Shoulder dystocia in deliveries of neonates <3500 grams.
To study risk factors for shoulder dystocia (ShD) among women delivering <3500 g newborn. A retrospective case-control study of all term live-singleton deliveries during 2011-2019. Women with neonatal birthweight <3500 g were included. We compared cases of ShD to other deliveries by univariate and multivariable regression. There were 79/41 092 (0.19%) cases of ShD among neonates <3500 g. In multivariable regression analysis, the following factors were independently associated with ShD; operative vaginal delivery (odds ratio [OR] 2.78; 95% confidence interval [CI]: 1.28-6.02, P = 0.009), vaginal birth after cesarean (VBAC, OR 2.74; 1.22-6.13, P = 0.010), sonographic abdominal circumference to biparietal diameter ratio (3.73 among ShD vs. 3.62, OR 1.35; 95% CI: 1.12-1.63, P = 0.001) and sonographic abdominal circumference to head circumference ratio (1.036 among ShD vs. 1.011, OR 3.04; 95% CI: 1.006-9.23, P = 0.049). There is an association between operative vaginal delivery and ShD also in deliveries <3500 g. Importantly, the proportions between the fetal head and abdominal circumference are a better predictor of ShD than the newborn fetal weight and VBAC is associated with ShD.


Beveled reversed elephant trunk procedure for complex aortic aneurysm.
The reversed elephant trunk procedure uses an inverted graft for distal aortic replacement before aortic arch replacement in patients with mega aorta, to reduce the risk in the second stage. However, the conventional technique restricts the maximum diameter of the inverted graft to the aortic graft diameter. We employed a beveled reversed elephant trunk procedure to overcome the discrepancy between graft diameters in a 54-year-old woman with a severely twisted ascending aortic graft and enlarging chronic dissection of the aortic arch and descending thoracic aorta. The patient was discharged with a satisfactory repair and no neurologic deficit.


Modelling cavitation erosion using fluid-material interaction simulations.
Material deformation and pitting from cavitation bubble collapse is investigated using fluid and material dynamics and their interaction. In the fluid, a novel hybrid approach, which links a boundary element method and a compressible finite difference method, is used to capture non-spherical bubble dynamics and resulting liquid pressures efficiently and accurately. The bubble dynamics is intimately coupled with a finite-element structure model to enable fluid/structure interaction simulations. Bubble collapse loads the material with high impulsive pressures, which result from shock waves and bubble re-entrant jet direct impact on the material surface. The shock wave loading can be from the re-entrant jet impact on the opposite side of the bubble, the fast primary collapse of the bubble, and/or the collapse of the remaining bubble ring. This produces high stress waves, which propagate inside the material, cause deformation, and eventually failure. A permanent deformation or pit is formed when the local equivalent stresses exceed the material yield stress. The pressure loading depends on bubble dynamics parameters such as the size of the bubble at its maximum volume, the bubble standoff distance from the material wall and the pressure driving the bubble collapse. The effects of standoff and material type on the pressure loading and resulting pit formation are highlighted and the effects of bubble interaction on pressure loading and material deformation are preliminarily discussed.


Accreditation of specialized asthma units for adults in Spain: an applicable experience for the management of difficult-to-control asthma.
This paper, developed by consensus of staff physicians of accredited asthma units for the management of severe asthma, presents information on the process and requirements for already-existing asthma units to achieve official accreditation by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Three levels of specialized asthma care have been established based on available resources, which include specialized units for highly complex asthma, specialized asthma units, and basic asthma units. Regardless of the level of accreditation obtained, the distinction of "excellence" could be granted when more requirements in the areas of provision of care, technical and human resources, training in asthma, and teaching and research activities were met at each level. The Spanish experience in the process of accreditation of specialized asthma units, particularly for the care of patients with difficult-to-control asthma, may be applicable to other health care settings.


The Synthesis of Hydroxyapatite by Hydrothermal Process with Calcium Lactate Pentahydrate: The Effect of Reagent Concentrations, pH, Temperature, and Pressure.
Hydroxyapatite and other calcium phosphates in the form of whiskers are lately widely considered as fillers for biocomposites due to their special biological and reinforcing properties. Depending on the method of synthesis, apatite whiskers of various sizes and phase composition can be obtained. In our work, hydroxyapatite (HAp) whiskers were successfully prepared in reaction between calcium lactate pentahydrate and orthophosphoric acid. The advantage of the proposed technique is the simple but precise control of the HAp crystal morphology and high product purity which is necessary for biomedical applications. The effect of reagent concentrations, pH, reaction temperature, and pressure on HAp whiskers' morphology and composition was investigated. In the result, we obtained hydroxyapatite of different morphology such as whiskers, hexagonal rods, and nanorods. The products were characterized by SEM, XRD, and FTIR. In this work, the synthesis of HAp whiskers by direct decomposition of calcium lactate pentahydrate chelates under hydrothermal conditions was showed for the first time.


Barebacking websites: electronic environments for reducing or inducing HIV risk.
Barebacking, or intentional unprotected anal intercourse (UAI), among men who have sex with men (MSM) has been a growing concern for the public health community because of UAIs link to HIV incidence and sexually transmitted infections (STIs). Men who bareback have created online spaces through websites that host thousands of profiles throughout the US and world. Adapting two domains from person-environment theory, this study contrasted the health messages surrounding the risks of UAI within two mainstream US-based barebacking websites. One website developed intensive systems to promote harm reduction, such as encouraging frequent HIV-testing, discussing STIs with partners, and limiting the number of partners. In contrast, the other site analysed negated the seriousness of HIV and STIs, which can have clear negative outcomes for patrons whom relied on this information. This analysis implicates the need to explore electronic environments as viable tools for HIV prevention and programme development.


The alkaloid centcyamine increases expression of klotho and lamin B1, slowing the onset of skin ageing in vitro and in vivo.
Klotho is a protein known for its beneficial effects on longevity. Centcyamine is an alkaloid present in certain plants whose extracts have an anti-inflammatory effect. Skin fibroblasts are essential to the formation and structure of the dermis. Centcyamine is an indole-based alkaloid composed of coumaric acid, a resveratrol precursor and methoxytryptamine, which can be both a precursor, or a derivative, of melatonin. Given these building blocks and their well-known bioactivities, it was of interest to explore the potential benefits of using this aryl-alkaloid, in cosmetic skincare applications. We tested cultured normal human dermal fibroblasts (NHDF) in vitro to observe how supplementation with centcyamine improves properties of the cells to counteract the effect of ageing. The expression of genes and proteins of interest was quantified. The effect on doubling time and cell function was evaluated following treatment of the cells over several replication cycles. Skin firmness, red spot index and skin isotropy were measured with Dynaskin® , Visia® and Primos® equipment, respectively, and compared over two months in a vehicle-controlled clinical trial on 60 persons. Centcyamine activates the expression of the gene KL and the related protein Klotho in dermal fibroblasts. Moreover, centcyamine slows the replicative ageing process of fibroblasts in culture. These cells retain cellular functions identical to those of young cells: the synthesis of lamin B1, a crucial regulatory protein of proliferation, as well as of collagen I and elastin is retained in aged cells. The clinical data are shown to improve skin isotropy in a majority of subjects, to reduce the red spot intensity and to maintain skin firmness in the treated group vs. the vehicle. The alkaloid centcyamine induces changes in the metabolism of the ageing process of human dermal fibroblasts. The up-to-now unobserved implication of both Klotho and lamin B1 to maintain homeostasis of the skin opens new venues for the prevention of age-related changes in skin structure. The in vitro and clinical data, while not demonstrated to be causally related, converge towards a common goal of skin repair and slower ageing processes.


Partially Resistant Avocado Rootstock Dusa® Shows Prolonged Upregulation of Nucleotide Binding-Leucine Rich Repeat Genes in Response to Phytophthora cinnamomi Infection.
Avocado is an important agricultural food crop in many countries worldwide. Phytophthora cinnamomi, a hemibiotrophic oomycete, remains one of the most devastating pathogens within the avocado industry, as it is near impossible to eradicate from areas where the pathogen is present. A key aspect to Phytophthora root rot disease management is the use of avocado rootstocks partially resistant to P. cinnamomi, which demonstrates an increased immune response following infection. In plant species, Nucleotide binding-Leucine rich repeat (NLR) proteins form an integral part of pathogen recognition and Effector triggered immune responses (ETI). To date, a comprehensive set of Persea americana NLR genes have yet to be identified, though their discovery is crucial to understanding the molecular mechanisms underlying P. americana-P. cinnamomi interactions. In this study, a total of 161 PaNLR genes were identified in the P. americana West-Indian pure accession genome. These putative resistance genes were characterized using bioinformatic approaches and grouped into 13 distinct PaNLR gene clusters, with phylogenetic analysis revealing high sequence similarity within these clusters. Additionally, PaNLR expression levels were analyzed in both a partially resistant (Dusa®) and a susceptible (R0.12) avocado rootstock infected with P. cinnamomi using an RNA-sequencing approach. The results showed that the partially resistant rootstock has increased expression levels of 84 PaNLRs observed up to 24 h post-inoculation, while the susceptible rootstock only showed increased PaNLR expression during the first 6 h post-inoculation. Results of this study may indicate that the partially resistant avocado rootstock has a stronger, more prolonged ETI response which enables it to suppress P. cinnamomi growth and combat disease caused by this pathogen. Furthermore, the identification of PaNLRs may be used to develop resistant rootstock selection tools, which can be employed in the avocado industry to accelerate rootstock screening programs.


Removal of mandibular tooth follicles before distraction osteogenesis.
Distraction osteogenesis is an innovative technique that has transformed the treatment of craniofacial malformations in young children. Bone generation obviates the need for graft material, which is in short supply in young patients, thus making possible surgical procedures on the craniofacial skeleton in young children. Sufficient mandibular volume is required for the osteotomy and placement of the device screws and/or pins. To have adequate bone stock and to facilitate distraction, the authors preoperatively examined all patients radiographically and selected those with tooth follicles that precluded successful osteotomy and pin placement for planned mandibular distraction. This report is of the first 13 children, aged 9 months to 6 years, who underwent predistraction enucleation. The osteotomy and device placement were performed successfully at least 4 months after enucleation. The described procedure has minimal morbidity and has resulted in successful subsequent distraction. The advantages, disadvantages, and cost-benefit issues are discussed.


Clinical outcomes following switching antipsychotic treatment due to market withdrawal: a retrospective naturalistic cohort study of pipotiazine palmitate injection (Piportil Depot) discontinuation, subsequent acute care use and effectiveness of medication to which patients switched.
Pipotiazine palmitate depot injection (Piportil) was withdrawn from the UK marketplace in 2015. Few studies exist on the clinical impact of such market withdrawal. Purpose: We aimed to identify a cohort of patients switching from pipotiazine following this withdrawal and explore factors associated with effectiveness of the medication switched to and subsequent acute service use. A naturalistic retrospective cohort study was conducted in Sussex, United Kingdom. Those discontinuing pipotiazine solely due to market withdrawal were identified from electronic patient database and manual searching. Multivariate logistic regression analyses and survival analyses were performed to explore associations between available baseline variables and dichotomous all-cause discontinuation of the next prescribed medication and admission to acute mental health services over the subsequent year. Of 205 patients identified as receiving pipotiazine in October 2014, 137 switched from this due to market withdrawal. Over the subsequent year, 31.5% discontinued the medication to which they were switched and 19% required acute care. Drug class switched to (typical depot vs atypical long acting injection (LAI) vs atypical oral) had no significant association with discontinuation. Switch to atypical LAI was significantly associated with acute care in comparison to typical depot. Those with a schizophrenia diagnosis were significantly less likely to discontinue switched medication or to receive acute care in comparison to those with schizoaffective disorder. Women were significantly more likely to discontinue switched medication than men. Of those requiring acute care, only 38% had required this in the previous 2 years. Antipsychotic market withdrawal has demonstrable negative clinical implications and requires careful clinical management. Increased acute care rates in those receiving an atypical LAI versus a typical depot following pipotiazine suggests lower effectiveness or possible withdrawal effects. No significant difference between depots, LAIs and oral medications on discontinuation supports the importance of a collaborative, fully informed approach when deciding next treatment options.


Lipschütz [corrected] ulcers--four cases.
A distinctive clinical entity of acute genital ulcers occurring in adolescents, with nonvenereal infectious etiology was described by Lipschütz in 1913. We describe four puberal virgin girls who developed fever and painful genital ulcers. The main causes infectious and noninfectious of ulceration were rejected. Although the etiology is unknown, recent cases related with Epstein-Barr virus acute infection have been reported.


Glial heterotopia of the lip: A rare presentation.
Glial heterotopia represents collections of normal glial tissue in an abnormal location distant to the central nervous system or spinal canal with no intracranial connectivity. Nasal gliomas are non-neoplastic midline tumours, with limited growth potential and no similarity to the central nervous system gliomas. The nose and the nasopharynx are the most common sites of location. Existence of glial heterotopia in the lip region is a rare developmental disorder. We report a case of large glial heterotopia in the upper lip region in a full-term female newborn which had intracranial extension with a fibrotic band. After the surgery, there was no recurrence in the follow-up period of 3 years. When glial heterotopia, which is a rare midline anomaly, is suspected, possible intracranial connection and properties of the mass should be evaluated by magnetic resonance imaging. By this way, lower complication rate and better aesthetic results can be achieved with early diagnosis and proper surgery.


Development of a novel recessive genetic male sterility system for hybrid seed production in maize and other cross-pollinating crops.
We have developed a novel hybridization platform that utilizes nuclear male sterility to produce hybrids in maize and other cross-pollinating crops. A key component of this platform is a process termed Seed Production Technology (SPT). This process incorporates a transgenic SPT maintainer line capable of propagating nontransgenic nuclear male-sterile lines for use as female parents in hybrid production. The maize SPT maintainer line is a homozygous recessive male sterile transformed with a SPT construct containing (i) a complementary wild-type male fertility gene to restore fertility, (ii) an α-amylase gene to disrupt pollination and (iii) a seed colour marker gene. The sporophytic wild-type allele complements the recessive mutation, enabling the development of pollen grains, all of which carry the recessive allele but with only half carrying the SPT transgenes. Pollen grains with the SPT transgenes exhibit starch depletion resulting from expression of α-amylase and are unable to germinate. Pollen grains that do not carry the SPT transgenes are nontransgenic and are able to fertilize homozygous mutant plants, resulting in nontransgenic male-sterile progeny for use as female parents. Because transgenic SPT maintainer seeds express a red fluorescent protein, they can be detected and efficiently separated from seeds that do not contain the SPT transgenes by mechanical colour sorting. The SPT process has the potential to replace current approaches to pollen control in commercial maize hybrid seed production. It also has important applications for other cross-pollinating crops where it can unlock the potential for greater hybrid productivity through expanding the parental germplasm pool.


Health status and health service utilization in remote and mountainous areas in Vietnam.
Self-rated health status and healthcare services utilization are important indicators to evaluate the performance of health system. In disadvantaged areas, however, little is known about the access and outcomes of health care services. This study aimed to assess health-related quality of life (HRQOL), health status and healthcare access and utilization of residents in mountainous and remote areas in Vietnam. A cross-sectional study was conducted in a convenient sample of residents in two provinces of Vietnam. Information about socio-economic, health status, HRQOL, healthcare seeking and services utilization were interviewed. EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5 L) was used to measure HRQOL. Of 200 respondents, mean age was 44.9 (SD = 13.9), 38.0 % were male. One third reported having any problem in Mobility, Usual activities, Pain or Discomfort, Anxiety or Depression. Women tended to suffer more problems in Pain/Discomfort and Anxiety/Depression and lower overall HRQOL than men. Over 90 % of respondents reported at least one health problem. Flu, cold and headache were the most commonly reported symptoms (41.5 %). Most of people preferred community health center when they had illness (96.0 %). Only 18.5 % people used traditional healers with the average of 5.8 times per year. Ethnicity, households' expenditure, illness and morbidity status, difficulty in accessing health care services were related to HRQOL.; Meanwhile, socioeconomic status, health problems, quality of services, and distances were associated with access to healthcare and traditional medicine services. Residents in difficult-to-reach areas had high prevalence of health problems and experienced social and structural barriers of healthcare services access. It is necessary to improve the availability and quality of healthcare and traditional medicine services to improve the health status of disadvantaged people.


Effect of fining and filtration on the haze formation in bayberry (Myrica rubra Sieb. et Zucc.) juice.
Bayberry juice was fined with the methods of xanthan/chitosan (XC) or gelatin/bentonite (GB), and then filtered with diatomaceous earth filtration (DF) or ultrafiltration (UF, MWCO 100 kDa). Their effects on juice haze formation were investigated. The XC fining method was more effective than the GB method in removal of the total monomeric anthocyanin, total phenolics, and protein, with less haze formed in the XC fined juice. The DF reduced 2-5% of the total phenolics and 21-23% of protein, while UF reduced 19-24% of the total phenolics and 34-38% of protein, respectively. The results showed that fining and then UF can reduce but cannot eliminate haze formation in bayberry juice. The storage temperature was a critical factor affecting haze formation, and the juice was more stable when stored at lower temperature (4 degrees C).


Research on the use intention of potential designers of unmanned cars based on technology acceptance model.
The success of unmanned car, an emerging tool of transportation with so many advantages, depends to a large extent on its user acceptability. Potential designers are both the decision makers of driverless car design and the users of driverless cars. This study aims to explore the influencing factors of the potential designers' intention to use unmanned cars. Based on the theory of Technology Acceptance Model (TAM), this study further expanded the TAM by incorporating perceived trust, perceived enjoyment and self-efficacy, so as to explain and predict potential designers' intention to use unmanned cars. The questionnaire is determined through theoretical literature, pre-tests, etc., and the Structural Equation Model is used to analyze the data of 202 valid survey samples to investigate the influencing factors of the willingness to use unmanned vehicles. The results show that potential designers' intention to use unmanned cars is positively affected by perceived trust, perceived enjoyment, perceived usefulness and perceived ease of use, and perceived trust has a positive effect on perceived ease of use, self-efficacy and perceived ease of use also have a positive effect on perceived usefulness. The findings of this study can provide designers and developers of unmanned cars, policy makers and implementers with guidance in the follow-up design, policy formulation and advertising of unmanned cars.


Monoamine transporter availability in Parkinson's disease patients with or without depression.
Depression is a common symptom in patients suffering from Parkinson's disease (PD) and markedly reduces their quality of life. As post-mortem studies have shown, its presence may reflect extensive cell loss in the midbrain and brainstem with imbalances in monoaminergic neurotransmitters. However, in vivo evidence of specific monoaminergic deficits in depressed PD patients is still sparse. Therefore, we studied PD patients with depression (PD+D) and without depression (PD-D) using high-resolution single-photon emission computed tomography (SPECT) and the monoamine transporter marker [(123)I]FP-CIT. A magnetic resonance imaging-based region-of-interest analysis was applied to quantify the specific-to-nondisplaceable [(123)I]FP-CIT binding coefficient V(3)'' in the striatum, thalamus and midbrain/brainstem regions. PD+D patients had significantly lower V(3)'' compared with PD-D patients in the striatum (p<0.001), thalamus (p=0.002), and midbrain/brainstem (p=0.025). Only PD+D patients without selective serotonin reuptake inhibitor (SSRI) treatment showed lower thalamic and midbrain V(3)'' than controls (p<0.001, p=0.029). In a small sub-group of SSRI-treated PD+D patients neither thalamic V(3)'' nor midbrain/brainstem V(3)'' differed from those in PD-D patients (p=0.168, p=0.201) or controls (p=0.384, p=0.318). Our data indicate that depression in PD is associated with a more pronounced loss of striatal dopamine transporter availability that is most likely secondary to increased dopaminergic degeneration. In addition, depressed PD patients have a lower availability of midbrain/brainstem monoamine transporters than nondepressed PD patients. These findings provide in vivo evidence in support of the known post-mortem data demonstrating more extensive nerve cell loss in PD with depression and indicate that SPECT imaging can help to identify pathophysiological changes underlying nonmotor symptoms in this common movement disorder.


Militarism, human welfare, and the APA Ethical Principles of Psychologists.
A case study is presented of the American Psychological Association (APA), as a health care organization that promotes human welfare. APA includes policies on human welfare in its Ethical Principles of Psychologists and even lists the advancement of psychology "as a means of promoting human welfare" on its letterhead. Nevertheless, APA has other policies and activities based on military and weapons work that appear to conflict with its promotion of human welfare. Although military work in and of itself may not necessarily be problematic, work that contributes to people purposely being harmed or killed should be squared with the association's ethical guidelines. The results presented here show that this may not be the case: There currently appears to be little justification in the Ethical Principles for work intended to harm people. APA's active lobbying, research, and development for the military are documented here, in relation to an analysis of the Ethical Principles. APA's uncritical support for Operation Desert Storm is examined specifically, with regard to weapons technology and therapeutic treatment of U.S. soldiers on the battlefield. This one-sided support for victims of the war is not in keeping with a Hippocratic health care ethic to treat patients needing care, and to do so with neutrality and impartiality. Similarities to a historical example of nationalistic mental health ethics are discussed, with a review of the development of the German Institute for Psychological Research and Psychotherapy and of the German Society for Psychology in the Nazi wartime effort and the Holocaust. The results here show similar deficiencies in APA's ethical standards, not the least of which is that the code applies to individual members but not to APA policies, committees, or activities. This article concludes with suggested criteria for the Ethical Principles that would at least (a) recognize the ambiguities in systematically developing and using weapons to hurt people and (b) provide an initial rationale of potential justifications.


Fistula-in-ano. A six year follow up study of 143 operated patients.
Of 143 patients operated upon for anal fistulae, all but eight have healed satisfactorally, Impaired healing was seen in patients with high fistulae operated with a modified Elting repair, and in patients suffering from Crohn's disease. When the internal opening was localized and the fistula laid open and excised, healing took place in almost all cases. This method may cause incontinence with high fistulae, and other methods must be used. A loop suture technique gave satisfoactory results both in regard to healing and anal control. Following a modified Elting repair in nine cases, recurrence was seen in four. However, we still believe this method is of value since it leaves the sphincters intact.


Lack of CYP3A inhibition effects of sertindole on terfenadine in healthy volunteers.
The effect of sertindole (a new selective antipsychotic compound) on the pharmacokinetic disposition of terfenadine was investigated. Thirteen subjects who completed the study received a single 120 mg dose of terfenadine alone or with concomitant 20 mg sertindole daily. The mean values for terfenadine Cmax (alone: 2.42 +/- 1.48 ng/ml, in combination: 2.99 +/- 1.85 ng/ml) and AUC (29.6 +/- 18.9 vs 37.9 +/- 23.4 ng x hr/ml) did not change statistically significant in the presence of sertindole (p > 0.05). Similarly, the mean Cmax (531 +/- 195 vs 506 +/- 190 ng/ml) and AUC (3,728 +/- 1,163 vs 4,003 +/- 1,739 ng x hr/ml) values of carboxyterfenadine did not change statistically significant in the presence of sertindole (p > 0.05). The other pharmacokinetic parameters of terfenadine and carboxyterfenadine such as Tmax, t1/2, as well as the carboxyterfenadine to terfenadine Cmax and AUC ratios did not change in the presence of sertindole. Although terfenadine is a substrate for CYP3A (cytochrome P-450 3A), while sertindole is a substrate for both CYP2D6 and CYP3A4, the results in this study suggest that sertindole, at a clinical dose, is not an inhibitor of the metabolism of terfenadine.


Identification and quantification of aflatoxins and aflatoxicol from poultry feed and their recovery in poultry litter.
Aflatoxins (AF) are toxic fungal secondary metabolites and are known mycotoxins pathological to animals and humans. Poultry litter is frequently used as a food supplement for ruminants, and when poultry feed contains AF, the litter becomes contaminated as well, thus having an effect on livestock health. This study identified and quantified AF (AFB(1), AFB(2), AFG(1), and AFG(2)) from poultry feed and their recovery, together with their metabolites (AFM(1), AFM(2), AFP(1), and aflatoxicol) in litter. An experiment with 25 Hy-Line W-36 hens, in their second production stage, 121 wk old, was carried out. Hens were distributed in 3 groups placed in individual cages and 1 ration of 250 g of feed was given to each hen daily. Nine hens of the control group were fed with clean feed, without AFB(1); the other 2 experimental groups, with 8 hens each, were fed with 2 AFB(1) concentrations: 30 and 500 microg.kg(-1). The feed was replaced and weighed daily throughout a 7-d period to register the amount of feed consumed by the hens. Litter from each hen was collected, weighed, and dried individually. The chemical analysis of 40 g of each one of the 200 feed and 200 litter samples was chemically extracted and concentrated with immunoaffinity columns for total AF. To quantify AF, calibration curves for each AF were done by HPLC. Feed samples of the 3 groups presented significant difference with AFB(2) and AFG(2), whereas in litter samples, there were significant differences for AFG(2) in the 500 microg.kg(-1) group. Poultry litter had traces of AFM(1), AFM(2), AFP(1), and AFL with no significant differences among treatments. Aflatoxin B(1) prevalence in litter samples can cause damages in livestock because this mycotoxin reduces the digestibility of ruminant feed up to 67%.


Genetically encoded fluorescent sensors reveal dynamic regulation of NADPH metabolism.
Reduced nicotinamide adenine dinucleotide phosphate (NADPH) is essential for biosynthetic reactions and antioxidant functions; however, detection of NADPH metabolism in living cells remains technically challenging. We develop and characterize ratiometric, pH-resistant, genetically encoded fluorescent indicators for NADPH (iNap sensors) with various affinities and wide dynamic range. iNap sensors enabled quantification of cytosolic and mitochondrial NADPH pools that are controlled by cytosolic NAD+ kinase levels and revealed cellular NADPH dynamics under oxidative stress depending on glucose availability. We found that mammalian cells have a strong tendency to maintain physiological NADPH homeostasis, which is regulated by glucose-6-phosphate dehydrogenase and AMP kinase. Moreover, using the iNap sensors we monitor NADPH fluctuations during the activation of macrophage cells or wound response in vivo. These data demonstrate that the iNap sensors will be valuable tools for monitoring NADPH dynamics in live cells and gaining new insights into cell metabolism.


Local thermotherapy of the benign prostate: a 1-year follow-up.
Local hyperthermia to the prostate has initially been found to be of considerable beneficial value in cancer of the gland and later also in benign prostatic hypertrophy (BPH) and in chronic prostatitis. The Prostathermer has been especially developed and used for this purpose. 124 patients with BPH, who have been treated by this method, were reevaluated after 1 year. This thermotherapy was well tolerated, and no noticeable complications were encountered. A sustained definite improvement in objective and subjective obstructive symptoms and signs was seen in 51% of the cases. Such definite and persistent improvement was best obtained when treatments were performed twice weekly for 60 min over a period of 3 weeks. Those patients with the more severe obstructive symptoms fared best. A full explanation for the effectiveness of this treatment of BPH has yet to be found. Although local hyperthermia cannot, at this stage, be considered as a radical form of treatment of BPH, it may offer definite relief to about 50% of the cases, particularly to those unwilling or unsuitable for surgery.


Radiofrequency ablation of the occipital nerves for treatment of neuralgias and headache.
The purpose of this study was to retrospectively assess the efficacy of radiofrequency ablation (RFA) therapy as a treatment for occipital neuralgias and headaches at health clinics in the United States between January 1, 2015 and June 20, 2022. We hypothesize that RFA is a minimally invasive treatment that provides significant pain relief long-term for occipital neuralgias and associated headaches. This retrospective analysis studies data collected from 277 occipital nerve RFA patients who had adequate pre-procedure and post-procedure follow-up for data analysis. Data collected includes the patient's age, biological sex, BMI, headache diagnosis, pre-procedure, and post-procedure pain score using the visual analog scale (VAS), subjective percent improvement in symptom(s), and duration of symptom relief. Statistical analysis used SPSS software, version 26 (IBM), using a paired t-test to assess the significance between pre and post-occipital RFA therapy pain scores. p-values were significant if found to be ≤0.05. The mean pre-procedure pain score before RFA therapy for patients who completed at least 6 months of follow-up was 5.57 (SD = 1.87) and the mean post-procedure pain score after RFA therapy was 2.39 (SD = 2.42). The improvement in pain scores between pre-procedure and post-procedure was statistically significant with a p-value < 0.001. The mean patient-reported percent improvement in pain following RFA therapy was 63.53% (SD = 36.37). The mean duration of pain improvement was 253.9 days after the initiation of therapy (SD = 300.5). When excluding patients who did not have any relief following their RFA procedure, the average pre-procedure pain score was 5.54 (SD = 1.81) and post-procedure pain score was 1.71 (SD = 1.81) with a p-value < 0.001. This study demonstrates the minimally invasive, safe, and effective treatment of RFA in patients with refractory occipital neuralgias and headaches. Additional studies are necessary to illuminate ideal patient characteristics for RFA treatment and the potential for procedural complications and long-term side effects associated with occipital nerve RFA therapy.


Exploring the dynamics of reaction N+SiH(4) with crossed molecular-beam experiments and quantum-chemical calculations.
We investigated the reaction N((4)S,(2)D,(2)P)+SiH(4) in crossed molecular beams at a collision energy of 4.7 kcal mol(-1) with a time-of-flight mass spectrometer and selective photoionization. Ion signals were observed at m/z=42-45, associated with two product channels, HSiNH/SiNH(2)+H+H and HSiN/HNSi+H(2)+H. The species producing the signal at m/z=43 is assigned to product HSiN/HNSi and that at m/z=44 to product HSiNH/SiNH(2). The signal observed at m/z=42 is attributed to daughter ions of those two products and that at m/z=45 to (29)Si and (30)Si isotopic variants. We report time-of-flight spectra as a function of laboratory angle and simulations for the two products, from which both kinetic-energy and angular distributions of products in the center-of-mass (c.m.) frame were derived. The dependence of release of kinetic energy on the c.m. scattering angle is weak. The average translational energy released is 7.7 kcal mol(-1) for product channel HSiNH/SiNH(2)+H+H and 30.3 kcal mol(-1) for product channel HSiN/HNSi+H(2)+H. Through consecutive triple fragmentation, the angular distribution is slightly anisotropic for product HSiNH/SiNH(2) but isotropic for product HSiN/HNSi. Assuming equal efficiencies of detection, we estimate the branching ratios of products HSiNH/SiNH(2) and HSiN/HNSi to be roughly 15:85. To facilitate an understanding of the reaction mechanisms, we calculated the potential-energy surface for reaction N((2)D)+SiH(4) with quantum-chemical methods. Reactions N((2)D)+SiH(4)-->SiNH(2)+H+H and N((2)D)+SiH(4)-->HNSi+H(2)+H account satisfactorily for the present experimental results. Isomeric products HSiNH and HSiN are minor in this work.


Correlates of HIV infection among street-based and venue-based sex workers in Vietnam.
Commercial sex work is one of the driving forces of the HIV epidemic across the world. In Vietnam, although female sex workers (FSWs) carry a disproportionate burden of HIV, little is known about the risk profile and associated factors for HIV infection among this population. There is a need for large-scale research to obtain reliable and representative estimates of the measures of association. This study involved secondary data analysis of the 'HIV/STI Integrated Biological and Behavioral Surveillance' study in Vietnam in 2009-2010 to examine the correlates of HIV among FSWs. Data collected from 5298 FSWs, including 2530 street-based sex workers and 2768 venue-based sex workers from 10 provinces in Vietnam, were analyzed using descriptive statistics and bivariate and multivariate logistic regression analyses. HIV prevalence among the overall FSW population was 8.6% (n = 453). However, when stratified by FSW subpopulations, HIV prevalence was 10.6% (n = 267) for street-based sex workers and 6.7% (n = 186) for venue-based sex workers. Factors independently associated with HIV infection in the multivariate analysis, regardless of sex work types, were injecting drug use, high self-perceived HIV risk, and age ≥ 25 years. Additional factors independently associated with HIV risk within each FSW subpopulation included having ever been married among street-based sex workers and inconsistent condom use with clients and having sex partners who injected drugs among venue-based sex workers. Apart from strategies addressing modifiable risk behaviours among all FSWs, targeted strategies to address specific risk behaviours within each FSW subpopulation should be adopted.


A study on the extraction of chitin and chitosan from the invasive sea urchin Diadema setosum from Iskenderun Bay in the Northeastern Mediterranean.
This work presents, for the first time, the extraction and characterization of chitin and chitosan from the testa (T) and spines (S) of the invasive sea urchin (Diadema setosum) from the İskenderun Bay in the Northeastern Mediterranean. Testa chitin (T-CT), spine chitin (S-CT), testa chitosan (T-CS), and spine chitosan (S-CS) were isolated following demineralization, deproteinization (chitin), and deacetylation (chitosan). The yield of chitin extraction from dry sea urchin testa (T-CT) and spines (S-CT) were 57.2 ± 1.43% and 67.1 ± 0.17%, respectively. The yield of chitosan produced from extracted testa (T-CS) and spines (S-CS) chitin were 87.3 ± 1.82% and 74.04 ± 1.27%, respectively. Degree of deacetylation (DD%) value were calculated using FT-IR (84.19% and 85.80%), resulting in a high DD. They were perfectly soluble in acidic solution. We also characterized the isolated chitin (T-CT and S-CT) and chitosan (T-CS and S-CS) by determining its physicochemical properties using X-ray powder diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), and scanning electron microscope analysis (SEM). Overall, the results indicated that the preparation of chitin and chitosan from the invasive sea urchin testa and spines could open the opportunity for the value-added seafood waste to be utilized in a wide range of practical applications such as medicine, pharmaceutical, and biotechnology.


Lysosome-targeted silicon quantum dots theranostics for simultaneous fluorescent imaging and photodynamic therapy.
As an emerging treatment method, photodynamic therapy (PDT) has attracted considerable interest due to the characteristics of non-invasiveness, repeatable treatment, high spatiotemporal resolution and few side effects. However, the life span (<40 ns) and diffusion distance (<20 nm) of reactive oxygen species such as singlet oxygen (1O2) in tumor cells are extremely short, which has seriously limited therapeutic efficacy of PDT. The enrichment site of photosensitizers in cancer cells is usually the first site of PDT action, which will not only affect the biological signaling pathway of cancer cell death, but also is closely related to the final therapeutic effect. Therefore, the design and preparation of photosensitizers targeting specific subcellular organelles can directly break the biological function of the organelle and trigger the corresponding cell death signaling pathway, which can significantly improve the efficacy of PDT. Herein, a lysosome-targeted silicon quantum dots (L-Si QDs) was first made by diethylene glycol-mediated synthetic route as a multicolor fluorescent imaging reagents and a new photosensitizer. The as-prepared L-Si QDs exhibit bright fluorescence with excellent pH stability and time stability, excitation-dependent emission, and good biocompatibility. Furthermore, the results of cell experiments showed that L-Si QDs was accumulated in lysosomes after being taken up by cancer cells, and can efficiently produce1O2upon 635 nm laser irradiation, which can damage lysosomes, up-regulate cleavage caspase-3, increase Bax release, down-regulate Bcl-2 and induce cell apoptosis finally. This study significantly broadens the biomedical applications of silicon quantum dots and provides excellent nanomaterials candidates for tumor phototherapy.


Computer-based three-dimensional measurement of carpal alignment: measurement techniques and normal ranges.
The three-dimensional carpal alignment was measured in the neutral wrist position in 121 asymptomatic volunteers using computer-based cone-beam CT analysis. Normal values and the reliability of the automated analysis are reported. An analysis software based on segmentation of CT images and mathematical modelling was used to determine several axis variants based on different landmarks and to calculate the intercarpal angles automatically. Twenty wrists were imaged twice to determine intra-observer reliability. Mean values using the preferred axis variants were: scapholunate angle 57° (SD 9°), radiolunate angle 2° (SD 10°), lunocapitate angle -14° (SD 9°). Using alternate axis variants notably changed the angles produced. The intra-observer reliability of the analysis was excellent (mean intraclass correlation coefficient 0.97, SD 0.03). Computer-based CT analysis enables highly reproducible and automated assessment of carpal alignment. This study provides a reference database for measurement techniques and normal carpal angle values in three-dimensional imaging.


Poly lactic acid--caprolactone copolymer tube with a denatured skeletal muscle segment inside as a guide for peripheral nerve regeneration: a morphological and electrophysiological evaluation of the regenerated nerves.
A biodegradable copolymer of poly L-lactic acid and epsilon-caprolactone (PLAC) was manufactured into a tube, in which a denatured skeletal muscle segment was placed longitudinally. This model tube was implanted as a guide to promote nerve regeneration across a 5 cm gap in the rabbit sciatic nerve. Five months after implantation, good nerve regeneration was found throughout the graft and in the distal host nerve. The population (29.6/16 x 10(2) microm(2)) of regenerated nerves in the graft was higher than that of the contralateral normal sciatic nerve (18.0/16 x 10(2) microm(2)). Regenerated nerve fibers extended to the distal host nerve. The number of myelinated fibers was 13.7/16 x 10(2) microm(2) at a level 1.5 cm from the distal suture. The diameters (below 2 microm) of most regenerated myelinated (nerves in the graft and in the distal host nerve were much smaller than those (6-8 microm) of normal nerves. Electrophysiological evaluation showed that the hindlimb muscle (gastrocnemius) was innervated by motor nerves in all animals 5 months after implantation. These results indicate that the PLAC tube with a denatured muscle segment inside provided good conditions for nerve fiber regrowth. The PLAC tube is thought to protect the denatured muscle segment from rapid dissociation in the host tissue.


The role of contour polarity, objectness, and regularities in haptic and visual perception.
Regularities like symmetry (mirror reflection) and repetition (translation) play an important role in both visual and haptic (active touch) shape perception. Altering figure-ground factors to change what is perceived as an object influences regularity detection. For vision, symmetry is usually easier to detect within one object, whereas repetition is easier to detect across two objects. For haptics, we have not found this interaction between regularity type and objectness (Cecchetto & Lawson, Journal of Experimental Psychology: Human Perception and Performance, 43, 103-125, 2017; Lawson, Ajvani, & Cecchetto, Experimental Psychology, 63, 197-214, 2016). However, our studies used repetition stimuli with mismatched concavities, convexities, and luminance, and so had mismatched contour polarities. Such stimuli may be processed differently to stimuli with matching contour polarities. We investigated this possibility. For haptics, speeded symmetry and repetition detection for novel, planar shapes was similar. Performance deteriorated strikingly if contour polarity mismatched (keeping objectness constant), whilst there was a modest disadvantage for between-2objects:facing-sides compared to within-1object:outer-sides comparisons (keeping contour polarity constant). For the same task for vision, symmetry detection was similar to haptics (strong costs for mismatched contour polarity, weaker costs for between-2objects:facing-sides comparisons), but repetition detection was very different (weak costs for mismatched contour polarity, strong benefits for between-2objects:facing-sides comparisons). Thus, objectness was less influential than contour polarity for both haptic and visual symmetry detection, and for haptic repetition detection. However, for visual repetition detection, objectness effects reversed direction (within-1object:outer-sides comparisons were harder) and were stronger than contour polarity effects. This pattern of results suggests that regularity detection reflects information extraction as well as regularity distributions in the physical world.


Development of a continuous testing apparatus for temperature reduction performance of cool coatings.
The working principle of a continuous testing apparatus for the temperature reduction performance of cool coatings is presented in this work. The apparatus consists of infrared reflector type lamps, an adiabatic box, and a data acquisition system. It was calibrated with the different conventional reference panels. The tests for dynamic and steady state temperature reduction performances were illustrated with two cool coatings. Results obtained directly from the simultaneous measurement are in good agreement with those calculated from separate measurements, thus confirming this apparatus as a valuable experimental tool for research and development of cool coatings.


Botulinum toxin for treatment of Raynaud phenomenon in CREST syndrome.
Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome is a form of a rare, clinical subtype of systemic sclerosis, known as limited systemic sclerosis. Limited systemic sclerosis, including CREST syndrome, manifests as fibrotic skin changes restricted to the hands and face, with vascular, musculoskeletal, and visceral involvement. We present a case of a 75-year-old woman with a longstanding history of CREST syndrome complicated by a digital ulceration and persistent pain associated with recalcitrant Raynaud phenomenon. After failing a number of first-line pharmacologic therapies such as diltiazem, sildenafil, and topical nitropaste, the patient was started on a trial of botulinum toxin for the left second digit, with 10 unit injections into both webspaces for a total of 20 units. Following injection, the patient reported no further baseline pain in the affected finger and an over fifty-percent improvement in discomfort with manipulation of the digit at a follow-up time of one week. The ulceration started healing within the following three weeks. This result was maintained at a follow-up time of six weeks.


Effect of additional polishing methods on the physical surface properties of different nanocomposites: SEM and AFM study.
This evaluated the arrangement of filler particles in depth of nanocomposites, and surface roughness, wettability, microtopography, and micromorphology following additional polishing step. Forty samples of each composite tested [Filtek Z350XT (FZ), IPS Empress Direct (IP)] were fabricated and finished/polished/additionally polished using one of the following methods (n = 10/group): no finishing/polishing (NFP), Sof-Lex Pop-On + no additional polishing (SP), Sof-Lex Pop-On + Astropol rubber polisher (SP+A), and Sof-Lex Pop-On + felt disc with polishing paste (SP+FP). Surface roughness (Ra) and contact angles were measured using a profilometer and goniometer, respectively. Microtopography and micromorphology were evaluated using atomic force microscopy and scanning electron microscopy, respectively. Ra and contact angle data were examined by two-way analysis of variance and Tukey's test (p < .05). Organic matrix, lower and larger filler particles were disposed in depth. Mean Ra values were lowest and contact angles were smallest in the NFP group for both composite resins. SP+A and SP+FP decreased mean Ra in comparison with SP for FZ, whereas only SP+FP decreased mean Ra in comparison with SP for IP. Only SP+FP increased contact angles in comparison with SP for FZ, whereas contact angles in the SP+A, SP+FP, and SP groups were similar for FZ. Both composites presented more uniform topography and smother surfaces following SP+A and SP+FP in comparison with SP. Therefore, additional polishing improved surface smoothness and decreased wettability of the composite resins studied. SP+FP produced smoother and less wettable surfaces for FZ and IP.


Transactivation of proenkephalin gene by HTLV-1 tax1 protein in glial cells: involvement of Fos/Jun complex at an AP-1 element in the proenkephalin gene promoter.
The human T-cell lymphotropic virus type 1 (HTLV-1), an etiologic agent for adult T-cell leukemia, is strongly associated with tropical spastic paraparesis, a chronic neurological disease. The HTLV-1 genome encodes a protein, tax1, an autoregulator of enhanced viral RNA transcription, that also transactivates/represses certain cellular gene promoters. Enkephalins are opioid peptides that function as neurotransmitters and neuroimmunomodulators. We earlier reported that the proenkephalin gene is transactivated by tax1 protein in glial cells. The nucleotide sequence upstream of -190 base pairs in the proenkephalin gene promoter is necessary for maximal transactivation by tax1 while the sequence downstream of -190 bp confers modest activation by tax1. We investigated the cellular transcription factors in tax1 expressing glial cells that associate with the proenkephalin promoter and herein demonstrate the enhanced interaction and involvement of c-Fos/c-Jun proteins in the complexes formed at the AP-1 site. The HTLV-1 tax1 expressing stable glial cell lines produced functional tax1 protein that increased the expression of endogenous proenkephalin gene. The comparative electrophoretic mobility shift and 'supershift' analysis using specific antibodies indicated the enhanced presence of c-Fos and c-Jun proteins in the DNA: protein complex formed at the AP-1 site. The c-Fos protein expression significantly increased in the tax1 expressing glial cells. The tax1 induced c-Fos protein levels and the concurrently increased association of c-Fos/c-Jun transcription factors at the AP-1 site imply a strong functional significance in the activation of proenkephalin gene expression in tax1 expressing glial cells.


Reactive oxygen species and platelet-activating factor synthesis in age-related glomerulosclerosis.
This work deals with the hypothesis that an increased synthesis of reactive oxygen species (ROS) or platelet-activating factor (PAF) (or both) may be implied in the genesis of age-related glomerulosclerosis. Plasma concentration and urinary excretion of both thiobarbituric acid-reactive substances (TBARS) and PAF were measured in young and old human beings and rats. Moreover, these same parameters as well as H2O2 synthesis and reduced glutathione (GSH) content were measured in isolated glomeruli of young (3 months) and old (18 months) Wistar rats. H2O2 synthesis and GSH content were also measured in cultured rat mesangial cells from young and old animals. Both human beings and rats showed a decreased glomerular filtration rate and an increased urinary protein excretion with respect to young individuals. Isolated glomeruli from old animals showed a higher protein content and a lower number of cell nuclei than those from young rats. No changes were detected in plasma concentration and urinary excretion of TBARS and PAF in either human beings or rats. Glomeruli from 18-month-old rats exhibited a higher content of TBARS and GSH and an increased synthesis of H2O2 and PAF than did those from 3-month-old rats. GSH content and H2O2 synthesis were higher in cultured cells from old rats than in those from young rats. These results point to the possibility that ROS or PAF could mediate some of the changes that characterize age-related glomerulosclerosis.


Is There More Than One Road to Nevus-Associated Melanoma?
The association of melanoma with a preexisting nevus is still a debated subject. Histopathological data support an associated nevus in approximately 30% of all excised melanomas. The annual risk of an individual melanocytic nevus becoming malignant is extremely low and has been estimated to be approximately 0.0005% (or less than 1 in 200,000) before the age of 40 years, to 0.003% (1 in 33,000) in patients older than 60 years. Current understanding, based on the noticeable, small, truly congenital nevi and nevi acquired early in life, is that the first develops before puberty, presents with a dermoscopic globular pattern, and persists for the lifetime, becoming later a dermal nevus in the adult. In contrast, acquired melanocytic nevi develop mostly at puberty and usually undergo spontaneous involution after the fifth decade of life. The purpose of this review is to analyze the data of the literature and to propose, on the basis of epidemiological and clinical-dermoscopic characteristics, a new model of melanogenesis of nevus-associated melanoma.


Distinctive denitrifying capabilities lead to differences in N2O production by denitrifying polyphosphate accumulating organisms and denitrifying glycogen accumulating organisms.
This study aims at investigating the denitrification kinetics in two separate enriched cultures of denitrifying polyphosphate accumulating organisms (dPAO) and denitrifying glycogen accumulating organisms (dGAO) and compare their N2O accumulation potential under different conditions. Two sequencing batch reactors were inoculated to develop dPAO and dGAO enriched microbial communities separately. Seven batch tests with different combinations of electron acceptors (nitrate, nitrite and/or nitrous oxide) were carried out with the enriched biomass from both reactors. Results indicate that in almost all batch tests, N2O accumulated for both cultures, however dPAOs showed a higher denitrification capacity compared to dGAOs due to their higher nitrogen oxides reduction rates. Additionally, the effect of the simultaneous presence of several electron acceptors in the reduction rates of the different nitrogen oxides was also assessed in dPAOs and dGAOs.


Molecular imaging of phosphorylation events for drug development.
Protein phosphorylation mediated by protein kinases controls numerous cellular processes. A genetically encoded, generalizable split firefly luciferase (FL)-assisted complementation system was developed for noninvasive monitoring phosphorylation events and efficacies of kinase inhibitors in cell culture and in small living subjects by optical bioluminescence imaging. An Akt sensor (AST) was constructed to monitor Akt phosphorylation and the effect of different PI-3K and Akt inhibitors. Specificity of AST was determined using a non-phosphorylable mutant sensor containing an alanine substitution (ASA). The PI-3K inhibitor LY294002 and Akt kinase inhibitor perifosine led to temporal- and dose-dependent increases in complemented FL activities in 293T human kidney cancer cells stably expressing AST (293T/AST) but not in 293T/ASA cells. Inhibition of endogenous Akt phosphorylation and kinase activities by perifosine also correlated with increase in complemented FL activities in 293T/AST cells but not in 293T/ASA cells. Treatment of nude mice bearing 293T/AST xenografts with perifosine led to a 2-fold increase in complemented FL activities compared to that of 293T/ASA xenografts. Our system was used to screen a small chemical library for novel modulators of Akt kinase activity. This generalizable approach for noninvasive monitoring of phosphorylation events will accelerate the discovery and validation of novel kinase inhibitors and modulators of phosphorylation events.


Histological evidence for muscle insertion in extant amniote femora: implications for muscle reconstruction in fossils.
Since the 19th century, identification of muscle attachment sites on bones has been important for muscle reconstructions, especially in fossil tetrapods, and therefore has been the subject of numerous biological and paleontological studies. At the microscopic level, in histological thin sections, the only features that can be used reliably for identifying tendon-bone or muscle-tendon-bone interactions are Sharpey's fibers. Muscles, however, do not only attach to the bone indirectly with tendons, but also directly. Previous studies failed to provide new indicators for muscle attachment, or to address the question of whether muscles with direct attachment can be identified histologically. However, histological identification of direct muscle attachments is important because these attachments do not leave visible marks (e.g. scars and rugosities) on the bone surface. We dissected the right hind limb and mapped the muscle attachment sites on the femur of one rabbit (Oryctolagus cuniculus), one Alligator mississippiensis, and one turkey (Meleagris cuniculus). We then extracted the femur and prepared four histological thin sections for the rabbit and the turkey and five histological thin sections for the alligator. Sharpey's fibers, vascular canal orientation, and a frayed periosteal margin can be indicators for indirect but also direct muscle attachment. Sharpey's fibers can be oriented to the cutting plane of the thin section at high angles, and two Sharpey's fibers orientations can occur in one area, possibly indicating a secondary force axis. However, only about 60% of mapped muscle attachment sites could be detected in thin sections, and frequently histological features suggestive of muscle attachment occurred outside mapped sites. While these insights should improve our ability to successfully identify and reconstruct muscles in extinct species, they also show the limitations of this approach.


Polycations which disorganize the outer membrane inhibit conjugation in Escherichia coli.
Outer membrane disorganizing polycation, polymyxin B nonapeptide (PMBN), reduced drastically the production of recombinants when present at sub-MIC concentrations during F'-mediated Escherichia coli conjugation. The decrease of recombinants was accompanied by a less marked decrease of viability in the recipient population in a manner resembling lethal zygosis. No reduction was seen when either donor or recipient was grown in the same PMBN concentration, washed and resuspended to PMBN-free medium before mating. The same concentration of outer membrane disorganizing polycations of higher bactericidal activity (protamine and polylysine) caused only a moderate reduction in transconjugant frequency when present during mating. Spermine and tetralysine, which are not effective disorganizers of the outer membrane, did not reduce the recombinant frequency or the viability of the recipients.


A SHH-responsive signaling center in the forebrain regulates craniofacial morphogenesis via the facial ectoderm.
Interactions among the forebrain, neural crest and facial ectoderm regulate development of the upper jaw. To examine these interactions, we activated the Sonic hedgehog (SHH) pathway in the brain. Beginning 72 hours after activation of the SHH pathway, growth within the avian frontonasal process (FNP) was exaggerated in lateral regions and impaired in medial regions. This growth pattern is similar to that in mice and superimposed a mammalian-like morphology on the upper jaw. Jaw growth is controlled by signals from the frontonasal ectodermal zone (FEZ), and the divergent morphologies that characterize birds and mammals are accompanied by changes in the FEZ. In chicks there is a single FEZ spanning the FNP, but in mice both median nasal processes have a FEZ. In treated chicks, the FEZ was split into right and left domains that resembled the pattern present in mice. Additionally, we observed that, in the brain, fibroblast growth factor 8 (Fgf8) was downregulated, and signals in or near the nasal pit were altered. Raldh2 expression was expanded, whereas Fgf8, Wnt4, Wnt6 and Zfhx1b were downregulated. However, Wnt9b, and activation of the canonical WNT pathway, were unaltered in treated embryos. At later time points the upper beak was shortened owing to hypoplasia of the skeleton, and this phenotype was reproduced when we blocked the FGF pathway. Thus, the brain establishes multiple signaling centers within the developing upper jaw. Changes in organization of the brain that occur during evolution or as a result of disease can alter these centers and thereby generate morphological variation.


Statistical consideration in testing for assay sensitivity in a "thorough" QT study.
The current guidelines, ICH E14, for the evaluation of non-antiarrhythmic compounds recommends a "thorough" QT study (TQT) to be conducted during clinical development. Typically the treatment arms in the TQT study should include study drug at therapeutic and supra-therapeutic doses, placebo and a positive control such as Moxifloxacin (Avelox). The current hypothesis for assay sensitivity involves testing at pre-selected time points, where electrocardiograms (ECG) are obtained, if the mean baseline adjusted differences between positive control and placebo are greater than 5 ms. Since multiple time points are tested, the overall type I error rate should be adjusted using an appropriate multiple comparison procedure. In this article, we consider some recently proposed tests (Zhang, 2008) and explore the use of some standard global test procedures such as O'Brien's ordinary least squares (OLS) and Lauter's standardized sum (SS) tests for testing sensitivity of positive control. The powers of several test procedures are evaluated using simulation. The simulation shows that Zhang's method performs quite well in general but the OLS and SS tests have higher power when the coefficient of variations of QTc intervals have high heterogeneity.


Do the rat anterior thalamic nuclei contribute to behavioural flexibility?
The rodent anterior thalamic nuclei (ATN) are vital for spatial memory. A consideration of their extensive frontal connections suggests that these nuclei may also subserve non-spatial functions. The current experiments explored the importance of the ATN for different aspects of behavioural flexibility, including their contribution to tasks typically associated with frontal cortex. In Experiment 1, rats with ATN lesions were tested on a series of response and visual discriminations in an operant box and, subsequently, in a water tank. The tasks included assessments of reversal learning as well switches between each discrimination dimension. Results revealed a mild and transient deficit on the operant task that was not specific to any stage of the procedure. In the water tank, the lesion animals were impaired on the reversal of a spatial discrimination but did not differ from controls on any other measure. Experiment 2 examined the impact of ATN damage on a rodent analogue of the 'Stroop', which assesses response choice during stimulus conflict. The lesion animals successfully acquired this task and were able to use contextual information to disambiguate conflicting cue information. However, responding during the initial presentation of conflicting cue information was affected by the lesion. Taken together, these results suggest that the ATN are not required for aspects of behavioural flexibility (discrimination learning, reversals or high-order switches) typically associated with the rat medial prefrontal cortex. The results from Experiment 2 suggest that the non-spatial functions of the ATN may be more aligned with those of the anterior cingulate cortex.


Adenovirus 12S E1A gene represses differentiation of F9 teratocarcinoma cells.
The F9 teratocarcinoma cell line differentiates in vitro after treatment with retinoic acid and cAMP and has been a widely used model system for the study of the molecular events that are responsible for cellular commitment and differentiation during early development. Previous experiments have suggested intriguing parallels between the control of gene expression during F9 cell differentiation and the regulation of gene expression by adenovirus E1A. Transfection of a 12S E1A-expressing plasmid into terminally differentiated, nonproliferating F9 cells generates, at high frequency, colonies of dividing cells, each of which expresses E1A. Cell lines established from these colonies proliferate in the presence of retinoic acid and have lost the fully differentiated phenotype as characterized by the absence of expression of a series of differentiation-specific genes. We conclude that expression of the viral 12S E1A gene product interferes with retinoic acid-induced F9 cell differentiation. Moreover, the results suggest that the differentiation process, as defined by markers of terminal differentiation, may not be a permanent event but can be reversed by E1A expression.


Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings.
Secondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors. We conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors. Baseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end-line distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end-line distress. We found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism. Clinical Trials NCT02390778 . Retrospectively registered 19 March 2015. The Good Schools Trial was registered at ( NCT01678846 ), on August 24, 2012.


Short Peptides Directing 1D Helical Arrays of Polyoxometalates with Controllable Pitches.
A series of cationic peptides with alternating hydrophilic and hydrophobic residues were elaborately designed and synthesized. These kinds of short peptides with protonated lysine groups can interact with anionic polyoxometalate nanoclusters through multivalent ionic bonds and hydrogen bonds, resulting in the formation of helical polyoxometalate arrays in aqueous solution. Fourier transform infrared (FTIR) spectroscopy, circular dichroism (CD), transmission electron microscopy (TEM), and dynamic light scattering (DLS) were utilized to characterize the self-assembled structures. TEM revealed that the polyoxometalate clusters form periodic arrays within the helical nanofibers. This work reports that the handedness of the helical fibers was attributed to the precise chirality expression of peptides. The l-type peptide directed the formation of left-handed polyoxometalate arrays, whereas right-handed polyoxometalate arrays were observed when the peptide was constituted by d-amino acids. It was also found that the pitch of the helical nanofibers is inversely proportional to the hydrophobicity of peptides with less hydrophobicity giving a larger helical pitch.


Characterization of suppressor cells in anterior chamber-associated immune deviation (ACAID) induced by soluble antigen. Evidence of two functionally and phenotypically distinct T-suppressor cell populations.
A large body of information exists describing the inability of animals receiving inoculations of antigen either intravenously (i.v.) or via the anterior chamber of the eye (AC) to mount delayed hypersensitivity (DH) responses to the injected antigen. Evidence indicates that the deviant humoral and cellular immunity that follows AC and i.v. inoculations of antigen is mediated, in part, by active suppression. Because of these similarities, it has been argued that immune deviation resulting from the AC inoculation [anterior chamber-associated immune deviation (ACAID)] of antigen represents nothing more than deviant immune responses known to be induced by the i.v. inoculation of antigens. Since circumstantial evidence suggests that AC injections may have unique immune effects, we wished to test the hypothesis that AC exposure to antigen elicits a unique form of systemic immune regulation. We have studied and compared the functional and phenotypic properties of suppressor cell populations induced by AC and i.v. inoculations of a soluble antigen, bovine serum albumin (BSA). Results indicate that AC inoculations of BSA (but not i.v. inoculations) activate antigen-specific. CD8+, I-J+ T lymphocytes which suppress the expression of DH responses, i.e. efferent suppression. We further report that AC and i.v. injection routes both activate antigen-specific afferent suppressor cell populations which impair the inductive phase of the immune response. However, the i.v.-induced afferent suppressor cells are CD8+ I-J+, whereas the AC-induced afferent suppressor cells are CD4+. We conclude that AC and i.v. exposures to soluble antigens are not immunologically equivalent, and that ACAID represents a uniquely regulated systemic immune response to intraocular antigens.


Metal-organic framework materials promote neural differentiation of dental pulp stem cells in spinal cord injury.
Spinal cord injury (SCI) is accompanied by loss of Zn2+, which is an important cause of glutamate excitotoxicity and death of local neurons as well as transplanted stem cells. Dental pulp stem cells (DPSCs) have the potential for neural differentiation and play an immunomodulatory role in the microenvironment, making them an ideal cell source for the repair of central nerve injury, including SCI. The zeolitic imidazolate framework 8 (ZIF-8) is usually used as a drug and gene delivery carrier, which can release Zn2+ sustainedly in acidic environment. However, the roles of ZIF-8 on neural differentiation of DPSCs and the effect of combined treatment on SCI have not been explored. ZIF-8-introduced DPSCs were loaded into gelatin methacryloyl (GelMA) hydrogel and in situ injected into the injured site of SCI rats. Under the effect of ZIF-8, axon number and axon length of DPSCs-differentiated neuro-like cells were significantly increased. In addition, ZIF-8 protected transplanted DPSCs from apoptosis in the damaged microenvironment. ZIF-8 promotes neural differentiation and angiogenesis of DPSCs by activating the Mitogen-activated protein kinase (MAPK) signaling pathway, which is a promising transport nanomaterial for nerve repair.


Efficiency of Matricaria chamomilla CH12 and number of doses of rabies vaccine on the humoral immune response in cattle.
This study evaluated the effect of Matricaria chamomilla and vaccination frequency on cattle immunization against rabies. Four groups (n = 15 /group) were treated with or without Matricaria chamomilla CH12 and vaccinated with one or two doses of rabies vaccine (30 day interval). No effect of chamomile was found on cattle immunization against rabies; however, antibody titers were protective in cattle vaccinated twice, while 93.3% of cattle vaccinated only once had titers under 0.5 UI/ml after 60 days. In conclusion, the use of chamomile did not alter the humoral immune response in cattle, and two vaccine doses are suggested for achieving protective antibody titers.


Hybridizing machine learning in survival analysis of cardiac PET/CT imaging.
Machine Learning (ML) allows integration of the numerous variables delivered by cardiac PET/CT, while traditional survival analysis can provide explainable prognostic estimates from a restricted number of input variables. We implemented a hybrid ML-and-survival analysis of multimodal PET/CT data to identify patients who developed myocardial infarction (MI) or death in long-term follow up. Data from 739 intermediate risk patients who underwent coronary CT and selectively stress 15O-water-PET perfusion were analyzed for the occurrence of MI and all-cause mortality. Images were evaluated segmentally for atherosclerosis and absolute myocardial perfusion through 75 variables that were integrated through ML into an ML-CCTA and an ML-PET score. These scores were then modeled along with clinical variables through Cox regression. This hybridized model was compared against an expert interpretation-based and a calcium score-based model. Compared with expert- and calcium score-based models, the hybridized ML-survival model showed the highest performance (CI .81 vs .71 and .64). The strongest predictor for outcomes was the ML-CCTA score. Prognostic modeling of PET/CT data for the long-term occurrence of adverse events may be improved through ML imaging score integration and subsequent traditional survival analysis with clinical variables. This hybridization of methods offers an alternative to traditional survival modeling of conventional expert image scoring and interpretation.


16-Isopropyl-5,9-dimethyl-tetra-cyclo-[10.2.2.0.0]hexa-dec-15-ene-5,13,14-trimethanol ethanol monosolvate.
The title compound, C(24)H(40)O(3)·C(2)H(6)O, is a substituted tetra-cyclo-[10.2.2.0(1,10).0(4,9)]hexa-decane derivative obtained from the reduction of maleopimaric acid which was isolated from a maleic anhydride modified rosin. In the crystal, the triol mol-ecule and the ethanol solvent mol-ecule are linked by hydroxyl O-H⋯O hydrogen bonds, giving a two-dimensional network structure.


Spin glasses in the nonextensive regime.
Spin systems with long-range interactions are "nonextensive" if the strength of the interactions falls off sufficiently slowly with distance. It has been conjectured for ferromagnets and, more recently, for spin glasses that, everywhere in the nonextensive regime, the free energy is exactly equal to that for the infinite range model in which the characteristic strength of the interaction is independent of distance. In this paper we present the results of Monte Carlo simulations of the one-dimensional long-range spin glasses in the nonextensive regime. Using finite-size scaling, our results for the transition temperatures are consistent with this prediction. We also propose and provide numerical evidence for an analogous result for dilutedlong-range spin glasses in which the coordination number is finite, namely, that the transition temperature throughout the nonextensive regime is equal to that of the infinite-range model known as the Viana-Bray model.


Therapeutic Plasmapheresis Enabling Radioactive Iodine Treatment in a Patient with Thyrotoxicosis.
Therapeutic plasma exchange (TPE) is one possible treatment for patients resistant to conventional antithyroid drugs or requiring urgent attention for thyrotoxicosis. We report a 35-yr-old man with thyrotoxicosis, ultimately attributed to Graves' disease in whom antithyroid drug used initially was soon discontinued, due to abnormal liver function, and replaced by Lugol's solution. Three weeks later, an escape phenomenon (to Lugol's solution) was apparent, so we performed TPE to control the thyrotoxicosis. Two courses of TPE by a centrifugal type machine resulted in diminished levels of thyroid hormone levels, which then rebounded after another two courses of membrane filtration type TPE. However, the patient could be treated with radioactive iodine therapy without any complications at present.


Universal spectral statistics in Wigner-Dyson, chiral, and Andreev star graphs. II. Semiclassical approach.
A semiclassical approach to the universal ergodic spectral statistics in quantum star graphs is presented for all known ten symmetry classes of quantum systems. The approach is based on periodic orbit theory, the exact semiclassical trace formula for star graphs, and on diagrammatic techniques. The appropriate spectral form factors are calculated up to one order beyond the diagonal and self-dual approximations. The results are in accordance with the corresponding random-matrix theories which supports a properly generalized Bohigas-Giannoni-Schmit conjecture.


Using portfolios in the assessment of learning and competence: the impact of four models.
This paper discusses the diversity of portfolio use highlighted in a study funded by the English National Board for Nursing, Midwifery and Health Visiting exploring the effectiveness of portfolios in assessing learning and competence (). Data collection was undertaken in two stages: through a national telephone survey of Higher Education Institutions (HEIs) delivering nursing programmes (stage 1); and through four in-depth case studies of portfolios use (stage 2). Data collection for stage two was undertaken through field work in four HEIs purporting to use portfolios as an assessment strategy, and their associated clinical placement settings. Four approaches to the structure and use of portfolios were evident from the stage 2 case study data; these were characterised as: the shopping trolley; toast rack; spinal column and cake mix. The case study data also highlighted the evolutionary nature of portfolio development and a range of additional factors influencing the effectiveness of their use, including language of assessment, degree of guidance and expectations of clinical and academic staff.


Toward quantitative electronic structure in small gold nanoclusters.
Ligand-protected gold nanoclusters (AuNCs) feature a dense but finite electronic structure that can be rationalized using qualitative descriptions such as the well-known superatomic model and predicted using quantum chemical calculations. However, the lack of well-resolved experimental probes of a AuNC electronic structure has made the task of evaluating the accuracy of electronic structure descriptions challenging. We compare electronic absorption spectra computed using time-dependent density functional theory to recently collected high resolution experimental spectra of Au9(PPh3)8 3+ and Au8(PPh3)7 2+ AuNCs with strikingly similar features. After applying a simple scaling correction, the computed spectrum of Au8(PPh3)7 2+ yields a suitable match, allowing us to assign low-energy metal-metal transitions in the experimental spectrum. No similar match is obtained after following the same procedure for two previously reported isomers for Au9(PPh3)8 3+, suggesting either a deficiency in the calculations or the presence of an additional isomer. Instead, we propose assignments for Au9(PPh3)8 3+ based off of similarities Au8(PPh3)7 2+. We further model these clusters using a simple particle-in-a-box analysis for an asymmetrical ellipsoidal superatomic core, which allows us to reproduce the same transitions and extract an effective core size and shape that agrees well with that expected from crystal structures. This suggests that the superatomic model, which is typically employed to explain the qualitative features of nanocluster electronic structures, remains valid even for small AuNCs with highly aspherical cores.


Propagation of avalanches in Mn12-acetate: magnetic deflagration.
Local time-resolved measurements of fast reversal of the magnetization of single crystals of Mn12-acetate indicate that the magnetization avalanche spreads as a narrow interface that propagates through the crystal at a constant velocity that is roughly 2 orders of magnitude smaller than the speed of sound. We argue that this phenomenon is closely analogous to the propagation of a flame front (deflagration) through a flammable chemical substance.


[Clinical application of bisphosphonate's pharmacokinetic principles].
Bisphosphonates are a group of osteotropic substances able to modulate bone metabolism in different ways. They all display similar pharmacokinetic characteristics when administered in proportional dosages and assessed by similar methods. With the exception of olpadronate which is soluble in water, bisphosphonates have poor solubility, and may easily precipitate in the digestive media. In spite of their low digestive absorption (Bioavailability: 0.3-5%), they are effectively administered by oral route. Once in plasma they distribute rapidly, being uptaked by mineralized tissues, plasma proteins or eliminated by renal filtration in few minutes. The fraction retained in bones may be stored for long periods (from months up to 10 years depending on the compound) in an apparent inactive compartment. The risks of newly released molecules may be related to the potency of the drug. Within the clinical range of doses, bisphosphonates are not retained in soft tissues. This may explain the lack of extraskeletal collateral effects. Plasma blood levels are scarcely related to the clinical activity. Therefore, dosage may be guided better by biochemical markers of the bone disease than by the standard kinetic variables. On the other hand, dose is independent from age and/or body weight. Only renal impairment may induce additional dose adjustments.


Monitoring internal training load and salivary immune-endocrine responses during an annual judo training periodization.
The objective of this study was to examine the internal training load (TL), IgA, and salivary steroid hormone responses in elite youth judo athletes during an entire annual training periodization. Ten male judo athletes (18±2 years, 72.3±12.3 kg, and 175±6 cm) competing at a state/national level were examined for the TL and salivary imune-endocrine responses variations over an annual judo season, divided in three macrocyles composed by distinct periods denominated preparatory period (PP), competitive period (CP) and transition period (TP). At the end of PP and CP, saliva samples were collected to determine cortisol, testosterone and IgA concentrations. Throughout PP and CP the session-rating of perceived exertion and the total duration of each session were monitored, allowing the internal TL and weekly training strain (TS) calculation. During all macrocycles, significant decreases in TL and TS were observed during CP compared with PP (P<0.05), although no significant differences were observed for immune-endocrine concentrations between PP and CP (P>0.05). Specific variations were observed comparing periods with similar characteristics throughout the macrocycles as higher TL and TS (PP1 to PP2 and PP3, P<0.05), increased testosterone (CP1 to CP3, P=0.024) and decreased testosterone-cortisol ratio (PP1 to PP2, P=0.005). The present findings suggest that the internal TL variations over an annual multipeak traditional periodization did not influence the resting mucosal immune-endocrinal responses in young judo athletes.


Pancreatic steatorrhea, malabsorption, and nutrition biochemistry: a comparison of Japanese, European, and American patients with chronic pancreatitis.
This article reports on steatorrhea, daily food intake, and fecal substances other than fecal fat (e.g., neutral sterols, bile acids, short-chain fatty acids) in pancreatic exocrine dysfunction arising from chronic pancreatitis (CP) in Japanese. European, and American patients. Changes in upper small intestinal pH and lipase secretion, plasma fatty acid profiles, serum fat-soluble vitamin levels and symptoms of their deficiency, and nutritional status are discussed in detail. Treatment of pancreatic steatorrhea is described. Throughout this study, we compared characteristics of maldigestion and malabsorption in these patient populations and our study revealed that fecal fat excretion reflected quantitative differences in fat consumption, plasma fatty acid profiles reflected quantitative and qualitative differences in fish oil consumption, and there were no differences in pancreatic exocrine dysfunction among these three groups. Since differences in fecal fat excretion and plasma fatty acid profiles appear to depend on dietary fats, the pathology and treatment of CP patients should be evaluated and the findings used to prescribe treatments.


The Endoscopic Submucosal Dissection Surgery in the Whole-Course Antegrade Endoscopic Approach: A More Effective Treatment Strategy for the Siewert II/III Type Mucosal Lesions of Esophagogastric Junction.
Objective: The purpose of this study was to investigate the safety and efficacy of endoscopic submucosal dissection (ESD) for treating cardiac mucosal lesions. Methods: A total of 86 patients with cardiac mucosal lesions were treated with ESD in retrograde endoscopic approach or antegrade endoscopic approach. The relationship between the two methods was analyzed according to the size, location, depth of pathological infiltration, classification, and examination results. The main evaluation indexes of intraoperative complications were operation time, bleeding, perforation, and complete resection (R0 resection). Results: Total R0 excision was performed in 85 patients and curative excision in 77 patients. When the diameter of lesion was 2-4 cm or >4 cm, the median treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .001, respectively). When the lesion was confined to the mucosa, the median treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .001). When the lesion was located in the posterior wall of the cardia, the average treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .05). When the lesion was located in the lesser curvature of the cardia, the average treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .001). Conclusion: The ESD surgery in the antegrade endoscopic approach is effective and safe for the treatment of cardiac mucosal lesions.


Deep learning powered coronary CT angiography for detecting obstructive coronary artery disease: The effect of reader experience, calcification and image quality.
To investigate the effect of reader experience, calcification and image quality on the performance of deep learning (DL) powered coronary CT angiography (CCTA) in automatically detecting obstructive coronary artery disease (CAD) with invasive coronary angiography (ICA) as reference standard. A total of 165 patients (680 vessels and 1505 segments) were included in this study. Three sessions were performed in order: (1) The artificial intelligence (AI) software automatically processed CCTA images, stenosis degree and processing time were recorded for each case; (2) Six cardiovascular radiologists with different experiences (low/ intermediate/ high experience) independently performed image post-processing and interpretation of CCTA, (3) AI + human reading was performed. Luminal stenosis ≥50% was defined as obstructive CAD in ICA and CCTA. Diagnostic performances of AI, human reading and AI + human reading were evaluated and compared on a per-patient, per-vessel and per-segment basis with ICA as reference standard. The effects of calcification and image quality on the diagnostic performance were also studied. The average post-processing and interpretation times of AI was 2.3 ± 0.6 min per case, reduced by 76%, 72%, 69% compared with low/ intermediate/ high experience readers (all P < 0.001), respectively. On a per-patient, per-vessel and per-segment basis, with ICA as reference method, the AI overall diagnostic sensitivity for detecting obstructive CAD were 90.5%, 81.4%, 72.9%, the specificity was 82.3%, 93.9%, 95.0%, with the corresponding areas under the curve (AUCs) of 0.90, 0.90, 0.87, respectively. Compared to human readers, the diagnostic performance of AI was higher than that of low experience readers (all P < 0.001). The diagnostic performance of AI + human reading was higher than human reading alone, and AI + human readers' ability to correctly reclassify obstructive CAD was also improved, especially for low experience readers (Per-patient, the net reclassification improvement (NRI) = 0.085; per-vessel, NRI = 0.070; and per-segment, NRI = 0.068, all P < 0.001). The diagnostic performance of AI was not significantly affected by calcification and image quality (all P > 0.05). AI can substantially shorten the post-processing time, while AI + human reading model can significantly improve the diagnostic performance compared with human readers, especially for inexperienced readers, regardless of calcification severity and image quality.


Super-resolution and apodization with discrete adaptive optics.
High-resolution imaging is of great importance in various fields. The use of pupil phase-only filters (PPF) exceeds the diffraction limit of the imaging system in a simple way. When dealing with distorted wavefronts, however, PPF require that aberrations be compensated for. In this paper, we introduce a novel technique consisting of the use of discrete adaptive optics with PPFs so that the compensating device implements the PPF at the same time. Analysis of the theory for point spread function reshaping using PPFs has enabled us to develop a new approach to characterizing apodizing filters. A validation experiment has been carried out, the first of its kind to our knowledge, in which a number of PPFs were combined with two levels of compensation. Our experimental results are discussed.


Colorectal cancer screening compliance and contemplation in gynecology patients.
Colorectal cancer screening (CRCS) should be a necessary part of gynecology (GYN) providers' preventive practices. The purpose of our study is to examine CRCS recommendations and adherence in this population. A questionnaire was administered to a prospective cohort of patients awaiting health maintenance exams at six academic and private gynecology offices. Patients reported demographics, CRC/breast/cervical screening adherence, CRCS recommendations, and future likelihood of CRCS. A total of 461 women aged 51 years and older completed the questionnaire. Sixty-six percent of respondents were compliant with CRCS compared to 93% and 86% for breast and cervical cancer screening, respectively (p < 0.001). GYN providers recommended CRCS in 43% of patients. Sixty-three percent were planning to undergo future CRCS. On multivariable analysis, characteristics associated with CRCS adherence included (odds ratio, 95% confidence interval): older age (1.1 per year, 1.1-1.2), previous mammography (3.7, 1.4-9.7), family history (FH) of CRC/polyps (1.9, 1.0-3.4), friend with CRC (2.6, 1.5-4.7), and any doctor recommending CRCS (8.2, 4.6-14.7). CRCS rates were higher among patients who received a recommendation from a PCP (primary care provider) than from a GYN provider. Factors associated with intention to undergo CRCS include previous mammography (1.4, 4.2-12.0), any doctor recommendation (6.4, 3.7-11.0), and FH of CRC/polyps (3.5, 1.9-6.3). CRCS recommendations by both GYNs and PCPs had a greater impact on CRCS contemplation than those from a PCP or GYN alone. In gynecology patients, having multiple providers recommend CRCS increases the likelihood of patients' intentions to undergo CRCS. However, CRCS compliance is primarily driven solely by PCP recommendations. Regardless, strategies must be in place to prompt gynecologists and nurse practitioners to discuss CRCS in eligible patients.


A new high-throughput screening-compatible gap junctional intercellular communication assay.
Gap junctions (GJs) are intercellular channels through which molecules smaller than 1 kDa can diffuse, and they have been suggested as drug targets. To develop chemical drugs acting on this target, a high-throughput screening (HTS) system for GJ modulators is necessary. We designed a new, high-throughput GJ intercellular communication (GJIC) assay. This assay system consisted of donor and acceptor cells from LN215 glioma cells that expressed SLC26A4 and yellow fluorescent protein-H148Q/I152L (YFP(QL)), respectively. The fluorescence of LN215-YFP(QL) acceptor cells, when cultured alone, was not quenched by iodide. However when donor and acceptor cells, or LN215-YFP(QL) and LN215-I(-) cells, were mixed and plated, they formed GJs. When iodide was added, it was transported into donor cells by SLC26A4, diffused through the GJs to acceptor cells, and quenched the YFP(QL) fluorescence. The quenching rate was optimal at a 2:1 mixture of donor and acceptor cells. The assay quality parameter, Z' factor, was calculated from data collected with vehicle and carbenoxolone. For each assay, the Z' factor increased with time. The Z' factor of a 10-s assay was 0.72 indicating that the assay quality was high enough for use in HTS. This assay system also worked well in HOS osteosarcoma cells with a Z' factor at 10 s of 0.70. We developed a new HTS system for GJ modulators. The system had a high assay quality with a Z' factor ≥ 0.70, was rapid and required only 10 s per well, was inexpensive in requiring no additional reagents, and was predicted to have a low rate of false-positive hits.


Frequency of anti-Chlamydia trachomatis antibodies in infertile women referred to Tabriz Al-Zahra hospital.
Infertility is one of the major issues in society and its incidence is estimated to be almost 10-15%. Chlamydia trachomatis (C. trachomatis) is an important cause of sexually transmitted diseases leading to infertility. This study was designed to determine the frequency of anti-C. trachomatis antibodies in infertile women at Al-zahra hospital, Tabriz, Iran. In this cross-sectional study, the blood samples were collected randomly from 184 infertile women (case group) and 100 pregnant women (control group). The frequency of specific IgG and IgM anti-C. trachomatis antibodies were evaluated using ELISA method. The frequency of IgG anti-C. trachomatis antibody in the control and case groups was 18% and 35.88%, respectively. IgM anti-C. trachomatis antibody was found in 2% of controls and 5.44% of infertile women. Our results showed the significant differences between the case and control groups in anti-C. trachomatis antibodies (IgG, p=0.035 and IgM, p=0.004). Also, no significant relation was seen between the frequency of anti-C. trachomatis antibodies and age, location, and tubal factor infertility in our two study groups. According to high frequency of antibody anti-C. trachomatis among infertile women in competition to the control group, evaluation and treatment of Chlamydia infections is necessary in these patients.