Rectal adenocarcinoma presenting with thigh muscle metastasis as the only metastatic site.
Rectal carcinoma with metastasis to skeletal muscle is a rare finding. According to literature review, 17 cases of skeletal muscle metastasis from colorectal carcinoma have been documented where only six cases were rectal carcinomas.We discuss a case of a middle-aged man with a known history of high-grade mucinous adenocarcinoma of the rectum, status post abdominoperineal resection followed by adjuvant radiotherapy and chemotherapy. During the planned chemotherapy course, a right proximal thigh subcutaneous mass was incidentally found which on subsequent biopsy proved to be metastatic from rectal primary site. On subsequent 18F-FDG (Fluorodeoxyglucose) positron emission tomography (PET)/CT scan after completion of chemotherapy for the purpose of treatment response evaluation, only FDG-avid lesion was residual right proximal thigh metastatic mass without involvement of other common sites, such as liver and lung. In this case, the 18F-FDG-PET/CT scan was able to exclude additional metastatic sites and also evaluate the patient's treatment response.


[Epitome of social work in hospitals in modern China-Social Work in Hospitals].
As the first theoretical monograph about social work in hospitals in China, Social Work in Hospitals was published by Chung Hwa Book Co. in 1946 and was an exposition on the concept, methods and measures of social work in hospitals in detail. The book analyzed the cultivation of quality in the staff and localization of social work in hospitals by introducing cases the author experienced, which made the book an epitome of observation of social work in hospitals in modern China. The social medical idea and case treatment method advocated in the book had their historical inspirational function in establishing a harmonious doctor-patient relationship, improving medical service quality and strengthening humane care.


An improved understanding of the causes of end-stage renal disease.
An understanding of the causes of end-stage renal disease (ESRD) is approached through a discussion of currently attributed causes, potentially unattributed causes, and the reasons for growth in new ESRD cases. The attributed causes of ESRD have varied over time and by region. In the United States, diabetes has long been the most common attributed cause of ESRD, accounting for 36% of incident cases in 1992. In contrast, diabetic ESRD is far less common in other countries. Hypertension and glomerulonephritis are the next most commonly attributed causes of ESRD, but these diagnoses are not necessarily based on consistent or uniform criteria. Mistaken classification of the cause of ESRD is possible in many cases. Emerging evidence suggests that other processes, including renovascular disease and analgesic ingestion, can cause or contribute to ESRD more often than they are recorded. The incidence of ESRD has been increasing at a rate of up to 9% per year. The likely reasons for ESRD growth include decreased competing risk from other diseases, increased referral and acceptance of patients with advanced renal failure, and increased renal disease.


Application of a picrolonate ion-selective electrode to the assay of calcium and piperazine in pharmaceuticals and serum.
The construction and some analytical applications of a liquid picrolonate (Picrl-) ion-selective electrode based on the tris(phenanthrolinato)iron(II) (ferroin) picrolonate salt, dissolved in 2-nitrotoluene, are described. The liquid membrane electrode exhibits a rapid and almost Nernstian response to picrolonate anions in the concentration range from 5 x 10(-2) to 5 x 10(-2) mol l-1. The response is virtually unaffected by pH changes in the range 3-10. Major interferents are picrates, 4-nitrophenolates, 3,5-dinitrosalicylates and 2,4-dinitrophenolates. In analytical applications direct potentiometric methods for the determination of picrolonates and indirect methods for the determination of calcium and piperazine are described. Calcium in the ranges 4-24 and 50-90 mg l-1, under specified experimental conditions, can be determined with mean relative errors of 1.1 and 1.4%, respectively. The method is applicable to soluble samples, pharmaceuticals and industrial and real human serum. Piperazine in the ranges 1-10 and 13-20 mg can be determined with a mean relative error of 1.2% in soluble salts and pharmaceutical formulations, respectively. An accuracy of better than 1.5% and a reproducibility (relative standard deviation) of 0.1% were achieved in the analysis of pharmaceutical products.


Interactions of chaperone alpha-crystallin with the molten globule state of xylose reductase. Implications for reconstitution of the active enzyme.
alpha-Crystallin is a multimeric protein that has been shown to function as a molecular chaperone. Present investigations were undertaken to understand its mechanism of chaperoning. For this functional in vitro analysis of alpha-crystallin we used xylose reductase (XR) from Neurospora crassa as the model system. Denaturation studies using the structure-perturbing agent guanidinium chloride indicated that XR folds through a partially folded state that resembles the molten globule. Fluorescence and delay experiments revealed that alpha-crystallin interacts with the molten globule state of XR (XR-m) and prevents its aggregation. Cold lability of alpha-crystallin.XR-m interaction was revealed by temperature shift experiments implicating the involvement of hydrophobic interactions in the formation of the complex. Reconstitution of active XR was observed on cooling the alpha-crystallin.XR-m complex to 4 degrees C or on addition of ATP at 37 degrees C. ATP hydrolysis is not a prerequisite for XR release since the nonhydrolyzable analogue 5'-adenylyl imidodiphosphate (AMP-PNP) was capable of reconstitution of active XR. Experimental evidence has been provided for temperature- and ATP-mediated structural changes in the alpha-crystallin.XR-m complex that shed some light on the mechanism of reconstitution of active XR by this chaperone. The relevance of our finding to the role of alpha-crystallin in vivo is discussed.


Alcohol-processable organic amorphous electrolytes as an effective electron-injection layer for organic light-emitting diodes.
A new series of monoammonium-based organic electrolytes with the tetrafluoroborate (BF(4)(-)) counteranion have been synthesized. Replacing the pendant ethyl groups in the fluorenyl unit with 4-ethoxyphenyl groups dramatically improves both solubility and morphological stability. The characterization of the alcohol-processable amorphous ionic compounds as an electron-injection layer in organic light-emitting diodes (OLEDs) reveals that the organic electrolyte that comprises a rigid linear-conjugated unit provides better device performance, with respect to its counterpart containing a branched bulky moiety. The capability of these compounds to facilitate electron injection from air-stable aluminum metal is preliminarily discussed on the basis of the investigations of the electron-only devices and photovoltaic experiments.


Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis.
To evaluate the clinical experience with methotrexate as a first-line corticosteroid-sparing drug in patients with resistant ocular inflammation. We retrospectively studied 39 consecutive patients with uveitis (n = 36) or scleritis (n = 3) who were treated with methotrexate following inadequate control with corticosteroids lasting five years. Criteria for initiating treatment with methotrexate and defining outcome were strictly defined. The cohort included 21 females and 18 males, all Caucasians, with a mean age of 26.6 years (range: 3-73 years). Patients were followed up for 21.5 +/- 12.6 months. Treatment was discontinued due to side effects in 10 patients (26%). Of the remaining 29 patients, full or partial control of inflammation was achieved in 23 (79%). Response to treatment was observed after a mean of 2.4 +/- 0.8 months. Ten patients were fully controlled and discontinued methotrexate therapy after a mean of 20.9 +/- 9.2 months, with no recurrence of inflammation. Use of topical and systemic corticosteroids was markedly reduced in responsive patients. Methotrexate is recommended as a first-line adjunct to or replacement of systemic corticosteroids in the treatment of ocular inflammation.


Cell weight kinetics simulation in chemostat and batch culture of the rhodophyte Porphyridium cruentum.
Experimental observations of cell size variations in the proliferating rhodophyte Porphyridium cruentum cultured under fully controlled conditions showed significant decreases from inoculation to a steady state in the chemostat with 0.23 d(-1) dilution rate and to a minimum in batch, dropping in size by ratios of over 10. To numerically simulate these variations, we assumed that the cell is made up of two categories of components that behave differently during the interphase and mitosis. These have been called essential (EC) and accessory (AC) components. It is assumed that the cell divides once the EC have doubled in size, regardless of the AC's state. The experimental cell weight time courses were correctly simulated by a model of synchronous cell kinetics based on these assumptions. The EC's specific growth rate was 1.5 times that of the whole cell, when no limitation occurred. The increase in cell weight observed during batch cultures after nutrient exhaustion was suitably simulated by assuming that EC growth stops when a limiting nutrient is exhausted. Several parameters characterizing the cell kinetics were defined, particularly the minimum minimorum EC or cell weight (26 and 15 pg for chemostat and batch, respectively), which was influenced by the cultivation method, and the maximum whole cell weight (224 to 244 pg), which depended on the inoculum's age. The influence of culture conditions on the amount of essential and accessory components contained in a cell was examined. A new approach was developed with respect to these compartments to determine the most suitable strategy and conduct a predictive approach for valuable molecule production.


WHAT DETERMINES FITNESS WHEN DISPERSAL IS LIMITED?
Simple evolutionary models typically assume a homogeneous environment in which all individuals have equal access to resources. However, when dispersal is limited this assumption is unlikely to correspond to reality. Instead, the offspring of relatively fecund parents can be expected to find that resources are scarce because of competition from their relatively large number of siblings. We show that these factors lead to selection for decreased variation in the number of offspring produced. We investigate the relationship between fitness and variation in fertility for a variety of different circumstances. Our results indicate that, in some cases, selection for reduced variation in fertility can be very substantial.


Timer to shut off portable air samplers.
Portable air samplers used at Los Alamos National Laboratory produce noise levels that make it difficult to conduct classes or tours in their vicinity. If air samplers are shut off during a class or tour, it may not be restarted at the end of the class or tour, preventing detection of low level airborne contamination or the measurement of a more significant release during a later operation. To enable clear communication during tours and classes a timer was designed and constructed that allows an air sampler to be shut of for a short, fixed duration and automatically restarted. A schematic and parts list is included.


The traditional Chinese medicine prescription patterns for migraine patients in Taiwan: a population-based study.
Traditional Chinese medicine (TCM), when given for symptom relief, has gained widespread popularity among migraine patients. The aim of this study is to analyze the utilization of TCM among migraine patients in Taiwan. The usage, frequency of service, and the Chinese herbal products prescribed for migraine were evaluated using a representative sample of one million subjects selected at random from the 22 million beneficiaries of the National Health Insurance scheme of Taiwan. Overall, 89.3% (N=12,827) migraine patients utilized TCM and 24.2% of them sought TCM with the intention of treating their migraine-related symptoms. Migraine patients who are living in urban area and those with an episodic migraine pattern (<15 days/month) (aOR=3.18, 95% CI: 2.75-3.67) were more likely to be TCM users than those living in a rural area and those who suffered from chronic migraine (≥15 days/month) (aOR=1.00). Overall, 81.2% of TCM visits involved the prescription of a Chinese herbal remedy or remedies and Chuan-Xiong-Cha-Tiao-San, Jia-Wei-Xiao-Yao-San, Ge-Gen-Tang, Xue-Fu-Zhu-Yu-Tang, Ban-Xia-Bai-Zhu-Tian-Ma-Tang, Qing-Shang-Juan-Tong-Tang, Xiao-Chai-Hu-Tang, Tian-Ma-Gou-Teng-Yin, Bu-Zhong-Yi-Qi-Tang, and Tian-Wang-Bu-Xin-Dan were the ten most frequently prescribed formula for treating migraine based on syndrome differentiation. Chuan-Xiong-Cha-Tiao-San, which contains sedative and anti-inflammatory agents, is the most commonly prescribed Chinese herbal formula for the treatment of migraine-related phenomena.


Detection of low-molecular-mass plasma peptides in the cavernous and systemic blood of healthy men during penile flaccidity and rigidity--an experimental approach using the novel differential peptide display technology.
To use Differential Peptide Display (DPD) technology to evaluate the patterns of low-molecular-mass peptides and small proteins in the systemic and cavernous blood taken from healthy adult male volunteers during the penile stages of flaccidity and rigidity. Results from basic research implicate a role of various peptides in the control of mammalian penile erectile tissue. Nevertheless, it is not yet known which particular peptides are essential in the regulation of penile flaccidity, tumescence, rigidity, and detumescence. Five healthy male subjects were exposed to visual and tactile erotic stimuli to elicit penile erection. Whole blood was simultaneously aspirated from the corpus cavernosum and cubital vein during penile flaccidity and rigidity. Plasma aliquots were subjected to DPD analysis by means of matrix-assisted-laser-desorption-ionization mass mapping and electrospray-ionization quadrupole--time-of-flight mass spectrometry. High-resolution two-dimensional peptide mass mapping revealed differences in the systemic and cavernous plasma samples related to penile flaccidity and rigidity. Distinct signals were recognized in the cavernous but not in the systemic plasma obtained during flaccidity. These signals were not registered in the plasma samples obtained from the corpus cavernosum during rigid erection. Although one signal was identified as the blood coagulation-activating peptide XIIIa, the remaining two signals could not be related to any known peptide. These signals may represent unknown local peptidergic factors that might be involved in the regulation of penile flaccidity. Our study demonstrates that DPD is a feasible method for detecting differences in the cavernous and systemic blood in relation to the different functional conditions of the penile erectile tissue. Additional studies using DPD should include the analysis of blood samples taken from the cavernous meshwork of healthy subjects during penile tumescence and detumescence to establish DPD as a valuable tool in contemporary corpus cavernosum basic research.


Effect of Different Ferrule Length on Fracture Resistance of Endodontically Treated Teeth: An In vitro Study.
A ferrule has been described as a key element of tooth preparation when using a post and a core. It is a vertical band of tooth structure at the gingival aspect of crown preparation. It lessens the stress transmission to the root which is due to forces from posts or bending during seating of the post. The incorporation of a ferrule can help to withstand the forces of occlusion, preserve the hermetic seal of the luting cement, and minimize the concentration of stresses at the junction of post and core. To evaluate and compare the effect of ferrule length on fracture resistance of endodontically treated mandibular premolar teeth, restored with prefabricated glass fiber post luted with resin cement, composite core and a full coverage metal crown. Forty freshly extracted mandibular premolars were treated endodontically. They were randomly divided into four groups according to their ferrule height: 3 mm, 2 mm, 1 mm and 0 mm (no ferrule). All specimens were restored with prefabricated glass fibre posts (Reforpost, Angelus) and composite resin (Filtek™ Z250XT). Standardized preparation was done on each specimen to receive a cast metal crown. The specimens were thermocycled and compressive static load at a crosshead speed of 1 mm/min was applied at an angle of 30° on lingual incline of buccal cusp of the crown until failure occurred. The load (N) at failure and mode of failure were recorded. Statistical analysis was performed with Kruskal Wallis test. Fracture resistance values among the groups was found to be statistically significant (p<0.001). The 3 mm ferrule group had significantly higher failure load (971.99±133.07) compared to 2 mm (848.84±109.60), 1 mm (714.64±133.89) and 0 mm ferrule groups (529.36±119.95). More favourable failure modes were observed in almost all groups. The results of this study showed that fracture resistance of endodontically treated teeth increases as ferrule length increases.


Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study.
To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)2) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)2 group. MTA and Ca(OH)2, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.


Theory-based research of high fidelity simulation use in nursing education: a review of the literature.
In this article, we explore the extent to which theory-based research is informing our understanding of high-fidelity simulation use in nursing education. We reviewed the primary literature archived in the Cumulative Index of Nursing and Applied Health Literature (CINAHL) and Proquest Dissertation and Theses for empirical reports using the key terms high-fidelity simulation and nursing from the years 1989 to 2009. Of the articles that matched our inclusion criteria: 45% made no use of theory; 45% made minimal use; and 10% made adequate use. We argue that theory-based research could bring coherence and external validity to this domain.


The effect of surgery on lymphoscintigraphy drainage patterns from the canine brachium in a simulated tumor model.
To determine the effect of surgery on lymphoscintigraphy drainage patterns from the canine brachium. Experimental study. Eight healthy research beagles. A predefined area of skin measuring 2 × 1.5 cm in dimension was designated on either the right or left brachium. Preoperative lymphoscintigraphy was performed with technetium sulfur colloid injected into the subcutaneous tissues around the predefined anatomic location in a four-quadrant technique. Dogs underwent surgery for excision of the predefined area of skin, subcutis, and fascia of the lateral head of the triceps muscle with 1-cm margins. Eighteen days after surgery, lymphoscintigraphy was again performed with technetium sulfur colloid injected into the subcutaneous tissues around the surgical scar in a four-quadrant technique. Sentinel lymph nodes were identified in eight of eight dogs preoperatively and in eight of eight dogs postoperatively. Agreement between the results of the preoperative and postoperative lymphoscintigraphy studies was identified as complete in four of eight dogs and partial in four of eight dogs. Sentinel lymph node identification occurred immediately in three of eight dogs preoperatively and in eight of eight dogs postoperatively. Sentinel lymph node identification occurred faster postoperatively. Agreement or partial agreement between the results of the preoperative and postoperative lymphoscintigraphy studies was observed in eight of eight dogs. Surgery appears to have an effect on lymphoscintigraphy drainage patterns. Additional studies are required to compare preoperative and postoperative sentinel lymph node mapping patterns in tumor-bearing dogs. However, this study provides preliminary information regarding the effect of surgery on sentinel lymph node identification.


An evaluation of the genetic conditioning of evoking pain.
Pain is an integral element of the pathogenic process and sometimes determines its course. Disorders in pain sensation, as well as its lack, the pain threshold, and variability in sensation of the same pain stimuli as more or less intensive by different persons, may be genetically conditioned. The aim of the study is to examine genes in pathogenesis of chronic pain. The study was conducted in a specially selected group of 31 persons: study group - 20 patients with chronic pain, and control group - 11 healthy individuals who did not experience pain. The control group of 11 healthy persons, compared with the study group, was the catalyst for determining the relative quantification (RQ) of gene expression. Biological material in the form of venous blood was collected from the study participants into the tubes containing anticoagulant EDTA KE/2.7 ml (ethylenediaminetetraacetic acid), preventing extracorporeal blood clotting. Analysis of expression of the examined genes showed over-expression of the DRD1 gene in patients experiencing chronic pain, which means that in these patients an increased number of dopamine D1 receptors encoded by this gene should be expected. The dopamine D1 receptor is a G-protein-coupled receptor which regulates (stimulates or inhibits) adenyl cyclase - the enzyme responsible for synthesis of cyclic AMP (cAMP). An increase in the concentration of cAMP in neurons enhances the sensation of pain. The genes (DRD1, COMT, OPRK1, HCN2) have a significant role in the pathogenesis of chronic pain in various diseases; they can also influence the perception of pain. Knowledge of these genes can contribute to the development of effective methods of combating pain.


Closure of a Large Thoracolumbar Myelomeningocele Using a Modified Bilateral Keystone Flap.
The keystone flap, an emerging reconstructive option that can be used in many parts of the body, is gaining popularity among reconstructive surgeons. These reliable and versatile flaps can be used for large myelomeningocele closure. A modified bilateral keystone flap was used to achieve tension-free closure of a large thoracolumbar myelomeningocele associated with severe kyphosis in a newborn girl. The flap was modified by undermining in the subfascial plane in the medial aspect of the middle third. This undermining was performed to facilitate flap movement while preserving random musculocutaneous perforators captured within the island of tissues. Laterally, we approached the border of the latissimus dorsi and dissected in the submuscular plane instead of the subfascial plane to preserve more muscular fasciocutaneous perforators. We achieved soft-tissue coverage that was durable, stable, and protective. Wound healing was prompt, and the patient had a satisfactory cosmetic result. No postoperative complications were observed, such as flap necrosis, dehiscence, leakage of cerebrospinal fluid, or infection. The proposed modified keystone flap is a promising addition to the armament of reconstructive surgeons that might improve outcomes and minimize complications in myelomeningocele repair. Keystone flaps provide an ideal reconstructive option for large thoracolumbar myelomeningocele repair. They are reliable, robust, and aesthetically acceptable.


C-H Bond Activation by Early Transition Metal Carbide Cluster Anion MoC3 (-).
Although early transition metal (ETM) carbides can activate CH bonds in condensed-phase systems, the electronic-level mechanism is unclear. Atomic clusters are ideal model systems for understanding the mechanisms of bond activation. For the first time, CH activation of a simple alkane (ethane) by an ETM carbide cluster anion (MoC3 (-) ) under thermal-collision conditions has been identified by using high-resolution mass spectrometry, photoelectron imaging spectroscopy, and high-level quantum chemical calculations. Dehydrogenation and ethene elimination were observed in the reaction of MoC3 (-) with C2 H6 . The CH activation follows a mechanism of oxidative addition that is much more favorable in the carbon-stabilized low-spin ground electronic state than in the high-spin excited state. The reaction efficiency between the MoC3 (-) anion and C2 H6 is low (0.23±0.05) %. A comparison between the anionic and a highly efficient cationic reaction system (Pt(+) +C2 H6 ) was made. It turned out that the potential-energy surfaces for the entrance channels of the anionic and cationic reaction systems can be very different.


Scaling children's waist circumference for differences in body size.
Both waist circumference (WC) and body size (height) increase with age throughout childhood. Hence, there is a need to scale WC in children to detect differences in adiposity status (eg, between populations and different age groups), independent of body size/height. Using two culturally different samples, 1 English (10-15.9 years n = 9471) and 2 Colombian (14-15 years, n = 37,948), for WC to be independent of height (HT), a body shape index was obtained using the allometric power law WC = a.HTb . The model was linearized using log-transformation, and multiple regression/ANCOVA to estimate the height exponents for WC controlling for age, sex, and any other categorical/population differences. In both samples, the power-law height exponent varied systematically with age. In younger children (age 10-11 years), the exponent was approximately unity, suggesting that pre-pubertal children might be geometrically similar. In older children, the height exponent declined monotonically to 0.5 (ie, HT0.5 ) in 15+ year-olds, similar to the exponent observed in adults. UK children's height-adjusted WC revealed a "u" shaped curve with age that appeared to reach a minimum at peak-height velocity, different for boys and girls. Comparing the WC of two populations (UK versus Colombian 14-15-year-old children) identified that the gap in WC between the countries narrowed considerably after scaling for height. Scaling children's WC for differences in height using allometric modeling reveals new insights into the growth and development of children's WC, findings that might well have been be overlooked if body size/height had been ignored.


Avulsion of the triceps tendon.
Two cases of the rare injury of avulsion of the triceps tendon are presented. The difficulties in clinical diagnosis and proper evaluation of the roentgenographic findings whenever present are discussed and the treatment is outlined.


Guidance on Frequency and Location of Environmental Sampling for Acinetobacter baumannii.
We assessed various locations and frequency of environmental sampling to maximize information and maintain efficiency when sampling for Acinetobacter baumannii. Although sampling sites in closer proximity to the patient were more likely positive, to fully capture environmental contamination, we found value in sampling all sites and across multiple days. Infect Control Hosp Epidemiol 2018;39:339-342.


Interactions of adenoviruses with platelets and coagulation and the vaccine-induced immune thrombotic thrombocytopenia syndrome.
The COVID-19 pandemic has had a heavy impact on global health and economy and vaccination remains the primary way of controlling the infection. During the ongoing vaccination campaign some unexpected thrombotic events have emerged in subjects who had recently received the AstraZeneca (Vaxzevria) vaccine or the Johnson and Johnson (Janssen) vaccine, two adenovirus vector-based vaccines. Epidemiological studies confirm that the observed/expected ratio of these unusual thromboses is abnormally increased, especially in women in fertile age. The characteristics of this complication, with venous thromboses at unusual sites, most frequently in the cerebral vein sinuses but also in splanchnic vessels, often with multiple associated thromboses, thrombocytopenia, and sometimes disseminated intravascular coagulation, are unique and the time course and tumultuous evolution are suggestive of an acute immunological reaction. Indeed, plateletactivating anti-PF4 antibodies have been detected in a large proportion of the affected patients. Several data suggest that adenoviruses may interact with platelets, the endothelium and the blood coagulation system. Here we review interactions between adenoviral vectors and the hemostatic system that are of possible relevance in vaccine-associated thrombotic thrombocytopenia syndrome. We systematically analyze the clinical data on the reported thrombotic complications of adenovirus-based therapeutics and discuss all the current hypotheses on the mechanisms triggering this novel syndrome. Although, considering current evidence, the benefit of vaccination clearly outweighs the potential risks, it is of paramount importance to fully unravel the mechanisms leading to vaccineassociated thrombotic thrombocytopenia syndrome and to identify prognostic factors through further research.


Distribution and antigenic analysis of circulating F(ab')2-reactive IgG in patients with HIV-1 infection.
Serum titers and molecular specificity of anti-F(ab')2 antibodies were investigated in human immunodeficiency virus type 1 (HIV-1) infection with respect to their supposed cytopenic role on CD4+ cells. The levels of antibodies to F(ab')2 fragment and to HIV-1 glycoprotein epitopes were measured by immunoenzymatic methods in an HIV-1+ population, including 86 drug addicts, 12 sexually infected patients, and 1 hemophiliac, grouped into Walter Reed (WR) clinical stages 2 to 6 of HIV-1 infection. Monoclonal F(ab')2-reactive IgM and IgG from cloned Epstein-Barr B cell transformants of selected patients were also investigated in regards to their HIV-1 glycoprotein specificities and cytotoxicity to the CD4+ cell membrane antigens (CEM) lymphoblasts by a Terasaki assay. Group A (51 sera from WR2 patients) showed the highest titers of IgG anti-F(ab')2 with no correlation to positivities to gp120, whereas sera with undetectable anti-F(ab')2 levels from group B (37 WR5 and WR6 patients) and from group C (11 WR3-WR6 patients with lymphocytotoxin-associated lymphopenia) were reactive to the virus envelope. Both anti-F(ab')2 monoclonal IgM and IgG failed to cross-react with the HIV-1 glycoproteins and the CD4+ CEM. Based on our data, anti-F(ab')2 antibodies are apparently unrelated to the CD4+ lymphopenia occurring in HIV-1-infection. In addition, their inability to bind the HIV-1 gp120 as sequence homologue of the CH1 domain of IgG suggests that their molecular target could include a few epitopes located within the VH and VL regions, thus supporting their potential role of antiidiotype molecules as described in autoimmunity.


Thyroid cancer development and progression: emerging role of cancer stem cells.
Thyroid cancer is the most common endocrine malignancy. Although the majority of thyroid cancers are well differentiated and have a favorable prognosis, a minor proportion are poorly differentiated malignancies, which show an aggressive behavior and are refractory to conventional cancer treatments. The molecular mechanisms underlying thyroid development and progression are incompletely understood. Most of thyroid tumorigenesis models propose that thyroid cancer originates from the normal thyrocytes that, via the accumulation of genetic alterations, acquire a malignant phenotype and the ability to metastatize. However, recent progress in clarifying the molecular mechanisms of thyroid embryogenesis/development and the discovery of fetal/stem-like cells within the thyroid gland, have raised the possibility that thyroid cancer originates from progenitor/stem cells. These cells have the ability to self-renew and to undergo multilineage differentiation, and are resistant to common anticancer treatments. Thyroid progenitor/stem cells have been isolated from thyroid cancer and the normal counterpart. Further insights in the biology of these cells will open new perspectives in terms of prevention, diagnosis and therapy of thyroid cancers, especially those with an aggressive behaviour. More effective protocols for the identification and isolation of thyroid cancer stem cells will allow us to specifically and safely target these cells with the aim to definitely eradicate aggressive thyroid cancers.


Development of a new measure of health-related quality of life for people with dementia: DEMQOL.
We identified the need to develop a scientifically rigorous measure of health-related quality of life (HRQL) in dementia that would be appropriate for use at all stages of dementia severity and would be available in both self- and proxy-report versions. We used standard psychometric methods to eliminate items with poor psychometric properties (item-reduction field test) and to assess the acceptability, reliability and validity of the item-reduced instruments (psychometric evaluation field test). We developed and validated two versions of DEMQOL: a 28-item interviewer-administered questionnaire that is self-reported by the person with dementia (DEMQOL) and a 31-item interviewer-administered questionnaire that is proxy-reported by a caregiver (DEMQOL-Proxy). DEMQOL shows high reliability (internal consistency and test-retest) and moderate validity in people with mild/moderate dementia. DEMQOL-Proxy shows good acceptability and internal consistency and moderate evidence of validity in people with mild/moderate and severe dementia. Test-retest reliability and performance in people with severe dementia need further testing. DEMQOL and DEMQOL-Proxy show psychometric properties that are comparable with the best available dementia-specific measures of HRQL. We recommend that DEMQOL and DEMQOL-Proxy are used together. Reliability and validity need to be confirmed in independent samples and responsiveness needs to be evaluated.


The yearly prevalence of findings in endoscopy of the lower part of the gastrointestinal tract.
Introduction. Endoscopy of the colon and rectum is increasingly used. Aim of the Study. All consecutive endoscopies of the colon and rectum were studied in order to assess the yearly prevalence of significant endoscopic diagnoses. Methods. All consecutive endoscopies of the colon and rectum were included. Endoscopies were done with endoscopes of Olympus. Significant endoscopic diagnoses were defined as colorectal cancer, polyps, diverticuli, large sessile polyps, and inflammatory bowel disease. Results. In 20 years a total of 24431 endoscopies were done. The yearly number of sigmoidoscopies was mean 96, range of 42-370. The number of colonoscopies was mean 1126, range of 643-1912. The number of colonoscopies significantly increased. The number of colonoscopies on request of an internist or gastroenterologist showed a slow but steady increase. Successful caecal intubation rose from 70% to 92% in 2011. Since 1996 there is a steep increase in the percentage of procedures with abnormalities. The number of cancer and polyps increased in twenty years. No great changes were seen in inflammatory bowel disease. Conclusion. Colonoscopy is a procedure with a high diagnostic yield. The number of patients with tumours rose in twenty years.


Gastric and enteric anisakiasis successfully treated with Gastrografin therapy: A case report.
We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hospital with epigastric pain and vomiting one day after eating raw fish. She exhibited tenderness in the epigastrium without obvious rebound tenderness or guarding. Computed tomography (CT) demonstrated segmental edema of the intestinal wall with proximal dilatation and a small number of ascites. Because enteric anisakiasis was suspected based on the patient's history of recent raw fish consumption and abdominal CT, we performed gastroscopy and confirmed that nine Anisakis larvae were attached to the gastric mucosa. All of the Anisakis larvae were extracted via endoscopy, and the patient was diagnosed with gastric and enteric anisakiasis. Additionally, in the hospital, we performed ileography twice using Gastrografin, which led to shortened hospital stay. Based on the clinical results of this case, we suggest that Gastrografin therapy is a safe, convenient, and useful method to extract enteric Anisakis larvae.


Lasiodiplodin analogues from the endophytic fungus Sarocladium kiliense.
A new 12-membered ring lactone, (3S),(6R)-6-hydroxylasiodiplodin (1), with two known analogues, (3R)-lasiodiplodin (2), and (3R),(5S)-5-hydroxylasiodiplodin (3) were isolated from the EtOH extracts of normal Apriona germari (Hope)-associated fungus Sarocladium kiliense grown in rice medium. The structures of compounds 1-3 were elucidated by a combination of spectroscopic data interpretation, single-crystal X-ray diffraction analysis, and modified Mosher's method.


Overall user satisfaction with family planning services and associated quality care factors: a cross-sectional analysis.
Studies of user satisfaction with family planning services (FPSs) have been conducted in different countries, and have been employed to identify ways of improving health, reducing costs and implementing reforms. The present work is the first-ever study undertaken in Mexico on the subject. Our objective was to identify how overall user satisfaction with FPSs in Mexico was related to: healthcare logistics, the functional value of services and the quality of interpersonal relations. Users of 18 public clinics were surveyed in 2015. Data collected referred to their past and present use of FPSs, as well as to their perceptions of the services provided. We built a logistic regression model with potentially influential variables in order to assess their association with overall satisfaction. According to the self-reports of the 722 users interviewed, the following factors were decisive in their overall satisfaction with services: receiving sufficient information during visits (OR = 3.38; 95% CI:1.88-6.06), feeling that their opinions were taken into consideration by clinic staff (OR = 2.58; 95% CI:1.14-5.85), feeling that the motives for their visits were addressed (OR = 2.71; 95% CI:1.29-5.71), being assigned enough time for consultation (OR = 2.35; 95% CI:1.26-4.37), having the opportunity to ask questions and clarify doubts (OR = 2.31; 95% CI:1.21-4.43), experiencing no or few interruptions during their medical consultations (OR = 1.97;95% CI:1.10-3.51), and feeling satisfied with the contraceptive method provided (OR = 1.79; 95% CI:1.03-3.11). Service providers must be kept well informed on the perspective of users concerning user expectations. Taking into account the cultural context and perceived needs of users while providing service would improve the quality of care and, hence, the overall satisfaction of users.


Esculentoside A inhibits LPS-induced BV2 microglia activation through activating PPAR-γ.
Neuroinflammation has been recognized as a factor in the pathogenesis of neurodegenerative diseases. Esculentoside A (EsA), a saponin isolated from Phytolacca esculenta, has been reported to have anti-inflammatory activity. However, little research has been reported on the anti-neuroinflammatory effects of EsA. EsA concentration-dependently suppressed LPS-induced TNF-α, IL-1β, and PGE2 production. LPS-induced NF-κB activation was inhibited by treatment of EsA. Furthermore, EsA concentration-dependently up-regulated the expression of PPAR-γ. In addition, GW9662, a specific PPAR-γ inhibitor, reversed the anti-inflammatory effects of EsA. In conclusion, these results indicate that EsA exerts anti-inflammatory effects by activating PPAR-γ.


[A case of mixed adenoneuroendocrine carcinoma of the esophagogastric junction treated with neoadjuvant chemotherapy].
We present a case of a 63-year-old man who was admitted to another hospital because of abdominal distension and body weight loss. Gastric endoscopy revealed a type III tumor at the posterior wall of the upper gastric body. The tumor had invaded into the esophagogastric junction. On the basis of the pathology of the biopsy specimen, the tumor was diagnosed as neuroendocrine carcinoma of the esophagogastric junction. Computed tomography (CT) scans showed regional lymph node swelling. Cisplatin( CDDP) +irinotecan( CPT-11) therapy was selected and administered to the patient. After 2 courses, the patient received S-1+CDDP. He was considered to have stable disease. We performed partial resection of the lower esophagus, total gastrectomy, splenectomy, and cholecystectomy. On pathology, the tumor was immunohistochemically positive for chromogranin A, AE1/AE3, neural cell adhesion molecule (NCAM), neuron-specific enolase (NSE), and p53. The Ki-67 index was 80%. The tumor was diagnosed as a mixed adenoneuroendocrine carcinoma (MANEC) of the esophagogastric junction. The patient was treated with S-1 and CDDP. Neuroendocrine cell carcinoma of the esophagogastric junction is rare and usually has a very poor prognosis. We herein report a case of mixed adenoneuroendocrine carcinoma of the esophagogastric junction that was curatively resected and resulted in patient survival without recurrence.


Porin biogenesis activates the sigma(E) response in Salmonella hfq mutants.
In Salmonella enterica, loss of RNA chaperon Hfq promotes proteolytic cleavage of anti-sigma(E) factor RseA leading to the constitutive induction of the sigma(E)-dependent envelope stress response. Seeking to identify the source of the inducing signal, in the present study we measured RseA cleavage and sigma(E)-dependent transcription in strains lacking relevant outer membrane protein (omp) genes. We found removal of the main Salmonella porin, OmpD, to markedly reduce sigma(E) activation in hfq mutant cells. Subsequent removal of LamB and of OmpC further attenuated the response, indicating that different OMPs collectively contribute to the sigma(E)-activated phenotype. Thus, loss of Hfq-mediated regulation might cause unfolded OMPs to accumulate in the periplasm, triggering the sigma(E) response. These findings corroborate the role of Hfq protein as a pleiotropic regulator of OMP biogenesis in Gram-negative bacteria.


Restoration of linear disturbances from oil-and-gas exploration in boreal landscapes: How can network models help?
In western Canada, decades of oil-and-gas exploration have fragmented boreal landscapes with a dense network of linear forest disturbances (seismic lines). These seismic lines are implicated in the decline in wildlife populations that are adapted to function in unfragmented forest landscapes. In particular, anthropogenic disturbances have led to a decline of woodland caribou populations due to increasing predator access to core caribou habitat. Restoration of seismic lines aims to reduce the landscape fragmentation and stop the decline of caribou populations. However, planning restoration in complex landscapes can be challenging because it must account for a multitude of diverse aspects. To assist with restoration planning, we present a spatial network optimization approach that selects restoration locations in a fragmented landscape while addressing key environmental and logistical constraints. We applied the model to develop restoration scenarios in the Redrock-Prairie Creek caribou range in northwestern Alberta, Canada, which includes a combination of caribou habitat and active oil-and-gas and timber extraction areas. Our study applies network optimization at two distinct scales to address both the broad-scale restoration policy planning and project-level constraints at the level of individual forest sites. We first delineated a contiguous set of coarse-scale regions where restoration is most cost-effective and used this solution to solve a fine-scale network optimization model that addresses environmental and logistical planning constraints at the level of forest patches. Our two-tiered approach helps address the challenges of fine-scale spatial optimization of restoration activities. An additional coarse-scale optimization step finds a feasible starting solution for the fine-scale restoration problem, which serves to reduce the time to find an optimal solution. The added coarse-scale spatial constraints also make the fine-scale restoration solution align with the coarse-scale landscape features, which helps address the broad-scale restoration policies. The approach is generalizable and applicable to assist restoration planning in other regions fragmented by oil-and-gas activities.


Hydrothermal synthesis of multi-cationic high-entropy layered double hydroxides.
High-entropy materials are compositionally complex materials which often contain five or more elements. The most commonly studied materials in this field are alloys and oxides, where their composition allows for tunable materials properties. High-entropy layered double hydroxides have been recently touted as the next focus for the field of high-entropy materials to expand into. However, most previous work on multi-cationic layered double hydroxides has focused on syntheses with 5 or less cations in the structure. To bridge this gap into high-entropy materials, this work explores the range and extent of different compositional combinations for high-entropy double layered hydroxides. Specifically, pure layered double hydroxides were synthesized with different combinations of 7 cations (Mg, Co, Cu, Zn, Ni, Al, Fe, Cr) as well as one combination of 8 cations by utilizing a hydrothermal synthesis method. Furthermore, magnetic properties of the 8-cation LDH were investigated.


SPA2Net: Structure-Preserved Attention Activated Network for Weakly Supervised Object Localization.
By exploring the localizable representations in deep CNN, weakly supervised object localization (WSOL) methods could determine the position of the object in each image just trained by the classification task. However, the partial activation problem caused by the discriminant function makes the network unable to locate objects accurately. To alleviate this problem, we propose Structure-Preserved Attention Activated Network (SPA2Net), a simple and effective one-stage WSOL framework to explore the ability of structure preservation of deep features. Different from traditional WSOL approaches, we decouple the object localization task from the classification branch to reduce their mutual influence by involving a localization branch which is online refined by a self-supervised structural-preserved localization mask. Specifically, we employ the high-order self-correlation as structural prior to enhance the perception of spatial interaction within convolutional features. By succinctly combining the structural prior with spatial attention, activations by SPA2Net will spread from part to the whole object during training. To avoid the structure-missing issue caused by the classification network, we furthermore utilize the restricted activation loss (RAL) to distinguish the difference between foreground and background in the channel dimension. In conjunction with the self-supervised localization branch, SPA2Net can directly predict the class-irrelevant localization map while prompting the network to pay more attention to the target region for accurate localization. Extensive experiments on two publicly available benchmarks, including CUB-200-2011 and ILSVRC, show that our SPA2Net achieves substantial and consistent performance gains compared with baseline approaches. The code and models are available at https://github.com/MsterDC/SPA2Net.


Inhibition of the tax-dependent human T-lymphotropic virus type I replication in persistently infected cells by the fluoroquinolone derivative k-37.
In the search for anti-human T-lymphotropic virus type-I (HTLV-I) compounds, we have evaluated several compounds for their inhibitory effects on HTLV-I replication in cell cultures. Among the test compounds, the fluoroquinolone derivative 7-(3,4-dehydro-4-phenyl-1-piperidinyl)-1,4-dihydro-6-fluoro-1-methyl-8- trifluoromethyl-4-oxoquinoline-3-carboxylic acid (K-37) was found to be a potent and selective inhibitor of HTLV-I replication in persistently infected cells, such as MT-2 and MT-4. When the cells were cultured in the presence of various concentrations of the compound, the 50% effective concentrations of K-37 for HTLV-I p19 antigen production were 0.44 and 0.24 microM in MT-2 and MT-4 cells, respectively. K-37 did not affect the viability and proliferation of these cells at these concentrations, and its 50% cytotoxic concentrations to MT-2 and MT-4 cells were 5.7 and 1.1 microM, respectively. The compound also showed selective inhibition of HTLV-I production in peripheral blood mononuclear cells obtained from patients with HTLV-I-associated myelopathy/tropical spastic paraparesis. Quantitative reverse transcription-polymerase chain reaction analysis revealed that K-37 selectively suppressed viral mRNA synthesis in MT-2 cells in a dose-dependent fashion. Furthermore, K-37 could inhibit the endogenous Tax-induced HTLV-I long terminal repeat (LTR)-driven reporter gene expression in MT-2 cells. Western blot analysis confirmed the reduced expression of Tax in MT-2 cells exposed to K-37. In contrast, when Tax was introduced into cells not infected with HTLV-I with a plasmid under the control of human cytomegalovirus promoter, the compound did not affect Tax-induced HTLV-I LTR-driven reporter gene expression. These results suggest that the inhibition occurred at the level of HTLV-I LTR-driven Tax expression.


Homology modeling of Mycoplasma pneumoniae enolase and its molecular interaction with human plasminogen.
Alpha (alpha)-enolase (e), a glycolytic enzyme, has an alternative role as a surface receptor of several bacteria mediating plasminogen (pg) binding. It is also recognized as a virulence factor of some pathogenic bacteria facilitating plasminogen activation and host cell invasion. A mycoplasmal alpha-enolase is also a plasminogen binding protein. Molecular interactions of enolase from Mycoplasma pneumoniae with host plasminogen would be useful for exploring the pathogen-host interaction. In an attempt to identify plasminogen binding sites of M. pneumoniae enolase, homology modeling and docking studies were conducted to obtain modeled structures of the M. pneumoniae enolase-plasminogen complex. The refined model was validated further by standard methods. Molecular docking revealed hydrogen bonding of eLys70-pgTyr50, eAsn165-pgThr66, eAla168-pgGlu21, eAsp17-pgLys70, and eAsn213-pgPro68/pgAsn69. Substantial decreases in accessible surface area (ASA) were observed and in concurrence with hydrogen bond pattern. These findings provide a detailed prediction of key residues that interact at the protein-protein interface. Our theoretical prediction is consistent with known biochemical data. The predicted interaction complex can be of great assistance in understanding structural insights, which is necessary to pathogen and host-component interaction. The ability of M. pneumoniae enolase to bind plasminogen may be indicative of an important role in invasion of this pathogen to host.


Cyclosporine immunosuppression.
The chemistry, pharmacokinetics, mechanism of action, clinical efficacy in organ transplants, adverse effects, and dosage and administration of cyclosporine, a new immunosuppressant, are reviewed. Advice on counseling patients who take the drug is also included. Cyclosporine is a cyclic undecapeptide with a high molecular weight. Its absorption from the gastrointestinal tract is slow, variable, and incomplete. Cyclosporine is highly protein bound and almost completely eliminated by hepatic metabolism. Its half-life is variable, and it has a volume of distribution of approximately 4 liter/kg and a poorly defined therapeutic range. Cyclosporine acts by blocking T-lymphocyte function without causing myelosuppression. Several randomized prospective trials have compared cyclosporine with standard immunosuppressive drug regimens in kidney and liver transplantations. A European Multicenter Trial treated 117 patients with cyclosporine alone and 115 patients with azathioprine and steroids. Graft survival rates at 11 months were 73% in the cyclosporine group and 53% in the control group. A Canadian Multicenter Trial Group, which studied 209 patients in two groups, found cyclosporine and prednisone to be superior to azathioprine and prednisone therapy. Graft survivals were 83.5% and 67% at nine months. Several studies of hepatic allograft recipients and of cardiac transplantations have found that cyclosporine and low-dose steroid therapy can lead to improved results. The adverse effects of cyclosporine include nephrotoxicity, hepatotoxicity, and electrolyte elevations. The dosage must be individualized. Most patients tolerate initial i.v. doses of 5 mg/kg and oral doses of 14-18 mg/kg. The exact indications for cyclosporine immunosuppression are still being defined for organ transplant recipients. Cyclosporine will likely play an important role in the improvement of transplantation results in the future.


Description of Amish Study data set.
A brief description is given on the ascertainment methods and diagnostic procedures for bipolar affective disorder patients and their relatives in Amish pedigrees. Data on a sample of five bipolar families are provided, including conventional blood typings, serum protein and RFLP data.


The Human Pelvis: Variation in Structure and Function During Gait.
The shift to habitual bipedalism 4-6 million years ago in the hominin lineage created a morphologically and functionally different human pelvis compared to our closest living relatives, the chimpanzees. Evolutionary changes to the shape of the pelvis were necessary for the transition to habitual bipedalism in humans. These changes in the bony anatomy resulted in an altered role of muscle function, influencing bipedal gait. Additionally, there are normal sex-specific variations in the pelvis as well as abnormal variations in the acetabulum. During gait, the pelvis moves in the three planes to produce smooth and efficient motion. Subtle sex-specific differences in these motions may facilitate economical gait despite differences in pelvic structure. The motions of the pelvis and hip may also be altered in the presence of abnormal acetabular structure, especially with acetabular dysplasia. Anat Rec, 300:633-642, 2017. © 2017 Wiley Periodicals, Inc.


Studies on ferrochelatase. The effects of thiols and other factors on the determination of activity.
1. Haems are unstable under aerobic conditions in the presence of thiols, which are used to activate the ferrochelatase enzyme; catalase inhibits this degradation of haem. In addition, thiols interfere with the determination of protohaem as its pyridine haemochromogen derivative. 2. Three ferrochelatase assays are described that minimize interference by these two reactions. Two of these assays involve measurement of porphyrin utilization, one spectrophotometrically and the second spectrofluorimetrically. The third assay measures haem formation by a pyridine haemochromogen technique. Results obtained with these three methods were in close agreement at a GSH concentration of 4mm. 3. The stimulatory effect of GSH on ferrochelatase has been confirmed. The spectrum of the haem formed is dependent on GSH concentration; at high GSH concentrations (20mm) the haem is in the reduced state, but at low concentration (4mm) the spectrum of the product resembles that of an oxidized haemoprotein such as ferrihaemoglobin. 4. The inhibitory effect of oxygen on ferrochelatase activity has been confirmed by spectrophotometric assay of porphyrin disappearance.


Chest wall reconstruction. Experience with 100 consecutive patients.
Experience with 100 consecutive chest wall reconstructions during the past 7 years was reviewed. There were 52 female and 48 male patients with ages ranging from 13 to 78 years (average 53). Of the 100 patients, 42 had tumors of the chest wall, 19 had radiation necrosis, 24 had infected median sternotomies , and 15 had combinations of the three. Seventy-six patients underwent skeletal resection of the chest wall. An average of 5.7 ribs were resected in 63 patients. Total or partial sternectomies were performed in 29. Ninety-two patients underwent 142 muscle flaps: 77 pectoralis major, 29 latissimus dorsi, and 36 other muscles, including serratus anterior, rectus abdominis, and external oblique muscles. The omentum was transposed in ten patients. Chest wall skeletal defects were closed with Prolene mesh in 29 patients and with autogenous ribs in 11. Eighty-nine patients underwent primary closure of the skin. The 100 patients underwent an average of 2.1 operations. Hospitalization averaged 17.5 days. There was one perioperative death (29 days). Two patients required tracheostomy. Follow-up averaged 21.6 months. There were 24 late deaths. All 99 patients who were alive 30 days after operation had excellent results at the time of death or last follow-up.


The effect of neighboring districts on body height of Polish conscripts.
The aim of the study was to investigate the correlation of heights of conscripts living in neighboring districts in Poland. The study used 10% of a nationally representative sample of 26,178 males 18.5-19.5 years old examined during the National survey of Polish conscripts conducted in 2001. The sample represented all regions and social strata of the country and included 354 different districts within 16 voivodships (provinces). Analyses were performed with the R statistical software. A small but significant correlation (0.24, p < 0.0001) was observed for height between 1st order neighboring districts. Correlations decreased with increased distances between neighboring districts, but remained significant for 7th node neighbors (0.18, p < 0.0001). Regarding voivodships (provinces), average height showed a geographical trend from the northwest (relatively tall) to the southeast (relatively short), and the correlation was stronger for first order neighboring provinces (0.796, p < 0.001). This study revealed clusters of tall people and short people, providing a support for hypothesis of the community effect in height. Small correlations between 1st order neighbors than in another country (Switzerland) may be associated with differences in geography, since in Poland there are no natural barriers (e.g., mountains) and road infrastructure is well-developed.


Long-lasting pathological consequences of overexpression-induced α-synuclein spreading in the rat brain.
Increased expression of α-synuclein can initiate its long-distance brain transfer, representing a potential mechanism for pathology spreading in age-related synucleinopathies, such as Parkinson's disease. In this study, the effects of overexpression-induced α-synuclein transfer were assessed over a 1-year period after injection of viral vectors carrying human α-synuclein DNA into the rat vagus nerve. This treatment causes targeted overexpression within neurons in the dorsal medulla oblongata and subsequent diffusion of the exogenous protein toward more rostral brain regions. Protein advancement and accumulation in pontine, midbrain, and forebrain areas were contingent upon continuous overexpression, because death of transduced medullary neurons resulted in cessation of spreading. Lack of sustained spreading did not prevent the development of long-lasting pathological changes. Particularly remarkable were findings in the locus coeruleus, a pontine nucleus with direct connections to the dorsal medulla oblongata and greatly affected by overexpression-induced transfer in this model. Data revealed progressive degeneration of catecholaminergic neurons that proceeded long beyond the time of spreading cessation. Neuronal pathology in the locus coeruleus was accompanied by pronounced microglial activation and, at later times, astrocytosis. Interestingly, microglial activation was also featured in another region reached by α-synuclein transfer, the central amygdala, even in the absence of frank neurodegeneration. Thus, overexpression-induced spreading, even if temporary, causes long-lasting pathological consequences in brain regions distant from the site of overexpression but anatomically connected to it. Neurodegeneration may be a consequence of severe protein burden, whereas even a milder α-synuclein accumulation in tissues affected by protein transfer could induce sustained microglial activation.


Phospholipases of mineralization competent cells and matrix vesicles: roles in physiological and pathological mineralizations.
The present review aims to systematically and critically analyze the current knowledge on phospholipases and their role in physiological and pathological mineralization undertaken by mineralization competent cells. Cellular lipid metabolism plays an important role in biological mineralization. The physiological mechanisms of mineralization are likely to take place in tissues other than in bones and teeth under specific pathological conditions. For instance, vascular calcification in arteries of patients with renal failure, diabetes mellitus or atherosclerosis recapitulates the mechanisms of bone formation. Osteoporosis-a bone resorbing disease-and rheumatoid arthritis originating from the inflammation in the synovium are also affected by cellular lipid metabolism. The focus is on the lipid metabolism due to the effects of dietary lipids on bone health. These and other phenomena indicate that phospholipases may participate in bone remodelling as evidenced by their expression in smooth muscle cells, in bone forming osteoblasts, chondrocytes and in bone resorbing osteoclasts. Among various enzymes involved, phospholipases A1 or A2, phospholipase C, phospholipase D, autotaxin and sphingomyelinase are engaged in membrane lipid remodelling during early stages of mineralization and cell maturation in mineralization-competent cells. Numerous experimental evidences suggested that phospholipases exert their action at various stages of mineralization by affecting intracellular signaling and cell differentiation. The lipid metabolites-such as arachidonic acid, lysophospholipids, and sphingosine-1-phosphate are involved in cell signaling and inflammation reactions. Phospholipases are also important members of the cellular machinery engaged in matrix vesicle (MV) biogenesis and exocytosis. They may favour mineral formation inside MVs, may catalyse MV membrane breakdown necessary for the release of mineral deposits into extracellular matrix (ECM), or participate in hydrolysis of ECM. The biological functions of phospholipases are discussed from the perspective of animal and cellular knockout models, as well as disease implications, development of potent inhibitors and therapeutic interventions.


The N-terminal 1000 residues of apolipoprotein B associate with microsomal triglyceride transfer protein to create a lipid transfer pocket required for lipoprotein assembly.
Apolipoprotein (apo) B, the major protein component of the atherogenic low-density lipoprotein (LDL), has a pentapartite structure, NH2-betaalpha1-beta1-alpha2-beta2-alpha3-COOH, the beta domains containing multiple amphipathic beta strands and the alpha domains containing multiple amphipathic alpha helixes. We recently reported that the first 1000 residues of human apoB-100 have sequence and amphipathic motif homologies to the lipid-pocket of lamprey lipovitellin (LV) [Segrest, J. P., Jones, M. K., and Dashti, N. (1999) J. Lipid Res. 40, 1401-1416]. The lipid-pocket of LV is a small triangular space lined by three antiparallel amphipathic beta sheets, betaA, betaB, and betaD. The betaA and betaB sheets are joined together by an antiparallel alpha helical bundle, alpha domain. We proposed [Segrest, J. P., Jones, M. K., and Dashti, N. (1999) J. Lipid Res. 40, 1401-1416] that formation of a LV-like lipid-pocket is necessary for lipid-transfer to apoB-containing lipoprotein particles and that this pocket is formed by association of the region of the betaalpha1 domain homologous to the betaA and betaB sheets of LV with a betaD-like amphipathic beta sheet from microsomal triglyceride transfer protein (MTP). To test this hypothesis, we generated four truncated cDNA constructs terminating at or near the juncture of the betaalpha1 and beta1 domains: Residues 1-800 (apoB:800), 1-931 (apoB:931), 1-1000 (apoB:1000), and 1-1200 (apoB:1200). Characterization of particles secreted by stable transformants of the McA-RH7777 cell line demonstrated that (i) ApoB:800, missing the betaB domain, was secreted as a lipid-poor aggregate. (ii) ApoB:931, containing most, but not all, of the betaB domain, was secreted as lipid-poor particles unassociated with MTP. (iii) ApoB:1000, containing the entire betaB domain, was secreted as a relatively lipid-rich particle associated hydrophobically with MTP. (iv) ApoB:1200, containing the betaalpha1 domain plus 200 residues of the beta1 domain, was secreted predominantly as a lipid-poor particle but also as a minor relatively lipid-rich, MTP-associated particle. We thus have captured an intermediate in apoB-containing particle assembly, a lipid transfer competent pocket formed by association of the complete betaalpha1 domain of apoB with MTP.


A Purified Serine Protease from Nereis virens and Its Impaction of Apoptosis on Human Lung Cancer Cells.
Nereis active protease (NAP) is a novel fibrinolytic active serine protease from the polychaete Nereis virens. In this study, NAP was purified from Nereis virens and the effects of NAP on human lung cancer cells were investigated. Our results indicated that NAP inhibited the proliferation and induced apoptosis of H1299 cells in a time- and dose-dependent manner. The loss of mitochondrial membrane potential, the activation of Bax and cleaved-caspase 3/9, the release of cytochrome C, and the suppression of Bcl-2 and poly-ADP ribose polymerase were observed in NAP-treated H1299 cells by flow cytometry and Western blotting. Moreover, the expression levels of Bax and Bcl-2 mRNA were determined by real-time quantitative polymerase chain reaction and the Bax/Bcl-2 expression ratio was increased in the NAP-treated cell lines. The results indicated that NAP-induced apoptosis may be related to mitochondria mediated apoptosis and occurs through caspase-dependent pathways. Then, the effects of NAP on tumor growth in animal models were observed, where 5 or 10 mg/kg of NAP noticeably reduced tumor volume and weight and increased apoptosis as determined by Western blotting when compared to the negative control group. Therefore, our findings suggest that NAP could be a hopeful anticancer medicine for its propensity to inhibit growth and induce of apoptosis in human lung cancer cells.


New concepts of the growth spurt of puberty.
The timing of the growth spurt of normal children does not affect their final height attainment. Growth rate during the growth acceleration of puberty correlates with changes in GH, and not sex steroid, secretion. GH secretion during puberty is pulse amplitude, and not frequency, modulated. In both central precocious puberty and normal puberty suppressed with a GnRH analogue, the rate of epiphyseal maturation is decreased as are GH pulse amplitude and growth, but with no influence on final height.


Volatile Compounds in Seasoning Sauce Produced from Soy Sauce Residue by Reaction Flavor Technology.
Volatile flavor compounds created in the mixture of enzymatic hydrolysates of soy sauce residue and defatted soybean by reaction flavor technology (RFT) were analyzed and compared using solid phase micro-extraction/gas chromatography/mass selective detector to develop a seasoning sauce. Using response surface methodology analysis, RFT was performed by adding 0.50% fructose, 0.33% glutamic acid, 0.68% arginine, 0.37% methionine, and 0.86% glycine in the base and reaction conditions at 93°C for 120 min. A total of 57 compounds, 43 in RFT and 45 in control, were detected, including 8 aldehydes and ketones, 6 aromatic hydrocarbons, 3 acids, 12 alcohols, 6 esters, 4 furans, 9 nitrogen-containing compounds, 4 sulfur-containing compounds, and 5 miscellaneous. In RFT samples, aldehydes and ketones, aromatic hydrocarbons, alcohols, esters, and S-containing compounds were significantly increased. Sulfur-containing compounds were increased by 687 fold compared to control samples (P<0.05). Among these, the main contributors to the aroma activity of RFT samples were considered to be, with a very low threshold, the newly generated compounds, dimethyl disulfide (roasted onion/garlic-like/meaty odor), dimethyl trisulfide (roasted garlic-like/meaty odor), and methional (roasted potato/potato chip-like odor).


Occult Fungal Scleritis.
To heighten awareness of occult fungal scleritis. Case report and review of the literature. A 73-year-old woman with diabetes mellitus was diagnosed for 3 months with immune-mediated scleritis and subsequently treated with corticosteroids. On referral, the patient had a scleral nodule with contiguous corneal infiltrate and hypopyon. Culture grew Fusarium species not further classified. The infection could not be controlled with antifungal therapy, and the eye was removed. No exogenous or endogenous source for the infection could be identified by clinical history or examination. Fungal scleritis can develop in persons without a history of foreign body injury, minor trauma, or evidence of endogenous fungemia. A high index of suspicion for infectious scleritis must be maintained in persons with presumed immune-mediated scleritis who fail to respond to conventional therapy, particularly if they present with decreased visual acuity.


The association of glutathione S-transferase gene mutations (including GSTT1 and GSTM1) with the prognostic factors and relapse in acute lymphoblastic leukemia.
Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. It accounts for one fourth of all childhood cancers and approximately 75% of all childhood leukemias. Some prognostic factors determine the outcome of therapy [e.g. age, sex, initial white blood cell count (WBC), etc.]; however, it is believed that other mechanisms such as glutathione S-transferase (GST) gene mutation, the expression of lung resistance protein (LRP), and multidrug resistance-associated protein (MRP) also plays a role in treatment failure. In this study, GST gene mutations including GSTM1 and GSTT1 were evaluated in patients with leukemia. Thirty newly diagnosed ALL patients younger than 15 years of age participated in the present study. Bone marrow aspiration and biopsy were evaluated for immune phenotyping and DNA was extracted for GST genotyping. All data plus sex, age, initial WBC count, central nervous system (CNS) or testicular involvement, immune phenotype, and outcome (relapse or not) were analyzed statistically. Genotyping showed that 46% were double null, 50% were M1 null and 93.3% were T1 null for GST mutations. There was no statistically significant relationship between GSTT1 and GSTM1 mutations, or between double null status, prognostic factors and relapse (P > .05). So, although the results of GST mutations were consistent, it seems that these mutations are not statistically significant.


Ankylosing spondylitis in the Mexican mestizo: patterns of disease according to age at onset.
We studied 87 Mexican mestizo patients (82 men and 5 women) with definite ankylosing spondylitis (AS) with particular reference to juvenile and adult onset types. HLA-B27 was present in 32 of 38. Forty-seven patients (54.0%) had onset before the age of 16 years and 40 (46.0%) thereafter. By the end of the 1st year of disease, main features included spinal involvement in 44 (50.6%), peripheral arthropathy in 57 (65.5%) and enthesopathy in 41 (47.1%). Frequency of these increased up to 100.0, 79.3 and 64.4%, respectively, through the course of the disease. Peripheral arthritis and/or enthesopathy occurred in 89.4 and 63.1% of juveniles and 37.5 and 27.5% of adults, respectively, while lumbar pain and/or stiffness occurred in 23.4% of the former and 82.5% of the latter during the first year of disease. Additional findings were high erythrocyte sedimentation rate, anemia and hypergammaglobulinemia. Uveitis was the commonest extraarticular manifestation occurring in 20.6%. Our data suggest that the clinical pattern of AS in our patients was influenced by both age at onset and sex distribution of the disease.


In-vivo dynamic deformation of the mitral valve anterior leaflet.
Surgical techniques have been developed for mitral valve repair for a wide range of pathologies. However, excessive tissue stress and damage have been identified as etiologic factors limiting long-term durability. Before computational models to optimize valve repair can be realistically developed, in-vivo dynamic mitral valve leaflet strain data are required. However, these data do not presently exist. In the present study, a sheep model and sonomicrometry were used to compute the in-surface Eulerian strain tensor of the anterior leaflet over the cardiac cycle at varying afterloads. The anterior leaflet of nine Dorsett sheep (35 kg to 45 kg) was instrumented with nine 1-mm hemispherical piezoelectric transducers in a 15-mm square array. Three-dimensional crystal spatial positions were recorded at 250 Hz over several cardiac cycles, with peak left ventricular pressures varying from 90 mm Hg to 200 mm Hg. The in-surface Eulerian strain tensor was computed from the crystal displacements. The mitral valve anterior leaflet experiences large anisotropic strains and peak strain rates of 400%/s, followed by an absolute cessation of any deformation during systole. Increasing left ventricular pressure also increased the effective leaflet stiffness but not the peak strains. We report the first data on the dynamic in-vivo strain tensor of a functioning mitral valve anterior leaflet, which indicated large anisotropic strains and very high strain rates. Our observations also suggest that changes in left ventricular pressure and annular geometry result in altered effective leaflet stiffness, and may be an important factor in reducing leaflet stress and as such potentially affect mitral valve repair longevity.


Common adolescent dance injuries.
Dancers are an interesting and exciting group of patients. An understanding of the pathomechanics of their injuries coupled with their genuine interest in a prompt recovery teaches much about the diagnosis, treatment, and prognosis of similar lower extremity disorders occurring in the population at large. The majority of dance injuries occur in the lower extremity, commonly in the foot and ankle. Conservative therapy is usually successful; surgical intervention is only rarely indicated. Rehabilitation following all injuries is important as well as attention to proper alignment and technique.


Injectable hydrogels for cartilage and bone tissue engineering.
Tissue engineering has become a promising strategy for repairing damaged cartilage and bone tissue. Among the scaffolds for tissue-engineering applications, injectable hydrogels have demonstrated great potential for use as three-dimensional cell culture scaffolds in cartilage and bone tissue engineering, owing to their high water content, similarity to the natural extracellular matrix (ECM), porous framework for cell transplantation and proliferation, minimal invasive properties, and ability to match irregular defects. In this review, we describe the selection of appropriate biomaterials and fabrication methods to prepare novel injectable hydrogels for cartilage and bone tissue engineering. In addition, the biology of cartilage and the bony ECM is also summarized. Finally, future perspectives for injectable hydrogels in cartilage and bone tissue engineering are discussed.


Evaluation of early efficacy endpoints for proof-of-concept trials.
A Phase II proof-of-concept (POC) trial usually uses an early efficacy endpoint other than a clinical endpoint as the primary endpoint. Because of the advancement in bioscience and technology, which has yielded a number of new surrogate biomarkers, drug developers often have more candidate endpoints to choose from than they can handle. As a result, selection of endpoint and its effect size as well as choice of type I/II error rates are often at the center of heated debates in design of POC trials. While optimization of the trade-off between benefit and cost is the implicit objective in such a decision-making process, it is seldom explicitly accounted for in practice. In this research note, motivated by real examples from the oncology field, we provide practical measures for evaluation of early efficacy endpoints (E4) for POC trials. We further provide optimal design strategies for POC trials that include optimal Go-No Go decision criteria for initiation of Phase III and optimal resource allocation strategies for conducting multiple POC trials in a portfolio under fixed resources. Although oncology is used for illustration purpose, the same idea developed in this research note also applies to similar situations in other therapeutic areas or in early-stage drug development in that a Go-No Go decision has to rely on limited data from an early efficacy endpoint and cost-effectiveness is the main concern.


Cessation of smoking rapidly decreases erectile dysfunction.
To assess the relationship between cessation of smoking and rapid improvement in erectile capacity as well as the effect of nicotine patches on nocturnal penile tumescence and rigidity. Nocturnal penile erections were studied in 10 smokers with use of the RigiScan portable home monitor. Two nights were monitored: for the first night, the patients had not stopped smoking; for the second night, the patients had stopped smoking for 24 hours. In addition, four men were monitored after cessation of smoking and wearing nicotine patches for 1 month. Multiple variables studied showed a statistically significant improvement in nocturnal penile tumescence and rigidity in the men who had stopped smoking for 24 hours. Continued improvement was noted in the four men who were monitored while not smoking and wearing nicotine patches for 1 month. Stopping cigarette smoking is a factor that rapidly improves penile tumescence and rigidity. Because the improvement continues while the patient is receiving nicotine from transdermal patches, some factor or factors other than the nicotine are responsible for the erectile dysfunction.


Young Adult Female Cancer Survivors' Concerns About Future Children's Health and Genetic Risk.
As young adult female cancer survivors (aged 18-35) make family-building decisions, understanding the specific nature of their concerns is important. We evaluated survivors' concerns about potential health risks to future children including genetic susceptibility for cancer with an internet-based survey study (N = 187). Sixty-five percent reported concern about passing on a genetic cancer risk to their children, and scores did not vary regardless of association with cancer at high risk for genetic transmission. Genetic counseling and education about family-building options may be important to survivors concerned about health risks to offspring to support family-building decisions based on personalized medical information.


Patterns of care analysis for salivary gland cancer: a survey within the German Society of Radiation Oncology (DEGRO) and recommendations for daily practice.
Salivary gland cancer (SGC) is rare and a heterogeneous type of cancer. Prospective randomized trials are lacking. No guideline focusing on standard procedures of radiotherapy (RT) in the treatment of SGC exists. Therefore, we surveyed the members of the German Society of Radiation Oncology (DEGRO) to gain information about current therapeutic strategies of SGC. An anonymous questionnaire was designed and made available on the online platform umfrageonline.com. The corresponding link was sent to all DEGRO members who provided their user data for contact purposes. Alternatively, a PDF printout version was sent. Frequency distributions of responses for each question were calculated. The data were also analyzed by type of institution. Sixty-seven responses were received, including answers from 21 university departments, 22 non-university institutions, and 24 radiation oncology practices. Six participants reported that their departments (practice: n = 5, non-university hospital: n = 1) did not treat SGC, and therefore the questionnaire was not completed. Concerning radiation techniques, target volume definition, and concomitant chemotherapy, treatment strategies varied greatly among the participants. Comparing university vs. non-university institutions, university hospitals treat significantly more patients with SGC per year and initiated more molecular pathological diagnostics. SGC represents a major challenge for clinicians, as reflected by the inhomogeneous survey results regarding diagnostics, RT approaches, and systemic therapy. Future prospective, multicenter clinical trials are warranted to improve and homogenize treatment of SGC and to individualize treatment according to histologic subtypes and risk factors.


Recent progress in nanocomposites of carbon dioxide fixation derived reproducible biomedical polymers.
In recent years, the environmental problems accompanying the extensive application of biomedical polymer materials produced from fossil fuels have attracted more and more attentions. As many biomedical polymer products are disposable, their life cycle is relatively short. Most of the used or overdue biomedical polymer products need to be burned after destruction, which increases the emission of carbon dioxide (CO2). Developing biomedical products based on CO2 fixation derived polymers with reproducible sources, and gradually replacing their unsustainable fossil-based counterparts, will promote the recycling of CO2 in this field and do good to control the greenhouse effect. Unfortunately, most of the existing polymer materials from renewable raw materials have some property shortages, which make them unable to meet the gradually improved quality and property requirements of biomedical products. In order to overcome these shortages, much time and effort has been dedicated to applying nanotechnology in this field. The present paper reviews recent advances in nanocomposites of CO2 fixation derived reproducible polymers for biomedical applications, and several promising strategies for further research directions in this field are highlighted.


An Efficient Hybrid Feature Selection Method Using the Artificial Immune Algorithm for High-Dimensional Data.
Feature selection provides the optimal subset of features for data mining models. However, current feature selection methods for high-dimensional data also require a better balance between feature subset quality and computational cost. In this paper, an efficient hybrid feature selection method (HFIA) based on artificial immune algorithm optimization is proposed to solve the feature selection problem of high-dimensional data. The algorithm combines filter algorithms and improves clone selection algorithms to explore the feature space of high-dimensional data. According to the target requirements of feature selection, combined with biological research results, this method introduces the lethal mutation mechanism and the Cauchy operator to improve the search performance of the algorithm. Moreover, the adaptive adjustment factor is introduced in the mutation and update phases of the algorithm. The effective combination of these mechanisms enables the algorithm to obtain a better search ability and lower computational costs. Experimental comparisons with 19 state-of-the-art feature selection methods are conducted on 25 high-dimensional benchmark datasets. The results show that the feature reduction rate for all datasets is above 99%, and the performance improvement for the classifier is between 5% and 48.33%. Compared with the five classical filtering feature selection methods, the computational cost of HFIA is lower than the two of them, and it is far better than these five algorithms in terms of the feature reduction rate and classification accuracy improvement. Compared with the 14 hybrid feature selection methods reported in the latest literature, the average winning rates in terms of classification accuracy, feature reduction rate, and computational cost are 85.83%, 88.33%, and 96.67%, respectively.


Argan oil prevents prothrombotic complications by lowering lipid levels and platelet aggregation, enhancing oxidative status in dyslipidemic patients from the area of Rabat (Morocco).
It is now established that patients with hyperlipidemia have a high risk of atherosclerosis and thrombotic complications, which are two important events responsible for the onset and progression of cardiovascular disease. In the context of managing dyslipidemia by means of dietary advice based on the consumption of argan oil, we wanted to investigate the effect of virgin argan oil on plasma lipids, and for the first time, on the platelet hyperactivation and oxidative status associated with dyslipidemia. This study concerns patients recruited in the area of Rabat in Morocco. 39 dyslipidemic (79% women) patients were recruited for our study in the area of Rabat in Morocco. They were randomly assigned to the two following groups: the argan group, in which the subjects consumed 25 mL/day of argan oil at breakfast for 3 weeks, and the control group in which argan oil was replaced by butter. After a 3-week consumption period, blood total cholesterol was significantly lower in the argan oil group, as was LDL cholesterol (23.8% and 25.6% lower, respectively). However, the HDL cholesterol level had increased by 26% at the end of the intervention period compared to baseline. Interestingly, in the argan oil group thrombin-induced platelet aggregation was lower, and oxidative status was enhanced as a result of lower platelet MDA and higher GPx activity, respectively. In conclusion, our results, even if it is not representative of the Moroccan population, show that argan oil can prevent the prothrombotic complications associated with dyslipidemia, which are a major risk factor for cardiovascular disease.


VLS (Vapor-Liquid-Solid): Newly Discovered Growth Mechanism on the Lunar Surface?
A probable vapor-liquid-solid (VLS) type of growth has been discovered for the first time in nature on the surface of lunar rock 15015. Scanning electron microprobe and energy dispersive x-ray data indicate that the growth occurs as metallic iron stalks from about 0.015 to 0.15 micrometer in diameter, with bulbous tips consisting of a mixture of iron and sulfur and measuring from about 0.03 to 0.2 micrometer in diameter. The stalk length is two to ten times the bulb diameter.


[4 weeks' administration of omeprazole: effect on acid behavior and basal hormone levels].
We have assessed the effect of omeprazole (30 mg daily) on gastric acid secretion as well as on basal hormone levels (fasting gastrin; TSH, T3, T4, TBG; insulin, glucagon, C-peptide; prolactin, testosterone, 17-beta-oestradiol, dihydroepiandrosterone, cortisol and PTH) in 8 healthy volunteers before and after a 28 day treatment. On day 29, i. e. one day after the last omeprazole dose, mean stimulated acid output was still reduced from 27.4 +/- 3.5 mmol H+/h (+/- SEM) to 7.8 +/- 1.4 mmol H+/h (72% inhibition). Fasting gastrin levels were raised from 55.5 +/- 6.8 pg/ml to 80.9 +/- 6.7 pg/ml (33% increase). On day 39, stimulated gastric acid secretion and fasting gastrin levels have been returned to pretreatment values. Basal levels of prolactin, testosterone, TSH, T3, T4, TBG, cortisol, PTH, 17-beta-oestradiol, insulin, glucagon, c-peptide, dihydroepiandrosterone remained unchanged by a 28-day omeprazole treatment. Omeprazole is a highly effective antisecretory compound without any effect on the basal hormone levels tested. Even after 28 days its effect on acid secretion and fasting gastrin levels was fully reversible.


Organization of the cat's lateral geniculate nucleus following interruption of prenatal binocular competition.
In adult cats which had an eye removed at least two weeks before birth the remaining retina projects to the entire ipsilateral and contralateral lateral geniculate nucleus. In these prenatally enucleated animals, all lateral geniculate neurons responded apparently normally to visual stimuli and retinotopy also appeared to be normal. These findings demonstrate that termination of in utero binocular competition induces marked morphological changes in the visual system, but the functional organization of the major retino-recipient structure develops normally.


[Nursing care to pregnant women with iron deficiency anemia].
This study was carried out with the following objectives: to set up a protocol of data survey and nursing diagnosis, and to detect the most frequent nursing diagnosis among pregnant women with iron deficiency anemia. The protocol was applied in 52 nursing visits to pregnant women who presented hemoglobin values lower than 11.0 g/dl. The most frequent nursing diagnosis were: altered nutrition, risk to infection, impaired maintenance of the home; knowledge deficit on adequate feeding; risk to fetal injury regarding decrease in uteroplacental perfucion; non-compliance risk. Based on nursing diagnoses, interventions and nursing expected results with its application were planned.


Mitral valve finite-element modelling from ultrasound data: a pilot study for a new approach to understand mitral function and clinical scenarios.
In the current scientific literature, particular attention is dedicated to the study of the mitral valve and to comprehension of the mechanisms that lead to its normal function, as well as those that trigger possible pathological conditions. One of the adopted approaches consists of computational modelling, which allows quantitative analysis of the mechanical behaviour of the valve by means of continuum mechanics theory and numerical techniques. However, none of the currently available models realistically accounts for all of the aspects that characterize the function of the mitral valve. Here, a new computational model of the mitral valve has been developed from in vivo data, as a first step towards the development of patient-specific models for the evaluation of annuloplasty procedures. A structural finite-element model of the mitral valve has been developed to account for all of the main valvular substructures. In particular, it includes the real geometry and the movement of the annulus and papillary muscles, reconstructed from four-dimensional ultrasound data from a healthy human subject, and a realistic description of the complex mechanical properties of mitral tissues. Preliminary simulations allowed mitral valve closure to be realistically mimicked and the role of annulus and papillary muscle dynamics to be quantified.


The management of hyponatremia in HIV disease.
Hyponatremia is reported to be the most common electrolyte abnormality encountered in clinical practice. Diagnosis and principles of management of hyponatremia are everyday issues in patient care. Interest has also been generated by its association with adverse prognosis from studies in specific disease groups. Patients with human immunodeficiency virus (HIV) disease are living longer and medical diseases similar to the general population are more frequently encountered in them. Hyponatremia has been observed to be widely prevalent in both hospitalized and outpatient HIV patients, although population-based estimates are not known. From case series, these patients appear to be at greater risk for the development of hyponatremia from pathomechanisms encountered in the non-HIV population. In addition, certain HIV-specific mechanisms from infectious etiologies, endocrine causes, and medications are unique to them. Using an illustrative case as an example, in the following review, we discuss the varied etiologies, pathogenetic mechanisms , clinical features, diagnosis, and outline the management of hyponatremia in HIV patients.


Palliative Care Utilization in Nontraumatic Intracerebral Hemorrhage in the United States.
Palliative care is now recognized as an essential component of comprehensive care in serious illness that interferes with quality of life. We explored utilization of palliative care in spontaneous intracerebral hemorrhage at a population level using a large national database. Population based cross-sectional study. Inpatient hospital admissions from the Nationwide Inpatient Sample. A total of 311,217 patients with intracerebral hemorrhage. Palliative care use. Intracerebral hemorrhage patients with and without palliative care were identified from the 2007-2011 Nationwide Inpatient Sample using International Classification of Diseases, 9th Revision, codes. Demographics, comorbidities, surgical procedures, and hospital characteristics were compared between patients receiving and not receiving palliative care (code V66.7). Resource utilization measures were inflation-adjusted cost of care and length of stay. Pearson chi square and Wilcoxon-Mann-Whitney tests were used for categorical and continuous variables respectively. Logistic regression was used to construct a predictive model of palliative care. Of the 311,217 intracerebral hemorrhage patients, 32,159 (10.3%) received palliative care. Utilization of palliative care increased from 4.3% in 2007 to 16.2% in 2011 (trend p < 0.001). Patients receiving palliative care had higher Charlson comorbidity scores (p < 0.001), higher all-patient refined diagnosis-related group mortality risk (p < 0.001), and lower resource utilization measures compared with those without palliative care. Independent predictors of palliative care use were older age (odds ratio, 4.06; 95% CI, 3.87-4.23; p < 0.001), female sex (odds ratio, 1.17; 95% CI, 1.14-1.20; p < 0.001), Caucasian race (p < 0.001), Medicare insurance (p < 0.001), hospitals in the west and mid-west (p < 0.001), hospital transfer (odds ratio, 1.23; 95% CI, 1.18-1.30; p < 0.001), high intracerebral hemorrhage case volume (p < 0.001), anticoagulant use (odds ratio, 1.24; 95% CI, 1.19-1.31; p < 0.001), higher Charlson comorbidity score, ventriculostomy placement (odds ratio, 1.18; 95% CI, 1.13-1.29; p < 0.001), and mechanical ventilation (odds ratio, 1.44; 95% CI, 1.39-1.49; p < 0.001). Cerebral angiogram, craniotomy, and gastrostomy were independently associated with absence of palliative care use. An apparent increasing trend of palliative care utilization in intracerebral hemorrhage has occurred over the last decade. After clinical severity adjustment, gender and racial differences and hospital characteristics appear to influence palliative care use among intracerebral hemorrhage patients in the United States.


Redefining the HIV epidemic in Nigeria: from national to state level.
Governments are increasingly recognizing the need to focus limited HIV resources on specific geographic areas and specific populations to have a greater impact. Nigeria, with the second largest HIV epidemic in the world, is an important example of where more localized programming has the potential to improve the efficiency of the HIV response. Using Spectrum software we modelled the Nigerian HIV epidemic using two methods: First, we created national HIV estimates using trends in urban and rural areas. Second, we created national HIV estimates using trends from each of the 37 states in Nigeria and aggregated these results. In both instances we used HIV surveillance data from antenatal clinics and household surveys and aggregated the trends to determine the national epidemic. The state models showed divergent trends in the 37 states. Comparing the national results calculated from the two methods resulted in different conclusions. In the aggregated state files, adult HIV incidence in Nigeria was stable between 2005 and 2013 (change of -6%), whereas the urban and rural file suggested incidence was decreasing over the same time (change of -50%). This difference was also reflected in the HIV prevalence trends, although the two methods showed similar trends in AIDS-related mortality. The two models had similar adult HIV prevalence in 2013: 3.0% (2.0-4.5%) in the aggregated state files versus 3.2% (3.0-3.5%) in the urban/rural file. The state-level estimates provide insight into the variations of the HIV epidemic in each state and provide useful information for programme managers. However, the reliability of the results is highly dependent on the amount and quality of data available from each sub-national area.