[Precision of conventional simulation: which extent of accuracy is reachable in head and neck region?].
In this prospective investigation we tested the absolute accuracy of a conventional localization of the isocenter obtained from a three-dimensional treatment plan in conformal radiotherapy of head and neck tumors. 41 isocenters in 41 consecutive patients with histologically proven tumors of the brain or head and neck region were included into this investigation. In all cases a stereotactic mask (Stryker-Leibinger) was made for fixation and positioning of the patients. The stereotactically guided fractionated radiotherapy was carried out on the base of CT and MRI. The stereotactic coordinates were defined by an external localization system. Afterwards each patient underwent a conventional simulation using exclusively anatomical reference points. Additionally, the patients were adjusted to the linac isocenter using a stereotactic targeting device. Deviations between the simulated and the external adjusted target point coordinates were recorded in X-, Y- and Z-direction and spatial error was calculated. Mean deviation was 2.15, 2.54, and 2.69 mm for X-, Y-, and Z-direction, respectively. The largest deviation was found in Z-direction with a maximum of over 11 mm. The spatial deviation per patient amounted 1.3-12.2 mm with a mean of 5.1 and a median value of 4.5 mm. That means that in half of the cases a deviation of 5 up to over 12 mm occurs in conventional simulation. Only in a quarter of the sample the deviation was 4 mm or below. The planning target volume definition requires a consideration of the inaccuracy of the conventional simulation. A reduction of the safety margin in the planning target volume assumes the use of the stereotactic target positioner. This is to postulate especially for the treatment of benign lesions or lesions or lesions adjacent to critical structures.


Integration of mental health services into primary care overcomes ethnic disparities in access to mental health services between black and white elderly.
The authors evaluated whether the integration of mental health into primary care overcomes ethnic disparities in access to and participation in mental health (MH) and substance abuse (SA) treatment. The authors conducted site-specific analysis of a multisite clinical trial to compare participation of black and white elderly in an integrated model of care (all MH/SA services are provided at primary care clinics) versus an enhanced referral model of care (all MH/SA services are provided at specialized MH clinics). In all, 183 elderly (56% black) diagnosed with depression (82%), anxiety (32%), and/or problem drinking (22%) were randomized. Blacks in the integrated arm were significantly more likely to have at least one MH/SA visit (77.5%) relative to blacks in the enhanced referral arm (22%; adjusted odds ratio [OR]: 14.13; confidence interval [CI]: 4.76-41.95, Wald chi(2): 22.75, df = 1, p <0.0001). There was no statistically significant difference between whites in the integrated treatment arm (66.6%) and whites in the enhanced referral arm (46.9%, adjusted OR: 2.98; CI: 0.98-9.06, Wald chi(2): 3.72, df = 1, p = 0.05). In the enhanced referral arm, blacks had a significantly smaller number of overall MH/SA visits (mean [SD]: 2.08 [5.28]) relative to whites (mean [SD]: 5.31 [7.76], adjusted incident rate ratio [IRR]: 2.87; CI: 1.06-7.73, Wald chi(2): 4.37, df = 1, p = 0.03). In the integrated arm, there was no statistically significant difference between blacks (mean [SD]: 3.22 [3.71]) and whites (mean [SD]: 2.75 [4.29], adjusted IRR: 0.58; CI: 0.25-1.33, Wald chi(2): 1.64, df = 1, p = 0.20). For both groups, time between baseline evaluation to first MH/SA visit was significantly shorter in the integrated treatment arm (for blacks: mean days [SD]: 31.06 [28.66]; for whites: mean days [SD]: 22.18 [33.88]) than in the enhanced referral arm (mean [SD]: 62.45 [43.53], adjusted hazard ratio [HR]: 7.82; CI: 3.65-16.75, Wald chi(2): 28.02, df = 1, p <0.0001; mean [SD]: 63.46 [32.41], adjusted HR: 2.48; CI: 1.20-5.13, Wald chi(2): 6.02, df = 1, p = 0.01, respectively). An integrated model of care is particularly effective in improving access to and participation in MH/SA treatment among black primary care patients.


The volumetric-tumour histogram-based analysis of intravoxel incoherent motion and non-Gaussian diffusion MRI: association with prognostic factors in HER2-positive breast cancer.
To evaluate the imaging biomarkers of human epidermal growth factor receptor 2 (HER2) positive breast cancer in comparison to other molecular subtypes and to determine the feasibility of identifying hormone receptor (HR) status and lymph node metastasis status using volumetric-tumour histogram-based analysis through intravoxel incoherent motion (IVIM) and non-Gaussian diffusion. This study included 145 breast cancer patients with 148 lesions between January and November in 2018. Among the 148 lesions, 74 were confirmed to be HER2-positive. The volumetric-tumour histogram-based features were extracted from the combined IVIM and non-Gaussian diffusion model. IVIM and non-Gaussian diffusion parameters obtained from images of the subjects with different molecular prognostic biomarker statuses were compared by Student's t test or the Mann-Whitney U test. The area under the curve (AUC), sensitivity, and specificity at the best cut-off point were reported. The Spearman correlation coefficient was calculated to analyse the correlations of clinical tumor nodule metastasis (TNM) stage and Ki67 with the IVIM and non-Gaussian diffusion parameters. The entropy of mean kurtosis (MK) was significantly higher in the HER2-positive group than in the HER2-negative group (p = 0.015), with an AUC of 0.629 (95% CI 0.546, 0.707), a sensitivity of 62.6%, and a specificity of 66.2%. For HR status, the MD 5th percentile was higher in the HR-positive group of HER2-positive breast cancer (p = 0.041), with an AUC of 0.643 (95% CI 0.523, 0.751), while for lymph node status, the entropy of mean diffusivity (MK) was lower in the lymph node positive group (p = 0.040), with an AUC of 0.587 (95% CI 0.504, 0.668). The clinical TNM stage and Ki67 index were correlated with several histogram parameters. Volumetric-lesion histogram analysis of IVIM and the non-Gaussian diffusion model can be used to provide prognostic information about HER2-positive breast cancers and potentially contribute to individualized anti-HER2 targeted therapy plans .


Adverse events due to change in organization of problem drug users' treatment?
This study set out to identify any undesirable consequences of legislative change in the organization of the treatment of problem drug users (PDUs), which aimed to combine their social and medical care. The method used was a register-based three-year follow-up prevalent cohort study. On 1 January 1996, the law was changed to allocate unambiguous and undivided responsibility for the combined social and medical care of PDUs in Denmark. The main objective of the legislative change was to move PDUs from treatment by general practitioners (GPs) and at private clinics to treatment institutions under the control of the counties. The possibility remained that medical treatment could, however, continue to be given by GPs or private clinics, based on specific agreements. The study showed that at the end of the period, 31 December 1998, two-thirds remained in treatment at private clinics or at GP surgeries. During the period only 8% of users were at some time without methadone treatment; 2% remained without methadone treatment throughout the study period. The transition from GPs and private clinics to the county treatment centres went smoothly. The number of PDUs in MMT (methadone maintenance treatment) in the city of Copenhagen increased in the period 1995 to 1998. The average quantity of methadone given to the cohort increased during these years from 72 mg per day to 92 mg per day. The legislative change therefore did not result in a higher threshold for treatment or a more restrictive prescription of methadone. No adverse effect on crime, hospital admissions, or death could be attributed to the legislative change in treatment organization.


MBD3/NuRD loss participates with KDM6A program to promote DOCK5/8 expression and Rac GTPase activation in human acute myeloid leukemia.
Cancer genome sequencing studies have focused on identifying oncogenic mutations. However, mutational profiling alone may not always help dissect underlying epigenetic dependencies in tumorigenesis. Nucleosome remodeling and deacetylase (NuRD) is an ATP-dependent chromatin remodeling complex that regulates transcriptional architecture and is involved in cell fate commitment. We demonstrate that loss of MBD3, an important NuRD scaffold, in human primary acute myeloid leukemia (AML) cells associates with leukemic NuRD. Interestingly, CHD4, an intact ATPase subunit of leukemic NuRD, coimmunoprecipitates and participates with H3K27Me3/2-demethylase KDM6A to induce expression of atypical guanine nucleotide exchange factors, dedicator of cytokinesis (DOCK) 5 and 8 (DOCK5/8), promoting Rac GTPase signaling. Mechanistically, MBD3 deficiency caused loss of histone deacytelase 1 occupancy with a corresponding increase in KDM6A, CBP, and H3K27Ac on DOCK5/8 loci, leading to derepression of gene expression. Importantly, the Cancer Genome Atlas AML cohort reveals that DOCK5/ 8 levels are correlated with MBD3 and KDM6A, and DOCK5/ 8 expression is significantly increased in patients who are MBD3 low and KDM6A high with a poor survival. In addition, pharmacological inhibition of DOCK signaling selectively attenuates AML cell survival. Because MBD3 and KDM6A have been implicated in metastasis, our results may suggest a general phenomenon in tumorigenesis. Collectively, these findings provide evidence for MBD3-deficient NuRD in leukemia pathobiology and inform a novel epistasis between NuRD and KDM6A toward maintenance of oncogenic gene expression in AML.-Biswas, M., Chatterjee, S. S., Boila, L. D., Chakraborty, S., Banerjee, D., Sengupta, A. MBD3/NuRD loss participates with KDM6A program to promote DOCK5/8 expression and Rac GTPase activation in human acute myeloid leukemia.


Molecular dynamic heterogeneity in relation to free volume and relaxation dynamics in organic glass-formers: oligomeric cis-1,4-poly(isoprene).
Herein, a combined study of the molecular rotation dynamics and free volume in cis-1,4-poly(isoprene) using two external probing techniques via ESR and PALS together with relaxation dynamics of the host medium via BDS is presented. The spectral evolution of the spin probe TEMPO from simulations over a wide range from 100 K up to 300 K exhibits three different regions of its correlation time consisting of a slow regime at low temperatures followed by the molecular dynamic heterogeneity zone from T = T = 155 K = 0.82 × T up to Tc ≅ 236 K = 1.26 × T and ending with a fast regime at high temperatures with the further characteristic ESR temperatures, T = 186 K ≅ T and T = 260 K. These are in close coincidence with four characteristic PALS temperatures: T = 160 K, T = 190 K, T = 227 K, and T = 263 K. Finally, using BDS, we revealed that the high-frequency features of the structural relaxation of 1,4-PIP 0.8k were related to the observed effects in the ESR and PALS response of the liquid state.


Oral administration of l-carnitine improves the clinical outcome of fertility in patients with IVF treatment.
Age-dependent decline of mitochondrial function has been proposed to be a main cause of decline of embryo quality. Then, l-carnitine plays important roles in reducing the membranous toxicity of free-fatty acids by forming acyl-carnitine and promoting β-oxidation, preventing cell damage. Recent research revealed that l-carnitine played important roles in vitro in oocyte growth, oocyte maturation and embryo development. However, such beneficial effects of l-carnitine in vivo have yet to be verified. The effect of oral l-carnitine supplementation on embryo quality and implantation potential was examined. A total of 214 patients were included in this study. They all previously received in vitro fertilization-embryo transfer (IVF-ET) and failed to conceive. Then they were administered l-carnitine for 82 days on average and underwent IVF-ET again. There were no significant differences in the total number of retrieved oocytes, and their maturation and fertilization rates between before and after l-carnitine administration. The quality of embryos on Days 3 and 5 after insemination was improved following l-carnitine administration (p < .05) in cycles after l-carnitine administration compared with previous cycles. Healthy neonates were born after IVF-ET following l-carnitine administration. Our data suggested that oral administration of l-carnitine to fertility patients improved the developmental competence of their oocytes after insemination.


Seemingly asymmetric atom-localized electronic densities following laser-dissociation of homonuclear diatomics.
Recent experiments on laser-dissociation of aligned homonuclear diatomic molecules show an asymmetric forward-backward (spatial) electron-localization along the laser polarization axis. Most theoretical models attribute this asymmetry to interference effects between gerade and ungerade vibronic states. Presumably due to alignment, these models neglect molecular rotations and hence infer an asymmetric (post-dissociation) charge distribution over the two identical nuclei. In this paper, we question the equivalence that is made between spatial electron-localization, observed in experiments, and atomic electron-localization, alluded by these theoretical models. We show that (seeming) agreement between these models and experiments is due to an unfortunate omission of nuclear permutation symmetry, i.e., quantum statistics. Enforcement of the latter requires mandatory inclusion of the molecular rotational degree of freedom, even for perfectly aligned molecules. Unlike previous interpretations, we ascribe spatial electron-localization to the laser creation of a rovibronic wavepacket that involves field-free molecular eigenstates with opposite space-inversion symmetry i.e., even and odd parity. Space-inversion symmetry breaking would then lead to an asymmetric distribution of the (space-fixed) electronic density over the forward and backward hemisphere. However, owing to the simultaneous coexistence of two indistinguishable molecular orientational isomers, our analytical and computational results show that the post-dissociation electronic density along a specified space-fixed axis is equally shared between the two identical nuclei-a result that is in perfect accordance with the principle of the indistinguishability of identical particles.


Toxicant-induced loss of tolerance--an emerging theory of disease?
This paper attempts to clarify the nature of chemical sensitivity by proposing a theory of disease that unites the disparate clinical observations associated with the condition. Sensitivity to chemicals appears to be the consequence of a two-step process: loss of tolerance in susceptible persons following exposure to various toxicants, and subsequent triggering of symptoms by extremely small quantities of previously tolerated chemicals, drugs, foods, and food and drug combinations including caffeine and alcohol. Although chemical sensitivity may be the consequence of this process, a term that may more clearly describe the observed process is toxicant-induced loss of tolerance. Features of this yet-to-be-proven mechanism or theory of disease that affect the design of human exposure studies include the stimulatory and withdrawallike nature (resembling addiction) of symptoms reported by patients and masking. Masking, which may blunt or eliminate responses to chemical challenges, appears to have several components: apposition, which is the overlapping of the effects of closely timed exposures, acclimatization or habituation, and addiction. A number of human challenge studies in this area have concluded that there is no physiological basis for chemical sensitivity. However, these studies have failed to address the role of masking. To ensure reliable and reproducible responses to challenges, future studies in which subjects are evaluated in an environmental medical unit, a hospital-based facility in which background chemical exposures are reduced to the lowest levels practicable, may be necessary. A set of postulates is offered to determine whether there is a causal relationship between low-level chemical exposures and symptoms using an environmental medical unit.


Moral distress: a pervasive problem.
The shortage of nurses and the flaws within the structure of the current health care system are compromising the nurse's ability to provide competent, compassionate care. Nurses are increasingly disturbed because they see themselves as ineffective advocates for their patients. Nurses, unable to take the appropriate ethical actions, feel paralyzed by their situation. The author's recent conversations with staff nurses about their clinical practice suggest that moral distress has become a very pervasive problem. The purpose of this article is to describe ethical practice, moral distress, the imbalance of power, and the nature of an ethical environment. There is a discussion of potential strategies that will help to create and maintain an ethical environment thereby reducing moral distress such as facilitating dialogue, developing a support system, providing opportunities for professional development, and developing and revising institutional policies.


Autoimmune giant cell myocarditis: clinical characteristics, experimental models and future treatments.
Although prognosis in acute myocarditis is generally moderate, giant cell myocarditis shows poor prognosis. Giant cell myocarditis is considered to be an autoimmune disease, however, its pathophysiology and specific treatment is yet to be elucidated. This article reviews the clinical characteristics of autoimmune myocarditis and its possible future treatments. An animal model of experimental autoimmune myocarditis (EAM) is characterized by severe myocardial damage and multinucleated giant cell infiltration, and this has been used as a disease model for human acute giant cell myocarditis. Using experimental models, we reported that NF-κB, cytokines, adhesion molecules and other factors play a critical role in the development of autoimmune myocarditis. Giant cell myocarditis, an autoimmune form of myocarditis, has a high mortality rate unless mechanical support or cardiac transplantation is performed. Therefore, further therapeutic applications of novel methodologies are needed to expand the number of alternative choices for treating autoimmune myocarditis.


Complete Determination of Nitrogen Quadrupole and Hyperfine Tensors in an Oxovanadium Complex by Simultaneous Fitting of Multifrequency ESEEM Powder Spectra
One-dimensional C- and X-band as well as two-dimensional X-band ESEEM experiments were performed on the complex oxobis(2-methylquinolin-8-olato) vanadium(IV) in frozen solution. A 14N ESEEM simulation strategy based on initial first- and second-order perturbation analysis of peak positions in orientationally selected ESEEM spectra is presented. The constraint parameters extracted enable one to reduce the number of free fitting parameters for each nitrogen from 10 to 4. These are the alpha, beta resp. the phi, theta Euler angles of the NQI and the HFI tensor defined in the coordinate system of the axial g tensor. The local symmetry of the complex allows one to reduce the number of free parameters to two angles only. Subsequently, a grid search in the remaining Euler space produced the starting parameters for the final fit of the 14N hyperfine and quadrupole tensors. The anisotropic nitrogen hyperfine interaction tensor was found to be strongly nonaxial (0.06, 0.51, -0.57) MHz with the components significantly smaller than the isotropic hyperfine constant -6.18 MHz. In contrast, the quadrupole tensor with K = 0.58 MHz is close to axial (eta = 0.13). These tensors share the principal axis normal to the ligand plane (as imposed by the local symmetry). The axes in the ligand plane are, however, rotated 50 degrees with respect to each other. The orientation of the quadrupole tensor axes correlate within 10 degrees with the orientation of the ligand plane following from the X-ray structure. Copyright 1998 Academic Press.


Ability-Based Emotional Intelligence Is Associated With Greater Cardiac Vagal Control and Reactivity.
Several distinct models of emotional intelligence (EI) have been developed over the past two decades. The ability model conceptualizes EI as a narrow set of interconnected, objectively measured, cognitive-emotional abilities, including the ability to perceive, manage, facilitate, and understand the emotions of the self and others. By contrast, trait or mixed models focus on subjective ratings of emotional/social competencies. Theoretically, EI is associated with neurobiological processes involved in emotional regulation and reactivity. The neurovisceral integration (NVI) model proposes a positive relationship between cardiac vagal control (CVC) and cognitive-emotional abilities similar to those encompassed by EI. The current study examined the association between CVC and EI. Because ability EI is directly tied to actual performance on emotional tasks, we hypothesized that individuals with higher ability-based EI scores would show greater levels of CVC at rest, and in response to a stressful task. Because mixed-models of EI are not linked directly to observable emotional behavior, we predicted no association with CVC. Consistent with expectations, individuals with higher levels of ability EI, but not mixed EI, had higher levels of CVC. We also found that individuals with greater levels of CVC who demonstrated reactivity to a stress induction had significantly higher EI compared to individuals that did not respond to the stress induction. Our findings support the theoretically expected overlap between constructs within the NVI model and ability EI model, however, the observed effect size was small, and the associations between EI and CVC should not be taken to indicate a causal connection. Results suggest that variance in the ability to understand emotional processes in oneself and to reason about one's visceral experience may facilitate better CVC. Future work manipulating either CVC or EI may prove informative in teasing apart the causal role driving their observed relationship.


Increasing acetyl-CoA metabolism attenuates injury and alters spinal cord lipid content in mice subjected to experimental autoimmune encephalomyelitis.
Acetate supplementation increases brain acetyl-CoA metabolism, alters histone and non-histone protein acetylation, increases brain energy reserves, and is anti-inflammatory and neuroprotective in rat models of neuroinflammation and neuroborreliosis. To determine the impact acetate supplementation has on a mouse model of multiple sclerosis, we quantified the effect treatment had on injury progression, spinal cord lipid content, phospholipase levels, and myelin structure in mice subjected to experimental autoimmune encephalomyelitis (EAE). EAE was induced by inoculating mice with a myelin oligodendrocyte glycoprotein peptide fragment (MOG35-55 ), and acetate supplementation was maintained with 4 g/kg glyceryl triacetate by a daily oral gavage. Acetate supplementation prevented the onset of clinical signs in mice subject to EAE compared to control-treated mice. Furthermore, acetate supplementation prevented the loss of spinal cord ethanolamine and choline glycerophospholipid and phosphatidylserine in mice subjected to EAE compared to EAE animals treated with water. Treatment increased saturated and monounsaturated fatty acid levels in phosphatidylserine compared to controls suggesting that acetate was utilized to increase spinal cord fatty acid content. Also, acetate supplementation prevented the loss of spinal cord cholesterol in EAE animals but did not change cholesteryl esters. Treatment significantly increased GD3 and GD1a ganglioside levels in EAE mice when compared to EAE mice treated with water. Treatment returned levels of phosphorylated and non-phosphorylated cytosolic phospholipase A2 (cPLA2 ) levels back to baseline and based on FluoroMyelin™ histochemistry maintained myelin structural characteristics. Overall, these data suggest that acetate supplementation may modulate lipid metabolism in mice subjected to EAE.


New double-door laminoplasty procedure for the axis to preserve all muscular attachments to the spinous process: technical note.
To prevent the occurrence of postoperative cervical malalignment, which is often a complication of conventional axial laminectomy or laminoplasty, the authors developed a new double-door laminoplasty procedure in which the C-2 spinal canal is expanded while all the muscular attachments to each split half of the spinous process remain undisturbed. In conjunction with laminoplasties at other levels, this procedure was performed in five patients with ossification of the posterior longitudinal ligament and cervical myelopathy. Neurological improvement was demonstrated in each patient, and there was no radiological evidence of cervical malalignment. The technique for this procedure is described and its usefulness in preventing postoperative spinal malalignment is discussed.


Long Noncoding RNA SLC20A1-1 Induces Nucleus Pulposus Apoptosis by Sponging miR-146a-5p.
Background: Intervertebral disc degeneration (IDD) is a common cause of lower back pain and is characterized by cellular apoptosis, senescence, and extracellular matrix degradation. In the current study, we aimed to identify the effect of the long noncoding RNA SLC20A1-1 on tumor necrosis factor α (TNF-α)-induced apoptosis of nuclear pulposus cells (NPCs). Materials and Methods: NPCs were induced by TNF-α and used as an in vitro model. The mRNA expression of SLC20A1-1 was detected by quantitative real-time PCR (qPCR) both in clinical samples and in vitro. The scratch assay, Transwell invasion assay, CCK-8 assay, and flow cytometry were used to measure cell migration, growth, and apoptosis. The binding site between SLC20A1-1 and miR-146a-5p was assessed by a dual-luciferase reporter assay. Results: The expression of SLC20A1-1 was significantly upregulated in herniated lumbar discs, and TNF-α induced SLC20A1-1 expression in NPCs. Overexpression of SLC20A1-1 inhibited NPC growth, promoted NPC apoptosis, and enhanced macrophage recruitment and migration. The effect of SLC20A1-1 on NPCs and macrophages could be reversed by etanercept treatment. Moreover, we found that SLC20A1-1 could suppress miR-146a-5p to induce TRAF6 and caspase 3 expression. Conclusion: Overall, SLC20A1-1, an IDD regulator, is involved in TNF-α-induced NPC apoptosis by sponging miR-146a-5p. Clinical Trial Registration number: NMU20210325.


Modelled seasonal influenza mortality shows marked differences in risk by age, sex, ethnicity and socioeconomic position in New Zealand.
Influenza is responsible for a large number of deaths which can only be estimated using modelling methods. Such methods have rarely been applied to describe the major socio-demographic characteristics of this disease burden. We used quasi Poisson regression models with weekly counts of deaths and isolates of influenza A, B and respiratory syncytial virus for the period 1994 to 2008. The estimated average mortality rate was 13.5 per 100,000 people which was 1.8% of all deaths in New Zealand. Influenza mortality differed markedly by age, sex, ethnicity and socioeconomic position. Relatively vulnerable groups were males aged 65-79 years (Rate ratio (RR) = 1.9, 95% CI: 1.9, 1.9 compared with females), Māori (RR = 3.6, 95% CI: 3.6, 3.7 compared with European/Others aged 65-79 years), Pacific (RR = 2.4, 95% CI: 2.4, 2.4 compared with European/Others aged 65-79 years) and those living in the most deprived areas (RR = 1.8, 95% CI: 1.3, 2.4) for New Zealand Deprivation (NZDep) 9&10 (the most deprived) compared with NZDep 1&2 (the least deprived). These results support targeting influenza vaccination and other interventions to the most vulnerable groups, in particular Māori and Pacific people and men aged 65-79 years and those living in the most deprived areas.


New insight into the working mechanism of lithium-sulfur batteries: in situ and operando X-ray diffraction characterization.
In order to improve the electrochemical performances of lithium-sulfur batteries, it is crucial to understand profoundly their working mechanism and the limitation factors. This communication presents synchrotron-based in situ XRD studies of structural modifications occurring inside the cell upon cycling, since the active material changes constantly its form between solid and liquid phases.


Inhibition by adenosine 3':5'-monophosphate of eicosanoid and platelet-activating factor biosynthesis in the mouse PT-18 mast cell.
A mouse spleen-derived mast cell line (PT-18) was employed to examine the mechanisms of adenosine 3':5'-monophosphate (cAMP)-mediated inhibition of antigen-induced lipid mediator biosynthesis. Specifically, we tested the hypothesis that increasing cAMP in mast cells inhibits lipid mediator biosynthesis by a mechanism independent of effects on histamine release (degranulation) or changes in cytosolic calcium concentration. Forskolin inhibited antigen-induced prostaglandin D2 (PGD2), leukotriene C4 (LTC4), and leukotriene B4 (LTB4) production by 30-50%. In contrast, forskolin had no inhibitory effect on antigen-induced increases in cytosolic calcium concentration, as monitored by the calcium indicator fura-2, or histamine release from the cells. The combination of the phosphodiesterase inhibitor isobutylmethylxanthine with forskolin inhibited the antigen-induced production of PGD2 and LTC4 by 90-100% and histamine release by about 60%. These responses were accompanied by a virtual abolition of the antigen-induced increase in cytosolic calcium. To test further the hypothesis that increasing cAMP can lead to inhibition of lipid mediator biosynthesis in the absence of effects on cytosolic calcium, we employed the calcium ionophores A23187 and ionomycin. Forskolin alone or in combination with isobutylmethylxanthine had no effect on ionophore-induced increases in cytosolic calcium but effectively inhibited leukotriene biosynthesis. In addition, increasing cyclic AMP led to an inhibition of ionophore-induced production of platelet-activating factor and liberation of arachidonic acid. These data suggest that a relatively modest increase in cAMP-dependent protein kinase activity in mast cells leads to inhibition of the lipase-catalyzed cleavage of arachidonic acid from membrane phospholipids in the absence of measurable effects on either histamine release or changes in cytosolic calcium concentration. This effect results in a selective inhibition of the biosynthesis of lipid mediators including LTC4, LTB4, PGD2, and platelet-activating factor.


Influence of urban vegetation on air pollution and noise exposure - A case study in Gothenburg, Sweden.
Air pollution levels (NO2, PAHs, O3) were investigated, before (BLE) and after (ALE) leaf emergence, in the urban landscape of Gothenburg, Sweden. The aims were to study the 1) spatial and temporal variation in pollution levels between urban green areas, 2) effect of urban vegetation on air pollution levels at the same distance from a major emission source (traffic route), 3) improvement of urban air quality in urban parks compared to adjacent sites near traffic, 4) correlation between air pollution and noise in a park. O3 varied little over the urban landscape. NO2 varied strongly and was higher in situations strongly influenced by traffic. Four PAH variables were included: total PAH, total particle-bound PAH, the quantitatively important gaseous phenanthrene and the highly toxic particle-bound benzo(a)pyrene. The variation of PAHs was similar to NO2, but for certain PAHs the difference between highly and less polluted sites was larger than for NO2. At a vegetated site, NO2 and particulate PAH levels were lower than at a non-vegetated site at a certain distance from a busy traffic route. This effect was significantly larger ALE compared to BLE for NO2, indicating green leaf area to be highly significant factor for air quality improvement. For particulate PAHs, the effect was similar BLE and ALE, indicating that tree bark and branches also could be an important factor in reducing air pollution. Parks represented considerably cleaner local environments (park effect), which is likely to be a consequence of both a dilution (distance effect) and deposition. Noise and air pollution (NO2 and PAH) levels were strongly correlated. Comparison of noise levels BLE and ALE also showed that the presence of leaves significantly reduced noise levels. Our results are evidence that urban green spaces are beneficial for urban environmental quality, which is important to consider in urban planning.


Artificial Intelligence Techniques for Automatic Detection of Peri-implant Marginal Bone Remodeling in Intraoral Radiographs.
Peri-implantitis can cause marginal bone remodeling around implants. The aim is to develop an automatic image processing approach based on two artificial intelligence (AI) techniques in intraoral (periapical and bitewing) radiographs to assist dentists in determining bone loss. The first is a deep learning (DL) object-detector (YOLOv3) to roughly identify (no exact localization is required) two objects: prosthesis (crown) and implant (screw). The second is an image understanding-based (IU) process to fine-tune lines on screw edges and to identify significant points (intensity bone changes, intersections between screw and crown). Distances between these points are used to compute bone loss. A total of 2920 radiographs were used for training (50%) and testing (50%) the DL process. The email@example.com metric is used for performance evaluation of DL considering periapical/bitewing and screws/crowns in upper and lower jaws, with scores ranging from 0.537 to 0.898 (sufficient because DL only needs an approximation). The IU performance is assessed with 50% of the testing radiographs through the t test statistical method, obtaining p values of 0.0106 (line fitting) and 0.0213 (significant point detection). The IU performance is satisfactory, as these values are in accordance with the statistical average/standard deviation in pixels for line fitting (2.75/1.01) and for significant point detection (2.63/1.28) according to the expert criteria of dentists, who establish the ground-truth lines and significant points. In conclusion, AI methods have good prospects for automatic bone loss detection in intraoral radiographs to assist dental specialists in diagnosing peri-implantitis.


Immune thrombocytopenic purpura at the diagnosis of Hodgkin disease.
We describe the case of a 76-year-old male presenting a thrombocytopenia at the diagnosis of Hodgkin disease. Basing on bone marrow biopsy and evolution, we diagnosed an immune thrombocytopenia and treated with intravenous gammaglobulins. The platelet count normalized in a few days under this therapy. Immune thrombocytopenia purpura (ITP) is a rare complication of Hodgkin disease (HD). It seems to be due to the production of antibodies directed against platelet membrane proteins. The patient's and the lymphoma's characteristics are not predictive for it to happen. The evolution of HD is also not influenced by its occurrence. Various treatments (including corticoids and immunomodulating agents) have been tried with different efficiencies.


A multilevel approach to relating subjective workload to performance after shifts in task demand.
The aim of this laboratory experiment was to demonstrate how taking a longitudinal, multilevel approach can be used to examine the dynamic relationship between subjective workload and performance over a given period of activity involving shifts in task demand. Subjective workload and conditions of the performance environment are oftentimes examined via cross-sectional designs without distinguishing within-from between-person effects. Given the dynamic nature of performance phenomena, multilevel designs coupled with manipulations of task demand shifts are needed to better model the dynamic relationships between state and trait components of subjective workload and performance. With a sample of 75 college students and a computer game representing a complex decision-making environment, increases and decreases in task demand were counterbalanced and subjective workload and performance were measured concurrently in regular intervals within performance episodes. Data were analyzed using hierarchical linear modeling. Both between- and especially within-person effects were dynamic. Nevertheless, at both levels of analysis, higher subjective workload reflected performance problems, especially more downstream from increases in task demand. As a function of cognitive-energetic processes, shifts in task demand are associated with changes in how subjective workload is related to performance over a given period of activity. Multilevel, longitudinal approaches are useful for distinguishing and examining the dynamic relationships between state and trait components of subjective workload and performance. The findings of this research help to improve the understanding of how a sequence of demands can exceed a performer's capability to respond to further demands.


Percutaneous Laser Disc Decompression (PLDD) for the Treatment of Contained Lumbar Disc Herniation.
Lumbar disc herniation is a common cause of back and radicular leg pain. A bulging annulus and contained herniated disc can compress a nearby exiting root as it enters the neuroforamen and may cause pain and neurological symptoms. Percutaneous laser disc decompression (PLDD) has been regarded as an effective alternative to microdiscectomy for the treatment of contained lumbar disc herniations. However, there is no consensus regarding the type of laser to use, the ideal wavelength, or the energy applied. The ideal laser irradiation should have a high water absorption coefficient and low tissue pervasion, to limit thermal injury. The 1470 nm wavelength of the diode laser is absorbed by water 40 times more effectively than the 980 nm wavelength. We conducted this study to evaluate the efficacy and safety of PLDD using a 1470 nm diode laser. We retrospectively reviewed the clinical data of 27 patients with radicular pain who underwent PLDD for the treatment of contained lumbar disc herniation during a 12-month period. The 1470 nm diode laser produces smaller local lesions, but greater tissue variations around the nucleus pulposus. This higher affinity for water lessens the formation of a carbonization zone, which results in less thermal injury of the adjacent nervous tissue. According to the MacNab criteria, 85.2% of the cases were improved at 6-month follow-up. Pain decreased from VAS 8.1 preoperatively to VAS 3.1 postoperatively. There is no consensus in the international literature regarding the ideal wavelength. Our results support the conclusion that PLDD using a 1470 nm diode laser is a safe and effective minimally invasive technique for patients with radicular pain affected by contained herniated lumbar discs.


Probing the interaction of tetraspanin CD151 with integrin alpha 3 beta 1 using a panel of monoclonal antibodies with distinct reactivities toward the CD151-integrin alpha 3 beta 1 complex.
CD151, a member of the tetraspanin family of proteins, forms a stable complex with integrin alpha 3 beta 1 and regulates integrin-mediated cell-substrate adhesion. However, the molecular basis of the stable association of CD151 with integrin alpha 3 beta 1 remains poorly understood. In the present study, we show that a panel of anti-human CD151 mAbs (monoclonal antibodies) could be divided into three groups on the basis of their abilities to co-immunoprecipitate integrin alpha 3: Group-1 mAbs were devoid of sufficient activities to co-precipitate integrin alpha 3 under both low- and high-stringency detergent conditions; Group-2 mAbs co-precipitated integrin alpha 3 under low-stringency conditions; and Group-3 mAbs exhibited strong co-precipitating activities under both conditions. Group-1 mAbs in particular exhibited increased reactivity toward integrin alpha 3 beta 1-unbound CD151, indicating that the binding sites for Group-1 mAbs are partly blocked by bound integrin alpha 3 beta 1. Epitope mapping using a series of CD151 mutants with substitutions at amino acid residues that are not conserved between human and mouse CD151 revealed that Gly(176)/Gly(177), Leu(191) and Gln(194) comprise epitopes characteristic of Group-1 mAbs. Replacement of short peptide segments, each containing one of these epitopes, with those of other tetraspanins lacking stable interactions with integrin alpha 3 beta 1 demonstrated that the segment from Cys(185) to Cys(192), including Leu(191), was involved in the stable association of CD151 with integrin alpha 3 beta 1, as was the Gln(194)-containing QRD peptide. Taken together these results indicate that two consecutive segments including two Group-1 epitopes, Leu(191) and Gln(194), comprise an interface between CD151 and integrin alpha 3 beta 1, and, along with the epitope including Gly(176)/Gly(177), are concealed by bound integrin.


Prevalence and correlates of subjective cognitive impairment in Chinese psychiatric patients during the fifth wave of COVID-19 in Hong Kong.
The extent of cognitive impairment and its association with psychological distress among people with pre-existing mental illness during COVID-19 is understudied. This study aimed to investigate prevalence and correlates of subjective cognitive impairment (SCI) in Chinese psychiatric patients during fifth-wave of COVID-19 in Hong Kong (HK). Four-hundred-eight psychiatric outpatients aged 18-64 years were assessed with questionnaires between 28 March and 8 April 2022, encompassing illness profile, psychopathological symptoms, coping-styles, resilience, and COVID-19 related factors. Participants were categorized into moderate-to-severe and intact/mild cognitive impairment (CI+ vs. CI-) groups based on severity of self-reported cognitive complaints. Univariate and multivariate regression analyses were conducted to determine variables associated with CI+ status. One-hundred-ninety-nine participants (48.8%) experienced CI+. A multivariate model on psychopathological symptoms found that depressive and post-traumatic-stress-disorder (PTSD)-like symptoms were related to CI+, while a multivariate model on coping, resilience and COVID-19 related factors revealed that avoidant coping, low resilience and more stressors were associated with CI+. Final combined model demonstrated the best model performance and showed that more severe depressive and PTSD-like symptoms, and adoption of avoidant coping were significantly associated with CI+. Almost half of the sample of psychiatric patients reported cognitive complaints during fifth-wave of COVID-19 in HK. Greater depressive and PTSD-like symptom severity, and maladaptive (avoidant) coping were found as correlates of SCI. COVID-19 related factors were not independently associated with SCI in psychiatric patients. Early detection with targeted psychological interventions may therefore reduce psychological distress, and hence self-perceived cognitive difficulties in this vulnerable population.


Direct identification of differentially expressed genes by cycle sequencing and cycle labelling using the differential display PCR primers.
Differential display PCR (DD-PCR) is an mRNA fingerprinting technique to identify differentially expressed genes by comparative display of arbitrarily amplified cDNA subsets. This attractively simple screening method was, however, followed by a labour intensive multistep identification procedure for DD-PCR products. In this report we demonstrate for the mouse mast cell protease 2 (MMCP-2) and the cytotoxic T-lymphocyte associated gene transcript CTLA-1 a streamlined approach by (i) direct cycle sequencing with the upstream differential display (DD) primer, followed by (ii) the PCR based generation of an antisense northern probe with the downstream anchor primer.


Feasibility of real-time 3D echocardiography in weightlessness during parabolic flight.
Aim of the study was to test the feasibility of transthoracic real-time 3D (Philips) echocardiography (RT3D) during parabolic flight, to allow direct measurement of heart chambers volumes modifications during the parabola. One RT3D dataset corresponding to one cardiac cycle was acquired at each gravity phase (1 Gz, 1.8 Gz, 0 Gz, 1.8 Gz) during breath-hold in 8 unmedicated normal subjects (41 +/- 8 years old) in standing upright position. Preliminary results, obtained by semi-automatically tracing left ventricular (LV) and left atrial (LA) endocardial contours in multiple views (Tomtec), showed a significant (p<0.05) reduction, compared to 1 Gz, of LV and LA volumes with 1.8 Gz, and a significant increase with 0 Gz. Further analysis will focus on the right heart.


Conceptualizing disability in nursing: some evidence from students and their teachers.
This paper reports on part of a larger study which examined the nature and influence of a pre-registration nursing curriculum on the preparation of student nurses to work with disabled people. Following case study methodology it focuses on how 'disability' is conceptualized by teachers and adult branch students involved in a particular curriculum. Definitions and working assumptions concerning disability held by nurses are likely to influence ways in which disabled people are cared for. The experiences of disabled people suggest that their contact with nurses is demeaning and disempowering. Some disabled people support a reconceptualization of 'disability', from a largely medical perspective to one which embraces its social dimensions. The results of thematic analysis of data from 16 semi-structured interviews are reported; these support the need for the social dimensions of disability to be given greater emphasis within nursing. Disability was found to be conceptualized as a form of deviation, a condition of dependency or a notion which defies definition. Language associated with disability was also highlighted as an area of concern. Implications for practice and education are alluded to in the light of increasing recognition of disability as an equality opportunity issue.


Predator cue-induced plasticity of morphology and behavior in planthoppers facilitate the survival from predation.
Predators can induce phenotypic plasticity in prey through selection driven by predation risk. However, defense plasticity is rarely reported in insects, let alone trans-generational plasticity, meaning the mechanisms underlying plasticity, how it impacts ecosystem evolution and how it might be exploited in pest control are poorly understood. Here we examine the morphological plasticity of small brown planthoppers (SBPHs), Laodelphax striatellus, elicited by caged predators, Paederus fuscipes in the parent or F1 generation and reveal the risk cues mediating these effects. We also uncover the survival outcomes in SBPHs with predator-induced defensive morphological traits by examining their survival probability and behavioral plasticity. Results showed that caged predators or predator odor cue gave rise to a higher proportion of long-winged, female SBPHs in the parent and F1 generations, but the proportion of males and their wing length were unaffected. The visual cue from predators elicited weaker effects. Surprisingly, we discovered these long-winged forms suffered a lower predation rate when attacked by P. fuscipes, owing to an enhanced agility level. Our results suggest the within- and trans-generational plasticity of induced defenses may cause profound effects on SBPH population dynamics and prey-predator interaction. Understanding this interaction and its underlying mechanisms illuminates important aspects of ecosystem evolution and helps predict pest dispersal or migration, which in turn may be exploited for pest control.


[Juvenile myelomonocytic leukaemia, xanthoma, and neurofibromatosis type 1].
The triple association of leukemia, xanthogranulomas, and type 1 neurofibromatosis was first described in 1958. Most leukemias were juvenile myelomonocytic leukemias (JMML), usually called juvenile chronic myelogenous leukemia. We describe a 22-month-old female child with neurofibromatosis 1, xanthomagranulomas, and a JMML. Her mother and her brother also had cutaneous café-au-lait spots. Our patient was treated with mercaptopurine and improved. However, 9 months later she experienced a blastic transformation. The presence of xanthomagranulomas and NF1 in a young child should alert to a possible development of JMML, especially in patients with a family history of NF1.


MicroRNA-590-3p promotes cell proliferation and invasion by targeting inositol polyphosphate 4-phosphatase type II in human prostate cancer cells.
Inositol polyphosphate 4-phosphatase type II emerges as a tumor suppressor in prostate cancer, and its loss of expression is associated with poor prognosis for prostate cancer. However, the mechanism of downregulation of inositol polyphosphate 4-phosphatase type II in prostate cancer development has not yet been fully clarified. In this study, microRNA-590-3p was found to be upregulated in both prostate cancer tissues and cell lines. Overexpression of microRNA-590-3p by microRNA-590-3p mimics promoted prostate cancer cell proliferation and invasion and accelerated the growth of xenografted tumors, while microRNA-590-3p inhibitors contributed to inhibition of cellular proliferation and invasion as well as tumor growth. A dual-luciferase reporter assay and expression analysis further confirmed that inositol polyphosphate 4-phosphatase type II was a direct target of microRNA-590-3p. Enforced expression of microRNA-590-3p led to repression of inositol polyphosphate 4-phosphatase type II messenger RNA and protein expression, as well as upregulation of p-Akt, p-FoxO3a, and cyclin D1 and downregulation of p21 expression in prostate cancer cell lines. Overexpression of inositol polyphosphate 4-phosphatase type II could reduce microRNA-590-3p-induced cell proliferation and invasion as well as tumor growth, and decrease microRNA-590-3p-mediated upregulation of cyclin D1 and downregulation of p21 expression in prostate cancer cells. Taken together, our findings reveal that microRNA-590-3p is a potential onco-microRNA that participates in carcinogenesis of human prostate cancer by suppressing inositol polyphosphate 4-phosphatase type II expression and involving the Akt/FoxO3a pathway. MicroRNA-590-3p may represent a potential therapeutic target for prostate cancer patients.


Thermally reversible hydration of beta-chitin.
Thermally induced transition between anhydrous and hydrated forms of highly crystalline beta-chitin was studied by differential thermal calorimetry (DSC) and X-ray diffraction. DSC of wet beta-chitin in a sealed pan gave two well-defined endothermic peaks at 85.2 and 104.7 degrees C on heating and one broad exothermic peak at between 60 and 0 degrees C on cooling. These peaks were highly reproducible and became more distinct after repeated heating-cooling cycles. The X-ray diffraction pattern of wet beta-chitin at elevated temperature showed corresponding changes in d-spacing between the sheets formed by stacking of chitin molecules. These phenomena clearly show that water is reversibly incorporated into the beta-chitin crystal and that the temperature change induces transitions between anhydrous, monohydrate, and dihydrate forms. The DSC behavior in heating-cooling cycles, including reversion between the two endothermic peaks, indicated that the transition between monohydrate and dihydrate was a fast and narrow-temperature process, whereas the one between the anhydrous and the monohydrate form was a slow and wide-temperature process.


The child accident repeater: a review.
The child accident repeater is defined as one who has at least three accidents that come to medical attention within a year. The accident situation has features in common with those of the child who has a single accident through simple "bad luck", but other factors predispose him to repeated injury. In the child who has a susceptible personality, a tendency for accident repetition may be due to a breakdown in adjustment to a stressful environment. Prevention of repeat accidents should involve the usual measures considered appropriate for all children as well as an attempt to provide treatment of significant maladjustment and modification of a stressful environment.


The Arabidopsis thaliana mobilome and its impact at the species level.
Transposable elements (TEs) are powerful motors of genome evolution yet a comprehensive assessment of recent transposition activity at the species level is lacking for most organisms. Here, using genome sequencing data for 211 Arabidopsis thaliana accessions taken from across the globe, we identify thousands of recent transposition events involving half of the 326 TE families annotated in this plant species. We further show that the composition and activity of the 'mobilome' vary extensively between accessions in relation to climate and genetic factors. Moreover, TEs insert equally throughout the genome and are rapidly purged by natural selection from gene-rich regions because they frequently affect genes, in multiple ways. Remarkably, loci controlling adaptive responses to the environment are the most frequent transposition targets observed. These findings demonstrate the pervasive, species-wide impact that a rich mobilome can have and the importance of transposition as a recurrent generator of large-effect alleles.


Transperineal template-guided mapping biopsy of the prostate.
Accurate diagnosis of prostate cancer has eluded clinicians for decades. With our current understanding of prostate cancer, urologists should devise and confidently present the available treatment options – active surveillance/radical treatment/focal therapy to these patients. The diagnostic modalities used for prostate cancer have the dual problem of false negativity and overdiagnosis. Various modifications in the prostate biopsy techniques have increased the accuracy of cancer detection, but we are still far from an ideal diagnostic technique. Transperineal template-guided mapping biopsy of the prostate is an exhaustive biopsy technique that has been improvised over the past decade, and has shown superior results to other available modalities. We have carried out a PubMed search on the available experiences on this diagnostic modality, and along with our own experiences, we present a brief review on transperineal template-guided mapping biopsy of the prostate.


Composition and antioxidant activity of the anthocyanins of the fruit of Berberis heteropoda Schrenk.
In present study, the anthocyanin composition and content of the fruit of B. heteropoda Schrenk were determined for the first time. The total anthocyanins were extracted from the fruit of B. heteropoda Schrenk using 0.5% HCl in 80% methanol and were then purified using an AB-8 macroporous resin column. The purified anthocyanin extract (PAE) was evaluated by high-performance liquid chromatography with a diode array detector (HPLC-DAD) and HPLC-high resolution-electrospray ionization-mass spectrometry (HPLC-HR-ESI-MS) under the same experimental conditions. The results revealed the presence of seven different anthocyanins. The major anthocyanins purified by preparative HPLC were confirmed to be delphinidin-3-O-glucopyranoside (30.3%), cyanidin-3-O-glucopyranoside (33.5%), petunidin-3-Ο-glucopyranoside (10.5%), peonidin-3-O-glucopyranoside (8.5%) and malvidin-3-O-glucopyranoside (13.8%) using HPLC-HR-ESI-MS and NMR spectroscopy. The total anthocyanin content was 2036.6 ± 2.2 mg/100 g of the fresh weight of B. heteropoda Schrenk fruit. In terms of its total reducing capacity assay, DPPH radical-scavenging activity assay, ferric-reducing antioxidant power (FRAP) assay and ABTS radical cation-scavenging activity assay, the PAE also showed potent antioxidant activity. The results are valuable for illuminating anthocyanins composition of B. heteropoda Schrenk and for further utilising them as a promising anthocyanin pigment source. This research enriched the chemical information of B. heteropoda Schrenk.


Degranulation of gastrointestinal mast cells contributes to hepatic ischemia-reperfusion injury in mice.
The pathological changes following liver damage, including those caused by ischemia and reperfusion (I/R), are closely related to gastrointestinal dysregulation. Mast cells (MCs) are tissue-resident immune cells abundant in the gastrointestinal system that play diverse roles. In view of the characteristic localization of MCs around the microvasculature, we hypothesized that a stimulus-specific set of mediators released through degranulation of gastrointestinal MCs, which are enriched in hepatic sinusoids via the hepatic system, subsequently participate in associated pathological development within the liver. To elucidate the biological role of gastrointestinal MC granules in liver damage, we employed an experimental liver I/R model that allows conditional ablation of MCs. Marked degranulation was detected during I/R, which showed a significant positive correlation with liver damage. Our experiments further disclosed that MC degranulation primarily enhanced the cycle of inflammatory damage in I/R liver consisting of liver sinusoidal endothelial cell death, neutrophil infiltration, and formation of a neutrophil extracellular trap, with a concomitant increase in adhesion molecules, inflammatory cytokines, chemokines, and oxidative stress. Based on the collective results, we propose that suppression of activity or number of MCs may present an effective strategy for protection against hepatic I/R injury.


Johann August Philipp Gesner (1738-1801). A review of his essay "The language amnesia" in the bicentennial anniversary of his death.
On the 200th anniversary of Johann August Philipp Gesner's death, this paper summarizes and discusses a paper on language amnesia published in 1770. The author had clear knowledge of selective mental impairments resulting from brain diseases, and of separate mental representations for words and their underlying concepts. However, to explain the language impairment, Gesner suggested that it would not be caused by focal damage to a specific anatomic and functional unit of the mind, but is the consequence of a general sluggishness of the mental processes.


Attentional weighting: a possible account of visual field asymmetries in visual search?
Several previous visual search studies measuring reaction times have demonstrated scanning biases across the visual field (i.e. a tendency to begin a serial search in a particular region of space). In the present study, we measured visual discrimination thresholds for a target presented amongst distractors using displays that were short enough to greatly reduce the potential for serial (i.e. scanning) search. For both a motion and orientation task, subjects' performance was significantly better when the target appeared in the inferior, as compared to the superior, visual field (no differences were observed between left and right visual fields). These findings suggest that subjects may divide attention unevenly across the visual field when searching for a target amongst distractors, a phenomenon we refer to as 'attentional weighting'. To rule out the possibility that these visual field asymmetries were sensory in nature, thresholds were also measured for conditions in which subjects' attention was directed to the location of the target stimulus, either because it was presented alone in the display or because a spatial cue directed subjects' attention to the location of that target presented amongst distractors. Under these conditions, visual field asymmetries were smaller (or non-existent), suggesting that sensory factors (such as crowding) are unlikely to account for our results. In addition, analyses of set-size effects (obtained by comparing thresholds for a single target vs. the target presented amongst distractors) could be accounted for by an unlimited capacity model, suggesting that multiple stimuli can be processed simultaneously without any limitations at an early stage of sensory processing. Taken together, these findings suggest the possible existence of biases in attentional weighting at a late stage of processing. The bias appears to favor the inferior visual field, which may arise from the fact that there is more ecologically-relevant information in this region of space.


Targeting hepatic macrophages to treat liver diseases.
Our view on liver macrophages in the context of health and disease has been reformed by the recognition of a remarkable heterogeneity of phagocytes in the liver. Liver macrophages consist of ontogenically distinct populations termed Kupffer cells and monocyte-derived macrophages. Kupffer cells are self-renewing, resident and principally non-migratory phagocytes, serving as sentinels for liver homeostasis. Liver injury triggers Kupffer cell activation, leading to inflammatory cytokine and chemokine release. This fosters the infiltration of monocytes into the liver, which give rise to large numbers of inflammatory monocyte-derived macrophages. Liver macrophages are very plastic and adapt their phenotype according to signals derived from the hepatic microenvironment (e.g. danger signals, fatty acids, phagocytosis of cellular debris), which explains their manifold and even opposing functions during disease. These central functions include the perpetuation of inflammation and hepatocyte injury, activation of hepatic stellate cells with subsequent fibrogenesis, and support of tumor development by angiogenesis and T cell suppression. If liver injury ceases, specific molecular signals trigger hepatic macrophages to switch their phenotype towards reparative phagocytes that promote tissue repair and regression of fibrosis. Novel strategies to treat liver disease aim at targeting macrophages. These interventions modulate Kupffer cell activation (e.g. via gut-liver axis or inflammasome formation), monocyte recruitment (e.g. via inhibiting chemokine pathways like CCR2 or CCL2) or macrophage polarization and differentiation (e.g. by nanoparticles). Evidence from mouse models and early clinical studies in patients with non-alcoholic steatohepatitis and fibrosis support the notion that pathogenic macrophage subsets can be successfully translated into novel treatment options for patients with liver disease. Macrophages (Greek for "big eaters") are a frequent non-parenchymal cell type of the liver that ensures homeostasis, antimicrobial defense and proper metabolism. However, liver macrophages consist of different subtypes regarding their ontogeny (developmental origin), differentiation and function. Understanding this heterogeneity and the critical regulation of inflammation, fibrosis and cancer by macrophage subsets opens promising new options for treating liver diseases.


[Acute dyspnea: what is the diagnostic role of B-type natriuretic peptide?].
Bedside dosage of B-type natriuretic peptide as a marker of congestive heart failure is of major interest in the evaluation of acute dyspnea. However, this test remains difficult to use because its interpretation depends upon the probability of disease and upon its diagnostic performance (sensitivity and specificity), varying with each BNP level. When the clinical probability of heart failure is low or high, BNP level doest not modify significantly the probability of disease. The test is useful when the diagnostic is uncertain (intermediate clinical probability), because a BNP value < 100 pg/ml makes the diagnosis of heart failure unlikely (high negative predictive value), and a value > 500 pg/ml very likely.


Paraneoplastic signs and symptoms of renal cell carcinoma: implications for prognosis.
Renal cell carcinoma (RCC) can present with a wide range of signs and symptoms. To our knowledge we report the first study to describe the frequency of paraneoplastic findings in a modern RCC series and assess the prognostic significance of each finding. Using the kidney cancer database at our institution 1,046 patients undergoing nephrectomy for RCC between 1989 and 2001 were assessed. The prognostic significance of symptoms present at diagnosis and findings on preoperative laboratory evaluation were examined in a univariate analysis as well as on multivariate analysis controlling for TNM stage, Fuhrman grade and Eastern Cooperative Oncology Group performance status (ECOG-PS). Mean followup to date of death or last contact for all patients was 40.3 months. Median time to death was 19.3 months. Most paraneoplastic signs and symptoms correlated with poor survival, although on multivariate analysis hypoalbuminemia, weight loss, anorexia and malaise predicted shorter survival. The frequency of each of these findings was 19.9%, 22.9%, 10.6% and 19.1%, respectively. Cachexia, defined as the presence of at least 1 of these findings, was noted in 35.3% of patients. Cachexia did not predict a higher recurrence rate in patients with localized disease and only malaise correlated with a decreased likelihood of responding to immunotherapy. Cachexia, defined as hypoalbuminemia, weight loss, anorexia or malaise, predicts worse survival after controlling for well established indicators of prognosis (TNM stage, Fuhrman grade and ECOG-PS). Consideration should be given to expanding the ECOG-PS to include measures for cachexia when applied to patients with RCC.


Effect of Alum Additions to Poultry Litter on In-House Ammonia and Greenhouse Gas Concentrations and Emissions.
Alum [Al(SO4) ·14HO] addition to poultry litter has been shown to reduce ammonia (NH) concentrations in poultry houses; however, its effects on greenhouse gas (GHG; NO, CH, and CO) emissions is unknown. The objectives of this study were to determine the effects of alum additions on (i) in-house NH and GHG concentrations, (ii) NH and GHG emissions, and (iii) litter chemical properties. Two identical broiler houses located in northwest Arkansas were used for this study: one house was a control and the other was treated with alum between each flock of birds. Ventilation rates were coupled with in-house NH and GHG measurements to determine emission rates. Overall, alum additions significantly reduced the daily average in-house NH concentration by 42% (8.9 vs. 15.4 μL L), and the overall NH emission rate was reduced by 47% (7.2 vs. 13.4 kg d house). The average cumulative NH emission for the three flocks was 330 kg house flock for the alum-treated house and 617 kg house flock for the control. Concentrations and emissions of nitrous oxide (NO) and methane (CH) from the alum-treated house were not significantly different than the untreated house. However, carbon dioxide (CO) emissions were significantly higher from the untreated house than the alum-treated house. Alum also significantly increased litter N content and reduced the C/N ratio. These results indicate that the addition of alum to poultry litter is not only an effective management practice for reducing in-house NH concentrations and emissions but also significantly reduces CO emissions from poultry facilities.


[Prevalence and influencing factors of food hypersensitivity in infants reported by parents in Chengdu City].
To understand the prevalence and influencing factors of food hypersensitivity in 1-year-old infants in Chengdu. A two-way cohort study was conducted to select 923 pairs of mothers and infants from the Second Hospital of Sichuan University from March 2014 to March 2015. The questionnaires and telephone follow-up surveys were used to investigate the incidence and influencing factors of parents' self-reported food hypersensitivity of infants. The prevalence of parents' self-reported food hypersensitivity was 14. 1% before the age of one year, and the average age of the first onset was(6. 9±3. 3) month old. The main manifestations were skin(85. 7%) and gastrointestinal symptoms(14. 3%), those were mainly caused by aquatic products(42. 3%), eggs(26. 0%), and milk(22. 1%). Family history of allergy, consumption of milk during pregnancy, exposure to pets during pregnancy, and addition of seafood within 6 months of age are risk factors for parents' self-reported food hypersensitivity in infants. Adding egg protein as early as possible within 1 year old may reduce the incidence of parents' self-reported food hypersensitivity of infants. Preventing food hypersensitivity should start from the beginning of pregnancy. Different types of complementary food have different effects on the occurrence of food hypersensitivity in infants. Personalized management of complementary food adding should be conducted according to infant genetic history, living environment and epidemiological survey data to preventing food hypersensitivity.


An Application of Chalcogenide Alloy Other than Storage Memory Field.
The necessity to handle mechanical functionality at nanoscale has recently motivated the prosperity of the nanoelectromechanical systems (NEMs). The fabrication of NEMS strongly depends on the so-called "topdown" techniques that are however limited by the resolution of electronbeam lithography. Meanwhile, the size of the NEMS needs to be shrunk continuously in order to further enhance the system performance. As a result, current research interest has been dedicated to "bottomup" techniques or even a hybridization of two aforementioned approaches, leading to the presence of the nanowire-based NEMs. Here, we presented some recent patent for nanowire-based NEMS. We investigate the resonant frequency and the frequency tuneability of the nanowire-based nanoelectromechanical system using Ge2Sb2Te5 media. By varying the nanowire dimensions, corresponding resonant frequencies and frequency tuneability are calculated using an established mechanical model. We theoretically study the frequency tuneability of the nanowire-based NEMs using GST media. The resonant frequencies and the corresponding frequency tuneabilities for different nanowire dimensions are investigated using a developed mechanical model, and a previously established electrothermal model is performed to imitate the frequency tuning behavior of the system along with the phase-change phenomenon. By carefully controlling the amorphous fraction of the active region, a very high resonant frequency can be tuned within an ultra-high adjustable bandwidth. In addition, the merits of the phase-change memories including great scalability, low power consumption, fast transition time, and non-volatility can be also found on the proposed system. These results will open up a route for designing the next generation NEMs, and also pioneer a new application field for the GST media. Today phase-change materials have received a wide range of applications from nonvolatile memories to neuromorphic networks due to its unique combinations of structural, electrical, and thermal properties. However, as the mechanical properties of phase-change materials exhibits a remarkable difference between the amorphous and crystalline phases, the feasibility of continuously changing the resonant frequency of the nanowires based on phase-change materials becomes viable.


[Immunoprophylaxis against Newcastle disease in white storks: vaccine selection and preliminary experiences].
Criteria for the selection of vaccines against Newcastle disease are presented. Questions related to safety and potency are considered. Intramuscular vaccination of 23 young storks with an inactivated vaccine is described. All storks tolerated the vaccination without recognizable undesired side-effects. The young storks reacted with the production of serum antibodies three weeks post vaccination. No data is yet available on the duration of the persistence of humoral antibodies. The vaccinated mature storks were free of detectable antibodies at the day of vaccination and five months later.


The CT appearances of gallbladder perforation.
Perforation of the gallbladder is an uncommon complication of acute cholecystitis that is associated with relatively high mortality. Symptoms and clinical signs can be indistinguishable from those of uncomplicated acute cholecystitis, leading to delayed diagnosis. We reviewed the clinical and imaging findings in 17 patients with gallbladder perforation confirmed at surgery.


Communication skills training: effects on attitudes toward communication skills and empathic tendency.
This study explored and compared medical students' attitudes toward communication skills and empathic tendency before and after communication skills training. Fifty-nine first-year students voluntarily completed a questionnaire consisting of the Communication Skills Attitudes Scale and the Empathic Tendency Scale before and after training. K-means cluster analysis and Student's t-test were used for statistical analysis. In the pre-test, 49% of the students had positive attitudes toward communication skills learning and 59% had higher empathic tendencies. In post-test, the mean score in the positive attitude group decreased significantly, whereas there was no change in the negative attitude group. In the high empathy group, empathy scores did not change significantly after training; however, in the low empathy group, empathic tendency significantly increased. As students' low empathic tendency level became higher and positive attitudes toward communication skills learning significantly changed in a negative direction after training, we observed that our training programme seems to have an effect that makes students similar to each other in terms of their empathic tendency and attitudes toward communication skills learning. Women had more positive attitudes toward communication skills and their empathic tendencies were higher than men's. Our findings suggest that our curriculum is in need of further examination and modification. Future studies with larger samples are needed to investigate the effects of communication skills training on students' attitudes.


Improved viability of latissimus dorsi muscle grafts after electrical prestimulation.
Surgical mobilization of the latissimus dorsi muscle (LDM) produces fiber degeneration, particularly in the distal part of the graft, that may compromise its function in clinical applications such as dynamic cardiomyoplasty. In five rats, the left LDM was stimulated continuously at 10 HZ. After 5 weeks, vessels perforating the chest wall were divided and the left LDM was mobilized as a pedicle graft based on the thoracodorsal artery. Twenty-four hours later, animals were killed and left and right LDMs were incubated with the vital stain nitroblue tetrazolium. Five control rats underwent a similar procedure without prestimulation. Mobilization of the LDM resulted in a loss of viability in the distal third of the muscle graft. This was reduced significantly by prestimulation (P = 0.006). Blood flow to the distal LDM graft is known to be augmented by electrical stimulation in situ before mobilization; the present results show that there is an associated enhancement of viability. The clinical implications of this finding are discussed.


Lactobacillaceae and cell adhesion: genomic and functional screening.
The analysis of collections of lactic acid bacteria (LAB) from traditional fermented plant foods in tropical countries may enable the detection of LAB with interesting properties. Binding capacity is often the main criterion used to investigate the probiotic characteristics of bacteria. In this study, we focused on a collection of 163 Lactobacillaceace comprising 156 bacteria isolated from traditional amylaceous fermented foods and seven strains taken from a collection and used as controls. The collection had a series of analyses to assess binding potential for the selection of new probiotic candidates. The presence/absence of 14 genes involved in binding to the gastrointestinal tract was assessed. This enabled the detection of all the housekeeping genes (ef-Tu, eno, gap, groEl and srtA) in the entire collection, of some of the other genes (apf, cnb, fpbA, mapA, mub) in 86% to 100% of LAB, and of the other genes (cbsA, gtf, msa, slpA) in 0% to 8% of LAB. Most of the bacteria isolated from traditional fermented foods exhibited a genetic profile favorable for their binding to the gastrointestinal tract. We selected 30 strains with different genetic profiles to test their binding ability to non-mucus (HT29) and mucus secreting (HT29-MTX) cell lines as well as their ability to degrade mucus. Assays on both lines revealed high variability in binding properties among the LAB, depending on the cell model used. Finally, we investigated if their binding ability was linked to tighter cross-talk between bacteria and eukaryotic cells by measuring the expression of bacterial genes and of the eukaryotic MUC2 gene. Results showed that wild LAB from tropical amylaceous fermented food had a much higher binding capacity than the two LAB currently known to be probiotics. However their adhesion was not linked to any particular genetic equipment.


Thoracolumbar extradural arachnoid cyst--three surgical case reports.
Three cases of symptomatic extradural arachnoid cyst were treated by surgery. Total excision of the cyst followed by tight closure of the fistula by suture was achieved in all 3 cases. Surgery improved the neurological deficits but urinary incontinence persisted in all three patients. Obliteration of the fistula is considered to be important at surgery from the etiological perspective of the cyst. There are many surgical options, but surgical removal of the cyst and obliteration of the communication usually leads to prompt improvement in neurological deficits. Instability, malalignment, and worsening scoliosis are well-recognized postoperative complications of excessive laminotomy, but the exposure should be wide enough to cover the cyst completely at the operation. Wide exposure of the entire cyst is preferable to avoid missing the fistula and to identify any adhesions or fistula between the cyst and the dura. Identification of the fistula location based on preoperative imaging studies is also important.


Redox mediator effect on water oxidation in a ruthenium-based chromophore-catalyst assembly.
The synthesis, characterization, and redox properties are described for a new ruthenium-based chromophore-catalyst assembly, [(bpy)(2)Ru(4-Mebpy-4'-bimpy)Ru(tpy)(OH(2))](4+) (1, [Ru(a)(II)-Ru(b)(II)-OH(2)](4+); bpy = 2,2'-bipyridine; 4-Mebpy-4'-bimpy = 4-(methylbipyridin-4'-yl)-N-benzimid-N'-pyridine; tpy = 2,2':6',2"-terpyridine), as its chloride salt. The assembly incorporates both a visible light absorber and a catalyst for water oxidation. With added ceric ammonium nitrate (Ce(IV), or CAN), both 1 and 2, [Ru(tpy)(Mebim-py)(OH(2))](2+) (Mebim-py = 2-pyridyl-N-methylbenzimidazole), catalyze water oxidation. Time-dependent UV/vis spectral monitoring following addition of 30 equiv of Ce(IV) reveals that the rate of Ce(IV) consumption is first order both in Ce(IV) and in an oxidized form of the assembly. The rate-limiting step appears to arise from slow oxidation of this intermediate followed by rapid release of O(2). This is similar to isolated catalyst 2, with redox potentials comparable to the [-Ru(b)-OH(2)](2+) site in 1, but 1 is more reactive than 2 by a factor of 8 due to a redox mediator effect.


Progressive Effects of Sildenafil on Visual Processing in Rats.
Photoreceptors are light-sensitive cells in the retina converting visual stimuli into electrochemical signals. These signals are evaluated and interpreted in the visual pathway, a process referred to as visual processing. Phosphodiesterase type 5 and 6 (PDE5 and 6) are abundant enzymes in retinal vessels and notably photoreceptors where PDE6 is exclusively present. The effects of the PDE inhibitor sildenafil on the visual system, have been studied using electroretinography and a variety of clinical visual tasks. Here we evaluate effects of sildenafil administration by electrophysiological recordings of flash visual evoked potentials (VEPs) and steady-state visual evoked potentials (SSVEPs) from key regions in the rodent visual pathway. Progressive changes were investigated in female Sprague-Dawley rats at 10 timepoints from 30 min to 28 h after peroral administration of sildenafil (50 mg/kg). Sildenafil caused a significant reduction in the amplitude of VEPs in both visual cortex and superior colliculus, and a significant delay of the VEPs as demonstrated by increased latency of several VEP peaks. Also, sildenafil-treatment significantly reduced the signal-to-noise ratio of SSVEPs. The effects of sildenafil were dependent on the wavelength condition in both assays. Our results support the observation that while PDE6 is a key player in phototransduction, near full inhibition of PDE6 is not enough to abolish the complex process of visual processing. Taken together, VEPs and SSVEPs are effective in demonstrating progressive effects of drug-induced changes in visual processing in rats and as the same paradigms may be applied in humans, representing a promising tool for translational research.


The "inverse relationship between evolutionary rate and age of mammalian genes" is an artifact of increased genetic distance with rate of evolution and time of divergence.
It has recently been claimed that older genes tend to evolve more slowly than newer ones (Alba and Castresana 2005). By simulation of genes of equal age, we show that the inverse correlation between age and rate is an artifact caused by our inability to detect homology when evolutionary distances are large. Since evolutionary distance increases with time of divergence and rate of evolution, homologs of fast-evolving genes are frequently undetected in distantly related taxa and are, hence, misclassified as "new." This misclassification causes the mean genetic distance of 'new' genes to be overestimated and the mean genetic distance of "old" genes to be underestimated.


Can de facto dosing practices bridge the knowledge gap in pediatric medication recommendations?
A knowledge gap exists in pediatric medication dosing recommendations due in part to the complexity of researching medication efficacy and safety in children. One possible resource resides in the electronic prescribing practices of pediatric clinicians. In this study, de facto pediatric weight-based levothyroxine dosing practices were studied as a potential source for pediatric medication clinical decision support. This was accomplished by extracting physical exam and prescription details from a well-used clinical data warehouse to calculate weight-based dosing practices, and comparing the results with established medication recommendations. Of the 854 prescriptions, 85.2% were under the recommended range, 9.37% were within the range and 5.39% were over the range. Thus, real world prescribing practices may differ from recommendations. Such information may be a valuable resource in pediatric clinical decision support, particularly where practice differs from recommendations, and can help close the knowledge gap where pediatric medication dosing information is sparse or unavailable.


Peripheral opioid analgesia.
Opioids have long been thought to act exclusively within the central nervous system. An increasing number of studies recently reported the existence of opioid receptors outside the central nervous system and therefore suggested that opioids are also able to produce analgesic effects in the periphery. Such effects are particularly prominent under painful inflammatory conditions, both in animals and in humans. During inflammatory processes, opioid receptors are transported from dorsal root ganglia towards the peripheral sensory nerve endings. At the same time, immune cells containing endogenous opioid peptides accumulate within the inflamed tissue. Environmental stimuli (e.g. stress) as well as releasing agents (e.g. corticotropin releasing factor, cytokines) can liberate these opioid peptides to interact with the neuronal opioid receptors and elicit local analgesia. The inflammation-induced activation of opioid production and the release of endogenous opioids from immune cells may lead to novel approaches for the development of peripherally acting analgesics. Clinical investigation now focuses on the development of new peripheral opioid agonists as well as on ways to stimulate the endogenous analgesic system in order to induce effective peripheral analgesia with reduced central side effects typically associated with opioids.


Reduction of detection limits of the direct deposition GC/FT-IR interface by surface-enhanced infrared absorption.
Even though the interface of gas chromatography (GC) and mass spectrometry (MS) is by far the most popular way of identifying molecules eluting from a GC in real time, the identification of compositional isomers by MS is equivocal at best. Much better results would be found by infrared spectrometry (IR) if the sensitivity of the GC/IR interface could be improved. In this paper, we show how the smallest quantity of molecules injected into a GC for which an identifiable infrared spectrum can be measured on-line has been reduced by a factor of 10 below the detection limit of the most sensitive current technique. A commercial direct deposition interface between a GC and a Fourier transform infrared spectrometer was modified by vapor-depositing an island film of silver on the surface of the zinc selenide substrate. Band intensities in the spectra of molecules located within approximately 4 nm of the surface of the silver islands were increased by at least 1 order of magnitude through surface-enhanced infrared absorption (SEIRA). The effectiveness of this approach was illustrated by comparing the limits of identification of butylbenzene isomers measured with and without the silver film. Comparison with the spectra of the same molecules measured by mass spectrometry showed the increased sensitivity and specificity of the GC/SEIRA interface.


Cataract surgery (phacoemulsification) in difficult cases.
By presenting three cataract surgeries, we discuss the difficulties of the interventions and the key moments. Case I: Mature cataract surgery on a patient with corneal opacities (maculas). Case II: Posterior polar cataract. Case III: Small pupil, shallow anterior chamber (dilating with Malyugin ring). The surgery of a mature cataract on an eye with corneal opacities can be performed by a surgeon with enough experience. The final visual acuity depends on the clarity of the center of the cornea. During the operation of a posterior polar cataract we have to be prepared to the rupture of the posterior capsule, which is more frequent than in other cases. These interventions are better to be made in centers with posterior pole surgery capabilities. The Malyugin ring is a novel PMMA device, which dilates the pupil, creating decent conditions for a cataract surgery This device can be inserted and pulled out through a standard 2,8 mm incision.


A recombinant protein of Salmonella Typhi induces humoral and cell-mediated immune responses including memory responses.
Gram negative enteric bacteria, Salmonella enterica serovar Typhi (S. Typhi), the etiological agent of typhoid fever is a major public health problem in developing countries. While a permanent solution to the problem would require improved sanitation, food and water hygiene, controlling the infection by vaccination is urgently required due to the emergence of multidrug resistant strains in multiple countries. The currently licensed vaccines are moderately efficacious with limited applicability, and no recommended vaccines exist for younger children. We had previously reported that a candidate vaccine based on recombinant outer membrane protein (rT2544) of S. Typhi is highly immunogenic and protective in mice. Here we show that rT2544-specific antiserum is capable of mediating bacterial lysis by the splenocytes through Antibody-Dependent Cellular Cytotoxicity (ADCC). Increased populations of rT2544-specific IgA and IgG secreting plasma cells are found in the spleen, mesenteric lymph nodes and peyer's patches. Cell-Mediated Immune Responses (CMIR) induced by rT2544 consist of Th1 cell differentiation and generation of cytotoxic T lymphocytes (CTL), which produce IFN-γ and are capable of destroying cells displaying T2544-derived antigens. rT2544 elicits pro-inflammatory cytokines (TNF-α, IL-6) from Bone Marrow-Derived Dendritic cells (BMDCs), while in vitro re-stimulation of rT2544-primed CD4+ T cells induces cell proliferation and generates higher amounts of Th1 cytokines, such as IFN-gamma, TNF-α and IL-2. Finally, the candidate vaccine induces immunological memory in the form of memory B and T lymphocytes. Taken together, the study further supports the potential of rT2544 as a novel and improved vaccine candidate against S. Typhi.


Complete Genome Sequence of Enterotoxigenic Escherichia coli Myophage Murica.
Murica is an rv5-like myophage that infects enterotoxigenic Escherichia coli. Pathogenic E. coli strains are responsible for many intestinal diseases, and phages that infect these bacteria may prove useful in preventing severe health issues. The following is a report of the complete genome sequence of Murica and its important features.


Synthesis and characterization of phthalic europium(III) fluorescent complex nanorods.
The rare earth ion europium(III) was chosen as the central fluorescent ion, and phthalic acid (H2L) was chosen as the ligand. The rod-like phthalic europium(III) fluorescent complex was synthesized using a co-precipitation method in a polyvinylpyrrolidone (PVP) aqueous medium. The chemical composition of the synthesized complex was speculated to be PVP/Eu2L3 x 3H2O by elemental analysis, inductively coupled plasma-atomic emission spectroscopy (ICP-AES), and Fourier-transform infrared spectroscopy (FT-IR). The X-ray diffraction analytic (XRD) results indicated that the synthesized complex is a crystalline substance, and the scanning electron microscopy (SEM) analytic results showed that the synthesized complex is nanorod with an average size of about 40 nm. The thermogravimetry and differential thermal analysis (TG-DTA) result showed that the nanoscale complex has good stability below 449 degrees C. Photoluminescence spectra (PL) spectra showed that the nanoscale complex emitted characteristic red luminescence of Eu (III) under ultraviolet light.


Recurrent spinal epidural metastases: a prospective study with a complete follow up.
Prospective studies with a complete follow up in patients with spinal epidural metastases (SEM) are rare, so little is known of the incidence and relevance of recurrent spinal epidural metastases (RSEM). This prospective study was undertaken as a part of a previously started and extended prospective study to determine the occurrence and details of RSEM. Patients with SEM of various primary malignancies were followed up until death. The diagnosis was confirmed after neurological examination by imaging studies visualising not only the clinically suspected level, but also as much of the spinal canal as possible. Recurrent spinal epidural metastases (RSEM) occurred in 21 of the 103 patients (20%) after a median interval of 7 months and, after treatment, a second recurrence occurred in 11 patients (11%), a third recurrence in two patients (2%), and a sixth recurrence in one patient (1%). RSEM developed about as often at the initial level (55%) as at a different level (45%), did not occur more often in patients with initially multiple SEM, but, not surprisingly, occurred much more often in patients with longer survival. About one half of the patients surviving 2 years, and nearly all patients surviving 3 years or longer developed RSEM. Ambulatory state could be preserved in most patients, even after their second recurrence. RSEM are common and even several episodes of RSEM in the same patient are not rare. Patients with SEM who survive long enough have a high risk of RSEM and prompt treatment of RSEM to maintain the ambulatory state of the patient is valuable.


Can increased nuchal translucency in the first trimester of pregnancy predict gestational diabetes mellitus.
The current study was designed to evaluate whether increased nuchal translucency can predict gestational diabetes mellitus. This was a prospective observational study. Among the pregnant women at 11-14 weeks of pregnancy who came to our prenatal unit for a first trimester screening test, 389 pregnant women whose nuchal translucency above 95th centile were selected as the study group and 386 age-matched pregnant women whose nuchal translucency were within the normal range were enrolled as a control group. First, subjects underwent a 50 g glucose screening test; if it was positive then a 100 g oral glucose tolerance test was performed. The main outcome measures were the prevalence of gestational diabetes mellitus and impaired glucose tolerance and the number of macrosomic infants. Impaired glucose tolerance was more common in pregnant women whose nuchal translucency was above the 95th centile (p = 0.048). In addition, macrosomic infants were also more common in pregnant women with a fetal nuchal translucency above the 95th centile (p = 0.045). Macrosomia was more common in the study group with gestational diabetes mellitus (p = 0.046). In conclusion, increased nuchal translucency seems to be predictive for impaired glucose tolerance and macrosomia, which are associated with gestational diabetes mellitus.


Statin/ezetimibe combination therapy vs statin monotherapy for carotid atherosclerotic plaque inflammation.
It remains uncertain whether statin/ezetimibe combination therapy serves as a useful and equivalent alternative to statin monotherapy for reducing atherosclerotic plaque inflammation. The aim of the present study was to compare the effects of statin/ezetimibe combination therapy and statin monotherapy on carotid atherosclerotic plaque inflammation using 18F-fluorodeoxyglucose (18FDG) positron emission tomography (PET)/computed tomography (CT) imaging. Data were pooled from 2 clinical trials that used serial 18FDG PET/CT examination to investigate the effects of cholesterol-lowering therapy on carotid atherosclerotic plaque inflammation. The primary outcome was the percent change in the target-to-background ratio (TBR) of the index vessel in the most diseased segment (MDS) at 6-month follow-up. Baseline characteristics were largely similar between the 2 groups. At the 6-month follow-up, the MDS TBR of the index vessel significantly decreased in both groups. The percent change in the MDS TBR of the index vessel (primary outcome) did not differ significantly between the 2 groups (-8.41 ± 15.9% vs -8.08 ± 17.0%, respectively, P = .936). Likewise, the percent change in the whole vessel TBR of the index vessel did not differ significantly between the 2 groups. There were significant decreases in total and LDL cholesterol levels in both groups at follow-up (P < .001). There were no significant correlations between the percent changes in MDS TBR of the index vessel, changes in the lipid, and high-sensitive C-reactive protein levels. The reduction in carotid atherosclerotic plaque inflammation by statin/ezetimibe combination therapy was equivalent to that by the statin monotherapy.


[How I explore...cheilitis].
A cheilitis is an inflammatory disease confined to the lips. Several origins are recognized. Their nature is often different in children and adults. Some are spongiotic due to irritation or allergic reaction. Other lesions are keratotic and can evolve to leucoplasia and epidermoid carcinoma.


The use of trochanteric slide osteotomy in the treatment of displaced acetabular fractures.
From January 2003 and February 2006, 31 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a single approach, involving a straight lateral incision centered over the greater trochanter, trochanteric osteotomy and dislocation of the femoral head. The mean age of the patients was 48 (range 20-74 years) with a mean follow up 24 months (range from 20 to 42 months). Ten fractures were classified as simple, and 21 as complex fractures. The mean time to surgery was 4.5 days (range from 0 to 14 days). Mean operating time was 118 min (range 52-168). Five patients presented with posterior dislocation of the hip joint at the time of initial presentation. The trochanteric fragment was fixed with three 3.5mm cortical screws. Congruent reduction was achieved in all patients and all osteotomies healed within 5 months. Clinical evaluation was based on the modified Merle d'Aubigne and Postel scoring. Motor strength of abduction was evaluated according to the Medical Research Council grading. Clinical scoring was excellent to good in 24%. The strength of the abductors was grade 0/5 in a patient with Brooker's class IV heterotopic ossification, and 3/5 in the two patients with necrosis of the femoral head. There were five patients with grade 4/5 and the 5/5 in the rest. Complications included two segmental femoral head necrosis, one of them combined with necrosis of the weight bearing acetabular dome area. These patients required total hip replacement. Mild heterotopic ossification grade II was seen in one patient and significant (grade IV), in another patient. Two patients developed superficial wound infection over the trochanteric area and another two patients persistent pain due to irritation caused by the screws. One patient developed peroneal nerve palsy which resolved 3 months after the surgery. The trochanteric slide osteotomy can enhance the exposure of the whole acetabulum and the femoral head. This allows better evaluation of any osteochondral lesions, intra-articular bony fragments and fracture steps, providing a more accurate reduction and easier fixation of the acetabular fracture.


Ultrasonic guided waves in elliptical annular cylinders.
This paper studies the influence of cross-section ovalness or ellipticity on lower order axisymmetric guided wave modes in thin pipes. The second longitudinal mode L(0,2) and the fundamental torsional mode T(0,1) are studied, as these are of interest to current pipe inspection. The semi-analytical finite element (FE) method is mainly used, with three-dimensional FE simulations for visualization and cross-validation of results. The studies reveal that even a small degree of ovalness can affect mode shapes and velocities. The effect is more pronounced on the L(0,2) mode than on T(0,1) and this may be important for practical inspection applications.