Modern imaging in the evaluation of hepatolithiasis.
Hepatolithiasis is a primary disease of the biliary ducts, presenting with recurrent pyogenic cholangitis, complicated by parenchymal infection, obstructive cholangiopathy and subsequent parenchymal destruction. Cholangiocarcinoma is a rarer complication. Modern imaging aims at accurate delineation of biliary ducts and liver parenchyma. It directs planning of surgical or interventional treatment, and serves to guide these procedures. The characteristic features comprise varying combinations of ductal dilatation, intrahepatic/extrahepatic ductal stones, segmental ductal strictures and lobar/segmental atrophy; and in acute exacerbation parenchymal or ductal contrast enhancement, abscess and biliary obstruction. Ultrasonography is the preferred primary examination. Further imaging depends on the ultrasonography findings, the patient's symptomatology, the clinical problems and the intended mode of treatment. Contrast cholangiography is warranted preceding biliary intervention. Computed tomography evaluates ductal stones, extent of disease, acute parenchymal complications and prior to hepatic resection. Magnetic resonance imaging is less accessible, but obtains cross-sectional findings similar to computed tomography. It comprehensively evaluates the liver and portal venous system, for prognostic indication and contemplation of liver resection. For diagnostic purposes, magnetic resonance cholangiography promises to replace the more invasive contrast cholangiography. Therapeutic approaches tailored to the results of strategically applied imaging helps to improve the outcome of patients with hepatolithiasis.


Troglitazone inhibits synthesis of transforming growth factor-beta1 and reduces matrix production in human peritoneal mesothelial cells.
Peritoneal matrix accumulation is a characteristic of peritoneal fibrosis (PF). Continuous ambulatory peritoneal dialysis (CAPD) patients with up-regulation of transforming growth factor-beta1 (TGF-beta1) in their drained effluent show an increased risk of PF. Inhibition of TGF-beta1 expression in human peritoneal mesothelial cells (HPMC) may provide a potential treatment for PF. Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists are increasingly used in patients with diabetes, but their effects on extracellular matrix (ECM) turnover are unknown. The aims of this study were to investigate the effects of the PPAR-gamma agonist troglitazone on TGF-beta1 expression and matrix production in HPMC. Human peritoneal mesothelial cells were cultured from human omentum by an enzyme digestion method, grown in a medium containing 30 mmol/L D-glucose. TGF-beta1 expression and matrix production and turnover were measured in HPMC in the presence and absence of 15 micromol/L troglitazone. The mRNA expressions of TGF-beta(1), Collagen I (Col I) and fibronectin (FN) were determined by semiquantification reverse-transcriptive polymerase chain reaction (RT-PCR). The protein of TGF-beta1 was determined by ELISA and proteins of Col I, FN were determined by western blot. The mRNA expression and protein of TGF-beta(1), Col I, FN were significantly increased in HPMC stimulated with 30 mmol/L D-glucose compared to the control group with F12 media (P < 0.01), which was reversed in the presence of troglitazone (15 micromol/L). Obvious decrease of TGF-beta(1) was found in troglitazone-treated groups as compared to groups stimulated with GS (P < 0.05). Exposure of HPMC to troglitazone reduced collagen I secretion (P < 0.05), and fibronectin secretion (P < 0.05). Troglitazone reduce the expression of TGF-beta(1) in HPMC stimulated by 30 mmol/L D-glucose, and reduces ECM production. These studies suggest that the PPAR-gamma agonists may have a specific role in ameliorating the course of progressive peritoneal fibrosis under long-term peritoneal dialysis states.


Magnetic fluctuation power near proton temperature anisotropy instability thresholds in the solar wind.
The proton temperature anisotropy in the solar wind is known to be constrained by the theoretical thresholds for pressure-anisotropy-driven instabilities. Here, we use approximately 1x10;{6} independent measurements of gyroscale magnetic fluctuations in the solar wind to show for the first time that these fluctuations are enhanced along the temperature anisotropy thresholds of the mirror, proton oblique firehose, and ion cyclotron instabilities. In addition, the measured magnetic compressibility is enhanced at high plasma beta (beta_{ parallel} greater, similar1) along the mirror instability threshold but small elsewhere, consistent with expectations of the mirror mode. We also show that the short wavelength magnetic fluctuation power is a strong function of collisionality, which relaxes the temperature anisotropy away from the instability conditions and reduces correspondingly the fluctuation power.


The correlation of sexual dimorphism in tooth size and arch form.
To determine the sexual dimorphism in the sizes of the 6 anterior teeth in the maxilla and the mandible, as well as the sexual dimorphism in the maxillary and mandibular arch forms in Greek patients seeking orthodontic treatment. An attempt was made to establish a correlation between tooth size and arch form. The sample consisted of 100 male and 100 female patients seeking orthodontic treatment, between the ages of 20 and 25 years, and with no history of prior orthodontic treatment. Mesiodistal measurements of the 6 anterior teeth, as well as sagittal and transverse measurements of the dental arches, were taken on both the maxillary and mandibular casts. The subjects of the sample were divided into 5 groups, according to certain arch form characteristics determined from these measurements. The female subjects in this sample had both smaller teeth and smaller maxillary and mandibular arch dimensions. No significant differences in the distribution of the 5 forms according to gender were seen. When comparing the sum of the mesiodistal distances of the 6 anterior teeth to the arch form, the results do not offer a safe conclusion.


Recurrent inversion with concomitant deletion and insertion events in the coagulation factor VIII gene suggests a new mechanism for X-chromosomal rearrangements causing hemophilia A.
Recurrent int22h-related inversions in the coagulation factor VIII gene (F8) are the most common cause of severe hemophilia A. Such inversions have repeatedly been hypothesized to be associated with concomitant deletions that are responsible for an increased risk of immune responses against therapeutic exogenous factor VIII. However, exact DNA breakpoints have not yet been reported. In a patient with persistent factor VIII-inactivating antibodies, molecular analysis of F8 including Southern Blot, long-range PCR and primer walking techniques revealed a combination of an int22h2-related inversion, deletion of exons 16-22 and insertion of a duplicated part of the X-chromosomal MPP1 gene. This novel genomic rearrangement was also detectable in the patient's mother, but absent in both maternal grandparents. The genetic defect most likely originated from a complex X-chromosomal recombination event during spermatogenesis due to the formation of a DNA loop stabilized by Alu and LINE repeat elements. Elucidation of such combined mutations may allow early identification of patients at high risk of developing factor VIII-neutralizing antibodies and will help to understand the mechanisms behind gross chromosomal rearrangements causing hemophilia A and other diseases.


Cue combination encoding via contextual modulation of V1 and V2 neurons.
Neurons in early visual cortical areas encode the local properties of a stimulus in a number of different feature dimensions such as color, orientation, and motion. It has been shown, however, that stimuli presented well beyond the confines of the classical receptive field can augment these responses in a way that emphasizes these local attributes within the greater context of the visual scene. This mechanism imparts global information to cells that are otherwise considered local feature detectors and can potentially serve as an important foundation for surface segmentation, texture representation, and figure-ground segregation. The role of early visual cortex toward these functions remains somewhat of an enigma, as it is unclear how surface segmentation cues are integrated from multiple feature dimensions. We examined the impact of orientation- and motion-defined surface segmentation cues in V1 and V2 neurons using a stimulus in which the two features are completely separable. We find that, although some cells are modulated in a cue-invariant manner, many cells are influenced by only one cue or the other. Furthermore, cells that are modulated by both cues tend to be more strongly affected when both cues are presented together than when presented individually. These results demonstrate two mechanisms by which cue combinations can enhance salience. We find that feature-specific populations are more frequently encountered in V1, while cue additivity is more prominent in V2. These results highlight how two strongly interconnected areas at different stages in the cortical hierarchy can potentially contribute to scene segmentation.


Osteoporosis and diabetes: The dual pandemics.
Bone health is an important, but neglected aspect of diabetes care. People with type 1 diabetes are known to have a lower bone mineral density (BMD), which put them at a greater risk of osteoporosis and fractures. While BMD in those with type 2 diabetes is often misleading, multiple factors operate to increase the risk of falls and fractures in them. This article provides an overview of osteoporosis in diabetes. It proposes a LEMON mnemonic to understand the multifaceted aspects of bone care.


Health and quality of life in patients with medication overuse headache syndrome after standardized inpatient rehabilitation: A cross-sectional pilot study.
The aim of this pilot study was to determine health-related quality of life (HRQoL) in patients with history of medication overuse headache (MOH) after detoxification and a headache-specific inpatient rehabilitation program and to receive necessary information for future prospective studies.HRQoL and headache-related disability were cross-sectionally measured by Short Form 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Migraine Disability Score (MIDAS), Coping Strategies Questionnaire (CSQ), and Symptom Checklist 90 revised (SCL-90-R). SF-36, HADS, and SCL-90-R data were compared to German population norms, stratified by age, sex, and comorbidities.Fifty-one patients (72.5% females, mean age 47.3 years) were included with an average headache duration of 25.3 years. Moderate to high levels of headache were reported on the MIDAS VAS at 6.51 (range 0-10); SF-36 bodily pain was 40.3 (norm = 59.0, P < .001, 100 = best). Impaired functioning averaged at 78.4 (100 = no impairment) on the MIDAS. In contrast, SF-36 physical functioning was comparable to the norm (mean: 78.4, norm = 81.8, P = .63). All other SF-36 scales were significantly lower than expected from the norm (all P < .001). The scales depression, anxiety, obsessive-compulsive, and interpersonal sensitivity were significantly affected, whereas the levels of SCL-90-R schizophrenia nuclear and schizotypia were not lower than the norm. Coping with pain was moderate.This pilot study is the first that presents a comprehensive and simultaneously specific assessment of health and quality of life of MOH patients after detoxification and inpatient rehabilitation. Moderate to high levels of pain and self-reported disability owing to headache were observed, whereas physical function on the SF-36 was not different from the expected level of the norm. Mental health was substantially affected in several dimensions, which had been described to reduce the ability to cope with pain. MOH patients seem to have high expectations of functionality, low symptomatology, and intact well-being.


saeRS and sarA act synergistically to repress protease production and promote biofilm formation in Staphylococcus aureus.
Mutation of the staphylococcal accessory regulator (sarA) limits biofilm formation in diverse strains of Staphylococcus aureus, but there are exceptions. One of these is the commonly studied strain Newman. This strain has two defects of potential relevance, the first being mutations that preclude anchoring of the fibronectin-binding proteins FnbA and FnbB to the cell wall, and the second being a point mutation in saeS that results in constitutive activation of the saePQRS regulatory system. We repaired these defects to determine whether either plays a role in biofilm formation and, if so, whether this could account for the reduced impact of sarA in Newman. Restoration of surface-anchored FnbA enhanced biofilm formation, but mutation of sarA in this fnbA-positive strain increased rather than decreased biofilm formation. Mutation of sarA in an saeS-repaired derivative of Newman (P18L) or a Newman saeRS mutant (ΔsaeRS) resulted in a biofilm-deficient phenotype like that observed in clinical isolates, even in the absence of surface-anchored FnbA. These phenotypes were correlated with increased production of extracellular proteases and decreased accumulation of FnbA and/or Spa in the P18L and ΔsaeRS sarA mutants by comparison to the Newman sarA mutant. The reduced accumulation of Spa was reversed by mutation of the gene encoding aureolysin, while the reduced accumulation of FnbA was reversed by mutation of the sspABC operon. These results demonstrate that saeRS and sarA act synergistically to repress the production of extracellular proteases that would otherwise limit accumulation of critical proteins that contribute to biofilm formation, with constitutive activation of saeRS limiting protease production, even in a sarA mutant, to a degree that can be correlated with increased enhanced capacity to form a biofilm. Although it remains unclear whether these effects are mediated directly or indirectly, studies done with an sspA::lux reporter suggest they are mediated at a transcriptional level.


Sapap4 deficiency leads to postsynaptic defects and abnormal behaviors relevant to hyperkinetic neuropsychiatric disorder in mice.
Postsynaptic proteins play critical roles in synaptic development, function, and plasticity. Dysfunction of postsynaptic proteins is strongly linked to neurodevelopmental and psychiatric disorders. SAP90/PSD95-associated protein 4 (SAPAP4; also known as DLGAP4) is a key component of the PSD95-SAPAP-SHANK excitatory postsynaptic scaffolding complex, which plays important roles at synapses. However, the exact function of the SAPAP4 protein in the brain is poorly understood. Here, we report that Sapap4 knockout (KO) mice have reduced spine density in the prefrontal cortex and abnormal compositions of key postsynaptic proteins in the postsynaptic density (PSD) including reduced PSD95, GluR1, and GluR2 as well as increased SHANK3. These synaptic defects are accompanied by a cluster of abnormal behaviors including hyperactivity, impulsivity, reduced despair/depression-like behavior, hypersensitivity to low dose of amphetamine, memory deficits, and decreased prepulse inhibition, which are reminiscent of mania. Furthermore, the hyperactivity of Sapap4 KO mice could be partially rescued by valproate, a mood stabilizer used for mania treatment in humans. Together, our findings provide evidence that SAPAP4 plays an important role at synapses and reinforce the view that dysfunction of the postsynaptic scaffolding protein SAPAP4 may contribute to the pathogenesis of hyperkinetic neuropsychiatric disorder.


Efficiently scanning a focus behind scattering media beyond memory effect by wavefront tilting and re-optimization.
One of the main challenges in the wavefront shaping technique is to enable controllable light propagation through scattering media. However, the scanning of the focus generated by wavefront shaping is limited to a small range determined by the optical memory effect (ME). Here, we propose and demonstrate efficiently scanning a focus behind scattering media beyond the ME region using the wavefront tilting and re-optimization (WFT&RO) method. After scanning an initial focus to a desired position by wavefront tilting, our approach utilizes the scanned focus at a new position as the "guide star" to do wavefront re-optimization, which can not only enhance the intensity of the focus to the value before scanning but also accelerate the optimization speed. Repeat such a process, we can theoretically fast scan the focus to any position beyond the ME region while maintaining a relatively uniform intensity. We experimentally demonstrate the power of the method by scanning a focus with uniform intensity values through an optical diffuser within a range that is at least 5 folds larger than the ME region. Additionally, for the case of two cascaded optical diffusers, the scanning range achieved is at least 7 folds larger than the ME region. Our method holds promising implications for applications such as imaging through media, where the ability to control light through scattering media is crucial.


Tyrosinated and detyrosinated microtubules in axonal processes of cerebellar macroneurons grown in culture.
We have used the monoclonal antibody YL 1/2 (Tyr) specific for tyrosinated tubulin, and a polyclonal antibody (Glu) specific for detyrosinated tubulin to visualize the distribution of microtubules and microtubule assembly sites during axonal outgrowth. Cerebellar macroneurons growing in culture initially extend several short and thin neurites which have the potential to differentiate either as axons or dendrites (Ferreira and Caceres: Developmental Brain Research 49:205-213, 1989). At the onset of axonal outgrowth the Tyr antibody labels the minor neurites, the axon, and its growth cone, while the Glu antibody only shows immunoreactivity in the axonal shaft. After nocodazole treatment, the Tyr staining disappears, whereas that produced by the Glu antibody remains practically unchanged. When nocodazole was removed, tyrosinated microtubules reappeared first at the tip of the axon, in a more distal region than that occupied by detyrosinated microtubules; another focal site of tyrosinated tubulin incorporation was detected in the cell body. Incorporation of tyrosinated tubulin into growing axons was also studied after taxol treatment. After long incubation periods in the presence of taxol, the Tyr staining disappeared from the axon but remained in the cell body; however, immunoreactivity in this site was negative when the cells were preincubated in the presence of protein synthesis inhibitors. Release from taxol results in the reappearance of Tyr immunoreactivity at the distal end of the axon. Taken collectively, the present results indicate 1) that in cerebellar macroneurons axonal differentiation is accompanied by a temporal and spatial differentiation of microtubules and 2) that there is an active site of tyrosinated tubulin assembly at the tip of axonal processes, and they suggest that the highly tyrosinated domain in this region is a consequence of rapid microtubule turnover and tubulin tyrosine ligase activity.


[Pathophysiology of heart failure: peripheral vascular and muscular mechanisms].
Exercise tolerance in patients with congestive heart failure correlates poorly with measures of systolic left-ventricular function and is determined by disturbances of the regulation of skeletal muscle perfusion and structural and metabolic changes of skeletal muscle itself. The increase in minimal vascular resistance in skeletal muscle is due to increased activities of the sympathetic nervous system, the renin-angiotensin and vasopressin systems and decreased and increased endothelium-mediated vasodilation and vasoconstriction, respectively. In addition, skeletal muscle atrophy, decreased oxidative capacity and a relative increase of easily fatiguable glycolytic muscle fibres also contribute to the reduction of exercise tolerance. The disturbances of skeletal muscle perfusion and changes of skeletal muscle are at least in part reversible by vasodilator therapy or, in the extreme situation, by cardiac transplantation.


A posterior sagittal approach for revision vaginoplasty.
To review our experience with revision vaginoplasty without using bowel, by the posterior sagittal approach. The notes of eight patients (median age 12.3 years, range 9.0-15.6) were retrospectively reviewed; all had had revision vaginoplasty using a posterior sagittal approach. Their original diagnosis was cloacal anomaly in three, urogenital sinus in two, cloacal exstrophy in two, and congenital adrenal hyperplasia in one patient. Indications for re-operation included: haematocolpos in four patients, absent vaginal opening in two, hydrocolpos in one, and vesico-vaginal fistula in one. The vagina was reconstructed by total urogenital mobilization in seven patients and in one by anastomosing anterior and posterior aspects of a duplicated vagina. The vagina was mobilized by up to 6 cm in this manner. Bowel was not required for any of the vaginoplasties. The median (range) inpatient stay was 6 (4-17) days after surgery and the median follow-up was 35.3 (4.5-50) months. One patient developed a vesico-vaginal fistula and vaginal stenosis, and had further surgery. Two patients required subsequent use of vaginal dilators. The remainder have had a satisfactory outcome. For revisional vaginal surgery the posterior approach provides excellent exposure, and can be useful in dealing with a variety of pathologies. Combined with total urogenital mobilization, vaginoplasty can be successful despite long common channels. However, there were still several complications.


Sensitivity Analysis of a 6 MeV Photon Beam Monte Carlo Model.
This study aimed to optimize efficiency in Monte Carlo (MC) simulation using sensitivity analysis of a beam model. The BEAMnrc-based model of 6 MV beam of a Siemens Primus linac was developed. For sensitivity analysis, the effect of the electron source, treatment head, and virtual phantom specifications on calculated percent depth dose (PDD) and lateral dose profiles was evaluated. The optimum mean energy (E) and the full width at half maximum (FWHM) of the intensity distribution of the electron beam were calculated as 6.7 MeV and 3 mm, respectively. Increasing E from 6.1 to 6.7 MeV, increased the PDD in the fall-off region by 4.70% and decreased the lateral profile by 8.76%. Changing the FWHM had a significant effect on the buildup region of PDD and the horns and out-of-field regions of the lateral profile. Increasing the collimators opening by 0.5 mm, PDD increased by 2.13% and the central and penumbra regions of profiles decreased by 1.98% and 11.40% respectively. Collimator properties such as thickness and density were effective in changing the penumbra (11.32% for 0.25 cm increment) and the out-of-field (22.82% for 3 g/cm3) regions of the lateral profiles. Analysis of a 6 MV model showed that PDD profiles were more sensitive to changes in energy than to FWHM of the electron source. The lateral profiles were sensitive to E, FWHM, and collimator opening. The density of the collimator affected only the out-of-field region of lateral profiles. The findings of this study may be used to make benchmarking of an MC beam model more efficient.


Health-related behaviors and lifestyle factors of patients with breast cancer.
The purpose of this article is to examine differences in the relationship of selected lifestyle factors and health-related behaviors between two groups of women. The study used part of the data gathered in a national Jordanian case-control survey of 100 women with breast cancer and an equal sample of controls. Controls were selected to match the cases (patients) in terms of their age, education, and place of residence. The Health Belief Model and the basic Epidemiological Model were the theoretical framework used in this study. Data were collected using an interview form that was specifically constructed for the national survey. It contained 6 sections: demographics, history of cancer in the family, reproductive history, environmental factors, lifestyle factors, and health education about breast self-examination. The study revealed that there were no significant differences between the patients and controls with regard to their intake of fat, vegetable oil, beef and lamb meat, and smoked food. Higher proportions of patients were found to consume more of the canned and spicy food and caffeinated drinks. Neither smoking nor living or working with someone who smokes showed any significant differences between the patients and controls. Most of the women with breast cancer were found to have exercised in the last 5 years before diagnosis. Having been exposed to stressful events was a major significant risk factor discriminating patients from controls. Finally, having prior knowledge of breast self-examination was a health-related factor that made these women more attentive to their health.


[Bacteremia due to Pasteurella spp.: a rare process in our hospital over the last 8 years].
To review and update the epidemic and clinical knowledge concerning disseminated blood disease caused by Pasteurella species in our area. Retrospective study of Pasteurella species bacteremia (PSB) episodes occurring in patients attended from January 1994 to December 2001 in a single tertiary hospital. Among the 31 clinical samples remitted to the Microbiology Laboratory in which a species of Pasteurella was identified, 5 (16%) corresponded to positive blood cultures in 5 patients. Pasteurella multocida was the predominant species, identified in 70% of all isolations and all but one positive blood culture. All the patients were adults over 50 years old and all had underlying illnesses causing comorbidity or some degree of immunocompromise, with cardiovascular and hypertensive conditions being the most frequent; only one patient had liver cirrhosis. In all cases, except one, contact or coexistence with dogs or cats was documented. The clinical presentation of PSB was non-specific and only two episodes were related with a possible focal, soft-tissue origin. There were no serious complications, such as septic shock, organ failure or invasive disease (meningitis or endocarditis). All patients cured with antimicrobial treatment, although surgical debridement of infected bite wounds was required in two cases. The betalactams and other families of antibiotics showed excellent in vitro activity against the five strains of Pasteurella isolated. PSB occurred in adult patients having a wide range of underlying illnesses and comorbidity factors. Most of them had contact with pets, though traumatic lesions were not present in all cases. Clinical presentation did not differ from other types of severe sepsis. Susceptibility and outcome of primary treatment with penicillins and other betalactams shows that they are still appropriate therapy. More emphasis should be placed on preventive measures related to care and hygiene among individuals with pets.


Success on a practical driver's license test with and without the presence of another testee.
The present study examined whether performance in practical driving tests differed when individuals were tested with and without the presence of another testee. In addition, this study examined whether such differences were dependent on the sex of the tested person, on that of the observer testee, and on the order of tests. It was found that for both males and females, a greater proportion of drivers who were tested alone passed the test as compared to drivers who were tested in pairs. Additionally, proportionately more males than females passed the driving test. Only for males was performance also dependent on the gender of the other tested individual. A greater proportion of males who were tested with an accompanying female passed the test than males who were tested with an accompanying male. These results are discussed in relation to social facilitation, gender differences in driving performance, and differences in testing procedures.


Endophytic Bacillus cereus Effectively Controls Meloidogyne incognita on Tomato Plants Through Rapid Rhizosphere Occupation and Repellent Action.
Root-knot nematodes (Meloidogyne spp.), which cause severe global agricultural losses, can establish a special niche in the root vascular cylinder of crops, making them difficult to control. Endophytic bacteria have great potential as biocontrol organisms against Meloidogyne incognita. Three endophytic bacteria were isolated from plant tissues and showed high nematicidal activity against M. incognita second-stage juveniles (J2) in vitro. The gyrB gene sequence amplification results indicated that the three isolates were Bacillus cereus BCM2, B. cereus SZ5, and B. altitudinis CCM7. The isolates colonized tomato roots rapidly and stably during the colonization dynamic experiment. Three pot experiments were designed to determine the potential of three endophytic bacterial isolates on control of root-knot nematodes. The results showed that the preinoculated B. cereus BCM2 experiment significantly reduced gall and egg mass indexes. The inhibition ratio of gall and egg mass was up to 81.2 and 75.6% on tomato roots and significantly enhanced shoot length and fresh weight. The other two experiments with inoculated endophytic bacteria and M. incognita at the same time or after morbidity had lower inhibition ratios compared with the preinoculated endophytic bacteria experiment. The confocal laser-scanning microscopy method was used to further study the possible mechanism of endophytic bacteria in the biocontrol process. The results showed the localization pattern of the endophytic bacteria B. cereus BCM2-(str')-pBCgfp-1 in tomato root tissues. Root tissue colonized by endophytic bacteria repelled M. incognita J2 infection compared with the untreated control in a repellence experiment. We isolated an endophytic B. cereus strain that stably colonized tomato and controlled M. incognita effectively. This strain has potential for plant growth promotion, successful ecological niche occupation, and M. incognita J2 repellent action induction. It plays an important role in endophytic bacteria against root-knot nematodes.


The Relationship Between Intertwin Membrane Separation and Pregnancy Outcome.
To evaluate the association of intertwin membrane separation and pregnancy outcome. This is a retrospective cohort study of women with dichorionic twins who were diagnosed with spontaneous intertwin membrane separation between 2004 and 2013 at a large tertiary care maternity hospital. Control participants were selected as the next two sets of dichorionic twins that delivered at the study institution after a case participant delivered and that did not have an intrauterine procedure. Maternal, fetal, and delivery characteristics were compared using Wilcoxon rank-sum tests. Logistic regressions were used to assess the association of membrane separation and preterm delivery. Among the 27 cases of spontaneous intertwin membrane separation, the median gestational age at diagnosis was 28 weeks (interquartile range 25.5-28.8) and the median gestational age at delivery was 37 weeks (interquartile range 35.3-37.0). The rate of preterm delivery, our primary outcome, was 48% for the case group and 76% for the control group (odds ratio [OR] 0.29, P=.01). The rate of spontaneous preterm delivery was also lower for the case group (19% compared with 44%; OR 0.25, P=.26) as was the rate of neonatal intensive care unit admission (37% compared with 61%; OR 0.37, P=.04). Our retrospective cohort study demonstrates that intertwin membrane separation is not associated with adverse outcomes in dichorionic twin pregnancies. Thus, it is reasonable to manage these pregnancies expectantly. II.


Factors Affecting Choice of Treatment for Early-Stage Breast Cancer in West Virginia: A 10-Year Experience from a Rural Tertiary Care Center.
Recent literature shows changing trends in use of breast conservation surgery (BCS), mastectomy, and contralateral prophylactic mastectomy (CPM) in women with early-stage breast cancer (ESBC). We analyzed factors associated with selection of these treatment modalities in a rural West Virginia tertiary care hospital. We conducted a 10-year analysis of women treated for ESBC at our institution from the institutional cancer registry. Variables were compared between patients choosing BCS versus mastectomy. In women who chose mastectomy, predictors for choice of CPM were also examined. Variables with P < 0.05 on univariate analysis were entered into a multivariate logistic regression model to define independent predictors of treatment choice. The mastectomy rate increased from 18.0 per cent in 2006 to 40.2 per cent in 2013. On multivariate analysis, insurance status (P < 0.001), comorbidities (P = 0.001), and surgeon graduation after 1987-a surrogate for surgeon age-(P = 0.010) predicted receipt of mastectomy. Of those receiving mastectomy, 106 (25.1%) elected CPM. CPM rates increased from 8.0 per cent in 2006 to 45.0 per cent in 2013. Younger age at diagnosis (P < 0.001) and use of preoperative MRI (P = 0.012) independently predicted use of CPM versus unilateral mastectomy. Rates of mastectomy and CPM in ESBC have increased in West Virginia over time. Independent predictors of selecting mastectomy over BCS included insurance status, surgeon age, and associated comorbidities. Younger patients and patients receiving preoperative MRI were more likely to choose CPM. Awareness of these factors will aid in counseling women with ESBC and allow clinicians to address potential biases or disparities that may affect treatment choices. Further prospective study of these findings is warranted.


[Anti-oncogram-oriented polychemotherapy in metastasizing squamous cell carcinoma of the skin: impressive partial remission].
Metastatic squamous cell carcinoma of the skin is associated with a poor prognosis even after surgical treatment or irradiation. Polychemotherapy can be used as an alternative regimen. We present a 65-year-old male patient with extensive metastatic squamous cell carcinoma of the skin after multiple surgical treatment and radiation. A combination of bleomycin, methotrexate and cisplatin, planned according to the anti-oncogram, resulted in rapid partial remission of the cutaneous metastases over several months.


Antagonistic effects of Streptomyces violaceusniger strain G10 on Fusarium oxysporum f.sp. cubense race 4: indirect evidence for the role of antibiosis in the antagonistic process.
Fusarium oxysporum f.sp. cubense is the causal pathogen of wilt disease of banana. A cost-effective measure of control for this disease is still not available. Streptomyces violaceusniger strain G10 acts as an antifungal agent antagonistic towards many different phytopathogenic fungi, including different pathogenic races of the Fusarium wilt pathogen. In an attempt to understand the mode of action of this antagonist in nature, the interaction between S. violaceusniger strain G10 and F. oxysporum f.sp. cubense was first studied by paired incubation on agar plates. Evidence for the in vitro antibiosis of strain G10 was demonstrated by inhibition zones in the "cross-plug" assay plates. Microscopic observations showed lysis of hyphal ends in the inhibited fungal colonies. Culture of strain G10 in liquid media produces antifungal metabolites, which showed in vitro antagonistic effects against F. oxysporum f.sp. cubense such as swelling, distortion and excessive branching of hyphae, and inhibition of spore germination. An indirect method was used to show that antibiosis is one of the mechanisms of antagonism by which strain G10 acts against F. oxysporun f.sp. cubense in soil. This study suggests the potential of developing strain G10 for the biological control of Fusarium wilt disease of banana.


Pharmacists' Advice about Driving for Diabetic Patients.
In November 2013, the Japanese Ministry of Health, Labour and Welfare issued a directive that required the revision of the package inserts of 13 substances whose consumption carries risks associated with driving and the operation of machinery due to their side effects, such as dizziness. Medical personnel are required to remind patients taking these drugs about the risks, but the abovementioned directive did not apply to any antidiabetic drugs at that point. In January 2014, it was decided that patients should "pay attention while driving and at the workplace" when taking any antidiabetic drugs. This point is mentioned in the "important precautions" section of the drugs' package inserts. Since the revised Road Traffic Law was enacted in June 2014, the penalty for car accidents caused by a lack of awareness of hypoglycemia has increased. It has therefore become essential for medical personnel to instruct diabetic patients how to avoid falling unconscious due to hypoglycemia during driving. Patients taking antidiabetic drugs that are categorized as high-risk drugs are required to take an extra set of precautions and these are important for preventing severe hypoglycemia as well as reducing patients' cardiovascular risk. For more than 20 years, my pharmacy has been giving annual intensive counseling on hypoglycemia to diabetic patients. This counseling includes reminding patients about preventative measures, the risks associated with driving, and the need to keep a source of sugar in their cars. Only about 10% of diabetic patients keep a source of sugar in their cars.


C-C bond formation and related reactions at the CNC backbone in (smif)FeX (smif = 1,3-di-(2-pyridyl)-2-azaallyl): dimerizations, 3 + 2 cyclization, and nucleophilic attack; transfer hydrogenations and alkyne trimerization (X = N(TMS)2, dpma = (di-(2-pyridyl-methyl)-amide)).
Molecular orbital analysis depicts the CNC(nb) backbone of the smif (1,3-di-(2-pyridyl)-2-azaallyl) ligand as having singlet diradical and/or ionic character where electrophilic or nucleophilic attack is plausible. Reversible dimerization of (smif)Fe{N(SiMe3)2} (1) to [{(Me3Si)2N}Fe]2(μ-κ(3),κ(3)-N,py2-smif,smif) (2) may be construed as diradical coupling. A proton transfer within the backbone-methylated, and o-pyridine-methylated smif of putative ((b)Me2(o)Me2smif)FeN(SiMe3)2 (8) provides a route to [{(Me3Si)2N}Fe]2(μ-κ(4),κ(4)-N,py2,C-((b)Me,(b)CH2,(o)Me2(smif)H))2 (9). A 3 + 2 cyclization of ditolyl-acetylene occurs with 1, leading to the dimer [{2,5-di(pyridin-2-yl)-3,4-di-(p-tolyl-2,5-dihydropyrrol-1-ide)}FeN(SiMe3)2]2 (11), and the collateral discovery of alkyne cyclotrimerization led to a brief study that identified Fe(N(SiMe3)2(THF) as an effective catalyst. Nucleophilic attack by (smif)2Fe (13) on (t)BuNCO and (2,6-(i)Pr2C6H3)NCO afforded (RNHCO-smif)2Fe (14a, R = (t)Bu; 14b, 2,6-(i)PrC6H3). Calculations suggested that (dpma)2Fe (15) would favorably lose dihydrogen to afford (smif)2Fe (13). H2-transfer to alkynes, olefins, imines, PhN═NPh, and ketones was explored, but only stoichiometric reactions were affected. Some physical properties of the compounds were examined, and X-ray structural studies on several dinuclear species were conducted.


Bibliometrics and social work: a two-edged sword can still be a blunt instrument.
In order to improve the productivity and impact of social work scholarship, the profession must look beyond bibliometrics to other issues that must be considered. These include the lag time between acceptance and publication of articles, the quality of peer review experienced by social work authors, and the overabundance of journals being published in social work.


A Comparative Study of Cathepsin D Expression in Peripheral and Central Giant Cell Granuloma of the Jaws by Immunohistochemistry Technique.
Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage. This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics. The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells (labeling index), the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared. The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9±4.03 and 95.6±2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups (p= 0.586). The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma (p> 0.001). Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion (p= 0.001). The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma.


Clinical profile differences between PTSD-diagnosed military veterans and crime victims.
Few studies have conducted symptom comparisons across different trauma-exposed populations. Evidence linking different types of trauma to variations in clinical presentation would have potential implications for the assessment and treatment of trauma-related psychopathology. The current study evaluated whether military veterans (n = 187) and civilian crime victims (n = 47) diagnosed with posttraumatic stress disorder differ in their self-reported posttraumatic symptoms as measured by the Trauma Symptom Inventory. A multivariate profile analysis revealed that military-related trauma is associated with more severe posttraumatic symptoms than criminal victimization and suggested that these 2 types of trauma have statistically distinct symptom profiles. Some potential implications of these findings and considerations for future research are discussed.


SCORING IN ACUTE PANCREATITIS: WHEN IMAGING IS APPROPRIATE?.
Acute pancreatitis (AP) is a frequent presentation to the emergency departments with a rising incidence and a great variability in clinical severity and outcome. The aim of this review is to offer a succinct presentation on acute pancreatitis scoring systems and the use of different imaging methods in severity prediction: Ranson criteria, Glasgow criteria, Hong Kong Score, Acute Physiology and Chronic Health Evaluation II (APACHE II), computed tomography scoring systems, Bedside Index of Severity in Acute Pancreatitis (BISAP) score, Panc 3, Japanese Severity Score (JSS), Harmless Acute Pancreatitis Score (HAPS), Pancreatitis Outcome Prediction (POP), Sequential Organ Failure Assessment (SOFA). This article also describes the Revised Atlanta Classification of AP (2012) and the correlation with computed tomography.


CREB regulates spine density of lateral amygdala neurons: implications for memory allocation.
Neurons may compete against one another for integration into a memory trace. Specifically, neurons in the lateral nucleus of the amygdala with relatively higher levels of cAMP Responsive Element Binding Protein (CREB) seem to be preferentially allocated to a fear memory trace, while neurons with relatively decreased CREB function seem to be excluded from a fear memory trace. CREB is a ubiquitous transcription factor that modulates many diverse cellular processes, raising the question as to which of these CREB-mediated processes underlie memory allocation. CREB is implicated in modulating dendritic spine number and morphology. As dendritic spines are intimately involved in memory formation, we investigated whether manipulations of CREB function alter spine number or morphology of neurons at the time of fear conditioning. We used viral vectors to manipulate CREB function in the lateral amygdala (LA) principal neurons in mice maintained in their homecages. At the time that fear conditioning normally occurs, we observed that neurons with high levels of CREB had more dendritic spines, while neurons with low CREB function had relatively fewer spines compared to control neurons. These results suggest that the modulation of spine density provides a potential mechanism for preferential allocation of a subset of neurons to the memory trace.


Tumor-induced osteomalacia.
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic form of renal phosphate wasting that results in severe hypophosphatemia, a defect in vitamin D metabolism, and osteomalacia. This debilitating disorder is illustrated by the clinical presentation of a 55-year-old woman with progressive fatigue, weakness, and muscle and bone pain with fractures. After a protracted clinical course and extensive laboratory evaluation, tumor-induced osteomalacia was identified as the basis of her clinical presentation. In this article, the distinctive clinical characteristics of this syndrome, the advances in diagnosis of TIO, and new insights into the pathophysiology of this disorder are discussed.


Heterotopic intrathymic thyroid tissue.
Heterotopic intrathymic thyroid tissue is an extremely rare condition, but it is important to distinguish it from metastases of clinically undetected thyroid carcinoma because metastatic papillary thyroid carcinoma is often so well differentiated, simulating normal thyroid tissue. Described herein are histological findings of heterotopic intrathymic thyroid tissue that was incidentally identified in a woman with papillary thyroid carcinoma during histological examination of a radical neck dissection specimen. These findings emphasize that this rare incidence may occur and should be differentiated from metastatic papillary carcinoma. Histologically, the patient's intrathymic thyroid follicles were identical to the normal thyroid follicles, having flat cuboidal cells with uniformly small nuclei without nuclear grooves or inclusions. The follicular cells had a low Ki-67 labeling index close to zero, and immunonegativity for galectin-3, HBME-1, and RET oncoprotein, in contrast to the tumor cells in primary papillary thyroid carcinoma of the patient. To the authors' knowledge this is the first case report of intrathymic heterotopic thyroid tissue posing a diagnostic difficulty in a patient with papillary thyroid carcinoma.


The orthodontic appliance: esthetic considerations.
The importance of attractive dental and facial appearance is at an all-time high for the American consumer. Because of this emphasis on appearance, the esthetic impact of the orthodontic appliance is a matter of great concern to prospective patients. This article presents an overview of the esthetic features of currently available orthodontic appliances.


Efficacy and safety of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers in diabetic nephropathy: a systematic review and meta-analysis.
Diabetic nephropathy (DN) is one of the most typical microangiopathies caused by diabetes. It often leads enormous physiological and psychological burdens for patients and seriously affects their quality of life. Therefore, effective combination therapy is necessary for these patients. In this study, we performed a meta-analysis to systematically evaluate and discuss the efficacy and safety of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in the treatment of DN. The PubMed, Embase, Web of Science, and Medline databases were selected as the sources of the literature search, and the search was limited to studies published in English. Studies related to ACEIs and ARBs in the treatment of DN published from January 2001 to January 2021 were included in this analysis. Meta-analysis was performed to calculate the reinforcement mean difference. In total, eight articles involving 1,893 cases with DN were included in this study. The results of this systematic review and meta-analysis showed that for patients with diabetic nephropathy,there were significant differences in 24-hour proteinuria [mean difference (MD) =-78.46, 95% confidence interval (95% CI): -80.25 to -76.66, P<0.00001], systolic blood pressure (MD =-9.11, 95% CI: -13.44 to -4.78, P<0.0001), and diastolic blood pressure (MD =-3.39, 95% CI: -5.68 to -1.11, P=0.004) between the combined ACEI and ARB group and the single ACEI or ARB group (P<0.05). In terms of safety, in addition to the significant difference in serum potassium (MD =0.1, 95% CI: 0.05 to 0.15, P=0.0001) between the combined ACEI and ARB group and the single drug group (P<0.1), there were no notable differences in serum creatinine (MD =0.66, 95% CI: -8.0 to 2.12, P=0.37), creatinine clearance (MD =-0.25, 95% CI: -0.62, 0.11, P=0.17), or the incidence of adverse reactions [odds ratio (OR) =1.19, 95% CI: 0.81 to 1.75, P=0.37]. A total of eight studies were included in this meta-analysis. The results showed that for patients with diabetic nephropathy, the combination of ACEI and ARB was more effective than ACEI or ARB alone, and also had higher safety.


Some blood genetic markers of selected tribes in Western Saudi Arabia.
A total of 292 randomly selected subjects belonging to two indigenous Arab tribes (Harbi and Ghamid) and two immigrant tribes (Mograbi and Mowallad), residents in Western Saudi Arabia, have been tested for genetic variants of six blood groups, four serum proteins, and five red cell enzyme systems. The distribution of the polymorphic systems was different between indigenous and immigrant tribes, and the present Arab population shows a considerable degree of admixture from the surrounding countries, in particular Africa.


Seven-degree head-down tilt reduces choroidal pulsatile ocular blood flow.
We investigated the effects of head-down tilt (HDT), which simulates microgravity during spaceflights, on the choroidal pulsatile ocular blood flow (POBF). This investigation is important because alterations in the choroidal blood flow can affect the function of retinal rods and cones that rely totally on the choroid for metabolites. Nineteen healthy adults between 20 and 38 yr of age participated in this study. The POBF was compared for: 1) baseline, wherein subjects were declined 30 degrees from vertical; 2) microgravity simulation where subjects were in a 7 degrees HDT for 2 min; 3) 90 min of the 7 degrees HDT; and 4) recovery, i.e., back at 30 degrees for 2 min. The group averaged POBF (Mean +/- SEM values: 828.43 +/- 48.88 microL x min(-1)) decreased immediately during the 2-min microgravity simulation (582.18 +/- 43.62 microL x min(-1)), remained at that inferior level at the 90-min mark of HDT (542.26 +/- 45.35 microL x min(-1)), and came back toward baseline POBF during the recovery period (760.11 +/- 46.03 microL x min(-1)) (p = 0.0001). The results show that simulated-microgravity of relatively short duration induces retinal hypoperfusion throughout the microgravity interval through the reduction in the POBF. This finding may have important implications regarding visual performance in space crewmembers placed in prolonged microgravity environments.


Clinical features and risk factors of acute hepatitis E with severe jaundice.
To compares the clinical features of patients infected with hepatitis E virus (HEV) with or without severe jaundice. In addition, the risk factors for HEV infection with severe jaundice were investigated. We enrolled 235 patients with HEV into a cross-sectional study using multi-stage sampling to select the study group. Patients with possible acute hepatitis E showing elevated liver enzyme levels were screened for HEV infection using serologic and molecular tools.HEV infection was documented by HEV antibodies and by the detection of HEV-RNA in serum. We used χ(2) analysis, Fisher's exact test, and Student's t test where appropriate in this study. Significant predictors in the univariate analysis were then included in a forward, stepwise multiple logistic regression model. No significant differences in symptoms, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, or hepatitis B virus surface antigen between the two groups were observed. HEV infected patients with severe jaundice had significantly lower peak serum levels of γ-glutamyl-transpeptidase (GGT) (median: 170.31 U/L vs 237.96 U/L, P = 0.007), significantly lower ALB levels (33.84 g/L vs 36.89 g/L, P = 0.000), significantly lower acetylcholine esterase (CHE) levels (4500.93 U/L vs 5815.28 U/L, P = 0.000) and significantly higher total bile acid (TBA) levels (275.56 μmol/L vs 147.03 μmol/L, P = 0.000) than those without severe jaundice. The median of the lowest point time tended to be lower in patients with severe jaundice (81.64% vs 96.12%, P = 0.000). HEV infected patients with severe jaundice had a significantly higher viral load (median: 134 vs 112, P = 0.025) than those without severe jaundice. HEV infected patients with severe jaundice showed a trend toward longer median hospital stay (38.17 d vs 18.36 d, P = 0.073). Multivariate logistic regression indicated that there were significant differences in age, sex, viral load, GGT, albumin, TBA, CHE, prothrombin index, alcohol overconsumption, and duration of admission between patients infected with acute hepatitis E with and without severe jaundice. Acute hepatitis E patients may naturally present with severe jaundice.


[Economic aspects of pharmacovigilance in the pharmaceutical industry].
The economical aspects of pharmacovigilance in the pharmaceutical industry can be assessed by two ways. First the balance between cost of avoiding adverse drug reactions (ADR) and cost of ADR should be evaluated during the development. The company will have to take into account both efficacy and safety of its compound. However if it increases the costs of avoiding ADR it will reduce the costs of avoiding ADR occurring after commercialisation. On the other hand the cost of side effects of a marketed compound can also be appreciated. This assessment will always have to be comparative with an other drug and to take into account the benefit of both drugs, if their efficacy is not deemed identical.


Phase-controlled supramolecular photochirogenesis in cyclodextrin nanosponges.
Pyromellitate-bridged cyclodextrin nanosponges (CDNSs) evolved from sol into gel state upon gradual increase of the concentration from 0.2 to 2000 mg mL(-1) in water. The enantiodifferentiating geometrical photoisomerizations of (Z)-cyclooctene and (Z,Z)-1,3-cyclooctadiene sensitized by CDNS at various concentrations were critically affected by the phase transition of CDNS to afford the corresponding (E)- and (E,Z)-isomers in the highest enantiomeric excesses in the gel state.


Topical Growth Factors for the Treatment of Facial Photoaging: A Clinical Experience of Eight Cases.
Background: Chronic exposure to solar ultraviolet irradiation can result in facial fine lines and wrinkles, poor texture, and sagging skin. Growth factors are polypeptides or proteins that play a key role in the regulation of a number of physiological processes. Topical application of growth factors also reduces signs of photoaging, promotes fibroblast and keratinocyte proliferation, and induces extracellular matrix formation. Objective: This study evaluated the efficacy of topical growth factor after microneedling treatment for the reduction of visual signs of facial photoaging in Fitzpatrick skin types III to IV. Methods: Eight patients applied 2mL of gel containing a mixture of four different growth factors to photodamaged facial skin after microneedling procedures. The gel contained a biosynthetic mixture of epidermal growth factor, fibroblast growth factor, hepatocyte growth factor, and insulin-like growth factor. This was performed every 10 days, with three treatments total. An independent physician evaluator used the Fitzpatrick wrinkle scale to evaluate clinical photographs that were taken pre- and posttreatment (at before treatment and after four weeks of treatment). Assessment of side effects was performed after the second and third treatments. Patient questionnaires were completed in the fourth week. Results: Based on the independent physician's clinical assessment, seven of the eight patients showed an improvement in texture, fine lines, and wrinkles, especially in the periorbital region. According to the patient questionnaire, four of the eight patients felt their wrinkles were improved, while all patients felt their skin texture was smoother. Five of the eight patients experienced slight redness at 1 to 2 days after treatment. Conclusion: The application of topical growth factors after microneedling can be useful to reduce visual signs of facial photoaging by improving skin texture and minimizing the appearance of fine lines and wrinkles.


The cytochrome c oxidase biogenesis factor AtCOX17 modulates stress responses in Arabidopsis.
COX17 is a soluble protein from the mitochondrial intermembrane space that participates in the transfer of copper for cytochrome c oxidase (COX) assembly in eukaryotic organisms. In this work, we studied the function of both Arabidopsis thaliana AtCOX17 genes using plants with altered expression levels of these genes. Silencing of AtCOX17-1 in a cox17-2 knockout background generates plants with smaller rosettes and decreased expression of genes involved in the response of plants to different stress conditions, including several genes that are induced by mitochondrial dysfunctions. Silencing of either of the AtCOX17 genes does not affect plant development or COX activity but causes a decrease in the response of genes to salt stress. In addition, these plants contain higher reactive oxygen and lipid peroxidation levels after irrigation with high NaCl concentrations and are less sensitive to abscisic acid. In agreement with a role of AtCOX17 in stress and abscisic acid responses, both AtCOX17 genes are induced by several stress conditions, abscisic acid and mutation of the transcription factor ABI4. The results indicate that AtCOX17 is required for optimal expression of a group of stress-responsive genes, probably as a component of signalling pathways that link stress conditions to gene expression responses.


ADAPTATION AND CONSTRAINT IN THE EVOLUTION OF SPECIALIZATION OF BAHAMIAN ANOLIS LIZARDS.
Interspecific interactions affect habitat use and subsequent morphological adaptation in Anolis lizards. We examined populations of two species of Anolis lizards that evolved in the species-rich communities of Cuba and are now widespread in the Bahamas. Because the species occupy islands in the Bahamas that vary in the number of lizard species present and other characteristics, we predicted that directional selection should have led to morphological differentiation. In particular, we expected that populations on one-species islands should have evolved toward a generalist morphology because of the lack of competitors. Divergence in both species has been adaptive; populations that use wider perches have longer legs. Nonetheless, these differences are relatively minor, and none of the populations appears to have differentiated from its ancestral "ecomorph" type toward a more generalized morphology. This stasis mirrors a trend observed in the radiation of Caribbean anoles, which exhibits repeated instances of evolutionary specialization, but few or no cases of reversion to a more generalized condition. The explanation for this directionality of evolution is not obvious but probably involves the tendency of specialized species to continue using and further adapting the niches for which they are specialized even as conditions change.


Acoustics of Kalasha laterals.
Kalasha, a Northwestern Indo-Aryan language spoken in a remote mountainous region of Pakistan, is relatively unusual among languages of the region as it has lateral approximants contrasting in secondary articulation-velarization and palatalization (/ɫ/ vs /lʲ/). Given the paucity of previous phonetic work on the language and some discrepancies between descriptive accounts, the nature of the Kalasha lateral contrast remains poorly understood. This paper presents an analysis of fieldwork recordings with laterals produced by 14 Kalasha speakers in a variety of lexical items and phonetic contexts. Acoustic analysis of formants measured during the lateral closure revealed that the contrast was most clearly distinguished by F2 (as well as by F2-F1 difference), which was considerably higher for /lʲ/ than for /ɫ/. This confirms that the two laterals are primarily distinguished by secondary articulation and not by retroflexion, which is otherwise robustly represented in the language inventory. The laterals showed no positional differences but did show considerable fronting (higher F2) next to front vowels. Some inter-speaker variation was observed in the realization of /ɫ/, which was produced with little or no velarization by older speakers. This is indicative of a change in progress, resulting in an overall enhancement of an otherwise auditorily vulnerable contrast.


Emotion processing in persons who respond vicariously towards others in pain: Disinhibited left-lateralized neural activity for threatening expressions.
We investigated emotional processing in vicarious pain (VP) responders. VP responders report an explicit sensory and emotional feeling of pain when they witness another in pain, which is greater in magnitude than the empathic processing of pain in the general population. In Study 1, 31 participants completed a chimeric faces task, judging whether emotional chimera in the left, or right, visual field was more intense. VP responders took longer to judge emotionality than non-responders, and fixated more on the angry hemiface in the right visual field, whereas non-responder controls had no lateralized fixation bias. In Study 2, blood-oxygen level-dependent signals were recorded during an emotional face matching task. VP intensity was correlated with increased insula activity and reduced middle frontal gyrus activity for angry faces, and with reduced activity in the inferior and middle frontal gyri for sad faces. Together, these findings suggest that VP responders are more reactive to negative emotional expressions. Specifically, emotional judgements involved altered left-hemisphere activity in VP responders, and reduced engagement of regions involved in emotion regulation.


Human fetal bone alkaline phosphatase: preliminary immunologic studies.
A partially purified human fetal bone alkaline phosphatase preparation (B-APf) exhibits a class of antigenic determinants not found on any adult bone or liver isoenzymes as well as a set of determinants which it shares with adult bone and liver. The evidence for this is the quantitative immunotitration data which demonstrate the expected precipitation of L-AP, B-APa, B-APf and K-AP by the anti-B-APf reagent at equivalence. However, at high antibody excess, I-AP and P-AP are also precipitated. Conversely, by employing an immunosorbent column of Sepharose-purified L-AP, one can remove the component carrying the antigenic determinants shared with L-AP, B-APa and K-AP. Remaining in solution are antibodies which recognize determinant(s) shared by B-APf, P-AP and I-AP.


Assessment of the use of angiotensin receptor blockers in major European markets among paediatric population for treating essential hypertension.
This study was conducted to assess the use of angiotensin receptor blockers (ARBs) in European paediatric patients experiencing essential hypertension. This was a retrospective analysis of the IMS MIDAS Prescribing Insight Medical Database. Five major important European markets, including France, Germany, Italy, Spain and the UK were studied for the usage of ARBs as either a monotherapy or fixed-dose combination (FDC) therapy . Paediatric patients with essential hypertension were identified using ICD-10 codes, and anatomical therapeutic chemical (ATC) classification was used to identify major classes of antihypertensives. Projected prescription data for paediatric patients (<18 years) in the time period of October 2005 to September 2006 were analysed. Special emphasis was placed on the category of 6-17 years of age, as many ARBs were recommended in children above 6 years of age. Out of 242,405 estimated paediatric patients with hypertension, 222,033 (91.6%) were diagnosed with essential hypertension. Out of 230,220 projected prescriptions dispensed in these essential hypertensives, approximately 76.2% were for patients in the category of 6-17 years of. In the age group of 6-17 years, ARBs constituted 25.5% of the projected prescriptions, with 10.6% in the form of FDC of ARBs with hydrochlorothiazides (HCTz). Projected ARB prescription usage, either as a monotherapy or as an FDC with HCTz, was higher in Italy (35.7%), France (30.9%) and Spain (28.1%), but was lower in Germany (5.3%), and non-existent in the United Kingdom. Valsartan-based and losartan-based FDCs were commonly used in the age range of 6-17 years, and accounted for 39. and 13.9% of the projected prescription volume in the ARB-FDC category, respectively. In a majority of the important European markets, paediatric hypertensive patients in the age range of 6-17 years are often treated with ARB monotherapy or FDC therapy. Some ARBs lack necessary clinical studies to support its use in treating essential hypertension in paediatric patients.


Navigating Digital Dermatology: An Analysis of Acne-Related Content on TikTok.
Background With TikTok's rising popularity as a hub for health information dissemination, the quality and nature of such content require assessment. This study investigates the popularity and quality of the top 100 most-liked videos tagged with "#acne" on TikTok. This study aims to examine the engagement and quality of acne-related content on TikTok, assess contributions from diverse sources, including physicians and non-physicians, and guide healthcare professionals in leveraging this platform for public health education. Methodology A cross-sectional analysis of the top 100 most-liked videos tagged with "#acne" on TikTok as of June 7, 2023, was conducted. Parameters assessed included the profession of the creator, gender, specialty, content type, and other observable characteristics. The quality was measured using the DISCERN tool. Results Of the dataset, 38 videos were by physicians and 29 by non-physicians. Physician-created content had higher mean views, likes, comments, shares, and favorites than non-physician-created content. Videos by dermatologists and non-dermatologists received similar engagement. Videos sharing personal experiences achieved the highest DISCERN score. Overall, DISCERN scores were uniformly low across all categories. Conclusions Physicians, especially dermatologists, are trusted sources of acne-related information on TikTok. The study underscores the need for professionals to provide reliable, evidence-based information on such platforms, guiding effective health communication in the digital age.


Enhancement of osteogenic differentiation of human adipose derived stem cells by the controlled release of platelet lysates from hybrid scaffolds produced by supercritical fluid foaming.
A new generation of scaffolds capable of acting not only as support for cells but also as a source of biological cues to promote tissue regeneration is currently a hot topic of in bone Tissue Engineering (TE) research. The inclusion of growth factor (GF) controlled release functionalities in the scaffolds is a possible strategy to achieve such goal. Platelet Lysate (PL) is an autologous source of GFs, providing several bioactive agents known to act on bone regeneration. In this study, chitosan-chondroitin sulfate nanoparticles loaded with PL were included in a poly(D,L-lactic acid) foam produced by supercritical fluid foaming. The tridimensional (3D) structures were then seeded with human adipose-derived stem cells (hASCs) and cultured in vitro under osteogenic stimulus. The osteogenic differentiation of the seeded hASCs was observed earlier for the PL-loaded constructs, as shown by the earlier alkaline phosphatase peak and calcium detection and stronger Runx2 expression at day 7 of culture, in comparison with the control scaffolds. Osteocalcin gene expression was upregulated in presence of PL during all culture period, which indicates an enhanced osteogenic induction. These results suggest the synergistic effect of PL and hASCs in combinatory TE strategies and support the potential of PL to increase the multifunctionality of the 3D hybrid construct for bone TE applications.


Urinary incontinence in women.
NICE guidance has been issued to help health professionals diagnose and manage urinary incontinence in women. The problem is common but under-reported as women are often too embarrassed to seek help. This report outlines assessment, diagnosis and treatment options for women with stress, urge or mixed urinary incontinence and overactive bladder syndrome.


Detection of unculturable bacteria in periodontal health and disease by PCR.
Recently developed molecular methods have made it possible to characterize mixed microflora in their entirety, including the substantial numbers of bacteria which do not grow on artificial culture media. In a previous study, molecular analysis of the microflora associated with acute oral infections resulted in the identification of three phylotypes, PUS3.42, PUS9.170, and PUS9.180, representing as-yet-uncultured organisms. The aim of this study was to design and validate specific PCR primers for these phylotypes and to determine their incidences in samples collected from healthy and diseased periodontal tissues. Two specific reverse primers were devised for each phylotype, and these were used in duplex PCRs with universal forward and reverse primers. All three phylotypes were detected in periodontal sites; PUS9.170, related to oral asaccharolytic Eubacterium spp., was significantly associated with disease. This study demonstrates the possibility of using unculturable, and therefore uncharacterized, organisms as markers of disease.


Neural responses to social and monetary reward in early adolescence and emerging adulthood.
Reward processing is often considered to be a monolithic construct, with different incentive types eliciting equivalent neural and behavioral responses. The majority of the literature on reward processing has used monetary incentives to elicit reward-related activity, yet social incentives may be particularly important due to their powerful ability to shape behavior. Findings from studies comparing social and monetary rewards have identified both overlapping and distinct responses. In order to explore whether reward processing is domain general or category specific (i.e., the same or different across reward types), the present study recorded ERPs from early adolescents (ages 12-13) and emerging adults (ages 18-25) while they completed social and monetary reward tasks. Temporospatial principal components analysis revealed morphologically similar reward positivities (RewPs) in the social and monetary reward tasks in each age group. In early adolescents, no significant difference was found between the magnitude of the RewP to social and monetary rewards. In emerging adults, however, the RewP to monetary rewards was significantly larger than the RewP to social rewards. Additionally, responses to feedback between the two tasks were not significantly correlated in either age group. These results suggest that both domain-general and category-specific processes underlie neural responses to rewards and that the relative incentive value of different types of rewards may change across development. Findings from this study have important implications for understanding the role that neural response to rewards plays in the development of psychopathology during adolescence.


New-onset refractory status epilepticus and febrile infection-related epilepsy syndrome.
New-onset refractory status epilepticus (NORSE) and febrile infection-related epilepsy syndrome (FIRES) are relatively rare clinical presentations. They are characterized by de novo onset of refractory status epilepticus (RSE) without clearly identifiable acute or active cause (structural, toxic, or metabolic). We reviewed the literature using PubMed reports published between 2003 and 2019 and summarized the clinical, neurophysiological, imaging, and treatment findings. Focal motor seizures, which tend to evolve into status epilepticus, characterize the typical presentation. Disease course is biphasic: acute phase followed by chronic phase with refractory epilepsy and neurological impairment. Aetiology is unknown, but immune-inflammatory-mediated epileptic encephalopathy is suspected. Electroencephalograms show variety in discharges (sporadic or periodic, focal, generalized, or more frequently bilateral), sometimes with a multifocal pattern. About 70% of adult NORSE have abnormal magnetic resonance imaging (MRI); in paediatric series of FIRES, 61.2% of patients have a normal brain MRI at the beginning and only 18.5% during the chronic phase. No specific therapy for FIRES and NORSE currently exists; high doses of barbiturates and ketogenic diet can be used with some effectiveness. Recently, anakinra and tocilizumab, targeting interleukin pathways, have emerged as potential specific therapies. Mortality rate is around 12% in children and even higher in adults (16-27%).


Guest Editorial - A personal journey in Acute Medicine.
This article describes my personal journey through Acute Medicine from the late 1980's and incorporates the development of Acute Medical Units (AMU's), co-establishing the Society for Acute Medicine (SAM), as well as involvement in the development of training curricula, research and audit. I am deeply indebted to a great number of professional colleagues over the last three decades, who have been pivotal to the development of the Acute Medicine specialism, and many of whom in turn became presidents of SAM.


Stable hydrogen evolution from CdS-modified CuGaSe2 photoelectrode under visible-light irradiation.
The photoelectrochemical properties of CuGaSe2 modified by deposition of a thin CdS layer were investigated. The CdS layer formed a p-n junction on the surface of the electrode, improving its photoelectrochemical properties. There was an optimal CdS thickness because of the balance between the charge separation effect and light absorption by CdS. CdS-deposited CuGaSe2 showed high stability under the observed reaction conditions and evolved hydrogen continuously for more than 10 days.


The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity.
Many patients with morbid obesity (BMI > 40 kg/m) have hypertension. The complex pathophysiological abnormalities linking hypertension to obesity have not been fully clarified, but abnormal sodium handling could be an important mechanism. Therefore, we examined changes in body fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90 mmol/day) and 5 days of a high-sodium diet (250 mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls. High sodium intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5 ± 4%; obese, normotensive patients: 10 ± 11%; nonobese controls: 7 ± 6%), cardiac output (CO) (obese, hypertensive patients: 17 ± 12%; obese, normotensive patients: 20 ± 16%; nonobese controls: 13 ± 14%) and stroke volume (SV) (obese, hypertensive patients: 27 ± 26%; obese, normotensive patients: 27 ± 24%; nonobese controls: 18 ± 27%) in all three groups with no differences between the groups. Despite an increase in CO during high salt intake, 24-h blood pressure (BP) was unchanged in patients and controls as a result of a reduction in total peripheral resistance (obese, hypertensive patients: -11 ± 11%; obese, normotensive patients: -10 ± 12%; nonobese controls: -5 ± 14%). Similar changes were observed during an incremental bicycle exercise test wherein CO and SV were higher, whereas mean arterial BP was unchanged at each exercise level during high sodium intake. Despite substantial increases in CO and SV, we did not observe any significant change in BP during high sodium intake, neither in morbid obese patients nor in lean individuals.


Prognostic Factors of Surgical Outcome after Spinous Process-Splitting Laminectomy for Lumbar Spinal Stenosis.
A retrospective case review. To assess the clinical and radiographic outcomes and identify the predictive factors associated with poor clinical outcomes after lumbar spinous process-splitting laminectomy (LSPSL) for lumbar spinal stenosis (LSS). LSPSL is an effective surgical treatment for LSS. Special care should be taken in patients with degenerative lumbar scoliosis (DLS). A consecutive retrospective case review of patients undergoing LSPSL for LSS with a minimum 2-year follow-up was performed. Mild DLS and mild degenerative spondylolisthesis (DS) were included in the study. The Japanese Orthopedic Association (JOA) score and recovery rate were reviewed. Poor clinical outcome was defined as a recovery rate <50% using Hirabayashi's method. A total of 52 patients (mean age, 72 years) met the inclusion criteria and had a mean follow-up of 2.6 years (range, 2-4.5 years). The preoperative diagnosis was LSS in 19, DS in 19, and DLS in 14 cases. The mean JOA score significantly increased from 14.6 to 23.2 at the final follow-up. The overall mean recovery rate was 60.1%. Thirteen patients (25%) were assigned to the poor outcome group. A higher rate of pre-existing DLS was observed in the poor outcome (poor) group (good, 15%; poor, 62%; p=0.003) than in the good outcome (good) group. None of the patient factors examined were associated with a poor outcome. A progression of slippage ≥5 mm was found in 8 of 24 patients (33%) in the DS group. A progression of curvature ≥5° was found in 5 of 14 patients (36%) in the DLS group. The progression of scoliosis and slippage did not influence the clinical outcome. The clinical and radiographic outcomes of LSPSL for LSS were favorable. Pre-existing DLS was significantly associated with poor clinical outcome.


[Topical anesthesia with the EMLA cream: application in pediatric urology].
EMLA Topical cream is a mixture of two local anaesthetics of the aminoamides group (lidocaine and prilocaine) with the ability to penetrate healthy skin. Since 1979 it has been used with good results in those countries where it is available, and where it has become a routinely used compound. In urology, it has been used to release is balanopreputial adherences as a skin anaesthetics in ESWL sessions, cauterization of penial injuries, etc. With the aim evaluating the efficacy of this cream in paediatric urology a prospective study was conducted in 15 boys undergoing release of balanopreputial adherences and 5 girls undergoing venous catheterizations. Following topical application of the cream and a 90 min median occlusion time, an 80% efficacy level was observed in both groups. Considering these results, which are similar to those seen in the literature, we believe that this compound is useful for ordinary practice.


Modeling seasonality in fecundability, conceptions, and births.
This paper develops a model of seasonal fluctuations in fecundability, conceptions, and births. We begin with a model of individual fecundability that combines behavioral and biological components, with particular attention to the roles of coital frequency, sperm concentration, fetal loss, and contraception. The individual-level model is then expanded into a model of seasonal fluctuations in births at the population level, which accounts explicitly for seasonal fluctuations in the size of the susceptible population. We illustrate the use of the model by analyzing proposed explanations of birth seasonality that rely on extreme summer heat.


Parental High-Fat Diet Promotes Inflammatory and Senescence-Related Changes in Prostate.
Background. Obesity and dietary habits are associated with increased incidences of aging-related prostatic diseases. The present study was aimed to investigate transgenerational effects of chronic high-fat diet (HFD) feeding on inflammation and senescence-related changes in prostate. Methods. Sprague-Dawley rats were kept on either normal or HFD one. Senescence-associated β-galactosidase (SA β-gal) activity, inflammation, and cellular proliferation were determined in the prostate. Results. Increased SA β-gal activity, expression of p53, and cell proliferation marker PCNA were observed in ventral prostate of HFD-fed rats. Immunostaining for p53 and PCNA revealed that the p53 immunopositive cells were primarily in stroma while PCNA immunopositive cells were epithelial cells. An increase in expression of cycloxygenase-2 (COX-2) and phosphorylation of nuclear factor-kappa B (NF-kB) was observed in prostate of weaning pups HFD-fed parents. However, in adult pups, irrespective of dietary habit, a significant increase in the expression of COX-2, PCNA, phosphorylation of NF-kB, infiltration of inflammatory cells, and SA β-gal activity was observed. Conclusions. Present investigation reports that HFD feeding promotes accumulation of p53 expressing cells, proliferation of epithelial cells, and senescence-related changes in prostate. Further, parental HFD-feeding upholds inflammatory, proliferative, and senescence-related changes in prostate of pups.


Nonsteroidal therapy of sarcoidosis.
None of the medications used in clinical practice to treat sarcoidosis have been approved by the regulatory authorities. Understanding how to use disease-modifying antisarcoid drugs, however, is essential for physicians treating patients with sarcoidosis. This review summarizes the recent studies of medications used for sarcoidosis with a focus on nonsteroidal therapies. Studies from 2006 to 2013 were considered for review to update clinicians on the most relevant literature published over the last few years. Several recently published pieces of evidence have helped expand our ability to more appropriately sequence second-line and third-line therapies for sarcoidosis. For instance, methotrexate and azathioprine may be useful and well tolerated medications as second-line treatment. Mycophenolate mofetil might have a role in neurosarcoidosis. TNF-α blockers and other biologics seem to be well tolerated medications for the most severely affected patients. Corticosteroids remain the first-line therapy for sarcoidosis as many patients never require treatment or only necessitate a short treatment duration. Second-line and third-line therapies described in this article should be used in patients with progressive or refractory disease or when life-threatening complications are evident at the time of presentation.


Drug Drop Test: How to Quickly Identify Potential Therapeutic Compounds for Mitochondrial Diseases Using Yeast Saccharomyces cerevisiae.
Mitochondrial diseases (MDs) refer to a group of clinically and genetically heterogeneous pathologies characterized by defective mitochondrial function and energy production. Unfortunately, there is no effective treatment for most MDs, and current therapeutic management is limited to relieving symptoms. The yeast Saccharomyces cerevisiae has been efficiently used as a model organism to study mitochondria-related disorders thanks to its easy manipulation and well-known mitochondrial biogenesis and metabolism. It has been successfully exploited both to validate alleged pathogenic variants identified in patients and to discover potential beneficial molecules for their treatment. The so-called "drug drop test", a phenotype-based high-throughput screening, especially if coupled with a drug repurposing approach, allows the identification of molecules with high translational potential in a cost-effective and time-saving manner. In addition to drug identification, S. cerevisiae can be used to point out the drug's target or pathway. To date, drug drop tests have been successfully carried out for a variety of disease models, leading to very promising results. The most relevant aspect is that studies on more complex model organisms confirmed the effectiveness of the drugs, strengthening the results obtained in yeast and demonstrating the usefulness of this screening as a novel approach to revealing new therapeutic molecules for MDs.


Vaccination with ENO1 DNA prolongs survival of genetically engineered mice with pancreatic cancer.
Pancreatic ductal adenocarcinoma (PDA) is an aggressive tumor, and patients typically present with late-stage disease; rates of 5-year survival after pancreaticoduodenectomy are low. Antibodies against α-enolase (ENO1), a glycolytic enzyme, are detected in more than 60% of patients with PDA, and ENO1-specific T cells inhibit the growth of human pancreatic xenograft tumors in mice. We investigated whether an ENO1 DNA vaccine elicits antitumor immune responses and prolongs survival of mice that spontaneously develop autochthonous, lethal pancreatic carcinomas. We injected and electroporated a plasmid encoding ENO1 (or a control plasmid) into Kras(G12D)/Cre (KC) mice and Kras(G12D)/Trp53(R172H)/Cre (KPC) mice at 4 weeks of age (when pancreatic intraepithelial lesions are histologically evident). Antitumor humoral and cellular responses were analyzed by histology, immunohistochemistry, enzyme-linked immunosorbent assays, flow cytometry, and enzyme-linked immunosorbent spot and cytotoxicity assays. Survival was analyzed by Kaplan-Meier analysis. The ENO1 vaccine induced antibody and a cellular response and increased survival times by a median of 138 days in KC mice and 42 days in KPC mice compared with mice given the control vector. On histologic analysis, the vaccine appeared to slow tumor progression. The vaccinated mice had increased serum levels of anti-ENO1 immunoglobulin G, which bound the surface of carcinoma cells and induced complement-dependent cytotoxicity. ENO1 vaccination reduced numbers of myeloid-derived suppressor cells and T-regulatory cells and increased T-helper 1 and 17 responses. In a genetic model of pancreatic carcinoma, vaccination with ENO1 DNA elicits humoral and cellular immune responses against tumors, delays tumor progression, and significantly extends survival. This vaccination strategy might be developed as a neoadjuvant therapy for patients with PDA.


Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries.
In an effort to improve health service delivery and achieve better health outcomes, the World Health Organization (WHO) has called for improved efficiency of health care systems to better use the available funding. This study aims to examine the efficiency of national health systems using longitudinal country-level data. Data on health spending per capita, infant mortality rate (IMR), under 5 mortality rate (U5MR), and life expectancy (LE) were collected from or imputed for 173 countries from 2004 through 2011. Data envelopment analyses were used to evaluate the efficiency and regression models were constructed to examine the determinants of efficiency. The average efficiency of the national health system, when examined yearly, was 78.9%, indicating a potential saving of 21.1% of health spending per capita to achieve the same level of health status for children and the entire population, if all countries performed as well as their peers. Additionally, the efficiency of the national health system varied widely among countries. On average, Africa had the lowest efficiency of 67%, while West Pacific countries had the highest efficiency of 86%. National economic status, HIV/AIDS prevalence, health financing mechanisms and governance were found to be statistically associated with the efficiency of national health systems. Taking health financing as an example, a 1% point increase of social security expenses as a percentage of total health expenditure correlated to a 1.9% increase in national health system efficiency. The study underscores the need to enhance efficiency of national health systems to meet population health needs, and highlights the importance of health financing and governance in improving the efficiency of health systems, to ultimately improve health outcomes.


Development of Indirect Competitive Enzyme-Linked Immunosorbent Assay to Detect Fusarium verticillioides in Poultry Feed Samples.
Fumonisins are a group of toxic secondary metabolites that are produced by Fusarium verticillioides which are associated with poultry health hazard and great economic losses. The objective of the present study was to develop an immunological method to detect F. verticillioides in poultry feed samples. An indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) based on a polyclonal antibody against 67 kDa protein of the F. verticillioides 97K exoantigen was developed to detect this fungus. Antibody anti-67 kDa protein showed cross-reactivity against F. graminearum (2⁻7%) and F. sporotrichioides (10%), but no or low cross-reactivity against Aspergillus sp. and Penicillium sp. exoantigens. The detection limit for the 67 kDa protein of F. verticillioides was 29 ng/mL. Eighty-one poultry feed samples were analyzed for Fusarium sp. count, 67 kDa protein of F. verticillioides and fumonisin concentrations. Eighty of the 81 feed samples (98.6%) showed Fusarium sp. contamination (mean 6.2 x 10⁴ CFU/g). Mean 67 kDa protein and fumonisin concentration in the poultry feed samples was 21.0 µg/g and 1.02 µg/g, respectively. The concentration of 67 kDa protein, as determined by ic-ELISA correlated positively (p < 0.05) with fumonisin levels (r = 0.76). These results suggest that this ic-ELISA has potential to detect F. verticillioides and predict fumonisin contamination in poultry feed samples.


Solitary central osteoma of the jaws: a diagnostic dilemma.
Osteomas are relatively rare benign osteogenic neoplasms, characterized by the proliferation of compact and/or cancellous bone. Osteomas can develop as peripheral (periosteal) masses attached to the cortical plates or as central lesions arising from endosteal bone surfaces. Although multiple osteomas of the jaws are a hallmark of Gardner syndrome (familial adenomatous polyposis), nonsyndromic cases are typically solitary. A search of the literature identified 91 well documented cases of solitary osteoma of the jaws published since 1955: 93.4% were peripheral and only 6.6% central, a ratio of 14:1 in favor of peripheral osteomas. Solitary central osteomas of the jaws seem to be very rare, with only 6 such cases reported since 1955. Adding the 4 new cases described here brings the total to 10 central osteomas, 30% occurring in the maxilla and 70% in the mandible. Whereas peripheral osteomas are fairly easy to diagnose, central osteomas pose a more challenging diagnostic problem and need to be differentiated from other similar lesions of the jaws, such as central ossifying fibroma, condensing osteitis, idiopathic osteosclerosis, osteoblastoma, cementoblastoma, and complex odontoma. With such a low number of cases of central osteoma reported, the objectives of the present report are to describe 4 new cases, analyze the clinical and radiographic characteristics, and discuss the features which distinguish these lesions from other similar lesions of the jaws.


Chemical composition and aroma evaluation of volatile oils from edible mushrooms (Pleurotus salmoneostramineus and Pleurotus sajor-caju).
This study is focused on the volatile oils from the fruiting bodies of Pleurotus salmoneostramineus (PS) and P. sajor-caju (PSC), which was extracted by hydrodistillation (HD) and solvent-assisted flavor evaporation (SAFE) methods. The oils are analyzed by gas chromatography-mass spectrometry (GC-MS), GC-olfactometry (GC-O), and aroma extract dilution analysis (AEDA). A total of 31, 31, 45, and 15 components were identified in PS (HD and SAFE) and PSC (HD and SAFE), representing about 80.3%, 92.2%, 88.9%, and 83.0% of the oils, respectively. Regarding the aroma-active components, 13, 12, 13, and 5 components were identified in PS (HD and SAFE) and PSC (HD and SAFE), respectively, by the GC-O analyses. The results of the sniffing test, odor activity value (OAV) and flavor dilution (FD) factor indicate that 1-octen-3-ol and 3-octanone are the main aroma-active components of PS oils. On the other hands, methional and 1-octen-3-ol were estimated as the main aroma-active components of PSC oils.


Efficacy of trimethoprim/sulfamethoxazole in experimental Escherichia coli bacteremia and meningitis.
We evaluated the activity of trimethoprim/sulfamethoxazole (TMP/SMZ) against a K1 Escherichia coli strain. Minimal inhibitory and bactericidal concentrations were 0.06/1.14 and 0.25/4.75 micrograms/ml, respectively. In vivo studies using an infant rat model of bacteremia and meningitis revealed that TMP/SMZ penetrated well into the cerebrospinal fluid (CSF) and that 37% of serum levels were achieved. The efficacy of TMP/SMZ was compared with that of ampicillin, chloramphenicol, cefotaxime and lamoxactam. Bacterial clearance from blood and CSF was significantly greater with TMP/SMZ than with ampicillin or chloramphenicol and mortality was significantly less than with chloramphenicol (p less than 0.01). However, 3 of 21 (14%) and 2 of 8 animals (25%) still had positive blood and CSF cultures after 3 days of treatment with TMP/SMZ. None of the survivors in the cefotaxime and lamoxactam groups were bacteremic after 1 day of therapy. Furthermore, 5 of 13 animals (38%) treated with TMP/SMZ developed meningitis during therapy, in contrast with none in the cefotaxime and lamoxactam groups. These findings indicate that although the activity of TMP/SMZ is bactericidal in vitro and in vivo against E. coli, TMP/SMZ may not provide optimal therapy for gram-negative bacillary meningitis in this model.


Plant-inspired multi-stimuli and multi-temporal morphing composites.
Plants are inspiring models for adaptive, morphing systems. In addition to their shape complexity, they can respond to multiple stimuli and exhibit both fast and slow motion. We attempt to recreate these capabilities in synthetic structures, proposing a fabrication and design scheme for multi-stimuli and multi-temporal responsive plant-inspired composites. We leverage a hierarchical, spatially tailored microstructural and compositional scheme to enable both fast morphing through bistability and slow morphing through diffusion processes. The composites consisted of a hydrogel layer made of gelatine and an architected particle-reinforced epoxy bilayer. Using magnetic fields to achieve spatially distributed orientations of magnetically responsive platelets in each epoxy layer, complex bilayer architectural patterns in various geometries were realised. This feature enabled the study of plant-inspired complex designs,viafinite element analysis and experiments. We present the design and fabrication strategy utilizing the material properties of the composites. The deformations and temporal responses of the resulting composites are analysed using digital image correlation. Finally, we model and experimentally demonstrate plant-inspired composite shells whose stable shapes closely mimic those of the Venus flytrap, while maintaining the multi-stimuli and multi-temporal responses of the materials. The key to achieving this is to tune the local in-plane orientations of the reinforcing particles in the bilayer shapes, to induce distributed in-plane mechanical properties and shrinkage. How these particles should be distributed is determined using finite element modelling. The work presented in this study can be applied to autonomous applications such as robotic systems.


Three-dimensional structure of chymotrypsin inactivated with (2S)-N-acetyl-L-alanyl-L-phenylalanyl alpha-chloroethane: implications for the mechanism of inactivation of serine proteases by chloroketones.
The reaction of enantiomerically pure (2S)-N-acetyl-L-alanyl-L-phenylalanyl alpha-chloroethane with gamma-chymotrypsin was studied as a probe of the mechanism of inactivation of serine proteases by peptidyl chloroalkanes. It was determined crystallographically that the peptidyl chloroethane alkylates His57 with retention of configuration at the chiral center, indicating a double displacement mechanism. We think it likely that a Ser195-epoxy ether adduct is an intermediate on the inactivation pathway, although other possibilities have not been disproven. Kinetic data reported by others [Angliker et al. (1988) Biochem. J. 256, 481-486] indicate that the epoxy ether intermediate is not an irreversibly inactivated form of enzyme [a conclusion confirmed experimentally (Prorok et al. (1994) Biochemistry 33, 9784-9790)] and that both ring closure of the tetrahedral intermediate to form the epoxy ether and ring opening by His57 partially limit the first-order rate constant for inactivation, ki. The peptidyl chloroethyl derivative adopts a very different active site conformation from that assumed by serine proteases inactivated by peptidyl chloromethanes. Positioning the chloroethyl derivative into the conformation adopted by chloromethyl derivatives would cause the extra methyl group to make a bad van der Waals contact with the inactivator P2 carbonyl carbon, thereby preventing the formation of the invariant hydrogen bond between the inactivator P1 amide nitrogen and the carbonyl group of Ser214. We conclude that the unusual conformation displayed by the chloroethyl derivative is caused by steric hindrance between the extra methyl group and the rest of the inactivator chain.


Ghrelin, Helicobacter pylori and body mass: is there an association?
Eradication of Helicobacter pylori is accompanied by an array of metabolic and hormonal changes in the host. Weight gain following H. pylori eradication is a poorly understood phenomenon and probably results from an interaction between multiple factors. Ghrelin, a peptide hormone secreted by the stomach, is involved in the regulation of food intake and appetite and may account for some of these changes. Although several observational studies have demonstrated that H. pylori infection suppresses circulating ghrelin levels, it has yet to be proven that ghrelin levels increase following eradication. On the other hand, gastric expression of ghrelin, also suppressed by H. pylori, clearly increases following eradication. The determinants of plasma ghrelin levels remain elusive, as do the effects of eradication on these levels. Weight gain following H. pylori eradication may be attributable to changes in plasma and gastric ghrelin; however, this hypothesis needs to be further investigated.