole group. Furthermore, the discriminate and convergent validity of the BIS-5 was evaluated by correlation with other instruments measuring impulsive traits and comparing sample subgroups. A two-factor solution could be identified in this German sample. Alcohol-dependent individuals showed significantly higher factor 1 values compared to suicidal patients. The group of suicidal patients had higher scores in factor 2 compared to controls. Factor 1 correlated most significantly with extraversion-related personality traits while factor 2 showed significant relationships with irritability and neuroticism. A two-factor solution may be more appropriate in using the BIS-5 scale in German samples. These two factors might reflect different aspects of impulsive behavior and might be useful to characterize impulsive behavior in psychiatric and non-psychiatric samples.


A serological study on the prevalence of Toxoplasma gondii in sheep of Lithuania.
In the present study the seroprevalence of the protozoan parasite Toxoplasma gondii infection in sheep was investigated in 6 regions of Lithuania. Blood samples were taken from 354 sheep and were tested using commercial ELISA method. The total seroprevalence of Toxoplasma gondii infection in sheep was 42.1%. Significant differences in seroprevalence were observed between age groups (P < or = 0.05). The results of this investigation suggest that the Toxoplasma gondii parasite is widely spread, and can be one of reasons of sheep abortion in Lithuania.


A relative bilingual advantage in switching with preparation: Nuanced explorations of the proposed association between bilingualism and task switching.
Bilingual language switching may increase general switching efficiency, but the evidence on this question is mixed. We hypothesized that group differences in switching might be stronger at a long cue-target interval (CTI), which may better tap general switching abilities (Yehene & Meiran, 2007). Eighty Spanish-English bilinguals and 80 monolinguals completed a color-shape switching task, and an analogous language-switching task, varying CTI (short vs. long) in both tasks. With longer preparation time (long CTI), bilinguals exhibited significantly smaller task-switching costs than monolinguals, but only in the first half of trials. Group differences diminished with practice, though practice benefitted RTs on short CTI trials more than long, and bilinguals committed fewer errors with practice especially at short CTI. Groups did not differ in mixing costs; however, across CTIs and tasks, bilinguals and monolinguals alike, exhibited robust correlations between mixing costs, but not between switching costs. These results confirm an association between bilingualism and switching efficiency that may be magnified with manipulations that target general switching ability (or could reflect better ability to take advantage of preparation time). However, practice effects observed within experimental paradigms, and between task correlations in costs, may reflect cognitive mechanisms specific to laboratory tasks much more than associations with general switching ability and executive control mechanisms-for which more reliable and valid measures can hopefully be developed in future work. (PsycINFO Database Record


Hepatic extraction fraction: interest of its quantification in patients with hepatic tumours.
This prospective study aimed to estimate the usefulness of the hepatic extraction fraction (HEF) in the context of the pre- and postoperative evaluation of patients with hepatic tumours. Seventy patients with colorectal metastases (n=25), hepatocellular carcinoma (n=25), cholangiocellular carcinoma (n=6), gastric cancer metastases (n=5), hemangioma (n=5) and others (n=4) were included. Thirty patients underwent hepatectomy. Child-Pugh score, prothrombin, albumin, ALT, AST, AF, LDH, total, direct and indirect bilirubin, platelet number as well as the HEF were evaluated in the preoperative period and one month after hepatectomy. Preoperative evaluation of HEF values between Child-Pugh A (93.6±17.3%) and Child-Pugh B/C (n=13; 58.1±28.6%) demonstrated significant differences (p=0.001). We found a high negative correlation between the preoperative HEF and ALT (p<0.001), AST (p<0.001), AF (p<0.001), TB (p<0.001), IB (p<0.001) and DB (p<0.001), and also a high positive correlation between the preoperative HEF and albumin (p<0.001) or prothrombin (p<0.01). All operated patients had a normal HEF and a positive correlation between the postoperative HEF and albumin (p<0.05) at one month after surgery. The HEF allows a dynamic evaluation of hepatocellular function, which is not possible with other clinical, biological and radiological methods.


The Importance of Sex and the Meaning of Sex and Sexual Pleasure for Men Aged 60 and Older Who Engage in Heterosexual Relationships: Findings from a Qualitative Interview Study.
That many older individuals continue to engage in various forms of sexual expression well into later life is now well established in the literature. To date, however, only a small body of qualitative research has examined older men's experiences and understandings of sex in later life. Likewise, the ways in which older men's discussions on sex may be used as an avenue for "doing" masculinity remain underexplored. Older men are particularly interesting in this regard, as they inhabit an increasingly subordinated position in relation to hegemonic masculine ideals because of their age. To what extent might this limit or, alternatively, open up the possibilities for sexual expression and subjectivity in later life? Drawing on a subset of findings from Sex, Age, and Me: A National Study with Australian Women and Men Aged 60 and Older, data from qualitative interviews with 27 Australian men were explored in this article. The first Australian study of its kind, we argue that older men who engage in heterosexual relationships draw on a diverse and complex array of discursive positions regarding sex, relationships, and masculinity in making sense of their experiences of sex in later life. Older men are a heterogeneous group, and their experiences and understandings of sex do not simplistically follow "decline" or "success" narratives of aging. The findings of this research build upon and extend emerging research illustrating the centrality of intimacy to older men's sexual lives, while simultaneously highlighting the ways in which the body and discursive constructions of sex intersect to shape older men's sexual subjectivities.


Plasma glucose and insulin responses to oral and intravenous glucose in cold-exposed humans.
Although glucose tolerance and skeletal muscle glucose uptake are markedly improved by cold exposure in animals, little is known about such responses in humans. This study used two variations of a glucose tolerance test (GTT) to investigate changes in carbohydrate metabolism in healthy males during nude exposure to cold. In experiment 1, an oral GTT was performed in the cold and in the warm (3 h at 10 or 29 degrees C). To bypass the gastrointestinal tract, and to suppress hepatic glucose output, a second experiment was carried out as described above, using an intravenous GTT. Even though cold exposure raised metabolic rate greater than 2.5 times, plasma glucose and insulin responses to an oral GTT remained unaltered. In contrast, cold exposure reduced the entire plasma glucose profile as a function of time during the intravenous GTT (P less than 0.05), as plasma glucose was returned to basal levels within 1 h in comparison to a full 2 h in the warm, despite low insulin levels. The results of the intravenous GTT demonstrate that even with low insulin levels, carbohydrate metabolism is increased in cold-exposed males. This effect could be masked in the oral GTT by gastrointestinal factors and a high hepatic glucose output. Cold exposure may enhance insulin sensitivity and/or responsiveness for glucose uptake, mainly in shivering skeletal muscles.


The change of activation energy in microchannel laminar flow as demonstrated by kinetic analysis of the DNA duplex-coil equilibrium.
This paper presents the capability of changing the activation energy of chemical reactions using microchannel laminar flow. Kinetic parameters of the duplex-coil equilibrium of DNA oligomers were studied by measuring the hysteresis between denaturation-renaturation curves using an in-house temperature-controllable microchannel-type flow cell. For this study, DNA oligomers were used because they allow physicochemical analysis and theoretical discussion. Kinetic parameters of the duplex-coil equilibrium of DNA oligomers were obtained by measuring the denaturation-renaturation hysteresis curves. Both cooling and heating curves were shifted to the high-temperature side at higher flow rates. The renaturation reaction was influenced by a slower flow rate. The effect of the slower flow rate was more pronounced for renaturation than denaturation reactions. The magnitude of the activation energies of association decreased as the flow rate increased, but that of the activation energies of the dissociation increased as the flow rate increased. Overall, these results suggest that chemical reactions' change of activation energy depends on the flow rate and the DNA molecular size.


Impact of a financial incentive policy on Korean nurse staffing.
This study was designed to determine (1) the impact of policy on longitudinal changes in nurse staffing levels and (2) the characteristics of policy-responsive Korean hospitals. A policy of varying nursing fees according to staffing grade by measuring the nurse-to-bed ratio has been implemented in Korean hospitals since 1999 with the aim of satisfying patient care needs and providing safe and high-quality nursing care. Nurse staffing hospital characteristics data were collected from Korean Hospital Nurses Association yearbooks for the period 1996-2011. The obtained time series nurse staffing data were analysed by assessing the nurse-to-bed ratio. Graphs were used to view nurse staffing trends in various nursing units by hospital type during the study period. Mixed repeated-measures modelling was used to analyse nurse staffing and hospital characteristics, with year categorized as a dummy variable. There were 585 and 1239 observations related to measurements of nurse staffing grade in 44 tertiary and 193 general hospitals, respectively. For measuring the nurse staffing grade in intensive care units, the number of observations for general hospitals was decreased to 1170. Long-term nurse staffing in general and intensive care units was improved post-policy compared with pre-policy in both tertiary and general hospitals. Nurse staffing was improved more in Seoul than in other areas and was significantly better for hospitals with more beds for both hospital types. Although the financial incentive policy implemented in Korea has had an overall positive result on nurse staffing, the effect was not assure in small-sized hospitals in rural area. A more refined method for calculating nurse staffing and increasing financial incentives relative to staffing grade is needed to improve hospital nurse staffing.


Serum Insulin, Glucose, Indices of Insulin Resistance, and Risk of Lung Cancer.
Background: Although insulin may increase the risk of some cancers, few studies have examined fasting serum insulin and lung cancer risk.Methods: We examined serum insulin, glucose, and indices of insulin resistance [insulin:glucose molar ratio and homeostasis model assessment of insulin resistance (HOMA-IR)] and lung cancer risk using a case-cohort study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of Finnish men. A total of 196 cases and 395 subcohort members were included. Insulin and glucose were measured in fasting serum collected 5 to 12 years before diagnosis. Cox proportional hazards models were utilized to estimate the relative risk of lung cancer.Results: The average time between blood collection and lung cancer was 9.6 years. Fasting serum insulin levels were 8.7% higher in subcohort members than cases. After multivariable adjustment, men in the fourth quartile of insulin had a significantly higher risk of lung cancer than those in the first quartile [HR = 2.10; 95% confidence interval (CI), 1.12-3.94]. A similar relationship was seen with HOMA-IR (HR = 1.83; 95% CI, 0.99-3.38). Risk was not strongly associated with glucose or the insulin:glucose molar ratio (Ptrend = 0.55 and Ptrend = 0.27, respectively).Conclusions: Higher fasting serum insulin concentrations, as well as the presence of insulin resistance, appear to be associated with an elevated risk of lung cancer development.Impact: Although insulin is hypothesized to increase risk of some cancers, insulin and lung cancer remain understudied. Higher insulin levels and insulin resistance were associated with increased lung cancer risk. Although smoking cessation is the best method of lung cancer prevention, other lifestyle changes that affect insulin concentrations and sensitivity may reduce lung cancer risk. Cancer Epidemiol Biomarkers Prev; 26(10); 1519-24. ©2017 AACR.


Ascaris lumbricoides and its invasion of the accessory cystic duct: an unusual presentation.
Around the world, Ascaris lumbricoides is the most common helminthic infection. We describe the case of a 25-year-old woman, known to have had Ascaris infestation, presenting with abdominal pain, constipation and jaundice together with fever and tachycardia. There was tenderness in the right hypochondrium and liver function tests confirmed cholestatic jaundice. An abdominal ultrasound showed multiple linear echogenic foci in the distal small intestine along with cholelithiasis and a thick-walled gall bladder with a single stone compressing the common bile duct (Mirizzi syndrome). The patient underwent exploratory laparotomy; more than 100 worms were found inside the small intestine and they were removed by enterotomy and manual decompression. No worm could be palpated within the common bile duct (CBD). Cholecystectomy was performed, during which an accessory cystic duct was noted opening into the common bile duct superiorly to the main cystic duct. A 10 cm live worm was found coming out of it and was removed via forceps. Later on an endoscopic retrograde cholangio-pancreatogram (ERCP) showed a widened ampulla, a mildly dilated common bile duct, but without any filling defects. The patient made an uneventful postoperative recovery being discharged on the ninth day. Worms in an accessory cystic duct have not been report in the medical literature so far.


Parathyroidectomy-induced thyroiditis.
To highlight the possibility of development of thyroiditis after parathyroidectomy. Clinical and laboratory findings in 2 cases are presented, and the relevant literature is reviewed. In 2 women (84 years old and 55 years old) with no history of thyroid disease in one of them and a remote history of excision of a follicular adenoma in the other, thyrotoxicosis developed a few days to a week after parathyroidectomy for primary hyperparathyroidism. The first patient underwent bilateral cervical exploration with removal of a right inferior parathyroid adenoma, whereas the second patient had excision of 3 1/2 parathyroid glands for 4-gland hyperplasia and 2 benign nodules from the left thyroid lobe. Both surgical procedures were uncomplicated. Neither patient had received any iodinated contrast agents or medications such as lithium or amiodarone before presentation. Laboratory results showed elevated levels of free thyroxine, suppressed thyroid-stimulating hormone levels, very low radioiodine uptake (in the second patient), and an elevated thyroglobulin level (in the first patient). Both patients were treated symptomatically with beta-adrenergic antagonists. Thyroid function normalized and symptoms diminished after 1 to 2 months. Parathyroidectomy-induced thyroiditis is underrecognized. The majority of patients are asymptomatic, although clinically significant thyrotoxicosis can also occur. Candidates for parathyroidectomy should be informed of this potential complication, and thyroid function should be assessed if clinically indicated.


Detections of the position-vectors of the multi targets located in a circular space based on an asymmetric coupling semiconductor lasers network.
We present a novel scheme for the detections of the position-vectors of the multi targets distributed in a circular space using multi channels of the probe chaotic waves emitted by the asymmetric coupling semiconductor lasers network (ACSLN), where these probe waves possess the attractive features of the time-space uncorrelation and wide bandwidth. Using these features, the accurate measurement for the position-vectors of the multi targets can be achieved by correlating the multi channels of the probe waves with their corresponding reference waves. The further research results show that the detections for the position-vectors of the multi targets possess very low relative errors that are no more than 0.22%. The ranging-resolutions for the multi targets located in a circular space can be achieved as high as 3 mm by optimizing some key parameters, such as injection current and injection strength. In addition, the ranging-resolutions exhibit excellent strong anti-noise performance even when the signal-to-noise ratio and relative noise intensity appear obvious enhancement. The detections for the position-vectors of the multi targets based on the ACSLN offers interesting perspectives for the potential applications in the driverless cars and the object tracking system with omnidirectional vision.


Building a testis: formation of functional testis tissue after transplantation of isolated porcine (Sus scrofa) testis cells.
During mammalian development, morphogenesis of the testis requires the coordinated interplay of somatic cells to form seminiferous cords in which the primitive germ cells reside. These cords are the precursor of the functional male gonad and as such form the basis of male fertility. Cell migration during mammalian organogenesis and formation of complex tissues, such as the testis, are difficult to study in situ. Herein, we report extensive rearrangement of cells to regenerate complete functional testis tissue after implantation of isolated neonatal porcine testis cells under the skin of immunodeficient mice. Somatic cells and germ cells reorganized into structures that have remarkable morphologic and physiologic similarity to normal testis tissue, forming the endocrine and spermatogenic compartment of the testis. This unique in vivo system provides an accessible model for the study of testicular morphogenesis that could be especially useful in nonrodent species.


[Roentgen-surgical interventions in combined treatment of patients, suffering hepatic metastases of noncolorectal cancer].
Results of combined treatment, using roentgen-surgical interventions, of 58 patients, suffering noncolorectal metastatic affection of the liver, complicated in 20 (34.5%) of them by obturation jaundice, were analyzed. While resectability of the metastases, preoperatively chemotherapy (CHT) or chemoembolization of hepatic artery (CHEHA) in 1 - 2 courses were performed, and then - hepatic resection of various volume, adjuvant regional CHEHA or systemic CHT. Median survival of the patients have constituted 31.2 mo. While presence of nonresectable metastases a regional chemoinfusion via hepatic arteries or CHEHA (2 - 3 courses) were performed. Median survival of this group of patients have constituted 15.3 mo. Application of cytostatics for regional therapy have permitted in 4 (6.9%) patients, in whom partial tumor regression was achieved, to perform radical hepatic resection. Complete answer on the treatment was not achieved in any patient, partial answer was noted in 16 (33.3%), the process stabilization - in 20 (41.7%), the tumor progress - in 12 (25.0%). In total 170 endovascular and 41 transcutaneous transhepatic endobiliary interventions were performed. After operation 1 (12.5%) patient died.


Tank Mixing Fungicides for Effectiveness Against Eastern Filbert Blight of Hazelnut.
Hazelnut (Corylus avellana) production in Oregon primarily occurs on cultivars susceptible to Anisogramma anomala, the causal agent of eastern filbert blight (EFB). Management of EFB involves planting resistant cultivars, removal of cankered limbs, and the application of fungicides. Tank mixes of demethylation-inhibiting (DMI; Fungicide Resistance Action Committee [FRAC] group 3) or quinone outside inhibitor (QoI; FRAC group 11) fungicides with chlorothalonil (FRAC group M5) at full or reduced rates were evaluated for effectiveness against A. anomala. The use of chlorothalonil in a mix with a DMI or QoI fungicide was an effective treatment for EFB even if each component of the mix was at half the labeled rate. Different liquid or dry formulations of chlorothalonil were equally effective in a tank mix for EFB control. The combination of propiconazole (FRAC group 3) tank mixed with trifloxystrobin (FRAC group 11) was not effective, whereas trees treated with propiconazole tank mixed with pyraclostrobin (FRAC group 11) resulted in significantly fewer EFB cankers compared with nontreated trees. When using tank mixes for EFB management, DMI fungicides should remain at full rates while mixing with a half-rate of chlorothalonil. In contrast, QoI fungicides and chlorothalonil could both be used at half-rates and still maintain acceptable EFB control. Tank mixing chlorothalonil with fungicides at risk of resistance development can help maintain consistent EFB control and should help prevent or delay the emergence of fungicide-resistant A. anomala isolates.


Media coverage of scientific meetings: too much, too soon?
Although they are preliminary and have undergone only limited peer review, research abstracts at scientific meetings may receive prominent attention in the news media. We sought to describe news coverage of abstracts, characterize the research, and determine subsequent full publication in the medical literature. We searched Lexis-Nexis to identify news stories printed in the 2 months following 5 scientific meetings held in 1998 (12th World AIDS Conference, American Heart Association, Society for Neuroscience, American Society of Clinical Oncology, and the Radiological Society of North America). We searched MEDLINE and contacted authors to determine subsequent publication in the medical literature within 3-3.5 years of the meetings. A total of 252 news stories reported on 147 research abstracts (average, 50 per meeting); 16% of the covered abstracts were nonhuman studies, 24% randomized trials, and 59% observational studies. Twenty-one percent of the human studies were small (ie, involving <30 subjects). In the 3 years after the meetings, 50% of the abstracts were published in high-impact journals (based on Institute for Scientific Information ratings), 25% in low-impact journals, and 25% remained unpublished. The publication record of the 39 abstracts receiving front-page newspaper coverage was almost identical to the overall rate. Meeting organizers issued press releases for 43 abstracts; these were somewhat more likely to receive prominent news coverage (35% covered on front page vs 23%, P =.14), but were no more likely to be published. Abstracts at scientific meetings receive substantial attention in the high-profile media. A substantial number of the studies remain unpublished, precluding evaluation in the scientific community.


Pyrroloquinoline Quinone Prevents Estrogen Deficiency-Induced Osteoporosis by Inhibiting Oxidative Stress and Osteocyte Senescence.
Accumulating studies have shown that oxidative stress increases with aging, which is related to the pathophysiology of postmenopausal osteoporosis. Pyrroloquinoline quinone (PQQ) is a natural anti-oxidant with anti-oxidative and anti-aging effects. However, it is unclear whether PQQ has a protective role against estrogen deficiency-induced osteoporosis. Here, we evaluated the efficacy of PQQ on bone mineral density, bone microarchitecture, bone turnover and biomechanical strength in ovariectomy (OVX)-induced osteoporosis mouse model. Although dietary PQQ supplement did not affect serum E2 levels and uterine weight in OVX mice, it could prevent OVX-induced bone loss and improve bone strength by inhibiting oxidative stress, osteocyte senescence and senescence-associated secretory phenotype (SASP), subsequently promoting osteoblastic bone formation and inhibiting osteoclastic bone resorption, which was comparable to treatment with exogenous estrogen. The results from our study provide experimental evidence for the clinical use of PQQ to prevent estrogen deficiency-induced osteoporosis.


CODA: quantitative 3D reconstruction of large tissues at cellular resolution.
A central challenge in biology is obtaining high-content, high-resolution information while analyzing tissue samples at volumes relevant to disease progression. We address this here with CODA, a method to reconstruct exceptionally large (up to multicentimeter cubed) tissues at subcellular resolution using serially sectioned hematoxylin and eosin-stained tissue sections. Here we demonstrate CODA's ability to reconstruct three-dimensional (3D) distinct microanatomical structures in pancreas, skin, lung and liver tissues. CODA allows creation of readily quantifiable tissue volumes amenable to biological research. As a testbed, we assess the microanatomy of the human pancreas during tumorigenesis within the branching pancreatic ductal system, labeling ten distinct structures to examine heterogeneity and structural transformation during neoplastic progression. We show that pancreatic precancerous lesions develop into distinct 3D morphological phenotypes and that pancreatic cancer tends to spread far from the bulk tumor along collagen fibers that are highly aligned to the 3D curves of ductal, lobular, vascular and neural structures. Thus, CODA establishes a means to transform broadly the structural study of human diseases through exploration of exhaustively labeled 3D microarchitecture.


Pathobiology of severe asthma.
Severe asthma (SA) afflicts a heterogeneous group of asthma patients who exhibit poor responses to traditional asthma medications. SA patients likely represent 5-10% of all asthma patients; however, they have a higher economic burden when compared with milder asthmatics. Considerable research has been performed on pathological pathways and structural changes associated with SA. Although limitations of the pathological approaches, ranging from sampling, to quantitative assessments, to heterogeneity of disease, have prevented a more definitive understanding of the underlying pathobiology, studies linking pathology to molecular markers to targeted therapies are beginning to solidify the identification of select molecular phenotypes. This review addresses the pathobiology of SA and discusses the current limitations of studies, the inflammatory cells and pathways linked to emerging phenotypes, and the structural and remodeling changes associated with severe disease. In all cases, an effort is made to link pathological findings to specific clinical/molecular phenotypes.


Dynamic model of visual recognition predicts neural response properties in the visual cortex.
The responses of visual cortical neurons during fixation tasks can be significantly modulated by stimuli from beyond the classical receptive field. Modulatory effects in neural responses have also been recently reported in a task where a monkey freely views a natural scene. In this article, we describe a hierarchical network model of visual recognition that explains these experimental observations by using a form of the extended Kalman filter as given by the minimum description length (MDL) principle. The model dynamically combines input-driven bottom-up signals with expectation-driven top-down signals to predict current recognition state. Synaptic weights in the model are adapted in a Hebbian manner according to a learning rule also derived from the MDL principle. The resulting prediction-learning scheme can be viewed as implementing a form of expectation-maximization (EM) algorithm. The architecture of the model posits an active computational role of the reciprocal connections between adjoining visual cortical areas in determining neural response properties. In particular, the model demonstrates the possible role of feedback from higher cortical areas in mediating neurophysiological effects due to stimuli from beyond the classical receptive field. Simulations of the model are provided that help explain the experimental observations regarding neural responses in both free viewing and fixation conditions.


[Resistance of microorganisms of coastal ecosystems of the Dead Sea to extremal factors].
Such extreme factors as UV radiation, high temperature and salinity, and also the small amount of accessible water have an influence on microorganisms of coastal ecosystems of the Dead Sea. Resistance to these factors of the microorganisms isolated from ecosystems of this region (vertical steep gorge around the Dead Sea, clay-salt plain and black highly mineralized muds) is studied. Aerobic, chemoorganotrophic, thermotolerant, moderately halophilic bacteria which, according to their morphological and physiological properties, are similar to species Gracilibacillus halotolerans, Salimicrobium album and genus Caryophanon have been isolated from these ecosystems. All strains grew at 0-10% of NaCl in the medium (one strain--at 15% of NaCl), in the range of 30-50 degrees C. Resistance to UV radiation has been revealed in all the investigated bacteria Lethal doses of UV (LD90 and LD99.99) for spore-forming strains of genus Gracilibacillus were 100-170 and 1100-1500 J/m2, respectively; for strain Salimicrobium 6t1 (does not form spores)--70 and 400 J/m2; for the strain lt4 (genus Caryophanon), forming filamentous (or trychomes)--150 and 1400 J/m2. Some strains of genus Gracilibacillus had strong antagonistic effect on conditionally pathogenic test cultures Staphylococcus aureus 209p and Candida albicans UCM Y-690. It is conceivable that resistance of microorganisms of coastal ecosystems of the Dead Sea to extreme factors was generated under the influence of abiotic (physical and chemical) factors typical of this region.


Review: Failure of current digoxin monitoring for toxicity: new monitoring recommendations to maintain therapeutic levels for efficacy.
The current recommendations for monitoring digoxin, a narrow therapeutic index drug, are limited to confirming medication use or investigating suspicion of toxicity and fail our oath to do no harm. Numerous meta-analyses evaluating digoxin use consistently recommend frequent monitoring to maintain the level of 0.5 to ≤1.0 ng/ml because higher levels lead to increased morbidity and mortality without benefit. Data from the United States National Poison Control Center (2012-2020) show annual deaths due to digoxin of 18-36 compared to lithium's 1-7, and warfarin's 0-2 respectively. The latter drugs also have narrow therapeutic indexes like digoxin yet are more carefully monitored. Recognition of digoxin toxicity is impaired as levels are not being routinely checked after medications are added to a patient's regimen. In addition, providers may be using ranges to guide treatment that are no longer appropriate. It is imperative that monitoring guidelines and laboratory therapeutic levels are revised to reduce morbidity and mortality due to digoxin. In this review, we provide a comprehensive literature review of digoxin monitoring guidelines, digoxin toxicity, and evidence to support revising the ranges for serum digoxin monitoring.


The role of the insulin-like growth factor system in the developing brain.
Insulin-like growth factors (IGFs) play a central role in brain growth and development, with IGF-1, its receptors and binding proteins (IGFBPs) being highly expressed, particularly in the olfactory bulb (OB), representing a local paracrine system. A potential role of IGFBPs in transporting and targeting IGFs to their receptors is supported by the finding that abundant IGFBP-2 is associated with cell surface proteoglycans. An OB organ culture system expressing IGF-1 and IGFBPs represents an in vitro injury model. Although IGF-1 is potently antiapoptotic for neurons and oligodendrocytes, marked gliosis and IGFBP-3 expression are seen, similar to in vivo injury responses, where intraventricular injection of IGF-1 postinjury enhances neuronal survival by blocking apoptosis. In contrast, des (1-3) IGF-1, which has low affinity for IGFBPs, is ineffective, supporting a transport or receptor targeting role for local IGFBPs. We conclude that the IGF system plays a crucial cell survival and growth role in the developing and injured brain and that IGFs have significant therapeutic potential.


[Resection of a synchronous liver metastasis from gastric cancer associated with portal vein tumor thrombosis - a case report].
The patient was a 71-year-old woman who was referred to our hospital with a diagnosis of gastric cancer. Computed tomography( CT) scans revealed a liver tumor, which we diagnosed as liver metastasis from the gastric cancer. A type 2 tumor was observed in the lesser curvature side of the gastric angle, and a huge tumor measuring 75 mm was seen in the lateral segment of the liver. A tumor thrombus from the metastatic lesion in the liver jutting out into the umbilical portion of the portal vein was observed. Measurement of tumor marker levels showed that the α-fetoprotein (AFP) level was slightly elevated at 20.7 ng/mL. Distal gastrectomy and resection of the left lobe of the liver were performed at surgery. The results of the pathological examination indicated a tub2, T3 (ss), N1, M1 (HEP), ly0, v2, stage IV gastric cancer with liver metastasis, and without AFP expression. The postoperative course was favorable, and the patient was treated in the outpatient clinic with postoperative adjuvant chemotherapy consisting of 80 mg of S-1. No adverse events were noted, and it was possible to complete 10 courses of chemotherapy. Because there was no evidence of recurrence, treatment was completed in 1 year and 2 months. No recurrence was observed until the third year after surgery. Consistent with a slight elevation in the tumor marker levels at 3 years and 6 months, recurrence was observed in the remnant liver. The patient died of her disease at 3 years and 10 months. Gastric cancers that give rise to portal vein tumor thrombosis are rare. Their outcome is generally poor, and early recurrence in the remnant liver is common. In the present case, R0 resection was possible because the liver metastasis was solitary and the tumor thrombosis was mild. To a certain extent, an improvement in the outcome was observed. However, the recurrence progressed rapidly, making it impossible to perform adequate treatment. More diligent examinations and continuation of long-term treatment might have been required to improve the patient's prognosis.


The big sell: Managing stigma and workplace discrimination following moderate to severe brain injury.
Misperceptions regarding persons with brain injuries (PWBI) can lead to stigmatization, workplace discrimination and, in turn, influence PWBIs full vocational integration. In this study we explored how stigma may influence return-to-work processes, experiences of stigma and discrimination at the workplace for persons with (moderate to severe) brain injuries, and strategies that can be employed to manage disclosure. Exploratory qualitative study; used in-depth interviews and an inductive thematic analytical approach in data analysis. Ten PWBI and five employment service providers participated. PWBI discussed their work experiences, relationships with supervisors and co-workers and experiences of stigma and/or discrimination at work. Employment service providers discussed their perceptions regarding PWBI's rights and abilities to work, reported incidents of workplace discrimination, and how issues related to stigma, discrimination and disclosure are managed. Three themes were identified: i) public, employer and provider knowledge about brain injury and beliefs about PWBI; ii) incidents of workplace discrimination; iii) disclosure. Misperceptions regarding PWBI persist amongst the public and employers. Incidents of workplace discrimination included social exclusion at the workplace, hiring discrimination, denial of promotion/demotion, harassment, and failure to provide reasonable accommodations. Disclosure decisions required careful consideration of PWBI needs, the type of information that should be shared, and the context in which that information is shared. Public understanding about PWBI remains limited. PWBI require further assistance to manage disclosure and incidents of workplace discrimination.


Application of Transcriptomics to Enhance Early Diagnostics of Mycobacterial Infections, with an Emphasis on Mycobacterium avium ssp. paratuberculosis.
Mycobacteria cause a wide variety of disease in human and animals. Species that infect ruminants include M. bovis and M. avium ssp. paratuberculosis (MAP). MAP is the causative agent of Johne's disease in ruminants, which is a chronic granulomatous enteric infection that leads to severe economic losses worldwide. Characteristic of MAP infection is the long, latent phase in which intermittent shedding can take place, while diagnostic tests are unable to reliably detect an infection in this stage. This leads to unnoticed dissemination within herds and the presence of many undetected, silent carriers, which makes the eradication of Johne's disease difficult. To improve the control of MAP infection, research is aimed at improving early diagnosis. Transcriptomic approaches can be applied to characterize host-pathogen interactions during infection, and to develop novel biomarkers using transcriptional profiles. Studies have focused on the identification of specific RNAs that are expressed in different infection stages, which will assist in the development and clinical implementation of early diagnostic tests.


Pulse-train control of photofragmentation at constant field energy.
We consider a phaselocked two-pulse sequence applied to photofragmentation in the weak-field limit. The two pulses are not overlapping in time, i.e., the energy of the pulse-train is constant for all time delays. It is shown that the relative yield of excited Br (*) in the nonadiabatic process: I + Br* ← IBr → I + Br, changes as a function of time delay when the two excited wave packets interfere. The underlying mechanisms are analyzed and the change in the branching ratio as a function of time delay is only a reflection of a changing frequency distribution of the pulse train; the branching ratio does not depend on the detailed pulse shape.


MiR-520d-5p directly targets TWIST1 and downregulates the metastamiR miR-10b.
MicroRNAs are key players in most biological processes. Some microRNAs are involved in the genesis of tumors and are therefore termed oncomiRs, while others, termed metastamiRs, play a significant role in the formation of cancer metastases. Previously, we identified ten different cellular microRNAs that downregulate the expression of MICB, a ligand of the activating NK receptor NKG2D. Interestingly, several of the ten MICB-targeting microRNAs, such as miR-10b, are involved in tumor formation and metastasis. In this work, we identify a complex interplay between these different microRNAs. Specifically, we demonstrate that three of the MICB-targeting microRNAs: miR-20a, miR-17-5p and miR-93, also target the same site in the 3'UTR of TWIST1, a transcription factor implicated in cancer metastasis. Additionally, we show that miR-520d-5p targets a different site in the 3'UTR of TWIST1. We next show that the miR-520d-5p-mediated decrease of TWIST1 expression results in reduced expression of one of its targets, miR-10b, and in the restoration of E-Cadherin expression, which in turn results in reduced cellular motility and invasiveness. Finally, we show that miR-520d-5p leads to reduced proliferation of tumor cells, and that high levels of miR-520d-5p correlate with higher survival rates of cancer patients.


[Home care of demented and non-demented patients. II: Health and burden of caregivers].
1911 informal caregivers from the Federal Republic of Germany who care for someone with a chronic, non-congenital condition rendering them in need of physical "hands-on" nursing completed a standardized questionnaire on their situation as caregivers. The questionnaire was pertinent in particular to their own somatic symptoms (Giessen Symptom List, GSL) as well as their subjective burden (Burden Scale for Family Caregivers, BSFC). Eight out of ten caregivers in Germany are women. The home care of a dementia patient or of a distant or non-related person is taken on significantly more frequently by female caregivers. Somatic symptoms covering the spectrum of exhaustion, aching limbs, and heart and stomach complaints are in greater evidence amongst caregivers of dementia patients than amongst those caring for elderly people with relatively unimpaired cognitive performance. In all, the average extent of the somatic symptoms lies significantly above the age and gender specific value for the general population. The increased subjective burden of caregivers caring for a dementia patient expresses itself particularly in more interpersonal conflicts and clashes of interest between the care given and other areas of activity.


Phytochemistry, antioxidant potential and antifungal of Byrsonima crassifolia on soil phytopathogen control.
The use of chemical defensives to control fungal diseases has by consequence to impact negatively over the environment and human health, this way, the use of plant extracts with antifungal properties along with proper cultural management makes viable an alternative plant production control, specially for familiar and organic cultures. The objective of this study was to perform phytochemical and antioxidant analysis of Byrsonima crassifolia (canjiqueira) barks and evaluate its antifungal potential over Fusarium solani and Sclerotinia sclerotiorum mycelial growth. The ethanol extract from plants collected in Pantanal, Mato Grosso do Sul, Brazil was submitted to phytochemical prospection, total phenol and flavonoids quantification and antioxidant activiy determination (DPPH). To evaluate antifungal activity concentrations of 800, 1200, 1600, 2000 and 2400 µg 100 mL-1 of ethanol extract were used. Which concentration was separately incorporated in agar (PDA) and shed in Petri dishes, followed by the fungi mycelial disc where the colonies diameter was measured daily. Negatives control with agar without extract and agar with an ethanol solution were used. The B. crassifolia ethanol extract presented inhibitory activity over the fungi studied where concentrations of 800 and 1600 µg 100 mL-1, inhibited 38% of the mycelial growth of F. solani; to S. sclerotiorum the best concentration was 2400 µg 100 mL1, reducing 37.5%. The antifungal bark extract potential of this specie is attributed to phenolic compounds and to triterpenes derivatives.


Chaotic advection and the emergence of tori in the Küppers-Lortz state.
Motivated by the roll-switching behavior observed in rotating Rayleigh-Benard convection, we define a Küppers-Lortz (K-L) state as a volume-preserving flow with periodic roll switching. For an individual roll state, the Lagrangian particle trajectories are periodic. In a system with roll-switching, the particles can exhibit three-dimensional, chaotic motion. We study a simple phenomenological map that models the Lagrangian dynamics in a K-L state. When the roll axes differ by 120 degrees in the plane of rotation, we show that the phase space is dominated by invariant tori if the ratio of switching time to roll turnover time is small. When this parameter approaches zero these tori limit onto the classical hexagonal convection patterns, and, as it gets large, the dynamics becomes fully chaotic and well mixed. For intermediate values, there are interlinked toroidal and poloidal structures separated by chaotic regions. We also compute the exit time distributions and show that the unbounded chaotic orbits are normally diffusive. Although the map presumes instantaneous switching between roll states, we show that the qualitative features of the flow persist when the model has smooth, overlapping time-dependence for the roll amplitudes (the Busse-Heikes model).


Assessing the spatial extent of breast tumor intrinsic optical contrast using ultrasound and diffuse optical spectroscopy.
Little is known about the relationship between anatomic and functional contrast derived from intrinsic optical signals. In order to address this relationship, finite-element (FEM) forward simulations were compared to diffuse optical spectroscopy (DOS) reflectance measurements obtained from 10 breast tumor patients. Clinical ultrasound images were used to estimate anatomical tumor size and depth for the FEM simulations. Actual DOS-measured tumor absorption could not be matched by forward model simulations when tumor size was constrained to match ultrasound dimensions. However, agreement was achieved when the lesion was viewed as a distribution of optical properties (i.e., an extended target). This result suggests that the spatial extent of optical contrast in breast tumors may be significantly greater than anatomical dimensions reported by standard imaging modalities. Analysis indicates that invasive breast tumors with anatomical dimensions of 1 cm may still be detectable at depths of 30 mm or more (the center of the lesion to the surface of tissue) using DOS in a reflectance geometry.


Effective mouth care for seriously ill patients.
Mouth care is often given low priority by nurses, and carried out by junior or unqualified staff. Proper assessment of the oral cavity is vital; a well-planned, multidisciplinary, regularly evaluated approach to mouth care is essential. Nurses must be familiar with the most and least effective oral-care products, to ensure they deliver high-quality, evidence-based mouth care. Greater liaison with dental staff may help in achieving this.


[Patients' expectations for medical care--concepts, typology, research methods].
The article reviews literature concerning patients' expectations for medical care. The concept of expectations, typology and research methods are discussed. The author indicates the need for in-depth investigations to determine how patients define their expectations. Qualitative techniques are of help. The standardization of terminology will enable a comparison of patients' expectations in Poland with patients' expectations in other countries.


Spinocerebellar degeneration.
The spinocerebellar degenerations/ataxias (SCAs) are a diverse group of rare, slowly progressive, neurological diseases, often inherited but of incompletely understood pathophysiology, which affect the cerebellum and its related pathways. They have few animal models and share no reliable biomarkers. They have, as yet, no universally validated rating scale for use in clinical trials. In the past 25 years, there have been, at most, 18 controlled (Class 1) trials for ataxia, which have focused on neurotransmitter mechanisms. There is currently only one National Institute of Neurological Disorders and Stroke-sponsored drug trial for ataxia (Phase I study of idebenone in Friedreich's ataxia). There are, as yet, no FDA-approved drugs for SCA. Current treatment practices encompass rehabilitation interventions and off-label use of symptomatic medications [1,2].


Factors Differentiating Childhood-Onset and Adolescent-Onset Schizophrenia:A Claims Database Study.
The greater severity and burden of illness in individuals with early onset schizophrenia (ie, before age 18 years) deserves further investigation, specifically regarding its prevalence in community-based treatment and its association with other psychiatric or medical conditions. A retrospective cohort design was employed using the South Carolina Medicaid claims database covering outpatient and inpatient medical services from January 1, 1999, through December 31, 2013, to identify patients aged ≤ 17 years with a diagnosis of schizophrenia spectrum disorders (ICD-9-CM). Logistic regression was used to examine the factors differentiating childhood- versus adolescent-onset schizophrenia in a community-based system of care. Early onset schizophrenia was diagnosed in 613 child and adolescent cases during the study epoch or 0.2% of this population-based cohort. The early onset cohort was primarily male (64%) and black (48%). The mean length of time followed in the Medicaid dataset was 12.6 years. Within the early onset cohort, 22.5% were diagnosed at age ≤ 12 years and 77.5% were diagnosed as adolescents. The childhood-onset subgroup was twice as likely to have speech, language, or educational disabilities and an attention-deficit/hyperactivity disorder diagnosis but significantly less likely to have schizophrenia or schizoaffective disorder, an organic brain disorder or mental retardation/intellectual disability, or a substance use disorder (adjusted OR = 2.01, 2.26, 0.38, 0.31, 0.47, and 0.32, respectively) compared to the adolescent-onset subgroup. Primary care providers should identify and maintain surveillance of cases of pediatric neurodevelopmental disorders, which appear to be highly comorbid and genetically related, and refer them early and promptly for specialized treatment.


Study of renal safety in amphotericin B lipid complex-treated patients.
To investigate the renal safety of amphotericin B lipid complex (ABLC), records from 3514 ABLC-treated patients with fungal infections were reviewed. The median change in predicted creatinine clearance (CCr) from baseline to the end of therapy was -3 mL/min (range, -119 to 118 mL/min); doubling of serum creatinine (S-Cr) level occurred in 13% of patients, and new dialysis was needed for 3% of patients. Patients with underlying renal disease who had received prior antifungal therapy demonstrated a median CCr of 0.5 mL/min (range, -107 to 52 mL/min). Despite increased risk for renal impairment in allogeneic hematopoietic stem-cell transplant recipients, only 17% of patients demonstrated end-of-therapy doubling of S-Cr levels, and the median change in CCr was -10 mL/min (range, -107 to 108 mL/min). In ABLC-treated patients, concomitant treatment with potentially nephrotoxic agents and a baseline S-Cr level of <2 mg/dL were factors predisposing for the development of nephrotoxicity. These data provide evidence that ABLC may be used safely to treat patients who are at increased risk for renal impairment.


An unexpected 2-histidine phosphoesterase activity of suppressor of T-cell receptor signaling protein 1 contributes to the suppression of cell signaling.
The suppressor of T-cell receptor (TCR) signaling (Sts) proteins Sts-1 and Sts-2 suppress receptor-mediated signaling pathways in various immune cells, including the TCR pathway in T cells and the Dectin-1 signaling pathway in phagocytes. As multidomain enzymes, they contain an N-terminal ubiquitin-association domain, a central Src homology 3 domain, and a C-terminal histidine phosphatase domain. Recently, a 2-histidine (2H) phosphoesterase motif was identified within the N-terminal portion of Sts. The 2H phosphoesterase motif defines an evolutionarily ancient protein domain present in several enzymes that hydrolyze cyclic phosphate bonds on different substrates, including cyclic nucleotides. It is characterized by two invariant histidine residues that play a critical role in catalytic activity. Consistent with its assignment as a phosphoesterase, we demonstrate here that the Sts-1 2H phosphoesterase domain displays catalytic, saturable phosphodiesterase activity toward the dinucleotide 2',3'-cyclic NADP. The enzyme exhibited a high degree of substrate specificity and selectively generated the 3'-nucleotide as the sole product. Sts-1 also had phosphodiesterase catalytic activity toward a 5-mer RNA oligonucleotide containing a 2',3'-cyclic phosphate group at its 3' terminus. To investigate the functional significance of Sts-1 2H phosphoesterase activity, we generated His-to-Ala variants and examined their ability to negatively regulate cellular signaling pathways. Substitution of either conserved histidine compromised the ability of Sts-1 to suppress signaling pathways downstream of both the TCR and the Dectin-1 receptor. Our results identify a heretofore unknown cellular enzyme activity associated with Sts-1 and indicate that this catalytic activity is linked to specific cell-signaling outcomes.


Cost-Effectiveness Analysis on Endoscopic Surveillance Among Western Patients With Barrett's Esophagus for Esophageal Adenocarcinoma Screening.
Incidence of esophageal adenocarcinoma (EAC) has risen rapidly over the past decades in Western countries. As a premalignant lesion, Barrett's esophagus (BE) is an established risk factor of EAC. This study estimated the impact of surveillance endoscopy for BE on population's survival upon EAC by a whole-population cost-effectiveness analysis among modeled Western population. Possibilities and survival payoffs were retrieved through literature searching based on PubMed database. Patients with BE were classified as adequate surveillance (AS), inadequate surveillance (IAS), and no surveillance groups. Direct cost of endoscopy per person-year was estimated from diagnosis of BE to before diagnosis of EAC in the whole-population model, whereas the payoff was 2-year disease-specific survival rate of EAC. AS for patients with BE had lower cost-effectiveness ratio (CER) than that of IAS group, as well as lower incremental cost-effectiveness ratio (6116 ∈/% vs 118,347 ∈/%). Prolonging the surveillance years could decrease the yearly cost in whole population and also relevant CERs, despite increased total cost. Increasing the proportion of participants in AS group could improve the survival benefit. The maximal payoff was up to 2-year mortality reduction of 2.7 per 100,000 persons by spending extra ∈ 1,658,913 per 100,000 person-years. A longer endoscopic surveillance among BE subpopulation plan can reduce yearly budget. Attempt to increase the proportion of AS participants can induce decline in population mortality of EAC, despite extra but acceptable expenditure. However, regarding optimal cost-effectiveness, further studies are still required to identify a high-risk subpopulation out of BE patients for endoscopic surveillance.


Imaging Features Following Breast Explant Surgery: A Pictorial Essay.
Breast implants can be removed with breast explantation surgery (BES) for various reasons, including patient dissatisfaction, capsular contracture, implant infection or rupture, breast implant-associated anaplastic large cell lymphoma, and a recently emerging phenomenon called breast implant illness. There is very limited data on the imaging appearance after BES. A retrospective chart review was performed for patients with BES findings on imaging reports for the period between October 2016 and October 2021. When assessing BES techniques, a key element is determining whether the implant's fibrous capsule requires removal. The second important question is if the patient requires an additional aesthetic procedure after BES. BES techniques include capsulotomy, and partial, total, or en bloc capsulectomy. Adjunctive aesthetic or reconstructive procedures after BES include fat grafting, mastopexy, augmentation, and reconstruction with flaps. The majority of post-BES breast imaging findings are related to the surgical scar/bed, thereby confirming that the type of explantation surgery is important. Imaging findings after BES include focal and global asymmetries, architectural distortions, calcifications, calcified and non-calcified fat necrosis, masses, hematomas, seromas, capsular calcifications, and silicone granulomas. Most importantly, since these patients have residual breast tissue, paying attention to imaging features that are suspicious for breast cancer is necessary.


Exposure to biological therapies during conception and pregnancy: a systematic review.
Biological therapies are effective treatments for psoriasis and are often prescribed to women of child-bearing age. To evaluate the safety of biological therapy in conception and/or pregnancy. We performed a systematic review of PubMed, MEDLINE, Embase and Cochrane databases for multivariate-adjusted studies of women exposed to biologics relevant to the treatment of psoriasis during conception and/or pregnancy. We identified four population-based cohort studies involving 1300 women exposed to tumour necrosis factor (TNF)-α inhibitors (TNFi) 3 months prior to or during the first 3 months of pregnancy. These studies showed a trend towards drug-specific harm with TNFi exposure in women with different inflammatory diseases, with an increased risk of congenital malformations [three studies; odds ratio (OR) range 1·32-1·64] and preterm birth (one study; OR 1·69, 95% confidence interval 1·10-2·60). This trend did not reach statistical significance in all studies; study heterogeneity, variation across comparator cohorts, inadequate adjustment for important confounding variables such as co-therapy, and an absence of a common constellation of malformations means there is uncertainty about the causal role of TNFi. No studies specifically addressed the effect of TNFi exposure in psoriasis during conception and/or pregnancy, or of interleukin (IL)-17 and IL-12/23 antagonists in any indication. When counselling women these findings must be balanced against the potential impact of untreated severe psoriasis on conception and/or pregnancy and maternal wellbeing; ongoing pharmacovigilance via registries remains essential to address this evidence gap.


Acute oxygen sensing by vascular smooth muscle cells.
An adequate supply of oxygen (O2) is essential for most life forms on earth, making the delivery of appropriate levels of O2 to tissues a fundamental physiological challenge. When O2 levels in the alveoli and/or blood are low, compensatory adaptive reflexes are produced that increase the uptake of O2 and its distribution to tissues within a few seconds. This paper analyzes the most important acute vasomotor responses to lack of O2 (hypoxia): hypoxic pulmonary vasoconstriction (HPV) and hypoxic vasodilation (HVD). HPV affects distal pulmonary (resistance) arteries, with its homeostatic role being to divert blood to well ventilated alveoli to thereby optimize the ventilation/perfusion ratio. HVD is produced in most systemic arteries, in particular in the skeletal muscle, coronary, and cerebral circulations, to increase blood supply to poorly oxygenated tissues. Although vasomotor responses to hypoxia are modulated by endothelial factors and autonomic innervation, it is well established that arterial smooth muscle cells contain an acute O2 sensing system capable of detecting changes in O2 tension and to signal membrane ion channels, which in turn regulate cytosolic Ca2+ levels and myocyte contraction. Here, we summarize current knowledge on the nature of O2 sensing and signaling systems underlying acute vasomotor responses to hypoxia. We also discuss similarities and differences existing in O2 sensors and effectors in the various arterial territories.


This town ain't big enough for both of us…or is it? Spatial co-occurrence between exotic and native species in an urban reserve.
Exotic species pose a threat to most ecosystems because of their potential to establish negative interactions with native biota. However, exotic species can also offer resources to native species, especially within highly modified environments such as urban ecosystems. We studied 17 exotic-native pairs of species with the potential to compete with one another, or in which one of the species could offer resources to the other, in an urban ecological reserve located within Mexico City. We used two-species occupancy models to analyze the potential association between the presence of the exotic species and the spatial distribution of the native species, as well as to assess if these species tend to avoid each other (negative spatial interaction) or to co-occur more often than expected under the hypothesis of independent occurrences (positive spatial interaction). Our results revealed few cases in which the exotic species influenced occupancy of the native species, and these spatial interactions were mainly positive, indicated by the fact that the occupancy of the native species was usually higher when the exotic species was also present. Seven of the eight observed non-independent patterns of co-occurrence were evident during the dry months of the year, when resources become scarce for most species. Our results also demonstrate that the observed patterns of species co-occurrence depend on the distance to the nearest urban structure and the amount of herb, shrub, and tree cover, indicating that these habitat features influence whether native species avoid or co-occur with exotic species. Our study represents an important contribution to the understanding of temporal dynamics in the co-occurrence between exotic and native species within urban ecological reserves.


Guest-host interactions and their impacts on structure and performance of nano-MoS2.
Different guest species, including amorphous carbon, polyvinyl pyrrolidone (PVP), ethylene diaminetrimolybdate (EDA) derived small molecules, have been successfully intercalated into a nano-scaled MoS2 (nano-MoS2). These guest species bridge the MoS2 slabs through chemical bonding and their host-guest interactions influence the structure and electrochemical performance of the nano-MoS2. When applied in lithium (Li) and sodium (Na) ion batteries, these MoS2 nanostructures exhibit distinguished intercalation thermodynamics and cycling performances. These findings shed light on the design of MoS2 nanostructures and other two-dimensional layer-structured materials.


Theanine maintains sleep quality in healthy young women by suppressing the increase in caffeine-induced wakefulness after sleep onset.
Energy drinks take advantage of caffeine's effects on wakefulness and performance; however, excessive intake has a negative effect on sleep. Green tea is consumed worldwide and has both a stimulating effect from caffeine and a calming or relaxing effect from theanine. Theanine reduces the excitotoxicity of caffeine. This study evaluated whether theanine improves the sleep quality worsened by caffeine in healthy young women. Sleep latency, sleep time, wake after sleep onset (WASO) time, and the number of WASOs were measured. A crossover study was performed using four treatment groups: theanine (50 mg), caffeine (30 mg), combined theanine and caffeine (TC), and placebo. The sleep stage was determined using electroencephalograms, and cerebral blood flow was measured using near-infrared spectroscopy. The caffeine group showed a significant increase in the WASO time compared with the placebo group; no difference was observed between the theanine or TC group and the placebo group. There were no differences in the sleep-onset latency or number of WASOs between the theanine, caffeine, or TC groups and the placebo group. In combination with theanine, only the caffeine-induced increase in the WASO time was suppressed. Our results suggest that theanine can reduce caffeine's effects on sleep quality.


Galactosaminogalactan (GAG) and its multiple roles in Aspergillus pathogenesis.
Aspergillus spp and particularly the species Aspergillus fumigatus are the causative agents of invasive aspergillosis, a progressive necrotizing pneumonia that occurs in immunocompromised patients. The limited efficacy of currently available antifungals has led to interest in a better understanding of the molecular mechanisms underlying the pathogenesis of invasive aspergillosis in order to identify new therapeutic targets for this devastating disease. The Aspergillus exopolysaccharide galactosaminogalactan (GAG) plays an important role in the pathogenesis of experimental invasive aspergillosis. The present review article summarizes our current understanding of GAG composition and synthesis and the molecular mechanisms whereby GAG promotes virulence. Promising directions for future research and the prospect of GAG as both a therapy and therapeutic target are reviewed.


HbA1c and the diagnosis of diabetes and prediabetes in a middle-aged and elderly Han population from northwest China (HbA1c).
To identify the optimal threshold of HbA1c and to evaluate the predictive performance of HbA1c levels in diagnosing diabetes and prediabetes in a middle-aged and elderly Han Chinese population from northwest China. In all, 3354 participants aged ≥ 40 years with no history of diabetes from northwest China were enrolled in the present cross-sectional study. All subjects underwent a 75-g oral glucose tolerance test (OGTT), as well as HbA1c testing. HbA1c thresholds for diagnosing diabetes and prediabetes were identified by the highest sum of sensitivity and specificity of each cut-off point, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of the HbA1c threshold. The mean (± SD) age of the participants was 57 ± 8 years, and 70.75% were women. Based on results of the OGTT, 1347 (40.16%) subjects had impaired fasting glucose and/or impaired glucose tolerance, and 725 (21.62%) had diabetes. The area under the ROC curve for detecting undiagnosed diabetes and prediabetes by HbA1c levels was 0.810 (95% confidence interval [CI] 0.796-0.823) and 0.732 (95% CI 0.717-0.747), respectively. HbA1c threshold of 6.4% and 6.1% produced the highest sum of sensitivity (60.00% and 61.49%) and specificity (87.33% and 73.24%) for diagnosing diabetes and prediabetes, respectively. HbA1c is an effective and convenient method for diagnosing diabetes and prediabetes. HbA1c thresholds of 6.4% and 6.1% may be used as diagnostic criteria for diabetes and prediabetes, respectively, in the Han Chinese population living in northwest China.


Salt tolerance in relation to elemental concentrations in leaf cell vacuoles and chloroplasts of a C4 monocotyledonous halophyte.
Halophytes accumulate and sequester high concentrations of salt in vacuoles while maintaining lower levels of salt in the cytoplasm. The current data on cellular and subcellular partitioning of salt in halophytes are, however, limited to only a few dicotyledonous C3 species. Using cryo-scanning electron microscopy X-ray microanalysis, we assessed the concentrations of Na, Cl, K, Ca, Mg, P and S in various cell types within the leaf-blades of a monocotyledonous C4 halophyte, Rhodes grass (Chloris gayana). We also linked, for the first time, elemental concentrations in chloroplasts of mesophyll and bundle sheath cells to their ultrastructure and photosynthetic performance of plants grown in nonsaline and saline (200 mM NaCl) conditions. Na and Cl accumulated to the highest levels in xylem parenchyma and epidermal cells, but were maintained at lower concentrations in photosynthetically active mesophyll and bundle sheath cells. Concentrations of Na and Cl in chloroplasts of mesophyll and bundle sheath cells were lower than in their respective vacuoles. No ultrastructural changes were observed in either mesophyll or bundle sheath chloroplasts, and photosynthetic activity was maintained in saline conditions. Salinity tolerance in Rhodes grass is related to specific cellular Na and Cl distributions in leaf tissues, and the ability to regulate Na and Cl concentrations in chloroplasts.


Impact of a category-3 hurricane on the need for surgical hospital care.
Hurricane Ivan, a strong category-3 hurricane, struck Grenada on 07 September 2004 and devastated the country. Grenada is a small, developing country, whose socio-economic environment and health service is typical of most countries located within the Caribbean hurricane belt. Previous reports describing the consequences of hurricanes on health-related issues have focused mainly on the experience of wealthier countries. The objective of this study was to document the types of patients and medical problems faced by a hospital surgical service as a result of a forceful hurricane in a developing country and to help surgical divisions in developing countries prepare for strong hurricanes. This is a retrospective study using medical records from the surgical ward of the Grenada General Hospital. Patients admitted to the surgical ward during the month following Ivan were assessed with respect to diagnosis, age, gender, and length of hospitalization. The patients admitted during the same period the previous year were used as a control group. The effects of the hurricane included a significant increase in the proportion of patients seen for diabetic feet, gunshot wounds, and infections due to wounds. The median length of the treatment time increased by 25%. In 2004, the total number of patients was 185 and in 2003, there were 167 patients admitted. The results of this study indicate that preparations for future hurricanes should include securing the capacity to handle the increased needs for hospital care, and ensuring that stocks of medicines, such as insulin and antibiotics, are sufficient, properly stored, and easily available to patients (e.g., by storing medicine at hurricane shelters equipped with generators and cold storage facilities). Diabetics should be instructed to use proper footwear to reduce the risk of cuts from debris.


Vertigo. How serious are recurrent and single attacks?
Through history taking and physical examination, the primary care physician should be able to distinguish between the four most common causes of recurrent vertigo. Particular caution is advised when dealing with the first attack of vertigo, because more sinister possibilities may be present, although most of the disorders that cause vertigo are benign. Categories of treatment that can be used include medical, rehabilitative or exercise-related, surgical, dietary, and unconventional (eg, acupuncture, manipulation).


Device-Compatible Chiroptical Surfaces through Self-Assembly of Enantiopure Allenes.
Chiroptical methods have been proven to be superior compared to their achiral counterparts for the structural elucidation of many compounds. To expand the use of chiroptical systems to everyday applications, the development of functional materials exhibiting intense chiroptical responses is essential. Particularly, tailored and robust interfaces compatible with standard device operation conditions are required. Herein, we present the design and synthesis of chiral allenes and their use for the functionalization of gold surfaces. The self-assembly results in a monolayer-thin room-temperature-stable upstanding chiral architecture as ascertained by ellipsometry, X-ray photoelectron spectroscopy, and near-edge X-ray absorption fine structure. Moreover, these nanostructures anchored to device-compatible substrates feature intense chiroptical second harmonic generation. Both straightforward preparation of the device-compatible interfaces along with their chiroptical nature provide major prospects for everyday applications.


No difference in sexual dysfunction after transabdominal preperitoneal (TAPP) approach for inguinal hernia with fibrin sealant or tacks for mesh fixation.
Postoperative sexual dysfunction in relation to laparoscopic groin hernia surgery may be related to methods of mesh fixation. However, this has not been investigated earlier. Moreover, results regarding sexual dysfunction in females have not been reported systematically. The aim of this study was to compare fibrin sealant versus tacks for fixation of mesh regarding sexual dysfunction in males and females. Using the Danish Hernia Database, patients operated laparoscopically for groin hernia with a transabdominal preperitoneal (TAPP) procedure with fibrin sealant or tacks for mesh fixation were sent a questionnaire regarding sexual dysfunction. Sexually active patients without recurrence were evaluated in this study. Pain during sexual activity was present in 115 of 1019 (11.3 %) males and 17 of 147 (11.6 %) females. There was no difference between fibrin sealant and tacks for mesh fixation and no difference between genders. Pain intensity, characteristics and origin were comparable between fibrin sealant and tacks for both genders. We found a relationship between a higher rate of sexual dysfunction and lower age for both genders. We found no difference between fibrin sealant and tacks in pain during sexual activity or intensity of pain. However, younger age may be a risk factor for pain during sexual activity. Considering the high rate of postoperative sexual dysfunction, it is important to include this topic in the preoperative patient information.


Individual differences in cognitive control: the role of psychoticism and working memory in set-shifting.
Set-shifting refers to a process of cognitive control which is shown through flexible behavioural adaptation to changes in task parameters or demands, such as the switching of an explicit rule (extra-dimensional rule shifting) or the reversal of a reinforcement-contingency (reversal-learning). Set-shifting deficits are widely documented in specific neuropsychological disorders, but seldom investigated in relation to normally-occurring individual differences. In a sample of healthy adults (N=78, 28% male), we demonstrate that Working Memory and trait Psychoticism have independent involvement in extra-dimensional rule shifting as measured using an analogue of the Wisconsin Card Sorting Test. Only Psychoticism, however, was involved in reversal-learning, as assessed using a recent modification of the Iowa Gambling Task. Individual differences in extra-dimensional rule shifting were explained in terms of rule abstraction speed, while individual differences in reversal-learning were explained in terms of response perseveration. These results clarify component processes in different forms of set-shifting, and highlight the role of individual differences, especially personality, in cognitive control.


Mycoplasma hyopneumoniae bacterins and porcine circovirus type 2 (PCV2) infection: induction of postweaning multisystemic wasting syndrome (PMWS) in the gnotobiotic swine model of PCV2-associated disease.
Groups (5 to 15 per group) of gnotobiotic swine were infected oronasally with porcine circovirus type 2 (PCV2) at 3 days of age and then given 1 of 6 different commercial Mycoplasma hyopneumoniae (M. hyopneumoniae) bacterins as either a single dose (7 d of age, 1 application products) or 2 doses (7 and 21 d of age, 2 application product). Control groups received PCV2 alone (n = 9) or were infected with PCV2 and immunized twice with keyhole limpet hemocyanin (KLH) emulsified in incomplete Freund's adjuvant (ICFA) (n = 7). Five of 7 (71%) PCV2-infected piglets immunized with KLH/ICFA developed mild or overt PMWS, whereas none of 9 piglets infected with PCV2 alone developed PMWS. Five of 12 (42%) piglets vaccinated with a commercial bacterin containing mineral oil adjuvant developed PMWS following vaccination. None of the PCV2-infected piglets in the other bacterin-vaccinated groups developed PMWS in this model of PCV2-associated disease. This difference in prevalence of PMWS in piglets given the mineral oil-adjuvanted M. hyopneumoniae bacterin and the other M. hyopneumoniae bacterin vaccination groups was statistically significant (P < 0.05).


Design of synthetic peptides for diagnostics.
Due to the advantageous properties of synthetic molecules compared to biological ones biological molecules in diagnostic tests are replaced increasingly by synthetic ones, usually synthetic peptides or related molecules. The replacement of biological antigens by synthetic peptides is most advanced at present, as well as the use of site-specific antibodies induced with synthetic peptides. Moreover recent results indicate that synthetic molecules may also replace antibodies. Ultimately this will lead to diagnostic assays built of synthetic molecules only.


Synergistic effects of atenolol and amlodipine for lowering and stabilizing blood pressure in 2K1C renovascular hypertensive rats.
To test the synergistic effects of atenolol and amlodipine on lowering blood pressure (BP) and reducing blood pressure variability (BPV) in 2-kidney, one-clip (2K1C) renovascular hypertensive rats. Forty-eight 2K1C renovascular hypertensive rats were randomly divided into 6 groups. They were respectively given 0.8% carboxymethylcellulose sodium (control), atenolol (10.0 mg/kg), amlodipine (1.0 mg/kg), and combined atenolol and amlodipine (low dose: 5.0+0.5 mg/kg; intermediate dose: 10.0+1.0 mg/kg; high dose: 20.0+2.0 mg/kg). The drugs were given via a catheter in a gastric fistula. BP was recorded for 25 h from 1 h before drug administration to 24 h after administration. Compared with BP before medication, all 3 doses of combined atenolol and amlodipine significantly decreased the BP at 24 h after administration, except for the low dose on diastolic BP. Compared with the control group, all 3 doses of combined atenolol and amlodipine significantly reduced the average BP levels for the 24 h period after administration; furthermore, the high and intermediate doses also significantly decreased the BPV levels for the same period. The q values calculated by probability sum analysis for systolic and diastolic BP for the 24 h period after administration were 2.29 and 1.45, respectively, and for systolic and diastolic BPV for the same period they were 1.41 and 1.60, respectively. There is significant synergism between atenolol and amlodipine in lowering and stabilizing BP in 2K1C renovascular hypertensive rats.


Extending the ecology of fear: Parasite-mediated sexual selection drives host response to parasites.
The 'ecology of fear' describes the negative effects natural enemies have on potential victims even when those victims are not consumed or infected. Although recent work has demonstrated parasites have non-consumptive effects (NCE) on potential hosts, how these effects vary within host populations is not well understood. We investigated how NCE vary based on host risk of infection and relative cost of infection by measuring the metabolic rate (MR) of naive Drosophila nigrospiracula exposed to an ectoparasite, Macrocheles subbadius. We tested two mutually exclusive hypotheses: 1) asymmetrical costs of infection drive adaptions for stronger responses to parasite exposure; or 2) asymmetrical risks of infection drive adaptions for stronger responses to parasite exposure. In this system, male flies have higher costs of infection relative to female flies due to parasite-mediated sexual selection; similarly, virgin females experience higher costs of infection relative to mated females. Risk of infection also varies among flies because mites preferentially infect female flies over males, and mites preferentially infect mated females over virgin females. Our results were compatible with the hypothesis that costs of infection drive the strength of response to mite risk. Female flies responded to parasite exposure with a 15.1% increase in MR, while exposed males showed a stronger response with a 31.3% increase in MR. Mated females increased their MR by 34.8% during mite exposure whereas virgin females experienced an increase of 61.2%. Our findings suggest that NCE of parasites can vary based on state-dependent costs of infection.


Noise reduction in three-dimensional phase-contrast MR velocity measurements.
The authors have developed a method to reduce noise in three-dimensional (3D) phase-contrast magnetic resonance (MR) velocity measurements by exploiting the property that blood is incompressible and, therefore, the velocity field describing its flow must be divergence-free. The divergence-free condition is incorporated by a projection operation in Hilbert space. The velocity field obtained with 3D phase-contrast MR imaging is projected onto the space of divergence-free velocity fields. The reduction of noise is achieved because the projection operation eliminates the noise component that is not divergence-free. Signal-to-noise ratio (S/N) gains on the order of 15%-25% were observed. The immediate effect of this noise reduction manifests itself in higher-quality phase-contrast MR angiograms. Alternatively, the S/N gain can be traded for a reduction in imaging time and/or improved spatial resolution.


TRUS-guided transperineal prostate 12+X core biopsy with template for the diagnosis of prostate cancer.
The objective of the present study was to explore the clinical value and safety of trans-rectal ultrasound (TRUS)-guided transperineal prostate 12+X core biopsy in the diagnosis of prostate cancer. Patients who received a TRUS-guided transperineal prostate biopsy for suspected prostate cancer at the General Hospital of The People's Liberation Army between September 2009 and May 2014 were retrospectively analyzed, this consisted of 1,300 patients. These patients were randomly divided into the 12+X core group or the standard 12-core group. The mean age of all the patients was 70.5 years old. Levels of prostate-specific antigen, digital rectal examination, transrectal ultrasound and magnetic resonance imaging (MRI) were checked and used as reference prior and subsequent to the biopsy procedure. The 12+X core group consisted of 937 patients and the 12-core group consisted of 363 patients. The mean number of core samples taken from both groups was 14.5 (ranging from 12 to 24) and the mean operative time of the whole group was 20.4 min (ranging from 15 to 40 min). The puncture positive detection rate of abnormal rectal examination, trans-rectal ultrasound, and MRI was 24.0, 30.1, and 59.2%, respectively, whereas the puncture positive rate was 47.2% in 12+X core group and 34.5% in 12-core group. Improved prostate needle biopsy with 12+X cores was found to have significantly higher detection rate than that with 12 cores as well as fewer post-operative complications, therefore making the method ideal for diagnosing prostate cancer.


Substance P, acetylcholinesterase, and beta-endorphin levels in the plasma and pericardial fluid of patients with and without angina pectoris.
We measured substance P-like immunoreactivity (SPLI), beta-endorphin-like immunoreactivity (BELI), acetylcholinesterase activity, and total protein content in pericardial fluid and plasma of patients with angina pectoris and patients with no angina pectoris. SPLI and BELI levels, acetylcholinesterase activity, and total protein content were determined by radioimmunoassay, a colorimetric method, and by the method of Lowry et al. (J Biol Chem 1951; 193:265-75), respectively. In the pericardial fluid, patients with angina had SPLI, BELI, acetylcholinesterase, and total protein values of 1.69 +/- 0.23 fmol/mg protein, 0.16 +/- 0.13 fmol/mg protein, 0.06 +/- 0.02 units, and 25.7 +/- 3.2 mg/ml, respectively. Patients with no angina had SPLI, BELI, acetylcholinesterase, and total protein values of 0.93 +/- 0.17 fmol/mg protein, 0.19 +/- 0.10 fmol/mg protein, 0.16 +/- 0.02 units, and 44.6 +/- 5.3 mg/ml, respectively. SPLI levels were significantly higher (p less than 0.03), and acetylcholinesterase (less than 0.002) and total protein content (less than 0.004) were significantly lower in the pericardial fluid of patients with angina when compared with those of patients with no angina. BELI levels were not significantly different between the two groups. In the plasma, no significant differences were found in SPLI, BELI, acetylcholinesterase, and total protein values between the two groups of patients. Patients with angina had SPLI, BELI, acetylcholinesterase, and total protein values of 0.47 +/- 0.26 fmol/mg protein, 0.06 +/- 0.06 fmol/mg protein, 0.29 +/- 0.15 units, and 68.2 +/- 8.7 mg/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)


A one-day census of acute psychiatric inpatient facilities in Italy: findings from the PROGRES-Acute Project.
On May 8, 2003, a survey was conducted of all inpatients at 369 psychiatric facilities for adult acute patients in all Italian regions except Sicily. The estimated point prevalence rate of admissions was 18.3 per 100,000 adult population. There were 305 involuntarily admitted patients (3.8%, or .70 per 100,000 population). Large differences between public and private facilities were found in age and gender distribution: the proportion of men age under age 35 was larger in public facilities, and the proportion of women age 65 and older was larger in private facilities. In Italy, monitoring and evaluation of community services, at both the local and national levels, is essential for policy development, implementation, and evaluation.