THE ROLE OF INBREEDING DEPRESSION IN MAINTAINING THE MIXED MATING SYSTEM OF THE COMMON MORNING GLORY, IPOMOEA PURPUREA.
Theoretical studies show that, although inbreeding depression (ID) will counterbalance the transmission advantage of selfing, it can only maintain a mixed mating system in plants when at least one of the following two conditions is met: (1) there is a positive association between selfing rates and the level of ID; and (2) ID is greater than 0.5 for the female component of fitness, while the average ID for male and female fitness is less than 0.5. This study tests whether these two conditions hold in the common morning glory, Ipomoea purpurea, which has a mixed mating system with 30% self-fertilization. Inbreeding depression was found in all but one fitness component measured in two groups of plants with distinct anther-stigma distances (ASD), a character that influences selfing rates. However, when examined separately, a negative association was found between selfing rates and ID; plants with large ASD (low-selfing-rate genotypes) tended to have higher ID than ones with small ASD (high-selfing-rate genotypes). Furthermore, the overall lifetime ID for male (12.5%) and female (24%) components of fitness, averaged across two ASD groups, were lower than what is necessary for ID to maintain an evolutionarily stable mixed mating system. Therefore, although inbreeding depression contributes to balancing the transmission advantage of selfing, it is not likely to be the primary mechanism maintaining the mixed mating system of I. purpurea. The contribution of other mechanisms is discussed.


An immortalized hamster corneal epithelial cell line for studies of the pathogenesis of Acanthamoeba keratitis.
The protozoan Acanthamoeba produces a severe keratitis in a small percentage of people, especially contact lens-wearers. The purpose of this work was to develop and characterize an immortalized line of hamster corneal epithelial cells to be used in studies of the pathogenesis of Acanthamoeba keratitis. Hamster corneal epithelial cells were maintained in primary culture and immortalized using simian virus 40 (SV40). Foci of transformed cells were cloned and subsequently characterized by phase-contrast microscopy and immunocytochemistry. Growth characteristics of the clone that were analyzed included loss of dependence on conditioned medium and ability to grow in soft agar. Cytotoxicity experiments were performed, to determine whether the selected clone was susceptible to Acanthamoeba infection in vitro. A cell line which exhibited epithelial morphology, as determined by phase contrast microscopy, was selected and cloned. Immunocytochemistry demonstrated the presence of keratin in the cloned cells, confirming the epithelial nature of the cell line. Immortalization was shown by loss of dependence on fibroblast-conditioned medium, ability to form colonies in soft agar and no apparent senescence following numerous passages in culture. This cell line was found to be sensitive to the cytotoxic effects of a pathogenic strain of Acanthamoeba. An immortalized line of hamster corneal epithelial cells was developed. This clone is susceptible to infection with Acanthamoeba and will be a useful tool with which to investigate the pathogenesis of Acanthamoeba keratitis.


Discriminating between normal and anomalous random walks.
Commonly, normal diffusive behavior is characterized by a linear dependence of the second central moment on time, {x2(t) proportional t, while anomalous behavior is expected to show a different time dependence, x2(t) proportional t{delta} with delta<1 for subdiffusive and delta>1 for superdiffusive motions. Here we explore in details the fact that this kind of qualification, if applied straightforwardly, may be misleading: there are anomalous transport motions revealing perfectly "normal" diffusive character (x2(t) proportional t) yet being non-Markov and non-Gaussian in nature. We use recently developed framework of Monte Carlo simulations which incorporates anomalous diffusion statistics in time and space and creates trajectories of such an extended random walk. For special choice of stability indices describing statistics of waiting times and jump lengths, the ensemble analysis of anomalous diffusion is shown to hide temporal memory effects which can be properly detected only by examination of formal criteria of Markovianity (fulfillment of the Chapman-Kolmogorov equation).


Fertility of lactating dairy cows administered recombinant bovine somatotropin during heat stress.
Administration of recombinant bovine somatotropin (bST) to lactating dairy cows during heat stress increases milk yield, but it also can increase body temperature and may therefore compromise fertility. However, it is possible that bST treatment could increase fertility during heat stress because it has been reported to increase fertility in lactating cows. In addition, bST increases secretion of insulin-like growth factor-I (IGF-I) that promotes embryo survival. The purpose of this study was to determine effects of bST on reproductive function in lactating dairy cows during heat stress. The experiment was conducted in southern Georgia from July to November 2005 using lactating Holstein cows (n = 276 for reproductive traits). For first service timed artificial insemination (TAI), cows were presynchronized with 2 injections of PGF(2alpha) given 14 d apart followed by a modified Ovsynch protocol (GnRH and insemination at 72 h following PGF(2alpha) ). Pregnancy was diagnosed by using ultrasonography on d 29 and reconfirmed by palpation between d 45 and 80 post-TAI. Nonpregnant cows were resynchronized with the modified Ovsynch protocol and received a second TAI. Treatment with bST started 1 wk before the start of Ovsynch and continued at 2-wk intervals. Blood samples were collected from a subset of cows to determine IGF-I profiles immediately before the first bST injection, 1 wk later, and at d 35 of bST treatment. Rectal temperatures were assessed on d 29 of bST treatment. Pregnancy rates (d 45 to 80 post-TAI) did not differ between bST and control cows for first- (16.7 vs. 15.2%) or second-service TAI (14.8 vs. 17.2%). Plasma concentrations of IGF-I and milk yield were greater for bST-treated cows following the initiation of bST treatment and bST increased rectal and vaginal temperatures. Body condition score was less for bST-treated cows. In conclusion, treatment with bST during heat stress increased IGF-I concentrations, milk yield over time, and rectal and vaginal temperatures without affecting first- or second-service pregnancy rates. Thus, at least under certain housing conditions, bST can be used to improve milk yield during heat stress without compromising fertility.


The reporting of fidelity measures in primary prevention programmes for eating disorders in schools.
The aim of this paper was to examine the extent to which controlled trials of face-to-face school-based primary prevention for eating disorders report their strategies for maintaining fidelity. A systematic review located 38 articles eligible for inclusion. These studies were assessed using 18 criteria for reporting fidelity maintenance strategies based on those recommended by the Treatment Fidelity Workgroup of the National Institute of Health Behavior Change Consortium. Fidelity reporting was generally poor. The studies reported between 22% and 56% of fidelity criteria. Detailed reporting of curriculum-as-usual control conditions was generally lacking, as were methods to ensure high-quality training and mechanisms to assess provider adherence to intervention protocol. Poor fidelity assessment and reporting is a problem in school-based primary prevention programmes for eating disorders. Recommendations for improving fidelity maintenance and reporting practices are provided.


[A retrospective study of patients with early onset of multiple sclerosis in Omskaya Oblast].
To study the features of multiple sclerosis (MS) with child age-at-onset, we examined 254 patients with confirmed diagnosis of MS. The disease developed at the age younger than 16 years in 27 patients. A control group included 303 healthy volunteers. Correlations between the rate of disease progression and the age-at-onset were found. The more benign course of MS was noted in patients with earlier disease onset. There were more women and the disease frequently manifested with retrobulbar nephritis in the group with early onset. The results indicated that a G allele of -308G/A polymorphism of the TNF-α gene might be a risk factor for MS. The A allele may play a protective function. No association between -137G/C IL-18 polymorphism and MS was found. These polymorphisms did not contribute to the predisposition to early onset of MS.


Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review.
The objectives of this scoping review were to identify (1) study designs and participant populations, (2) types of specific methodology and (3) common results, conclusions and recommendations from the body of evidence regarding our research question; is there a relationship between sleep posture and spinal symptoms. Scoping review. PEDro, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Medline, ProQuest, PsycINFO, SportDISCUS and grey literature from inception to 10 April 2018. Using a modified Arksey and O'Malley framework, all English language studies in humans that met eligibility criteria using key search terms associated with sleep posture and spinal symptoms were included. Data were independently extracted by two reviewers and mapped to describe the current state of the literature. Articles meeting the search criteria were critically appraised using the Downs and Black checklist. From 4186 articles, four articles were identified, of which three were epidemiological and one interventional. All studies examined three or more sleep postures, all measured sleep posture using self-report and one study also used infrared cameras. Two studies examined symptoms arising from the lumbar spine, one the cervical spine and one the whole spine. Waking pain and stiffness were the most common symptoms explored and side lying was generally protective against spinal symptoms. This scoping review highlights the importance of evaluating sleep posture with respect to waking symptoms and has provided preliminary information regarding relationships between sleep posture and spinal symptoms. However, there were not enough high-quality studies to adequately answer our research question. It is recommended future research consider group sizes and population characteristics to achieve research goals, that a validated measure be used to assess sleep posture, that characteristics and location of spinal symptoms are clearly defined and that the side lying posture is subclassified.


Biphasic contrast-enhanced multisection dynamic MR imaging of the liver: potential pitfalls.
Biphasic contrast material-enhanced dynamic magnetic resonance (MR) imaging is an important technique for evaluating liver disease. However, several potential diagnostic pitfalls may be encountered, including lobar, segmental, subsegmental, and subcapsular hyperperfusion abnormalities; early-enhancing pseudolesions, particularly in the medial segment of the left hepatic lobe; heterogeneous hyperperfusion abnormalities throughout the liver; and hypointense pseudolesions due to vascular artifacts, unenhanced hepatic vessels, partial volume artifacts, magnetic susceptibility artifacts, and regenerative nodules in cirrhosis. These abnormalities sometimes have appearances similar to those of true lesions or tumor spread to the surrounding liver parenchyma on arterial-dominant phase dynamic MR images. In most cases, however, no corresponding abnormalities are seen with other pulse sequences or on delayed-phase MR images. In addition, hyperperfusion abnormalities due to readily recognizable causes are often found in characteristic locations and thus can be differentiated from true tumors. An understanding of the causes of these potential pitfalls and how to avoid them will help radiologists understand and correctly interpret images.


Thoracic anesthesia in the elderly.
The mean age of patients presenting for thoracic surgery is rising steadily, associated with an increased demand for thoracic surgical treatments by geriatric patients. With increasing age, physiologic changes and comorbidities have to be considered. Thoracic anesthesia for elderly patients requires greater specific knowledge. Respiratory mechanics change progressively during aging, and the pharmacology of different drugs is also altered with increasing age. This has implications for the preoperative, intraoperative and postoperative management of elderly patients scheduled for thoracic surgery. Special focus has to be placed on preoperative evaluation, the ventilation regime and general intraoperative management. Effective postoperative pain treatment after geriatric thoracic surgery requires careful pain assessment and drug titration. Considering key points of physiology and pharmacology can help to provide best possible care for the increasing number of elderly patients in thoracic surgery. Management of geriatric patients in thoracic surgery offer opportunities for anaesthetic interventions including protective ventilation, use of different anesthetics, anaesthesia monitoring, fluid management and pain therapy.


[Practical guidelines in case of nipple discharge].
Nipple discharge is a frequent reason for women to consult their physician, led by the fear of cancer. Fortunately, almost 90 % of cases have a benign aetiology. The main challenge is to rule out any malignant pathology by collecting a detailed history and clinical exam in order to define a targeted imaging. The aim of this review is to facilitate the management of nipple discharge. The most common aetiologies of nipple discharge are described, along with a systematic clinical approach to exclude any underlying malignancy and minimize invasive examinations.


Linking posttraumatic stress disorder and psychosis: a look at epidemiology, phenomenology, and treatment.
Several recent studies have provided direct evidence for the link between posttraumatic stress disorder (PTSD) and psychosis. Patients with psychotic disorders are known to be at a higher risk of traumatization and PTSD. Additionally, preclinical and clinical data suggest that the effects of trauma exposure on neural networks may provide a common diathesis for disorders like PTSD and schizophrenia. This article reviews evidence on a) the magnitude of association between PTSD and psychosis, b) the causal mechanisms implicated, and c) treatment considerations relevant to this association. A comprehensive MEDLINE search was conducted, and articles pertinent to epidemiological, clinical, and treatment aspects of comorbid PTSD and psychosis were identified. High rates of PTSD characterize patients with severe mental illness. Psychotic phenomena may also be a relatively common manifestation in patients with chronic PTSD. However, in clinical settings, the diagnosis is often missed, and few systematic guidelines exist for the identification and treatment of these comorbidities. Future neurobiological and treatment studies may be useful in better informing the clinical management of these subgroups.


Cyclic Peptides as T-Type Calcium Channel Blockers: Characterization and Molecular Mapping of the Binding Site.
T-type calcium (CaV3) channels play a crucial role in the generation and propagation of action potentials in excitable cells and are considered potential drug targets for the treatment of neurological and cardiovascular diseases. Given the limited pharmacological repertoire for these channels, there is a great need for novel potent and selective CaV3 channel inhibitors. In this study, we used Xenopus oocytes to heterologously express CaV3.1 channels and characterized the interaction with a small cyclic peptide, PnCS1. Using molecular modeling, PnCS1 was docked into the cryo-electron microscopy structure of the human CaV3.1 channel and molecular dynamics were performed on the resultant complex. The binding site of the peptide was mapped with the involvement of critical amino acids located in the pore region and fenestrations of the channel. More specifically, we found that PnCS1 reclines in the central cavity of the pore domain of the CaV3.1 channel and resides stably between the selectivity filter and the intracellular gate, blocking the conduction pathway of the channel. Using Multiple Attribute Positional Scanning approaches, we developed a series of PnCS1 analogues. These analogues had a reduced level of inhibition, confirming the importance of specific residues and corroborating our modeling. In summary, functional studies of PnCS1 on the CaV3.1 channel combined with molecular dynamics results provide the basis for understanding the molecular interactions of PnCS1 with CaV3.1 and are fundamental to structure-based drug discovery for treating CaV3 channelopathies.


Comparison of adverse effects of anti-tumor therapy for breast cancer shortly after COVID-19 diagnosis vs. the control period.
COVID-19 is an acute infectious disease caused by SARS-CoV-2. The best time to restart antitumor therapy in breast cancer patients after SARS-CoV-2 infection is unknown. This study aimed to evaluate treatment-related adverse events in breast cancer patients who received antitumor therapies within a short time after SARS-CoV-2 infection (observation) as well as before (control) and to provide safety data. We conducted a self-controlled cohort study using the data from the Breast Disease Center of Peking University First Hospital. We identified patients who received antitumor therapy within 28 days after COVID-19 infection between December 20, 2022, and January 20, 2023. The primary outcome was treatment-related adverse events. McNemar's test was used to compare the incidence rate of adverse reactions between periods. We identified 183 patients with breast cancer, of whom 109 were infected with SARS-CoV-2 within 28 days before antitumor treatment and were included. In total, 28 patients (25.7%) received neoadjuvant therapy, 60 (55.0%) received adjuvant therapy, and 21 (19.3%) received advanced rescue therapy. None of patients required hospitalization for severe or critical COVID-19, but 15 patients (13.8%) still had sequelae of COVID-19 while receiving antitumor treatment. The most common adverse events were peripheral neuropathy (n = 32 [29.4%]), pain (n = 29 [26.6%]), fatigue (n = 28 [25.7%]), nausea (n = 23 [21.1%]), and neutropenia (n = 19 [17.4%]). There was no increased risk of overall treatment-related adverse events (n = 87 [79.8%] vs. n = 91 [83.5%]; p = 0.42) or serious adverse events (n = 13 [11.9%] vs. n = 12 [11.0%]; p = 1.00) from receiving antitumor therapy shortly after the diagnosis of COVID-19. We also found no increased risk in subgroup analyses, and no patients discontinued antitumor therapy due to adverse events. Restarting antitumor therapy 2-4 weeks after having mild or moderate COVID-19 is a relatively safe strategy for breast cancer patients that does not increase the risk of treatment-related adverse events.


Silencing c-Myc Enhances the Antitumor Activity of Bufalin by Suppressing the HIF-1α/SDF-1/CXCR4 Pathway in Pancreatic Cancer Cells.
Pancreatic cancer is one of the most aggressive malignancies. Bufalin, a traditional Chinese medicine, has been used to treat pancreatic cancer as an antitumor agent although the mechanism by which it exerts its effects is still unclear. c-Myc has been found to be overexpressed in more than half of human cancers including pancreatic cancer. However, the role of c-Myc in pancreatic cancer cells and its influence in bufalin-treated pancreatic cancer are yet to be clarified. The present study aimed to investigate the role of c-Myc in the antitumor activity of bufalin in pancreatic cancer. c-Myc siRNA and overexpression plasmid were transfected into pancreatic cancer cells to construct the cell models. c-Myc expression was detected via quantitative real-time polymerase chain reaction and western blot. The effect of c-Myc on bufalin-induced inhibition of cell proliferation was detected via CCK-8 assay. Cell apoptosis and the cell cycle were analyzed via flow cytometry. Cell invasion and migration was detected via Transwell and wound healing assays, respectively. In addition, the effect of bufalin on the suppression of tumor growth in vivo was studied in nude mice model subcutaneously injected with PANC-1 and SW1990 cells. Hematoxylin-eosin and terminal deoxynucleotidyl transferase dUTP nick-end labeling assay were used to evaluate pathological changes in vivo. The expression of HIF-1α/SDF-1/CXCR4 were detected via western blot. CCK-8 assay showed that bufalin could inhibit the proliferation of pancreatic cancer cell, and c-Myc downregulation enhanced this effect. Similarly, c-Myc downregulation enhanced the effect of bufalin on cell cycle arrest, apoptosis, and the invasion and migration of pancreatic cancer cell in vitro. Further mechanism assay showed that c-Myc enhances the effect by regulating the HIF-1α/SDF-1/CXCR4 signaling pathway. The in vivo studies verified the results that c-Myc enhances the effect of bufalin through regulation of the HIF-1α/SDF-1/CXCR4 pathway. Downregulation of c-Myc enhanced the antitumor activity of bufalin in pancreatic cancer cells by suppressing the HIF-1α/SDF-1/CXCR4 pathway. These findings indicate that c-Myc inhibitors could enhance the clinical therapeutic effect of bufalin and may expand the clinical application of bufalin accordingly.


Computed tomographic angiography and digital subtraction angiography findings in popliteal artery entrapment syndrome.
To evaluate computed tomographic angiography (CTA) and digital subtraction angiography (DSA) findings in popliteal artery entrapment syndrome (PAES). Nine patients (13 limbs) who underwent surgical treatment for PAES were evaluated retrospectively. All cases showed various anomalous relationships between the popliteal artery and the neighboring muscular structures. Both CTA and DSA were performed on each affected limb. Computed tomographic angiography showed the detailed anatomy of the region well enough and established the diagnosis of PAES in all of the cases. Characterization and classification based on CTA imaging were consistent with surgical photography. Deviation, occlusion, aneurysm, and stenosis of popliteal artery can be demonstrated by CTA and DSA. Digital subtraction angiography was diagnostic in 6 limbs in 5 patients. Computed tomographic angiography can demonstrate both the vascular changes and the anatomic variations in the popliteal fossa and may be valuable in the diagnosis of PAES.


Effects of pyriproxyfen on wild populations of the housefly, Musca domestica, and compatibility with its principal parasitoids.
The housefly, Musca domestica L., is an important pest of animal agriculture. Effective fly management requires integration of manure management, mass trapping, biological control, and selective insecticide use. Insecticidal control of houseflies is difficult due to the rapidity of resistance development, yet the insect growth regulator pyriproxyfen (PPF) is one of few insecticides that may still be effective. Here, we tested the susceptibility of wild housefly populations in the USA and in Israel to PPF, as well as the effect of PPF on housefly parasitoids of the genera Muscidifurax and Spalangia. Most housefly populations from both countries were completely eliminated at PPF concentrations of 100 mg kg-1 (USA) and 600 mg kg-1 (Israel). One population from each country exhibited initial levels of PPF tolerance. PPF efficacy significantly decreased in cow manure. Emergence rates of parasitoids developing in PPF-treated hosts at concentrations of ≥600 mg kg-1 were significantly affected, whereas other fitness parameters were moderately to non-affected. PPF is still an effective tool for housefly control, but resistance management practices should be employed to avoid resistance. PPF is compatible with principal housefly parasitoids at concentrations <600 mg kg-1 , and is suitable for use in integrated pest management. © 2017 Society of Chemical Industry.


Endometrial Regenerative Cell-Derived Conditioned Medium Alleviates Experimental Colitis.
Traditional interventions can play a certain role in attenuating ulcerative colitis (UC), known as one type of inflammatory bowel diseases, but sometimes are not effective. Endometrial regenerative cells (ERCs) have been shown to exert immunosuppressive effects in different models of inflammation, and stem cell-derived conditioned media (CM) have advantages over cell therapy in terms of easy access and direct action. However, whether ERC-CM could alleviate colitis remains unclear and will be explored in this study. Menstrual blood was collected from healthy female volunteers to obtain ERCs and ERC-CM. Acute colitis was induced by 3% dextran sodium sulfate (DSS), and ERC-CM was injected on days 4, 6, and 8, respectively, after induction. The disease activity index was calculated through the record of weight change, bleeding, and fecal viscosity during the treatment process. Histological features, macrophage and CD4+ T cell in the spleen and colon, and cytokine profiles in the sera and colon were measured. In addition, an in vitro lymphocyte proliferation assay was measured by using a CCK-8 kit in this study. ERC-CM treatment significantly improved the symptoms and histological changes in colitis mice. ERC-CM increased the percentage of Tregs in the spleen and colon but decreased the percentages of M1 macrophages and Th1 and Th17 cells in the spleen and decreased the population of Th17 cells in the colon. In addition, ERC-CM treatment decreased the local expression of TNF-α, IL-6, and iNOS in the colon. Furthermore, ERC-CM increased the levels of anti-inflammatory cytokines IL-10 and IL-27 but decreased proinflammatory cytokines IL-6 and IL-17 in the sera. In addition, ERC-CM significantly inhibited ConA-induced mouse lymphocyte proliferation in vitro. The results suggest that ERC-CM can exert similar therapeutic effects as ERCs and could be explored for future application of cell-free therapy in the treatment of colitis.


Are self-esteem and academic achievement reciprocally related? Findings from a longitudinal study of Mexican-origin youth.
Previous research has shown that self-esteem is associated with academic achievement. However, few studies have used longitudinal data to examine how self-esteem and achievement co-develop over a long time span, and even fewer have focused on ethnic minority youth. We used data from a longitudinal study of Mexican-origin youth (N = 674) to examine the bidirectional associations between self-esteem and academic achievement from 5th to 11th grade. Global and domain-specific self-esteem (academic, honesty, peer relationships, appearance) were assessed at ages 10, 12, 14, and 16 using Marsh et al.'s (2005) Self-Description Questionnaire. Academic achievement was assessed at the same ages using self-reported grades and standardized test scores from school records. Youth with high global and academic self-esteem showed relative improvements in their grades (but not test scores), and youth who received higher grades and test scores showed relative increases in global and academic self-esteem. Youth with high honesty self-esteem showed relative increases in grades and test scores, and youth with higher grades showed relative increases in peer relationship self-esteem. Students who feel better about themselves tend to show improvements in their grades, and getting better grades and test scores promotes more positive self-views.


Drug-associated skin lesions in a patient with myelofibrosis receiving ruxolitinib.
Ruxolitinib, a small molecule JAK-1/2 inhibitor, was approved by the U.S. Food and Drug Administration (FDA) in November 2011, as the first therapeutic for the treatment of intermediate and high-risk myelofibrosis. The Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway is one of the most well-studied intracellular signaling networks. Recent advances in our understanding of the complexities of signal activation and regulation of gene expression has provided opportunities for targeted therapeutic interventions. Although numerous inhibitors of the JAK/STAT pathway are currently being evaluated in clinical trials, ruxolitinib represents the first FDA approved in-class JAK inhibitor. We report a drug eruption associated with ruxolitinib.


Assessment of central and peripheral nerve functions in chain-saw operators: a study of short-latency somatosensory evoked potential and peripheral nerve conduction.
In order to clarify the effects of local vibration on the peripheral and central nervous system, peripheral (median) nerve conduction velocities and short-latency somatosensory evoked potentials (SSEP) following stimulation of the median nerve at the wrist were measured in 15 male forest workers in 1986. They had engaged in chain-saw operation for 16-34 (mean 22) years; their working days in 1985 averaged 124 days with a range of 50-203 days. The results indicated significant delays in maximal motor and sensory nerve conduction velocities followed by prolongation of all 4 peak latencies of SSEP up to the sensory cortex of the brain (N9, N13, N20 and P23 latencies) in chain-saw operators; their N9 and P23 latencies were significantly correlated with total working days per year. On the other hand, no significant prolongation of the interpeak latencies of SSEP (i.e., cervico-spinobulbar and central conduction times) was found in the workers. It is concluded that local vibration predominantly affects peripheral nerve conduction; cervico-spinobulbar and central nerve conduction may not be significantly affected.


5-azactidine and zorubicin for patients with previously treated acute nonlymphocytic leukemia: a Cancer and Leukemia Group B pilot study.
Twenty-nine adults with advanced acute nonlymphocytic leukemia were treated with an intensive chemotherapy program consisting of 5-azacitidine and zorubicin. Overall, eight patients (28%) achieved a complete remission. Although only one of 19 patients with refractory leukemia responded, seven of ten patients who were treated immediately following relapse from a prior remission achieved another complete remission. The duration of remission ranged from 5 to 33 weeks (median, 14). Treatment resulted in severe toxic reactions including myelosuppression, renal tubular dysfunction, and elevations in liver enzymes. In addition, each of the 15 patients who died of treatment-associated complications had a severe infection. This combination of 5-azacitidine and zorubicin is relatively ineffective for truly refractory leukemia, but it may be a useful alternative following relapse.


Left internal carotid artery agenesis with trans-sellar collateral and a right aortic arch: Case report.
We present a case of unilateral internal carotid artery (ICA) agenesis with trans-sellar anastomosis associated with a right aortic arch, and discuss the embryonic development and clinical implications of this condition. A 26-year-old woman without significant medical history was referred to our hospital complaining of tinnitus. She denied any other symptoms, and examination did not reveal any other neurological deficits. Radiological examinations showed agenesis of the right ICA with trans-sellar anastomosis, and a right aortic arch. This vascular configuration reflects the anatomical homology with avian vascular structure. Recognition of this anomaly has important implications for clinical situations, such as the planning of carotid or transsphenoidal surgery, the management of thromboembolic disease, and the surveillance and detection of associated cerebral aneurysms.


Mycobacterium tuberculosis functional genetic diversity, altered drug sensitivity, and precision medicine.
In the face of the unrelenting global burden of tuberculosis (TB), antibiotics remain our most effective tools to save lives and control the spread of Mycobacterium tuberculosis (Mtb). However, we confront a dual challenge in our use of antibiotics: simplifying and shortening the TB drug regimen while also limiting the emergence and propagation of antibiotic resistance. This task is now more feasible due to the increasing availability of bacterial genomic data at or near the point of care. These resources create an opportunity to envision how integration of bacterial genetic determinants of antibiotic response into treatment algorithms might transform TB care. Historically, Mtb drug resistance studies focused on mutations in genes encoding antibiotic targets and the resulting increases in the minimal inhibitory concentrations (MICs) above a breakpoint value. But recent progress in elucidating the effects of functional genetic diversity in Mtb has revealed various genetic loci that are associated with drug phenotypes such as low-level MIC increases and tolerance which predict the development of resistance and treatment failure. As a result, we are now poised to advance precision medicine approaches in TB treatment. By incorporating information regarding Mtb genetic characteristics into the development of drug regimens, clinical care which tailors antibiotic treatment to maximize the likelihood of success has come into reach.


Current concepts and outcomes in cemented femoral stem design and cementation techniques: the argument for a new classification system.
Cemented implant fixation design principles have evolved since the 1950s, and various femoral stem designs are currently in use to provide a stable construct between the implant-cement and cement-bone interfaces.Cemented stems have classically been classified into two broad categories: taper slip or force closed, and composite beams or shaped closed designs. While these simplifications are acceptable general categories, there are other important surgical details that need to be taken into consideration such as different broaching techniques, cementing techniques and mantle thickness.With the evolution of cemented implants, the introduction of newer implants which have hybrid properties, and the use of different broaching techniques, the classification of a very heterogenous group of implants into simple binary categories becomes increasingly difficult. A more comprehensive classification system would aid in comparison of results and better understanding of the implants' biomechanics.We review these differing stem designs, their respective cementing techniques and geometries. We then propose a simple four-part classification system and summarize the long-term outcomes and international registry data for each respective type of cemented prosthesis. Cite this article: EFORT Open Rev 2020;5:241-252. DOI: 10.1302/2058-5241.5.190034.


Why We Should Preach to the Climate Change Choir: The Importance of Science Communication That Engages People Who Already Accept Climate Change.
AbstractClimate change is one of the most urgent issues facing society today, and scientists have an important opportunity to teach students and other audiences about climate change. With climate communication, it can be tempting to think that the primary goal should be to get more people to accept climate change, but true climate literacy requires not just an understanding of the reality of climate change but also acting on that understanding. Here, I argue that there is an important role for communicating about climate change with people who already accept that it is occurring. Such communication can help people improve their understanding, increasing their certainty regarding climate change and its drivers, and spur them to take action. Social science research has important insights regarding how to communicate in a way that encourages people to change behaviors, including aiming to increase personal and collective efficacy and helping people figure out how to meet key needs while reducing greenhouse gas emissions. Climate change communicators should seek out audiences that already accept climate change, helping those individuals deepen their understanding and energizing and empowering these people to act.


CYP2D6 genotype is not associated with survival in breast cancer patients treated with tamoxifen: results from a population-based study.
A number of studies have tested the hypothesis that breast cancer patients with low-activity CYP2D6 genotypes achieve inferior benefit from tamoxifen treatment, putatively due to lack of metabolic activation to endoxifen. Studies have provided conflicting data, and meta-analyses suggest a small but significant increase in cancer recurrence, necessitating additional studies to allow for accurate effect assessment. We conducted a retrospective pharmacogenomic analysis of a prospectively collected community-based cohort of patients with estrogen receptor-positive breast cancer to test for associations between low-activity CYP2D6 genotype and disease outcome in 500 patients treated with adjuvant tamoxifen monotherapy and 500 who did not receive any systemic adjuvant therapy. Tumor-derived DNA was genotyped for common, functionally consequential CYP2D6 polymorphisms (*2, *3, *4, *6, *10, *41, and copy number variants) and assigned a CYP2D6 activity score (AS) ranging from none (0) to full (2). Patients with poor metabolizer (AS = 0) phenotype were compared to patients with AS > 0 and in secondary analyses AS was analyzed quantitatively. Clinical outcome of interest was recurrence free survival (RFS) and analyses using long-rank test were adjusted for relevant clinical covariates (nodal status, tumor size, etc.). CYP2D6 AS was not associated with RFS in tamoxifen treated patients in univariate analyses (p > 0.2). In adjusted analyses, increasing AS was associated with inferior RFS (Hazard ratio 1.43, 95% confidence interval 1.00-2.04, p = 0.05). In patients that did not receive tamoxifen treatment, increasing CYP2D6 AS, and AS > 0, were associated with superior RFS (each p = 0.0015). This population-based study does not support the hypothesis that patients with diminished CYP2D6 activity achieve inferior tamoxifen benefit. These contradictory findings suggest that the association between CYP2D6 genotype and tamoxifen treatment efficacy is null or near null, and unlikely to be useful in clinical practice.


How exaptations facilitated photosensory evolution: Seeing the light by accident.
Exaptations are adaptations that have undergone a major change in function. By recruiting genes from sources originally unrelated to vision, exaptation has allowed for sudden and critical photosensory innovations, such as lenses, photopigments, and photoreceptors. Here we review new or neglected findings, with an emphasis on unicellular eukaryotes (protists), to illustrate how exaptation has shaped photoreception across the tree of life. Protist phylogeny attests to multiple origins of photoreception, as well as the extreme creativity of evolution. By appropriating genes and even entire organelles from foreign organisms via lateral gene transfer and endosymbiosis, protists have cobbled photoreceptors and eyespots from a diverse set of ingredients. While refinement through natural selection is paramount, exaptation helps illustrate how novelties arise in the first place, and is now shedding light on the origins of photoreception itself.


A systematic study of Girdin on cell proliferation, migration and angiogenesis in different breast cancer subtypes.
Breast cancer has one of the highest incidences in females worldwide. Girdin is a novel actin‑binding protein, that induces cell migration and angiogenesis. However, a systematic study of Girdin function in distinct subtypes of breast cancer has not been reported to date. Therefore, the present study aimed to investigate the role of Girdin on cell proliferation, migration and angiogenesis in different subtypes of breast cancer. For this purpose, the breast epithelial MCF‑7, breast ductal T47D and breast metastatic MDA‑MB‑231 cancer cell lines were selected. Girdin small interfering RNA (siRNA) was transfected into MCF‑7, T47D and MDA‑MB‑231 cells. Girdin knockdown suppressed cell viability and migration in the different cancer cells tested. Girdin knockdown also suppressed mRNA expression of vascular endothelial growth factor (VEGF), and activation of phosphatidyl inositol 3‑kinase (PI3K) and RAC‑α serine/threonine‑protein kinase (Akt) in the subtypes tested. In conclusion, these data indicate that Girdin knockdown suppressed cell viability and migration and may suppress angiogenesis via the PI3K/Akt signaling pathway, in various breast cancers subtypes. The present study therefore suggests a role for Girdin as a novel therapeutic target for breast cancer, independent of subtype.


MCM2 and Ki-67 expression in human lung adenocarcinoma: prognostic implications.
The expressions of minichromosome maintenance protein 2 (MCM2), Ki-67, and p53 were examined to analyze their pathobiological significance in human lung adenocarcinomas. We performed Western blot analysis in six human lung adenocarcinoma cell lines and immunohistochemistry in 145 surgically removed adenocarcinomas to examine the MCM2 expression. Labeling indices (LIs; %) of MCM2, Ki-67, and p53 in the tumor cells were compared with clinicopathological profiles and overall survival rates. MCM2 protein was detected in all cell lines examined, with specific bands. MCM2 LIs were significantly correlated with sex, histological type, differentiation, pathological stage, and LIs of Ki-67 and p53 (p < 0.05). Significantly higher LIs of MCM2 and Ki-67 were noted in the 122 non-pure bronchioloalveolar carcinomas than in the 23 pure bronchioloalveolar carcinomas (p < 0.01), and the prognosis was poorer in the former than in the latter (p < 0.01). Sex, pathological stage, and high LIs of MCM2 and/or Ki-67 were independent prognostic factors (p < 0.05). High LIs of MCM2 and/or Ki-67 suggest a poor prognosis in patients with lung adenocarcinoma (non-pure bronchioloalveolar carcinoma).


Influence of environmental conditions and surface treatments on the photoluminescence properties of GaN nanowires and nanofins.
Due to their intrinsically large surface-to-volume ratio, nanowires and nanofins interact strongly with their environment. We investigate the role of the main air constituents nitrogen, oxygen and water on the efficiency of radiative recombination in GaN nanostructures as a function of different surface treatments and at temperatures up to 200 °C. Oxygen and water exposures exhibit a complex behavior as they can both act quenching and enhancing on the photoluminescence intensity dependent on the temperature. For oxygen, these characteristics are already observed for low concentrations of below 0.5% in nitrogen. While the photoluminescence intensity changes induced by oxygen occur independently of illumination, the influence of water is light-induced: it evolves within tens of seconds under ultraviolet light exposure and is heavily influenced by the nanostructure pre-treatment. In contrast to observations in dry atmospheres, water prevents a recovery of the photoluminescence intensity in the dark. Combined measurements of the electrical current through GaN nanofins and their photoluminescence intensity reveal the environmental influence on the interaction of non-radiative recombination processes and changes in the surface band bending of the nanostructures. Several investigated solvents show an enhancing effect on the PL intensity increase, peaking in c-hexane with a 26-fold increase after 6 min of light exposure. Stabilization of the PL intensity was achieved by a passivation of the GaN surface with GaxOy, and ZnO shells. Surprisingly, Al2O3coatings resulted in a highly instable PL intensity during the first minutes of illumination. Our findings reveal the high importance of controlled environmental conditions for the investigation of nanostructures, especially when aimed at their applications in the fields of environmental sensing, photo-catalysis and light-emitting diodes.


Heterodimers of the transcriptional factors NFATc3 and FosB mediate tissue factor expression for 15(S)-hydroxyeicosatetraenoic acid-induced monocyte trafficking.
Tissue factor (TF) is expressed in vascular and nonvascular tissues and functions in several pathways, including embryonic development, inflammation, and cell migration. Many risk factors for atherosclerosis, including hypertension, diabetes, obesity, and smoking, increase TF expression. To better understand the TF-related mechanisms in atherosclerosis, here we investigated the role of 12/15-lipoxygenase (12/15-LOX) in TF expression. 15(S)-hydroxyeicosatetraenoic acid (15(S)-HETE), the major product of human 15-LOXs 1 and 2, induced TF expression and activity in a time-dependent manner in the human monocytic cell line THP1. Moreover, TF suppression with neutralizing antibodies blocked 15(S)-HETE-induced monocyte migration. We also found that NADPH- and xanthine oxidase-dependent reactive oxygen species (ROS) production, calcium/calmodulin-dependent protein kinase IV (CaMKIV) activation, and interactions between nuclear factor of activated T cells 3 (NFATc3) and FosB proto-oncogene, AP-1 transcription factor subunit (FosB) are involved in 15(S)-HETE-induced TF expression. Interestingly, NFATc3 first induced the expression of its interaction partner FosB before forming the heterodimeric NFATc3-FosB transcription factor complex, which bound the proximal AP-1 site in the TF gene promoter and activated TF expression. We also observed that macrophages from 12/15-LOX-/- mice exhibit diminished migratory response to monocyte chemotactic protein 1 (MCP-1) and lipopolysaccharide compared with WT mouse macrophages. Similarly, compared with WT macrophages, monocytes from 12/15-LOX-/- mice displayed diminished trafficking, which was rescued by prior treatment with 12(S)-HETE, in a peritonitis model. These observations indicate that 15(S)-HETE-induced monocyte/macrophage migration and trafficking require ROS-mediated CaMKIV activation leading to formation of NFATc3 and FosB heterodimer, which binds and activates the TF promoter.


Role of sublingual misoprostol for cervical priming in first trimester medical termination of pregnancy.
To evaluate the efficacy and safety of sublingual misoprostol as facilitator in first trimester medical termination of pregnancy (MTP) by surgical method. This was a prospective open label study conducted at a tertiary center. A total 150 patients at 6-12 wks gestation requesting for MTP were randomized into two groups. Patients in study group (n=75) received sublingual misoprostol three hours before surgical abortion and in control group (n=75) directly underwent surgical abortion without prior cervical priming with misoprostol. The outcomes of both groups were recorded in terms of baseline cervical dilatation, need of additional cervical dilatation, intraoperative blood loss, operative time and procedure related complications. The results were statistically analyzed using student-t test and chi-square test. p-value of <0.05 and <0.001 were considered significant and highly significant respectively. The mean baseline cervical dilatation was significantly more in study group compared to control group (8.6±1.3mm versus 5±2.3mm; p <0.001) and the operative time and intraoperative blood loss were also less (p<0.001). Higher incidence of side effects like nausea, vomiting and pyrexia were recorded in sublingual misoprostol group but were well tolerable to the patients. Sublingual misoprostol is an effective and safe drug for cervical priming prior to surgical evacuation and has good patient acceptability.


Tuning the Carbon Nanotube Selectivity: Optimizing Reduction Potentials and Distortion Angles in Perylenediimides.
Different water-soluble perylenediimides (PDIs) have been used to individualize and stabilize single-walled carbon nanotubes (SWCNTs) in aqueous media. A key feature of the PDIs is that they can be substituted at the bay positions via the addition of two and/or four bromines. This enables control over structural and electronic PDI characteristics, which prompted us to conduct comparative assays with focus on SWCNTs' chirality and charge transfer. Electrochemical, microscopic, and spectroscopic experiments were used to investigate the SWCNT chiral selectivity of PDIs, on the one hand, and charge-transfer reactions between SWCNTs and PDIs, on the other hand.


Hospital Regimens Including Probiotics Guide the Individual Development of the Gut Microbiome of Very Low Birth Weight Infants in the First Two Weeks of Life.
It is unknown to what extent the microbiome of preterm infants is influenced by hospital regimens including the use of different probiotics when it comes to the prevention of necrotizing enterocolitis (NEC). Prospective controlled multicenter cohort study including very low birth weight infants from three neonatal intensive care units (NICUs) between October 2015 and March 2017. During this time span, stool was sampled every other day during the first two weeks and samples were subjected to amplicon-based microbiome analyses. Out of these, seventeen negative controls were processed (German Registry of Clinical Trials (No.: DRKS00009290)). The groups (3 × 18 infants) showed no statistically significant difference regarding gestational age, birth weight, APGAR scores and oxygen demand. 2029 different taxa were detected, including Enterococcus and Staphylococcus, as well as the probiotic genera Lactobacillus and Bifidobacterium predominating. The bacterial load was found to increase earlier on when probiotics were used. Without probiotics administration, Lactobacillus and Bifidobacterium contributed only marginally to the fecal microbiome. Some infants did not respond to probiotic administration. The samples from all centers participating reached a very similar diversity after two weeks while the microbiome samples from all three centers clustered significantly yet varied from each other. Probiotics proved to be safe and initiated an earlier increase of bacterial load (with marked individual divergences), which might play a crucial role in the prevention of neonatal morbidities. Meconium was found not to be free of bacterial DNA, and oral antibiotics did not influence the fecal microbiome development negatively, and hospital regimes led to a center-specific, distinct cluster formation.


Interactions of nucleotide analogues with rod outer segment guanylate cyclase.
Light activation of cyclic GMP hydrolysis in rod outer segments is mediated by a G-protein which is active in the GTP-bound form. Substitution of GTP with a nonhydrolyzable GTP analogue is thought to leave the G-protein in a persistently activated state, thereby prolonging the hydrolysis of cyclic GMP. Restoration of cyclic GMP concentration in the cell also depends upon GTP since it is the substrate for guanylate cyclase, but little is known about the effects of GTP analogues on this enzyme. We report here the effects of the analogues of GTP and ATP as inhibitors and substrates of rod disk membrane guanylate cyclase. The rate of cyclic GMP synthesis from GTP in rod disk membranes was about 50 pmol min-1 (nmol of rhodopsin)-1. Analogues of GTP and adenine nucleotides competitively inhibited the cyclase activity. The order of inhibition, with magnesium as metal cofactor, was ATP greater than GMP-PNP greater than AMP-PNP approximately GTP-gamma-S; with manganese, AMP-PNP was more inhibitory than GTP-gamma-S. The inhibition constants, with magnesium as cofactor, were 0.65-2.0 mM for GTP-gamma-S, 0.4-0.8 mM for GMP-PNP, 1.5-2.3 mM for AMP-PNP, and 0.07-0.2 mM for ATP. The fraction of cyclase activity inhibited by analogues was similar at 1 and 0.03 microM calcium. Besides inhibition of cyclase, the analogues also served as its substrates. GTP-gamma-S substituted GTP with about 85% efficiency while GMP-PNP and ATP were about 5 and 7% as efficient, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)


Odd-even effects on the structure, stability, and phase transition of alkanethiol self-assembled monolayers.
Molecular dynamics simulations were conducted to predict the structural properties and phase transition temperatures of n-alkanethiols CH(3)(CH(2))(n-1)SH (Cn, 4 ≤ n ≤ 22) self-assembled monolayers (SAMs) on Au (111) surfaces. We studied the effects of chain length on the structural properties, including tilt and orientation angles, and on phase transition temperature. We found clear dependence of the structural properties, on both the number of carbon atoms, n; and on n being odd or even. Alkanethiols with n ≤ 7 show liquid-like behavior and large rotational mobility, whereas those with n ≥ 12 are well-ordered and stable. For 12 ≤ n ≤ 15, odd-even effects are observed, where for n = odd, larger tilt angles, oriented in the direction of their next next nearest neighbor (NNNN), and for n = even, lower tilt angles, mostly tilted toward next nearest neighbor (NNN), were observed. For 15 ≤ n ≤ 19, we find tilt angle and orientation to be independent of n. For all alkanethiols, a gradual decrease of the tilt angle occurred by increasing the temperature from 300 to 420 K. Order-disorder phase transitions occurred at a certain temperature. This was signified by abrupt instabilities in the tilt orientation angle. This transition temperature showed an enhancement of ∼67-100 °C over the melting point of the corresponding n-alkane bulk system. This enhancement depended on n, and was larger for n = odd. Overall, we found that odd alkanethiols show better structural and thermal stability, and smaller gauche defects.


Renal compensation to chronic hypoxic hypercapnia: downregulation of pendrin and adaptation of the proximal tubule.
The molecular basis for the renal compensation to respiratory acidosis and specifically the role of pendrin in this condition are unclear. Therefore, we studied the adaptation of the proximal tubule and the collecting duct to respiratory acidosis. Male Wistar-Hannover rats were exposed to either hypercapnia and hypoxia [8% CO(2) and 13% O(2) (hypercapnic, n = 6) or normal air (controls, n = 6)] in an environmental chamber for 10 days and were killed under the same atmosphere. In hypercapnic rats, arterial pH was lower than controls (7.31 +/- 0.01 vs. 7.39 +/- 0.01, P = 0.03), blood HCO(3)(-) concentration was increased (42 +/- 0.9 vs. 32 +/- 0.24 mM, P < 0.001), arterial Pco(2) was increased (10.76 +/- 0.4 vs. 7.20 +/- 0.4 kPa, P < 0.001), and plasma chloride concentration was decreased (92.2 +/- 0.7 vs. 97.2 +/- 0.5 mM, P < 0.001). Plasma aldosterone levels were unchanged. In the proximal tubule, immunoblotting showed an increased expression of sodium/bicarbonate exchanger protein (188 +/- 22 vs. 100 +/- 11%, P = 0.005), confirmed by immunohistochemistry. Total Na/H exchanger protein expression in the cortex was unchanged by immunoblotting (119 +/- 10 vs. 100 +/- 11%, P = 0.27) and immunohistochemistry. In the cortex, the abundance of pendrin was decreased (51 +/- 9 vs. 100 +/- 7%, P = 0.003) by immunoblotting. Immunohistochemistry revealed that this decrease was clear in both cortical collecting ducts (CCDs) and connecting tubules (CNTs). This demonstrates that pendrin expression can be regulated in acidotic animals with no changes in aldosterone levels and no external chloride load. This reduction of pendrin expression may help in redirecting the CNT and CCD toward chloride excretion and bicarbonate reabsorption, contributing to the increased plasma bicarbonate and decreased plasma chloride of chronic respiratory acidosis.


Building sustainable health and education partnerships: stories from local communities.
Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change.


The intimate relationship as a site of social protection: Partnerships between people who inject drugs.
Public health research treats intimate partnerships as sites of risk management, including in the management of HIV and hepatitis C transmission. This risk-infused biomedical approach tends to undermine appreciation of the emotional and socially situated meanings of care in intimate partnerships. In this article we explore qualitative interview accounts of the care enacted in partnerships between people who inject drugs, drawing on a 2014 study of 34 couples and 12 individuals living in two locations of Australia. A thematic analysis highlights 'best friend relationships', 'doing everything together', 'co-dependency', and 'doing normalcy' as core to narratives of care. As we will argue, the accounts position the care undertaken by couples as at once shaped by day-to-day practices of drug use and by social situation, with the partnership enacting care as a form of social protection, including protection from stigma and other environmental hostilities. The intimacy of doing everything together offers insulation against stigma, yet also reproduces its isolating effects. While the care produced in drug-using partnerships is presented as double-edged, we note how interview accounts are used to deflect the charge that these relationships represent harmful co-dependency. Taken together, the interview accounts negotiate a 'counter-care' in relation to normalcy, presenting the intimate partnership between people who use drugs as a legitimate embodiment of care.


High-dose simvastatin for aneurysmal subarachnoid hemorrhage: multicenter randomized controlled double-blinded clinical trial.
Experimental evidence has indicated the benefits of simvastatin for the treatment of subarachnoid hemorrhage. Two randomized placebo-controlled pilot trials that used the highest clinically approved dose of simvastatin (80 mg daily) gave positive results despite the fact that a lower dose of simvastatin (40 mg daily) did not improve clinical outcomes. We hypothesized that a high dose of 80 mg of simvastatin daily for 3 weeks would reduce the incidence of delayed ischemic deficits after subarachnoid hemorrhage compared with a lower dose (40 mg of simvastatin daily) and lead to improved clinical outcomes. The study design was a randomized controlled double-blinded clinical trial. Patients with aneurysmal subarachnoid hemorrhage (presenting within 96 hours of the ictus) from 6 neurosurgical centers were recruited for 3 years. The primary outcome measure was the presence of delayed ischemic deficits, and secondary outcome measures included a modified Rankin disability score at 3 months and an analysis of cost-effectiveness. No difference was observed between the groups treated with the higher dose or the lower dose of simvastatin in the incidence of delayed ischemic deficits (27% versus 24%; odds ratio, 1.2; 95% confidence interval, 0.7-2.0; P=0.586) or in the rate of favorable outcomes (modified Rankin Scale score, 0-2) at 3 months (73% versus 72%; odds ratio, 1.1; 95% confidence interval, 0.6-1.9; P=0.770). High-dose simvastatin treatment should not be prescribed routinely for aneurysmal subarachnoid hemorrhage. http://www.clinicaltrials.gov. Unique identifier: NCT01077206.


Optimising the cost-effectiveness of speed limit enforcement cameras.
Using the 140 speed cameras in New York City (NYC) as a case study, we explore how to optimise the number of cameras such that the most lives can be saved at the lowest cost. A Markov model was built to explore the economic and health impacts of speed camera installations in NYC as well as the optimal number and placement. Both direct and indirect medical savings associated with speed cameras are weighed against their cost. Health outcomes are measured in terms of quality-adjusted life years (QALYs). Over the lifetime of an average NYC resident, the existing 140 speed cameras increase QALYs by 0.00044 units (95% credible interval (CrI) 0.00027 to 0.00073) and reduce costs by US$70 (95% CrI US$21 to US$131) compared with no speed cameras. The return on investment would be maximised where the number of cameras more than doubled to 300. This would further increase QALY gains per resident by 0.00083 units (95% CrI 0.00072 to 0.00096) while reducing medical costs by US$147 (95% CrI US$70 to US$221) compared with existing speed cameras. Overall, this increase in cameras would save 7000 QALYs and US$1.2 billion over the lifetime of the current cohort of New Yorkers. Speed cameras rank among the most cost-effective social policies, saving both money and lives.


Validation of housekeeping genes in the brains of rats submitted to chronic intermittent hypoxia, a sleep apnea model.
Obstructive sleep apnea (OSA) is a syndrome characterized by intermittent nocturnal hypoxia, sleep fragmentation, hypercapnia and respiratory effort, and it has been associated with several complications, such as diabetes, hypertension and obesity. Quantitative real-time PCR has been performed in previous OSA-related studies; however, these studies were not validated using proper reference genes. We have examined the effects of chronic intermittent hypoxia (CIH), which is an experimental model mainly of cardiovascular consequences of OSA, on reference genes, including beta-actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase and eukaryotic 18S rRNA, in different areas of the brain. All stability analyses were performed using the geNorm, Normfinder and BestKeeper software programs. With exception of the 18S rRNA, all of the evaluated genes were shown to be stable following CIH exposure. However, gene stability rankings were dependent on the area of the brain that was analyzed and varied according to the software that was used. This study demonstrated that CIH affects various brain structures differently. With the exception of the 18S rRNA, all of the tested genes are suitable for use as housekeeping genes in expression analyses.


Fluorescence Correlation Spectroscopy with Photobleaching Correction in Slowly Diffusing Systems.
Fluorescence correlation spectroscopy (FCS) is a powerful tool to quantitatively study the diffusion of fluorescently labeled molecules. It allows in principle important questions of macromolecular transport and supramolecular aggregation in living cells to be addressed. However, the crowded environment inside the cells slows diffusion and limits the reservoir of labeled molecules, causing artifacts that arise especially from photobleaching and limit the utility of FCS in these applications. We present a method to compute the time correlation function from weighted photon arrival times, which compensates computationally during the data analysis for the effect of photobleaching. We demonstrate the performance of this method using numerical simulations and experimental data from model solutions. Using this technique, we obtain correlation functions in which the effect of photobleaching has been removed and in turn recover quantitatively accurate mean-square displacements of the fluorophores, especially when deviations from an ideal Gaussian excitation volume are accounted for by using a reference calibration correlation function. This allows quantitative FCS studies of transport processes in challenging environments with substantial photobleaching like in living cells in the future.


A blueprint for lead hazards.
OSHA has been criticized heavily during the last decade for not providing construction workers the same level of protection afforded employees in general industry. Now that it has adopted this standard, it would not be surprising if it decided to flex its newfound muscle by targeting the construction industry for lead inspections this spring. It is January now, and construction activity in most of the country will be slow until March or April. Smart contractors should use this slack time to formulate a compliance strategy, weigh their options and develop a management plan. It is also a good time to begin obtaining cost estimates for air monitoring, ventilation equipment, hygiene facilities and medical surveillance.


Spinal cord involvement of primary central nervous system lymphomas: histopathological examination of 14 autopsy cases.
The brain and spinal cord from 14 patients with primary central nervous system lymphomas (PCNSL) were systematically examined to determine the distribution and frequency of spinal cord lesions. Spinal cord involvement was observed in four cases (cases 1-4). In cases 1 and 2, tumor cells were spread widely in the brain and extended downward to C4 and Th8 in the spinal parenchyma and to C2 and Th2 in the subarachnoid space (SAS), respectively. In case 3, tumors were found in the cerebrum but not in the cerebellum or brainstem. In the spinal cord there was massive subarachnoid involvement from C2 to L4 and localized parenchymal invasion from Th8 to L4. In case 4, tumors were found in the parenchyma from brainstem to Th2 and in the SAS all around the cord. Diffuse subarachnoid proliferation with parenchymal invasion via the Virchow-Robin space was found in the spinal cord. The route of tumor spread in cases 1 and 2 was considered to be intra-parenchymal invasion from the medulla oblongata to the spinal cord because the cord lesions had continuity with the brain lesions. In contrast, the cord lesions in cases 3 and 4 were considered to be spread via the CSF because the lesions had no continuity with the brain lesions in case 3, and spinal SAS involvement was more extensive than the parenchymal lesions in both cases. These findings suggest that spinal cord involvement is not a rare event in PCNSL and that there are two routes of spread: direct invasion from the medulla oblongata and dissemination via the CSF.


Isolation, structure, and bioactivities of polysaccharides from Cyclocarya paliurus (Batal.) Iljinskaja.
Cyclocarya paliurus (Batal.) Iljinskaja, a well-known edible and medicinal plant, has been widely used in China as a traditional medicine for treating hypertension and diabetes. C. paliurus possesses various bioactivities, such as antihyperglycemic, antihyperlipidemic, antihypertensive, anticancer, antifatigue, antioxidation, antimicrobial, colon health-promoting, and immunological activities. Polysaccharides, as natural macromolecules with various biological activities, are considered to be the main effective components in C. paliurus. Here, we summarize studies of polysaccharides from C. paliurus over the past 20 years, including extraction and purification processes, structure, and bioactivities.


Association of cytochrome P450 enzymes is a determining factor in their catalytic activity.
Previously, our laboratory demonstrated that one cytochrome P450 isoenzyme can influence the catalytic properties of another P450 isoenzyme when combined in a reconstituted system. Moreover, our data and that of other investigators indicate that P450 interaction is required for catalytic activity even when one isoenzyme is present. The goal of the current study was to examine the possible mechanism of these interactions in more detail. Analyzing recently published X-ray data of microsomal P450 enzymes and protein docking studies, four types of dimer formations of P450 enzymes were examined in more detail. In case of two dimer types, the aggregating partner was shown to contribute to NADPH cytochrome P450 reductase (CPR) binding-a flavoprotein whose interaction with P450 is required for expressing P450 functional activity of the neighboring P450 moiety. Thus, it was shown that dimerization of P450 enzymes might result in an altered affinity towards the CPR. Two dimer types were shown to exist only in the presence of a substrate, while the other two types exist also without a substrate present. The molecular basis was established for the fact that the presence of a substrate and other P450 enzymes simultaneously determine the catalytic activity. Furthermore, a kinetic model was improved describing the catalytic activity of P450 enzymes as a function of CPR concentration based on equilibrium between different supramolecular organizations of P450 enzymes. This model was successfully applied in order to explain our experimental data and that of other investigators.


Usefulness of the tensile gallbladder fundus sign in the diagnosis of early acute cholecystitis.
The purpose of this article is to evaluate the usefulness of the tensile gallbladder fundus sign on CT in diagnosing early acute cholecystitis. The tensile gallbladder fundus sign on CT is defined as the absence of gallbladder fundus flattening by the anterior abdominal wall due to increased gallbladder pressures. Between October 2010 and March 2012, 222 patients with confirmed diagnoses of acute cholecystitis by surgery or follow-up imaging studies underwent CT scans in the emergency department because of right upper quadrant pain. Two radiologists retrospectively reviewed all CT images to determine the presence of the tensile gallbladder fundus sign and other CT findings previously reported to be suggestive of acute cholecystitis. Diagnostic performances were calculated and analyzed using pairwise comparisons of receiver operating characteristic curves. The kappa statistic was calculated to evaluate the interobserver agreement. Using the diagnostic criteria in which acute cholecystitis is defined as the presence of three or more classic CT findings, the addition of the tensile gallbladder fundus sign increased the area under the receiver operating characteristic curve (Az) value from 0.693 to 0.739 (p = 0.003). In the subgroup of 91 patients with no other CT features suggestive of acute cholecystitis, the sensitivity, specificity, and Az value of the tensile gallbladder fundus sign for acute cholecystitis were 74.1%, 96.9%, and 0.855, respectively. Interobserver agreement was good with the tensile gallbladder fundus sign (κ = 0.721). The tensile gallbladder fundus sign may be useful for diagnosing acute cholecystitis, especially in the early stage when other CT findings are absent.


Magnetic resonance imaging findings of two sisters with Van der Knaap leukoencephalopathy.
Megalencephalic leukoencephalopathy with subcortical cysts, or Van der Knaap leukoencephalopathy, is a rare disease which is characterised by macrocephaly and neurological disorders with autosomal recessive inheritance. Magnetic resonance imaging is very helpful for determining distinctive findings and distinguishing other diseases. We present the radiological findings of two sisters (aged 6 and 10 years) diagnosed with Van der Knaap leukoencephalopathy.


Primer pheromones in social hymenoptera.
Social insect are profoundly influenced by primer pheromones (PPhs), which are efficient means for maintaining social harmony in the colony. PPhs act by affecting the physiology of the recipients with a subsequent shift in their behavior, and many PPhs have a releaser effect (i.e., changing the probability of performing a certain behavior upon perception). In this review we try to clarify the interplay between such dual pheromonal effects. Only a few PPhs have been identified, and we provide evidence for their existence in multiple species of social Hymenoptera, which is the most extensively studied of the social insects. We focus on the regulation of reproduction, social policing, and task allocation. Considering PPhs in a broad sense, we also discuss fertility signals and the role of cuticular hydrocarbons as putative PPhs. Identification of the underlying chemistry of PPhs offers insights into insect physiology and the evolution of social behavior. PPhs of the honey bee are used to demonstrate the complexity of pheromonal communication in social insects.


Scrub typhus pneumonitis: an entity which is frequently missed.
Four cases of scrub typhus pneumonitis are reported. Diagnosis was confirmed by positive Weil-Felix OX-K reaction and immunofluorescent antibody test for Rickettsia tsutsugamushi. Two patients presented with atypical pneumonia and two had overwhelming pneumonia resembling adult respiratory distress syndrome. All patients made a full recovery after appropriate treatment.


Combined use of vitamin D3 and metformin exhibits synergistic chemopreventive effects on colorectal neoplasia in rats and mice.
Vitamin D3 and metformin are widely used in humans for regulating mineral metabolism and as an antidiabetic drug, respectively; and both of them have been shown to have chemopreventive effects against various tumors. This study was designed to investigate the potential synergistic chemopreventive effects of vitamin D3 and metformin against the development of early colon neoplasia in two models. The first model was a 1,2-dimethylhydrazine dihydrochloride (DMH)-induced colon cancer rat model and the second, a DMH-dextran sodium sulfate (DSS)-induced colitis-associated colon neoplasia mouse model. Compared with either vitamin D3 or metformin alone, combined use of vitamin D3 and metformin showed more pronounced effect in reducing the numbers of aberrant crypt foci (ACF) and tumor in the colon. The most prominent inhibitory effects were observed in the vitamin D3 medium dose (100 IU/kg/d) and metformin medium dose (120 mg/kg/d) combination group. Furthermore, our results showed that enhancement of metformin's chemopreventive effects by vitamin D3 was associated with downregulation of S6P expression, via the AMPK (IGFI)/mTOR pathway. In addition, enhancement of vitamin D3's chemopreventive effects by metformin was associated with inhibition of the protein expressions of c-Myc and Cyclin D1, via the vitamin D receptor/β-catenin pathway. These findings show that the combined use of vitamin D3 and metformin exhibits synergistic effects against the development of early colon neoplasia. They suggest that the combined use of vitamin D3 and metformin may represent a novel strategy for chemoprevention of colorectal cancer.


Lifetime earnings patterns, the distribution of future Social Security benefits, and the impact of pension reform.
In order to assess the effect of Social Security reform on current and future workers, it is essential to accurately characterize the initial situations of representative workers affected by reform. For the purpose of analyzing typical reforms, the most important characteristic of a worker is the level and pattern of his or her preretirement earnings. Under the current system, pensions are determined largely by the level of the workers' earnings averaged over their work life. However, several reform proposals would create individual retirement accounts for which the pension would depend on the investment accumulation within the account. Thus, the pension would also depend on the timing of the contributions into the account and hence on the exact shape of the worker's lifetime earnings profile. Most analysis of the distributional impact of reform has focused, however, on calculating benefit changes among a handful of hypothetical workers whose relative earnings are constant over their work life. The earnings levels are not necessarily chosen to represent the situations of workers who have typical or truly representative earnings patterns. Consequently, the results of such analysis can be misleading, especially if reform involves introducing a fundamentally new kind of pension formula. This article presents two broad approaches to creating representative earnings profiles for policy evaluation. First, we use standard econometric methods to predict future earnings for a representative sample of workers drawn from the Survey of Income and Program Participation (SIPP). Our statistical estimates are based on a simple representation of typical career earnings paths and a fixed-effect statistical specification. Because our estimation file contains information on each worker's annual earnings from 1951 through 1996 as reported in the Social Security Administration's earnings files, we have a record (though an incomplete one) of the actual earnings that will be used to determine future benefit payments. Our estimates of the earnings function permit us to make highly differentiated predictions of future earnings for each member of our sample. By combining the historical information on individual earnings with our prediction of future earnings up through the normal retirement age, our first approach produces tens of thousands of predicted career earnings paths that can be used in microsimulation policy analysis. Our second approach to creating lifetime earnings profiles is similar in some ways to the traditional method. For example, it is based on the creation of only a handful of "stylized" career earnings patterns. An important difference with the traditional method, however, is that we define the career earnings patterns so that they are truly representative of patterns observed in the workforce. We use simple mathematical formulas to characterize each stylized earnings pattern, and we then produce estimates of the average path of annual earnings for workers whose career earning path falls within each of the stylized patterns we have defined. Finally, we calculate the percentage of workers in successive birth-year cohorts who have earnings profiles that match each of the stylized earnings patterns. Although this method may seem simple, it allows the analyst to create stylized earnings patterns that are widely varied but still representative of earnings patterns observed among sizable groups of U.S. workers. The effects of policy reforms can then be calculated for workers with each of the stylized earnings patterns. Our analysis of U.S. lifetime earnings patterns and of the impact of selected policy reforms produces a number of findings about past trends in earnings, typical earnings patterns in the population, and the potential impact of reform. The analysis focuses on men and women born between 1931 and 1960. Along with earlier analysts, we find that men earn substantially higher lifetime wages than women and typically attain their peak career earnings at a somewhat earlier age. However, the difference in career earnings patterns between men and women has narrowed dramatically over time. Workers with greater educational attainment earn substantially higher wages than those with less education, and they attain their peak career earnings later in life. For example, among men with the least education, peak earnings are often attained around or even before age 40, whereas many men with substantial postsecondary schooling do not reach their peak career earnings until after 50. Our tabulations of the lifetime earnings profiles of the oldest cohorts (born around 1930) and projections of the earnings of the youngest profiles (born around 1960) imply that the inequality of lifetime earnings has increased noticeably over time. Women in the top one-fifth of female earners and men in the top one-fifth of male earners are predicted to receive a growing multiple of the economy-wide average wage during their career. Women born between 1931 and 1935 who were in the top fifth of female earners had lifetime average earnings that were approximately equal to the average economy-wide wage. In contrast, women born after 1951 who were in the top fifth of earners are predicted to earn almost 50 percent more, that is, roughly 150 percent of the economy-wide average wage. Women with a lower rank in the female earnings distribution will also see gains in their lifetime average earnings, but their gains are predicted to be proportionately much smaller than those of women with a high rank in the distribution. Men with high earnings are also predicted to enjoy substantial gains in their relative lifetime earnings, while men with a lower rank in the earnings distribution will probably see a significant erosion in their typical wages relative to the economy-wide average wage. That is mainly the result of a sharp decline in the relative earnings of low-wage men born after 1950. In creating stylized earnings profiles that are representative of those of significant minorities of U.S. workers, we emphasized three critical elements of the earnings path: the average level of earnings over a worker's career, the upward or downward trend in earnings from the worker's 30s through his or her early 60s, and the "sagging" or "hump-shaped" profile of earnings over the worker's career. That classification scheme yields 27 characteristic patterns of lifetime earnings. Surprisingly, the differnce between men and women within each of those categories is quite modest. The main difference between men and women is in the proportions of workers who fall in each category. Only 14 percent of men born between 1931 and 1940 fall in earnings categories with the lowest one-third of lifetime earnings, whereas 53 percent of women born in those years have low-average-earnings profiles. On the other hand, women born in those years are more likely to have a rising trend in lifetime earnings, while men are more likely to have a declining trend. We find that the distribution of lifetime earnings contains relatively more workers with below-average earnings and relatively fewer with very high earnings than assumed in the Social Security Administration's traditional policy analysis. For example, the "low earner" traditionally assumed by the Office of the Chief Actuary is assigned a level of average lifetime earnings that we find to be higher than the average earnings of persons in the bottom one-third of the lifetime earnings distribution. The stylized earnings profiles developed here can be used for policy evaluation, and the results can be compared with those from the more traditional analysis. That comparison produces several notable findings. Because earnings profiles that are actually representative of the population tend to have lower average earnings than assumed in the traditional analysis, workers typically accumulate somewhat less Social Security wealth than implied in the traditional analysis. On the other hand, because the basic benefit formula is tilted in favor of lower-income workers, the internal rate of return on Social Security contributions is somewhat higher than detected in the traditional analysis. Moreover, the primary insurance amount measured as a percentage of the worker's average indexed earnings tends to be higher than implied by the traditional analysis. Finally, the stylized earnings patterns can be used to compare benefit levels enjoyed by workers under the traditional Social Security formula and under an alternative plan based on individual investment accounts. That comparison shows, as expected, that the traditional formula favors low-wage workers and one-earner couples, while an investment account favors single, high-wage workers. Comparing two workers with the same lifetime average earnings, the traditional formula favors workers with rising earnings profiles (that is, with lifetime earnings heavily concentrated at the end of their career), while investment account pensions favor workers with declining earnings profiles (that is, with earnings concentrated early in their career).


Influence of mesophilic and thermophilic conditions on the anaerobic digestion of food waste: Focus on the microbial activity and removal of long chain fatty acids.
The mesophilic reactor (MR) exhibited advantages in biogas production and performance stability over thermophilic reactor (TR) during the long-term anaerobic digestion (AD) of food waste (FW) with stepwise organic loading rate elevating. It was interesting to explore the mechanism causing the divergences in performances between these two reactors. The microbial activity was compared on day 110 when TR began to deteriorate. The results show that MR had significantly higher specific acetoclastic methanogenic activities (SAMA) and specific propionate and butyrate oxidative activities (SPOA and SBOA) than TR. The SAMA, SPOA and SBOA in TR were only 50.3%, 18.6% and 46.4% of those values in MR, respectively. Remarkably, the specific hydrogenotrophic methanogenic activity of 15.5±2.1, 15.7±4.6 mmol CH4·L-1 original slurry·d-1 in MR and TR was comparative with insignificant difference, which indicates that the microbial activity in TR had been inhibited widely apart from the hydrogenotrophic methanogenesis. Additionally, many particles with the diameters of 1-2 mm were observed to form in MR and identified as complexes of calcium and long chain fatty acids (LCFAs). The formation of calcium crystallization might alleviate the inhibition of LCFAs during AD of FW, which further supports the better performance in MR than TR.


Inhibit My Disinhibition: The Role of the Inferior Frontal Cortex in Sexual Inhibition and the Modulatory Influence of Sexual Excitation Proneness.
Sexual behaviour is the result of an interplay between distinct neural inhibitory and excitatory mechanisms. Individual differences in sexual excitation and sexual inhibition are proposed to play an important role in the processes sustaining the regulation of sexual behaviour. While much research has focused on the neural correlates of response inhibition, highlighting a prominent role of the inferior frontal gyrus (IFG), very little is known regarding the neural mechanisms underlying different aspects of sexual inhibition. Here, we experimentally combined functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) to: (i) test the functional role of IFG during motivational and cognitive sexual inhibition; and (ii) reveal whether this IFG involvement in sexual inhibitory processes depends on sexual excitation and sexual inhibition as traits. Twenty-two participants performed an Approach-Avoidance (AA) and a Negative Affective Priming (NAP) paradigm to assess motivational and cognitive sexual inhibition respectively. Our fMRI study showed IFG being selectively activated during cognitive but not motivational sexual inhibition. Importantly, the level of this neural activity was modulated by individual sexual excitation scores. Interestingly, a transient disruption of IFG activity using TMS led to an improvement in cognitive, not motivational, sexual inhibition, but only when accounting for individual sexual excitation scores. These findings clearly document that sexual excitation modulates IFG activity levels during cognitive sexual inhibition, and at the same time determines the effects of TMS on IFG by improving cognitive control exclusively for individuals with high sexual excitation scores. These findings provide new insights regarding the functional role of IFG, and underscore the relevance of individual psychological differences in understanding the brain mechanisms underlying socioaffective processes.


Improving Wayfinding for Older Users With Selective Attention Deficits.
Older adults experience difficulties with navigating their environments, and may need to rely on signs more heavily than younger adults. However, older adults also experience difficulties with focusing their visual attention, which suggests that signs need to be designed with the goal of making it as easy as possible to attend to them. This article discusses some design principles that may be especially important to compensate for declining attentional focus. These principles include distinctiveness, consistent appearance and location, standardized images, simplicity, isolation from other elements of the environment, and reassurance about the current route.


A combined surgical approach to non-oat-cell pulmonary carcinoma with single cerebral metastasis.
Eighty consecutive patients with pulmonary non-oat-cell carcinoma and a single cerebral metastasis were followed for at least 5 years after therapy. Forty were treated by surgical excision at both sites of disease plus whole-brain irradiation in most cases (group 1). The remaining 40 patients, an observational cohort, were treated either by surgery at only one site of disease (usually craniotomy), whole-brain irradiation, chemotherapy, or some combination of these modalities (group 2). The 1-year survival in group 2 was 15%, and all were dead at 2 years. In group 1, hospital mortality was 1.5%, the 1-year survival rate 35%, the 2-year survival rate 25%, and the 5-year survival rate 12.5%. All the five year survivors were patients with N0 disease. In this subgroup of group 1, the five year survival was 20%. All patients surviving for more than 2 years were in group 1 and had a Karnofsky rating greater than 50 and N0 disease after staging. These data indicate that a combined surgical approach can be accomplished with low morbidity, low mortality, and increased survival rates, especially for patients with N0 disease who are vigorous enough to undergo the combined treatment.


Strategies for the storage of Ancylostoma caninum third-stage larvae.
Although cryopreservation protocols for storage of hookworm larvae have been described, the circumstances under which the technique is necessary to ensure larval survival are not well defined. The motility of infective-stage larvae (as judged by observation) and their ability to migrate through canine skin in vitro were measured over a 7-mo period in worms held at room temperature and worms that had been cryopreserved at the start of the experiment. Cryopreserved worms showed motility and migration proportions of 45.6-48.0% and 26.8- 34.0%, respectively, throughout the experiment, compared with percentages of 92.7 and 84.1%, respectively, in the original fresh worms. Larvae held at room temperature showed a gradual decrease in motility and migration ability over the experimental period. Motility and migratory ability of cryopreserved larvae was only significantly higher (P < 0.01) than room temperature-stored larvae from 4 and 5 mo onward, respectively.


Evaluation of the effects of rocuronium bromide on haemodynamics and left ventricular function in patients undergoing abdominal aortic surgery.
In an open study of 26 patients undergoing abdominal aortic surgery, the effects of rocuronium 0.6 mg kg-1 (eight patients) and 0.9 mg kg-1 (nine patients) were compared with those of pancuronium 0.085 mg kg-1 (eight patients) on haemodynamic parameters and transoesophageal echocardiography. The anaesthetic technique was based on a benzodiazepine and low dose fentanyl (6 micrograms kg-1). Pancuronium was associated with a significant increase in mean arterial pressure, end-diastolic area and heart rate, none of which were seen after rocuronium at either dose level.


Structured report for dynamic ultrasonography in patients with suspected or known endometriosis: Recommendations of the International Society for Gynecologic Endoscopy (ISGE).
The International Society for Gynecologic Endoscopy (ISGE) developed this project to establish the recommendations for structured reporting of dynamic ultrasound findings, promoting on this manner the practice of standardized, comprehensive and systematic evaluation and reporting of endometriosis in pelvic structures, in correlation with the #Enzian classification. A non-systematic review was done through a search on the following databases: MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), Health Technology Assessment Database and Web of Science, using the medical subject heading (MeSH) term "endometriosis" (MeSH Unique ID: D004715) in combination with "diagnostic imaging" (MeSH Unique ID Q000000981) and "consensus" (MeSH Unique ID D032921). The information extracted from the articles of interest, written in English and published from inception of the above-mentioned databases until May 2021, was graded by the level of evidence using the American College of Chest Physicians (ACCP) classification system. The recommendations for a structured reporting of ultrasound findings were developed through multiple cycles of literature analysis and expert discussion following the Delphi method. The ISGE recommends the adoption of the terms, definitions and methods proposed by the International Deep Endometriosis Analysis (IDEA) Group for ultrasound assessment of patients with suspected or known endometriosis (grade 1C), since this is the most comprehensive and systematic concept currently available. This paper provides the ISGE structured reporting template for presenting quantitative and qualitative information upon the IDEA consensus-based sonographic assessment of the uterus, adnexa, anterior and posterior compartment. The #Enzian classification is recommended to summarize the findings in a standard fashion (grade 1B). Mapping of pelvic endometriosis by ultrasound is accurate when trained sonographers perform the technique. Structured reporting of the lesions may improve patient counseling and treatment planning, including the organization of multidisciplinary teams and the selection of the most appropriate medical or surgical therapeutic strategy.


Conceptual design of a divertor Thomson scattering diagnostic for NSTX-U.
A conceptual design for a divertor Thomson scattering (DTS) diagnostic has been developed for the NSTX-U device to operate in parallel with the existing multipoint Thomson scattering system. Higher projected peak heat flux in NSTX-U will necessitate application of advanced magnetics geometries and divertor detachment. Interpretation and modeling of these divertor scenarios will depend heavily on local measurement of electron temperature, Te, and density, ne, which DTS provides in a passive manner. The DTS design for NSTX-U adopts major elements from the successful DIII-D DTS system including 7-channel polychromators measuring Te to 0.5 eV. If implemented on NSTX-U, the divertor TS system would provide an invaluable diagnostic for the boundary program to characterize the edge plasma.


Literature review of pain management for people with chronic pain.
Multimodal approaches toward relieving pain, patients' participation, and improving self-efficacy are important for chronic pain management. The aims of this review were to identify possible options of nursing strategies for pain management in individuals with chronic pain and to determine the effectiveness of these strategies for pain relief/pain-related problems; therefore, nurses and researchers could consider and/or adopt multimodal chronic pain management strategies. A Systematic Integrated Literature Review was conducted. Published work related to pain management in individuals with chronic pain was identified by searching databases and reviewed. Among the studies reviewed, we identified 35 studies that focused on pain management strategies. In 10 studies, interventions such as integrated and multidisciplinary pain management programs were associated with significant decreases in pain intensity. However, they reported that the long-term effectiveness of pain relief was not satisfactory. Individuals with chronic pain reported that strategies including pharmacotherapy, physical activity, social support from friends and family, acupuncture, heating, rest, diets, or life-style changes helped them to effectively manage their pain. We identified possible options of pain management strategies and explored effectiveness of chronic pain interventions. The long-term effects of pain relief interventions and social support for individuals with chronic pain require further investigation.


Hyperelasticity, viscoelasticity, and nonlocal elasticity govern dynamic fracture in rubber.
Dynamic cracks in rubber can spontaneously oscillate under certain biaxial strain conditions [R. D. Deegan et al., Phys. Rev. Lett. 88, 014304 (2002)]. We have found that this unusual phenomenon can be understood from the unique mechanical properties of rubber: hyperelasticity, viscoelasticity, and nonlocal elasticity. While all these are important, the decisive role of nonlocality needs to be particularly emphasized. Through numerical simulations with a lattice model, we have quantitatively reproduced the experimental results.


Gene expression is differentially regulated in skeletal muscle and circulating immune cells in response to an acute bout of high-load strength exercise.
High-intensity exercise induces many metabolic responses. In is unknown whether the response in the peripheral blood mononuclear cells (PBMCs) reflects the response in skeletal muscle and whether mRNA expression after exercise can be modulated by nutritional intake. The aims were to (i) investigate the effect of dairy proteins on acute responses to exercise in skeletal muscle and PBMCs measuring gene expression and (ii) compare this response in young and older subjects. We performed two separate studies in young (20-40 years) and older subjects (≥70 years). Subjects were randomly allocated to a milk group or a whey group. Supplements were provided immediately after a standardized exercise session. We measured mRNA expression of selected genes after a standardized breakfast and 60/120 min after finishing the exercise, using RT-qPCR. We observed no significant differences in mRNA expression between the milk and the whey group; thus, we merged both groups for further analysis. The mRNA expression of IL6, TNF, and CCL2 in skeletal muscle increased significantly after exercise compared with smaller or no increase, in mRNA expression in PBMCs in all participants. The mRNA expression of IL1RN, IL8, and IL10 increased significantly in skeletal muscle and PBMCs. Some mRNA transcripts were differently regulated in older compared to younger participants in PBMCs. An acute bout of heavy-load strength exercise, followed by protein supplementation, caused overlapping, but also unique, responses in skeletal muscle and PBMCs, suggesting tissue-specific functions in response to exercise. However, no different effects of the different protein supplements were observed. Altered mRNA expressions in PBMCs of older participants may affect regenerative mechanisms.