Cat got your artery? Point of care ultrasound in the evaluation of penetrating trauma by a feline: a case report.
Point of care ultrasound is an important tool for diagnosis of musculoskeletal and vascular pathology in patients presenting to the emergency department. Superficial vascular and soft tissue structures are well-visualized at the bedside using modern ultrasound systems and have image characteristics that can be rapidly identified. This report describes the use of point of care ultrasound to distinguish between rapidly progressive soft tissue infection and vascular injury following penetrating trauma from a cat scratch. Ultrasound allowed the physician to rapidly make accurate decisions about the next necessary steps in the patient's care. Point of care ultrasound provides immediate diagnostic information to supplement indeterminate physical examination findings. In this case, it allowed the treating physician to make the diagnosis of arterial injury using ultrasound image characteristics. An integrative approach to ultrasonography of superficial musculoskeletal and vascular structures could enhance clinical decision making and improve care of patients with similar complaints.


The relationship between Muc5ac high secretion and Munc18b upregulation in obese asthma.
Mucus production and hypersecretion are important pathophysiological features of asthma. Airway mucus secretion is more serious in obese asthma. Therefore, it is of great significance to elucidate the mechanism of asthma airway mucus high secretion in improving the control of asthma and the prognosis of obese asthmatic patients. Obese asthmatic mice model was established to test the airway resistance and mucin secretion by hematoxylin-eosin (HE) staining. Munc18b and Muc5ac expression levels were determined by Western-blotting. Munc18b conditioned knockout mice were adopted to explore the mechanism of Muc5ac high secretion. The mice weight increased in obese asthmatic model accompanied by elevated airway resistance. HE staining showed enhanced mucin secretion, which was correlated to weight and airway resistance. Munc18b and Muc5ac expressions significant upregulated in an obese asthmatic mouse model compared with normal control. Muc5ac expression failed to show elevation in Munc18b conditioned knockout mice. Muc5ac high secretion was positively correlated with Munc18b upregulation in obese asthma. Munc18b participated in inducing Muc5ac high expression.


[Effects of leaf litter replacement on soil biological and chemical characteristics in main artificial forests in Qinling Mountains].
Through 2 years leaf litter replacement experiments in 4 typical artificial pure forests Larix kaempferi, Pinus tabulaeformis, Catalpa fargesii, and Quercus aliena var. acuteserrata in Qinling Mountains of China, this paper studied the effects of leaf litter replacement on soil biological and chemical characteristics and the interspecific relationships between different tree species. The results showed that the annual decomposition rate of broad-leaved litter was 33.70% higher than that of needle-leaved litter. The annual decomposition rate of needle-leaved litter increased by 8.35%-12.15% when replaced to broad-leaved forests, whereas that of broad-leaved litter decreased by 5.38%-9.49% when replaced to needle-leaved forests. Leaf litter replacement between needle and broad-leaved forests could increase the contents of soil organic-C and available N, P and K, and the increments were obviously higher in needle-leaved forests (8.70%-35.84%) than in broad-leaved forests (3.73%-10.44%). In needle-leaved forests, the increments with the replacement of C. fargesii litter (24.63%-35.84%) were higher than those with the replacement of Q. aliena var. acuteserrata litter (8.70%-28.15%). Furthermore, the replacement of broad-leaved litter could make the soil pH in needle-leaved forests changed from light-acid to neutral, and increase soil enzyme activities, microbial amounts, and microbial biomass C and N contents. The increments with the replacement of C. fargesii litter were higher than those with the replacement of Q. aliena var. acuteserrata litter. The soil enzyme activities, microbial amounts, and microbial biomass C and N contents in broad-leaved forests after the replacement of needle-leaved litter differed with broadleaved tree species. Q. aliena var. acuteserrata forest had the higher soil enzyme activities and microbial biomass C and N contents, while C. fargesii forest was in adverse. It was suggested that in the control of soil degradation under artificial pure forests, much attention should be paid to the direction of interspecific relationship in mixed forestation and leaf litter replacement.


A functional evaluation of prosthetic foot kinematics during lower-limb amputee gait.
This paper reports on a functional evaluation of prosthetic feet based on gait analysis. The aim is to analyse prosthetic feet behaviour under loads applied during gait in order to quantify user benefits for each foot. Ten traumatic amputees (six trans-tibial and four trans-femoral) were tested using their own prosthetic foot. An original protocol is presented to calculate the forefoot kinematics together with the overall body kinematics and ground reaction forces during gait. In this work, sagittal motion of the prosthetic ankle and the forefoot, time-distance parameters and ground reaction forces were examined. It is shown that an analysis of not only trans-tibial but also trans-femoral amputees provides an insight in the performance of prosthetic feet. Symmetry and prosthetic propulsive force were proved to be mainly dependant on amputation level. In contrast, the flexion of the prosthetic forefoot and several time-distance parameters are highly influenced by foot design. Correlations show influential of foot and ankle kinematics on other parameters. These results suggest that prosthetic foot efficiency depends simultaneously on foot design and gait style. The evaluation, proposed in this article, associated to clinical examination should help to achieve the best prosthetic foot match to a patient.


Inflammation and vascular diseases.
Chronic venous disease and cardiovascular atherothrombotic diseases have a high prevalence worldwide. The aetiopathogenesis of both these vascular conditions may share certain aetiopathogenetic moments. Abnormal blood flow, altered intravascular tension, and subsequent endothelial dysfunction may all play an important role. Another plausible alternative is the correlation of some risk factors of both diseases, in particular obesity and metabolic syndrome with all its components and an impact on atherogenesis as well as chronic venous disease. The relationship may even be causal, that is a chronic vessel wall inflammation which is present in advanced venous insufficiency might accelerate atherogenesis. On the other hand, altered haemodynamics in right ventricular dysfunction with a subsequent elevation in venous pressure can worsen or induce venous insufficiency, and/or undoubtedly cause symptoms and signs typical of chronic venous disease. As suggested by the findings published recently in the Gutenberg Health Study, particularly its subanalysis regarding the relationship of venous disease and cardiovascular diseases, the venous and arterial beds can be affected by common aetiopathogenetic factors or both the systems can interfere with each other.


Multichannel Transcranial Direct Current Stimulation Combined With Treadmill Gait Training in Patients With Parkinson's Disease: A Pilot Study.
Gait problems are critical impairments in Parkinson's disease (PD) and are related to increased risk of fall and negatively impact activities of daily life. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modify the cortical excitability of gait-related brain regions. In this study, we investigated whether multichannel tDCS with simultaneous treadmill gait training could improve gait in PD. Twenty-four patients with PD were assigned randomly to a real or sham tDCS group. Before intervention, one patient of the real tDCS group was dropped out, leaving 23 patients to be analyzed in this study. Each patient underwent 30 min of treadmill gait training for 10 sessions over four consecutive weeks. Multichannel 4x1 tDCS was applied using five 6-cm-diameter round electrodes. One anode was placed on the CZ, and four cathodes were positioned symmetrically over the FZ, C5, C6, and PZ. Anodal tDCS (2mA) and sham tDCS were delivered for 20 min. The secondary outcomes were gait performance, as measured by the timed up and go test (TUG) and freezing of gait questionnaire (FOG-Q), and balance was assessed using the dynamic gait index (DGI), Berg balance scale (BBS), and functional reach test (FRT). Motor and non-motor performance of patients with PD were assessed using the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Participants were assessed before the intervention, immediately after the intervention, and 4 weeks after completion of the intervention. The real tDCS group showed a significant improvement in the 10-m walk test, but the sham group did not. Among the secondary outcome measures, MDS-UPDRS part II, TUG, and BBS were improved only in the real tDCS group. Particularly, MDS-UPDRS part II showed a significant group*time interaction effect, indicating that real tDCS demonstrated a better effect on the activities of daily living patients with PD. The results of this pilot study suggest that multichannel tDCS applied on the leg motor cortex during treadmill gait training is a safe and effective means to improve gait velocity in patients with PD. Additional rigorous, large-sample, multicenter, randomized controlled trials are needed to confirm the effect of tDCS as a therapeutic adjunct for gait rehabilitation of patients with PD.


The changing epidemiology of methicillin-resistant Staphylococcus aureus in the United States: a national observational study.
Methicillin-resistant Staphylococcus aureus (MRSA) can cause major illness and death and impose serious economic costs on patients and hospitals. Community-associated MRSA (CA-MRSA) is a growing problem in US hospitals, which are already dealing with high levels of hospital-associated MRSA (HA-MRSA), but little is known about how patient age and seasonal differences in the incidence of these 2 forms of MRSA affect the epidemic. By using national data on hospitalizations and antibiotic resistance, we estimated the magnitude and trends in annual S. aureus and MRSA hospitalization rates from 2005-2009 by patient age, infection type, and resistance phenotype (CA-MRSA vs. HA-MRSA). Although no statistically significant increase in the hospitalization rate was seen over the study period, the total number of infections increased. In 2009, there were an estimated 463,017 (95% confidence interval: 441,595, 484,439) MRSA-related hospitalizations at a rate of 11.74 (95% confidence interval: 11.20, 12.28) per 1,000 hospitalizations. We observed significant differences in infection type by age, with HA-MRSA-related hospitalizations being more common in older individuals. We also noted significant seasonality in incidence, particularly in children, with CA-MRSA peaking in the late summer and HA-MRSA peaking in the winter, which may be caused by seasonal shifts in antibiotic prescribing patterns.


Interleukin-2 and Interleukin-8 Gene Polymorphisms and Acquired Aplastic Anemia Risk in a Chinese Population.
Cytokines IL-2 and IL-8 both participate in immune regulation. However, the relationship between polymorphisms in these two cytokines and the risk of acquired aplastic anemia (acquired AA) has not been explored. We selected five SNPs including rs11575812, rs2069772 and rs2069762 of IL-2, rs2227306 and rs2227543 of IL-8. SNaPshot genotyping was used to test the genotypes of IL-2 and IL-8 polymorphisms in a population of 101 acquired AA patients and 165 healthy controls. The rs2069762 G allele appeared to be a protective mutation, but no significant differences were found in other four SNPs. We also found that rs2069762 had an impact on the transcriptional regulation. It could be assumed that the rs2069762 polymorphism might reduce the risk of acquired aplastic anemia, while the remaining four SNPs might not contribute to susceptibility to acquired AA in a Chinese population.


Levels and formation of α-dicarbonyl compounds in beverages and the preventive effects of flavonoids.
Methylglyoxal (MGO) and glyoxal (GO), α-dicarbonyl compounds found in the Maillard reaction, progressively and irreversibly modify proteins. Beverages are an exogenous source of α-dicarbonyl compounds and may potentially increase MGO and GO levels in vivo. Using GC-FID method, we detected the MGO and GO contents of 86 beverages in Chinese supermarkets. The highest MGO and GO 587.5 µg/100 mL and 716.7 µg/100 mL respectively found in soyamilk and coffee. Herbal beverages, which contained bioactive components, had lower average levels of MGO (48.1 µg/100 mL) and GO (25.9 µg/100 mL). A box-and-whisker plot was used to display variation of the same group drinks, and comparing distributions between six different groups. It was further discovered that fat, protein and flavonoids, in addition to sweeteners, had notable effects on the formation of MGO and GO in soybean milk. The result of LC/MS indicated that quercetin could prevent the formation of MGO by trapping MGO to form the mono-MGO and di-MGO adducts during soybean milk manufacturing.


Pre-germinated brown rice could enhance maternal mental health and immunity during lactation.
Rice is a dietary staple worldwide, especially pre-germinated brown rice has recently been widely served in Japan because of its abundant nutrition. Relationship between lactation and pre-germinated brown rice has attracted interest in terms of mental health and immunity. To demonstrate that Japanese foods are beneficial for psychosomatic health, the effects of pre-germinated brown rice on the mental status and immunological features during lactation were investigated. Forty-one breast-feeding mothers were recruited, and randomly divided into two groups. One group took pre-germinated brown rice and the other white rice (control) as their staple diet for 2 weeks. The Profile of Mood States (POMS) and salivary amylase activity as psychological indices and secretory IgA (s-IgA) and lactoferrin (LTF) in breast milk as immunological indices were determined before and after dietary intervention, and changes were investigated. In the psychological assessment, the scores of depression, anger-hostility, and fatigue were decreased on POMS analysis in the pre-germinated brown rice diet group, resulting in a significant decrease in total mood disturbance (TMD). The salivary amylase activity measurement suggested that resistance to stress was increased in the pre-germinated brown rice diet group. On the immunological assessment, the s-IgA level was significantly increased in the pre-germinated brown rice diet group. We have shown that pre-germinated brown rice may have beneficial effects on psychosomatic health.


Nonseptic lateral sinus thrombosis: the otolaryngologic perspective.
Nonseptic lateral sinus thrombosis (NSLST) differs from septic lateral thrombosis (SLST) in that it is not associated with ear or sinus infection, it usually occurs in the adult population, and it has an ambiguous clinical presentation. The otolaryngologist is often consulted about diagnostic findings associated with lateral sinus thrombosis. We report three cases of NSLST that required otolaryngologic assessment. The patients were women, ages 23 to 31 years. Presenting symptoms were headaches in all three patients; one also had concomitant ear pain. Two patients had negative head computed tomography scans; only magnetic resonance imaging was diagnostic. Treatment of NSLST consists of anticoagulation and elimination of predisposing factors. Familiarity with this condition is fundamental for early diagnosis and initiation of appropriate therapy. We discuss the origins and causes of NSLST, clinical presentation, preferred diagnostic strategy, and treatment alternatives.


Effectiveness of the Sexual Health/Reproductive Health Education Given to Turkey Adolescents Who Use Alcohol or Substance.
The research was conducted experimentally to evaluate the effectiveness of the sexual health/reproductive health (SH/RH) education given to Turkish adolescents who use alcohol or illicit substances. The population was adolescents who use alcohol and substances and were inpatients at the Child and Adolescent Substance Addiction Research, Treatment and Education Center. The adolescents were grouped into the following three groups: Group 1 (control group), Group 2 (those who have received training once), and Group 3 (those who have received training twice). Data were collected between September 2011 and December 2012 using the forms Self-Introduction and Information on Sexual Health-Reproductive Health and Information on Sexual Health-Reproductive Health Education Modules. Upon studying the total SH/RH test scores of the groups individually, a statistically significant difference was observed in the scores of Groups 2 and 3 (p < .01). Upon studying the change in the posttest scores from the pretest ones for each group individually, the increase in the scores of Group 3 (34.57 ± 16.33) was observed to have a statistically highly significant difference from those of Groups 1 (2.73 ± 10.65) and 2 (20.23 ± 12.09; p < .01). Adolescents who abuse alcohol or substances should be given SH/RH education in a repetitive manner for prevention of risky sexual behavior.


Sinapic acid derivatives from the seeds of Raphanus nussatirus L.
A new disulfide glycoside, raphthioglucoside (1), and a new sinapic acid derivative, sinapic acid 5-hydroxymethylfurfural ester (2), together with sinapic acid (3) have been isolated from the seeds of Raphanus nussatirus L. The structures of compounds 1-3 were determined based on chemical analysis and spectroscopic methods (UV, 1D and 2D NMR, HRFABMS, HREIMS and elemental analysis).


Effects of Kaempferia parviflora Wall. Ex. Baker and sildenafil citrate on cGMP level, cardiac function, and intracellular Ca2+ regulation in rat hearts.
Although Kaempferia parviflora extract (KPE) and its flavonoids have positive effects on the nitric oxide (NO) signaling pathway, its mechanisms on the heart are still unclear. Because our previous studies demonstrated that KPE decreased defibrillation efficacy in swine similar to that of sildenafil citrate, the phosphodiesterase-5 inhibitor, it is possible that KPE may affect the cardiac NO signaling pathway. In the present study, the effects of KPE and sildenafil citrate on cyclic guanosine monophosphate (cGMP) level, modulation of cardiac function, and Ca transients in ventricular myocytes were investigated. In a rat model, cardiac cGMP level, cardiac function, and Ca transients were measured before and after treatment with KPE and sildenafil citrate. KPE significantly increased the cGMP level and decreased cardiac function and Ca transient. These effects were similar to those found in the sildenafil citrate-treated group. Furthermore, the nonspecific NOS inhibitor could abolish the effects of KPE and sildenafil citrate on Ca transient. KPE has positive effect on NO signaling in the heart, resulting in an increased cGMP level, similar to that of sildenafil citrate. This effect was found to influence the physiology of normal heart via the attenuation of cardiac function and the reduction of Ca transient in ventricular myocytes.


The IE2 60-kilodalton and 40-kilodalton proteins are dispensable for human cytomegalovirus replication but are required for efficient delayed early and late gene expression and production of infectious virus.
The human cytomegalovirus (HCMV) IE2 86-kDa protein is an essential transactivator of viral and cellular gene expression. Additional proteins of 60 and 40 kDa are expressed from the IE2 gene at late times postinfection and are identical to the C terminus of IE2 86. We have constructed HCMV recombinants that express wild-type full-length IE2 86 but do not express the IE2 40- and 60-kDa proteins. Each of these recombinants is viable, indicating that neither the 60-kDa nor the 40-kDa protein is required for virus replication, either alone or in combination. Cells infected with the IE2 60 and IE2 40 deletion mutants, however, exhibit decreased expression of selected viral genes at late times. In particular, expression of the viral DNA replication factor UL84 is affected by the deletion of IE2 40, and expression of the tegument protein pp65 (ppUL83) is affected by the deletion of both IE2 40 and IE2 60. IE2 60 and IE2 40 are also required for the production of normal levels of infectious virus. Finally, IE2 40 appears to function as a repressor of major immediate-early transcription in the infected cell. These results begin to define functions for the IE2 60- and IE2 40-kDa proteins and indicate that these products contribute both to the expression of selected viral genes and to the overall progression of the infection.


Upper gastrointestinal endoscopy in a rural hospital: a facility assessed.
In an isolated hospital in Pakistan, upper gastrointestinal endoscopy has been used to clarify the pathological cause and significance of common symptoms. Indications for its use include dysphagia, vomiting, and epigastric pain related to meals. In small hospitals where results of barium studies are unsatisfactory, endoscopy, easily learned and rapidly carried out, can be a more informative and cost-effective alternative.


Inconsistency of a dissipative contribution to the mass flux in hydrodynamics.
The possibility of dissipative contributions to the mass flux is considered in detail. A general thermodynamically consistent framework is developed to obtain such terms, the compatibility of which with general principles is then checked-including Galilean invariance, the possibility of steady rigid rotation and uniform center-of-mass motion, the existence of a locally conserved angular momentum, and material objectivity. All previously discussed scenarios of dissipative mass fluxes are found to be ruled out by some combinations of these principles but not a new one that includes a smoothed velocity field v[over ] . However, this field v[over ] is nonlocal and leads to unacceptable consequences in specific situations. Hence, we can state with confidence that a dissipative contribution to the mass flux is not possible.


Neuroinflammation and the cGAS-STING pathway.
The recent discovery of cyclic GMP-AMP synthase (cGAS) as the mammalian cytosolic DNA sensor has profound therapeutic implications for infection, immunology, and cancer. Because neurovirology, neuroimmunology, neuro-oncology, and neurodegeneration implicate cytosolic DNA sensing, cGAS activation and induction of the downstream signaling protein stimulator of interferon genes (STING) has become increasingly recognized as a crucial determinant of neuropathophysiology. This Neuro Forum article reviews recent advances on the role of cGAS-STING signaling in neuroinflammation and neurological disease.


In vitro radiosensitization by oxaliplatin and 5-fluorouracil in a human colon cancer cell line.
The current study was designed to compare the radiosensitizing effects of oxaliplatin and 5-fluorouracil (5FU) in a human colon cancer cell line. A human colon cancer cell line (S1) was treated with various doses of oxaliplatin, 5FU, radiation, and combinations thereof. Various clinically used schedules were mimicked. 5FU was either incubated during 1 h ("bolus") or 24 h ("continuous infusion"). When combining oxaliplatin and 5FU, an isobologram analysis revealed synergistic effects, regardless of 5FU schedule. The IC(10) and IC(50)-doses for the drugs where then combined with radiotherapy. With equitoxic drug doses (IC(50)), radiosensitization was observed in the following order: oxaliplatin > 5FU 24 h > 5FU 1 h exposure. The degree of potentiation corresponded to approximately 0.8 Gy, 0.7 Gy, and 0.2 Gy, respectively. In this experimental setting, oxaliplatin seemed to be a better radiosensitizer than 5FU, and longer incubation time with 5FU was better than short exposure.


Transit peptide diversity and divergence: A global analysis of plastid targeting signals.
Proteins are targeted to plastids by N-terminal transit peptides, which are recognized by protein import complexes in the organelle membranes. Historically, transit peptide properties have been defined from vascular plant sequences, but recent large-scale genome sequencing from the many plastid-containing lineages across the tree of life has provided a much broader representation of targeted proteins. This includes the three lineages containing primary plastids (plants and green algae, rhodophytes and glaucophytes) and also the seven major lineages that contain secondary plastids, "secondhand" plastids derived through eukaryotic endosymbiosis. Despite this extensive spread of plastids throughout Eukaryota, an N-terminal transit peptide has been maintained as an essential plastid-targeting motif. This article provides the first global comparison of transit peptide composition and summarizes conservation of some features, the loss of an ancestral motif from the green lineages including plants, and modifications to transit peptides that have occurred in secondary and even tertiary plastids.


A new scoring system to predict mortality in community-acquired pneumonia: CURB (S)-65.
The first decision to be made in the case of community-acquired pneumonia (CAP) is whether hospitalization of the patient is mandatory. In this study, we aimed to investigate whether the addition of oxygenation parameters to CURB-65 has diagnostic value in predicting mortality in CAP. A total of 903 CAP patients were included in the study. Patients with a CURB-65 score of 0 and 1 were classified as Group 1 and patients with a CURB-65 score of 2 or more were classified as Group 2. The prediction of mortality through Pneumonia Severity Index (PSI), CURB-65 and CURBS-65/CURBP-65 with the addition of SaO2 and PaO2 values; hence the four different models, was compared among all patient groups. As a result, 3.3% of the cases in Group 1 and 12.7% of the cases in Group 2 died. In both CURB-65 groups, it was noted that the frequency of patients with SaO2 <90% was significantly higher in the dead group than in the alive patient group (p=0.009 and p=0.001, respectively). In the univariate analysis, PaO2<60, and SaO2<90 were significantly associated with mortality. Model 2 (CURBS-65) and Model 3 (CURBP- 65) were examined, SaO2<90 (OR 2.08) was found to have an effect on death. In predicting mortality by the receiver operating characteristics (ROC) analysis, it was understood that the CURBS-65 score had a slightly higher area under the curve (AUC) value than CURB-65. As a result, it has been shown that the use of CURBS-65 scoring instead of CURB-65 clinical scoring may be more useful in predicting mortality.


[Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat].
Pulmonary hypertension (PH) is a severe and often rapidly progressive disease with fatal outcome. Endothelial dysfunction in PH is associated with decreased nitric oxide production. After reviewing the mechanisms of action and the evidence base for specific therapy with phosphodiesterase 5 inhibitors (PDE-5) and soluble guanylate cyclase stimulators, a reseach review on switching from PDE-5 to riociguat is conducted. A potential advantage of riociguat is its independence from endogenous nitric oxide and from the other (besides PDE-5) isoenzymes of phosphodiesterases. The favorable efficacy profile of sildenafil has been proven for the main forms of pulmonary arterial hypertension, of riociguat for the main forms of pulmonary arterial hypertension and chronic thromboembolic PH. The clinical efficacy of replacing PDE-5 with riociguat has been demonstrated in uncontrolled trials and in the randomized controlled study REPLACE. The possibility of therapy optimization by switching from IFDE-5 to riociguat is fixed in the Russian (class and level of evidence B-3) and Eurasian (class and level of evidence IIb-B) clinical guidelines, as well as in the materials of the Cologne Expert Consensus. An additional argument for switching is the lower cost as compared to combination therapy in the Russian Federation. According to the Russian and Eurasian guidelines for PH and the Russian instructions for the use of riociguat, the drug should be taken at least 24 hours after sildenafil discontinuation.


A case-control study of the relation between plasma selenium and asthma in European populations: a GAL2EN project.
There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma. The GA(2)LEN network has organized a multicentre case-control study in Europe to assess the relation of plasma selenium to asthma. The network compared 569 cases in 14 European centres with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 576 controls from the same centres with no diagnosis of asthma and no asthmatic symptoms in the last 12 months. All cases and controls were selected from the same population defined by age and place of residence. Mean plasma selenium concentrations among the controls ranged from 116.3 microg/l in Palermo to 67.7 microg/l in Vienna and 56.1 microg/l among the children in Oslo. Random effects meta-analysis of the results from the centres showed no overall association between asthma and plasma selenium [odds ratio (OR)/10 microg/l increase in plasma selenium: 1.04; 95% confidence interval (CI): 0.89-1.21] though there was a significantly protective effect in Lodz (OR: 0.48; 95% CI: 0.29-0.78) and a marginally significant adverse effect in Amsterdam (OR: 1.68; 95% CI: 0.98-2.90) and Ghent (OR: 1.35; 95% CI: 1.03-1.77). This study does not support a role for selenium in protection against asthma, but effect modification and confounding cannot be ruled out.


Experimental determination of surface heat transfer coefficient in a dry ice-ethanol cooling bath using a numerical approach.
BACKGROUND: Dry ice-ethanol bath (-78 degree C) have been widely used in low temperature biological research to attain rapid cooling of samples below freezing temperature. The prediction of cooling rates of biological samples immersed in dry ice-ethanol bath is of practical interest in cryopreservation. The cooling rate can be obtained using mathematical models representing the heat conduction equation in transient state. Additionally, at the solid cryogenic-fluid interface, the knowledge of the surface heat transfer coefficient (h) is necessary for the convective boundary condition in order to correctly establish the mathematical problem. The study was to apply numerical modeling to obtain the surface heat transfer coefficient of a dry ice-ethanol bath. A numerical finite element solution of heat conduction equation was used to obtain surface heat transfer coefficients from measured temperatures at the center of polytetrafluoroethylene and polymethylmetacrylate cylinders immersed in a dry ice-ethanol cooling bath. The numerical model considered the temperature dependence of thermophysical properties of plastic materials used. A negative linear relationship is observed between cylinder diameter and heat transfer coefficient in the liquid bath, the calculated h values were 308, 135 and 62.5 W/(m2K) for PMMA 1.3, PTFE 2.59 and 3.14 cm in diameter, respectively. The calculated heat transfer coefficients were consistent among several replicates; h in dry ice-ethanol showed an inverse relationship with cylinder diameter.


New fluorescence PET systems based on N2S2 pyridine-anthracene-containing macrocyclic ligands. spectrophotometric, spectrofluorimetric, and metal ion binding studies.
Three new fluorescent devices for protons and metal ions have been synthesized and characterized, and their photophysical properties have been explored; these are the macrocycles 7-(9-anthracenylmethyl)-3,11-dithia-7,17-diazabicyclo[11.3.1]heptadeca-1(17),13,15-triene (L1) and 7-(10-methyl-9-anthracenylmethyl)-3,11-dithia-7,17-diazabicyclo[11.3.1]heptadeca-1(17),13,15-triene (L2) and the bis macrocycle 7,7'-[9,10-anthracenediylbis(methylene)]bis-3,11-dithia-7,17-diazabicyclo[11.3.1]heptadeca-1(17),13,15-triene (L3). All these systems have a pyridil-thioether-containing macrocycles as a binding site and an anthracene moiety as a signaling agent. The coordination properties of these ligands toward Cu(II), Co(II), Ni(II), Zn(II), and Pd(II) have been studied in solution and in the solid state. The addition of these metal ions to dichloromethane solutions of L1, L2, and L3 produce strong changes in the absorption and emission spectra of these ligands. The stoichiometry of the species, formed at 298 K, have been determined from absorption and fluorescence titrations. The Co(II) and Cu(II) complexes of L1 have been studied by EPR spectroscopy. This last complex and its free ligand have also been characterized by X-ray crystallography.


Preventing percutaneous absorption of industrial chemicals: the "skin" denotation.
Percutaneous absorption has received comparatively little attention in occupational health, although this route of entry has repeatedly caused occupation-related intoxications. In practice, the evaluation of skin penetration rates is far from simple. Much evidence has been obtained from studies of chemicals used for cosmetics and topical therapeutics, but the information available on compounds encountered in occupational health is limited. The data obtained from experimental studies have confirmed that the concentration, type of vehicle, skin area, skin condition, and extent of occlusion are important factors in determining the degree of percutaneous absorption, but no general model has been developed. Also, too little is known about the basic chemical properties governing the rate of penetration. Thus, prediction is difficult and bound to be rather inaccurate. Current preventive practice follows the procedure used by ACGIH and is mainly based on a "skin" denotation in official listings of chemicals to which exposure limits have been allocated. The number of substances and groups of chemicals which have received skin denotation in 17 selected countries varies between 24 and 179 and a total of 275 are listed as a skin hazard in one or more countries; ACGIH lists 143. Thus, the denotation practice varies. As an unfortunate result of these discrepancies and the dichotomy of skin denotation, the absence of skin denotation may erroneously indicate that efforts to protect the skin are unnecessary. Thus, an evaluation of skin penetration potentials should be incorporated in occupational health practice as a supplement to the official denotations.


A Comparative Study of Rat Lung Decellularization by Chemical Detergents for Lung Tissue Engineering.
Lung disease is the most common cause of death in the world. The last stage of pulmonary diseases is lung transplantation. Limitation and shortage of donor organs cause to appear tissue engineering field. Decellularization is a hope for producing intact ECM in the development of engineered organs. The goal of the decellularization process is to remove cellular and nuclear material while retaining lung three-dimensional and molecular proteins. Different concentration of detergents was used for finding the best approach in lung decellularization. In this study, three-time approaches (24, 48 and 96 h) with four detergents (CHAPS, SDS, SDC and Triton X-100) were used for decellularizing rat lungs for maintaining of three-dimensional lung architecture and ECM protein composition which have significant roles in differentiation and migration of stem cells. This comparative study determined that variable decellularization approaches can cause significantly different effects on decellularized lungs. Results showed that destruction was increased with increasing the detergent concentration. Single detergent showed a significant reduction in maintaining of three-dimensional of lung and ECM proteins (Collagen and Elastin). But, the best methods were mixed detergents of SDC and CHAPS in low concentration in 48 and 96 h decellularization. Decellularized lung tissue can be used in the laboratory to study various aspects of pulmonary biology and physiology and also, these results can be used in the continued improvement of engineered lung tissue.


Body cooling in human males by cold-water immersion after vigorous exercise.
Five male subjects were immersed to neck level in a whole-body water calorimeter (water temperature 19 degrees C) on two occasions. One immersion was preceded by 30 min of exercise on a treadmill at 80% of the subjects' maximum heart rate, while the other was preceded by no exercise (control). Ventilation, oxygen consumption, hand-grip strength, and heat loss (measured by calorimetry) results showed no significant differences between resting and exercise trials. Minute ventilation and oxygen consumption increased during the immersion but the magnitude of the increase varied among subjects. There was a significant decrease is isometric hand-grip strength after 30 min of immersion. Rectal temperatures fell faster (0.031 degree C +/- 0.004 degree C/min) for exercised subjects than for controls (0.019 degree C +/- 0.005 degree C/min) between 10 and 45 min of immersion (P less than 0.01). It appears that vigorous preimmersion exercise may shorten survival time in cold water due to an increase in cooling rate.


Adaptive topography in family-structured models of kin selection.
Adaptive topographies provide a means of summarizing the qualitative dynamics of evolution. Inclusive fitness serves as an organizing concept in much of sociobiology. Through the use of Sewall Wright's "fitness function," the theoretical equivalence of these concepts for weak selection in family-structured populations is demonstrated.


The highly synergistic, broad spectrum, antibacterial activity of organic acids and transition metals.
For millennia, transition metals have been exploited to inhibit bacterial growth. We report here the potentiation of the anti-bacterial activity of transition metals by organic acids. Strong synergy between low, non-toxic concentrations of transition metals and organic acids was observed with up to ~1000-fold higher inhibitory effect on bacterial growth. We show that organic acids shuttle transition metals through the permeability barrier of the bacterial membrane, leading to increased influx of transition metals into bacterial cells. We demonstrate that this synergy can be effectively used to inhibit the growth of a broad range of plant and human bacterial pathogens, and suggest that a revision of food preservation and crop protection strategies may be in order. These findings bear significant biomedical, agricultural, financial and environmental opportunities.


Gravity Line-Hip Axis Offset as a Guide for Global Alignment to Prevent Recurrent Proximal Junctional Kyphosis/Failure.
Proximal junctional kyphosis/failure (PJK/F) is a potentially serious complication after adult spinal deformity (ASD) corrective surgery. Recurrent PJK/F is especially troublesome, necessitating fusion extension and occasionally resulting in irreversible neurological deficits. The gravity line (GL) offers valuable insights into global sagittal balance. This study aims to examine the postoperative GL-hip axis (GL-HA) offset as a critical risk factor for recurrent PJK/F. We retrospectively reviewed patients with ASD who had undergone revision surgery for initial PJK/F at a single academic center. Patients were categorized into 2 groups: nonrecurrent PJK/F group and recurrent PJK/F group. Demographics, surgical characteristics, preoperative and postoperative parameters of spinopelvic and global alignment, and the Scoliosis Research Society-22 scores were assessed. We examined these measures for differences and correlations with recurrent PJK/F. Our study included 32 patients without recurrent PJK/F and 28 patients with recurrent PJK/F. No significant differences were observed in baseline demographics, operative characteristics, or Scoliosis Research Society-22 scores before and after surgery. Importantly, using a cutoff of -52.6 mm from logistic regression, there were considerable differences and correlations with recurrent PJK/F in the postoperative GL-HA offset, leading to an odds ratio of 7.0 (95% CI: 1.94-25.25, P = .003). Postoperative GL-HA offset serves as a considerable risk factor for recurrent PJK/F in patients with ASD who have undergone revision surgery. Overcorrection, with GL-HA offset less than -5 cm, is associated with recurrent PJK/F. The instrumented spine tends to align the GL near the HA, even at the cost of proximal junction.


Synthesis of adult myosin light chains by embryonic muscle cultures.
Myosin light chain synthesis has been analyzed in cultures of fast and slow muscles from chicken and quail embryos. Synthesis was assayed by [35S]methionine incorporation and two-dimensional electrophoresis of total cell extracts. Our results show that differentiated cultures of embryonic anterior latissimus dorsi and pectoral muscles synthesize proteins that comigrate on two-dimensional gels with the five myosin light chains of adult fast (pectoral) and slow (anterior latissimus dorsi) muscle. Partial proteolytic digestion and peptide analyses further confirm the identity of these proteins as adult light chains. Cultures of dividing myoblasts do not synthesize any of these fiber type isozymes, and synthesis of the isozymes is initiated at myoblast fusion. Also, myogenic clones drived from single myoblasts differentiate to synthesize these five myosin light chains, indicating that individual myoblasts have the potential to express the synthesis of all fiber type light chain isozymes. We conclude that the primary events in muscle differentiation include the initiation of synthesis of the entire set of adult fast and slow myosin light chain isozymes. The developmental and physiological implications of these results for the establishment of fiber type specificity are discussed.


Note: a simple experimental arrangement to generate optical vortex beams.
In this Note, we present a simple experimental arrangement to generate optical vortex beams. We have demonstrated how by taking print of an interferogram on a transparent sheet, vortex beams with various topological charges can be generated. Experimental results show that the vortex beam indeed carries the topological charge that is used to compute the interferograms. In addition to being simple and inexpensive, one major advantage of the arrangement is that it makes it possible to generate different vortex beams quickly, unlike using the photographic process to create the holograms.


Construction and characterization of centromeric plasmids for Komagataella phaffii using a color-based plasmid stability assay.
The yeast Komagataella phaffii is widely used as a microbial host for heterologous protein production. However, molecular tools for this yeast are basically restricted to a few integrative and replicative plasmids. Four sequences that have recently been proposed as the K. phaffii centromeres could be used to develop a new class of mitotically stable vectors. In this work, we designed a color-based genetic assay to investigate plasmid stability in K. phaffii and constructed vectors bearing K. phaffii centromeres and the ADE3 marker. These genetic tools were evaluated in terms of mitotic stability by transforming an ade2/ade3 auxotrophic strain and regarding plasmid copy number by quantitative PCR (qPCR). Our results confirmed that the centromeric plasmids were maintained at low copy numbers as a result of typical chromosome-like segregation during cell division. These features, combined with in vivo assembly possibilities, prompt these plasmids as a new addition to the K. phaffii genetic toolbox.


The efficacy of Virkon-S for the control of saprolegniasis in common carp, Cyprinus carpio L.
Saprolegnia parasitica is a fish pathogen that causes severe economic losses worldwide. Virkon-S is a well-known disinfectant known to exhibit antimicrobial activities against bacteria, viruses, and fungi. In this study, we tested the anti-fungal activity of Virkon-S against S. parasitica, the major causal agent of saprolegniasis. The lowest concentration of Virkon-S that prevented germination or the visible growth of spores and the percent spore germination were determined using potato dextrose agar plates containing different concentrations of Virkon-S. The cytotoxic effect was evaluated using the Ez-Cytox Cell Viability Assay with epithelioma papulosum cyprini (EPC) cells grown in L-15 medium and acute toxicity tests were carried out with cultured fingerlings of common carp for 96 h. Artificial infection with S. parasitica was performed by placing the fish in tanks containing zoospores of S. parasitica after descaling and wounding at three positions. The diseased fish were kept in tanks containing 2, 4, and 10 ppm of Virkon-S for 10 days to observe the treatment effect. The in vitro assay results showed that Virkon-S could inhibit spore germination and the resulting mycelial growth at a concentration as low as 4 ppm. No cytotoxic effect on EPC cells was observed even at a concentration as high as 100 ppm. Additionally, no acute toxicity in the common carp was observed at 10 ppm following 96 h exposure. Ten days of treatment with 4 and 10 ppm Virkon-S resulted in complete reversal of artificially-induced saprolegniasis in the common carp. This data indicates that Virkon-S can be used for the control of saprolegniasis without harmful effects in fish. However, further research on the effect in humans and food supplies is necessary.


Spatial trend and probabilistic health risk assessment of heavy metals, nitrate, and fluoride in groundwater resources, West Azerbaijan province, Iran.
The quality of water resources used for drinking and their health effects is vitally important. The present study investigated the concentrations of F-, NO3-, and metal elements like Hg, Mn, As, and Pb in the groundwater resources and their health risk assessment on the west margin of Urmia Lake, Iran. Sampling points were selected and taken from 121 groundwater resources in the summer of 2014. Heavy metals (Pb, As, Mn, and Hg) were measured by ICP-OES (inductively coupled plasma optical emission spectrometer, model: Arcos, Germany), and some ions (Na+, NO3-, F-, and Cl-) by flame photometer and spectrophotometer according to the standard methods, respectively. The nitrate concentration range in groundwater samples measured from 1.7 to 137 mg/L and fluoride from 0.4 to 4.5 mg/L. The probabilistic method and Monte Carlo simulation were used to estimate carcinogenic and noncarcinogenic risks. The concentration of study elements in most samples was obtained in the WHO (World Health Organization) recommended range. The order of HM (heavy metal) concentration is based on the overall mean: Mn > As > Hg > Pb. The HI (hazard index ) level was found to be more than 1 for noncarcinogenic risk for As and NO3- and permissible risks for the other elements and fluoride. ELCR (excess lifetime cancer risk) levels of As were acceptable, except for some sampling points, the central region in the study area, near the seashore of Urmia Lake. Finally, it can be stated that the groundwater resources in the studied area are acceptable for drinking in most places. Still, due to the effects of As and NO3- contaminated water, the quality is unacceptable for drinking in some places. So, monitoring water quality is recommended by finding contamination sources to decrease the health risks of drinking consumption.


Dimethyl Fumarate Protects against Lipopolysaccharide- (LPS-) Induced Sepsis through Inhibition of NF-κB Pathway in Mice.
Sepsis is one of the most severe complications and causes of mortality in the clinic. It remains a great challenge with no effective treatment for clinicians worldwide. Inhibiting the release of proinflammatory cytokines during sepsis is considered as an important strategy for treating sepsis and improving survival. In the present study, we have observed the effect of dimethyl fumarate (DMF) on lipopolysaccharide- (LPS-) induced sepsis and investigated the possible mechanism. By screening a subset of the Johns Hopkins Drug Library, we identified DMF as a novel inhibitor of nitric oxide synthesis in LPS-stimulated RAW264.7 cells, suggesting that DMF could be a potential drug to treat sepsis. To further characterize the effect of DMF on LPS signaling, TNF-α, MCP-1, G-CMF, and IL-6 expression levels were determined by using cytokine array panels. In addition, an endotoxemia model with C57BL/6 mice was used to assess the in vivo efficacy of DMF on sepsis. The survival rate was assessed, and HE staining was performed to investigate histopathological damage to the organs. DMF was found to increase the survival of septic mice by 50% and attenuate organ damage, consistent with the reduction in IL-10, IL-6, and TNF-α (inflammatory cytokines) in serum. In vitro experiments revealed DMF's inhibitory effect on the phosphorylation of p65, IκB, and IKK, suggesting that the primary inhibitory effects of DMF can be attributed, at least in part, to the inhibition of phosphorylation of IκBα, IKK as well as nuclear factor-κB (NF-κB) upon LPS stimulation. The findings demonstrate that DMF dramatically inhibits NO and proinflammatory cytokine production in response to LPS and improves survival in septic mice, raising the possibility that DMF has the potential to be repurposed as a new treatment of sepsis.


On the density scaling of pVT data and transport properties for molecular and ionic liquids.
In this work, a general equation of state (EOS) recently derived by Grzybowski et al. [Phys. Rev. E 83, 041505 (2011)] is applied to 51 molecular and ionic liquids in order to perform density scaling of pVT data employing the scaling exponent γ(EOS). It is found that the scaling is excellent in most cases examined. γ(EOS) values range from 6.1 for ammonia to 13.3 for the ionic liquid [C(4)C(1)im][BF(4)]. These γ(EOS) values are compared with results recently reported by us [E. R. López, A. S. Pensado, M. J. P. Comuñas, A. A. H. Pádua, J. Fernández, and K. R. Harris, J. Chem. Phys. 134, 144507 (2011)] for the scaling exponent γ obtained for several different transport properties, namely, the viscosity, self-diffusion coefficient, and electrical conductivity. For the majority of the compounds examined, γ(EOS) > γ, but for hexane, heptane, octane, cyclopentane, cyclohexane, CCl(4), dimethyl carbonate, m-xylene, and decalin, γ(EOS) < γ. In addition, we find that the γ(EOS) values are very much higher than those of γ for alcohols, pentaerythritol esters, and ionic liquids. For viscosities and the self-diffusion coefficient-temperature ratio, we have tested the relation linking EOS and dynamic scaling parameters, proposed by Paluch et al. [J. Phys. Chem. Lett. 1, 987-992 (2010)] and Grzybowski et al. [J. Chem. Phys. 133, 161101 (2010); Phys. Rev. E 82, 013501 (2010)], that is, γ = (γ(EOS)/φ) + γ(G), where φ is the stretching parameter of the modified Avramov relation for the density scaling of a transport property, and γ(G) is the Grüneisen constant. This relationship is based on data for structural relaxation times near the glass transition temperature for seven molecular liquids, including glass formers, and a single ionic liquid. For all the compounds examined in our much larger database the ratio (γ(EOS)/φ) is actually higher than γ, with the only exceptions of propylene carbonate and 1-methylnaphthalene. Therefore, it seems the relation proposed by Paluch et al. applies only in certain cases, and is really not generally applicable to liquid transport properties such as viscosities, self-diffusion coefficients or electrical conductivities when examined over broad ranges of temperature and pressure.


[Exercise deep venous thrombosis: myth or reality? About three cases of pulmonary embolism in long-distance runners].
The most frequent manifestation of exercise deep vein thrombosis (DVT) is the one occurring in upper limbs, in some specific and stereotypic conditions, sometimes complicated by pulmonary embolisms. A few cases of lower limbs DVT are reported in athletes. Some pathophysiologic arguments (rheological modifications, parietal lesions and coagulation abnormalities) suggest a link between DVT and exertion, but the causality is sometimes difficult to establish. We report three cases of pulmonary embolism occurring after a prolonged effort of running in trained marathon athletes. To our knowledge, very few similar cases have ever been reported. The possible responsibility of such physical efforts is discussed, as well as other potential cofactors such as coagulation abnormalities and hormonal contraception.


Effectiveness of needle/syringe exchange program in Tbilisi.
IDUs are under the high risk of HIV and other blood born diseases. In Georgia injecting drug use is associated with two third of registered HIV/AIDS cases. Majority of them are also infected with B and C Hepatitis. One of the main components of HIV/AIDS prevention among drug users is considered to be harm reduction programs, among them syringe exchange program. We conducted observational cohort study and performed interviewing participants of syringe exchange program using structured questionnaire. The interviewing was conducted at intake, after 3 months and at the end of the program. During interviewing we used risk assessment questionnaire which we have little adapted (Risk Assessment Battery, Navaline, et al, 1994). The data were statistically analysed using SPPS-11, 5 program. The aim of the study was to assess the efficacy of outreach and needle exchange programs in terms of reduction of HIV risk behavior of injection drug users in Tbilisi. The results of the study show visible reduction in injection risk behavior for clients being in the program for at least three months. There was not seen any significant change in the level of sexual risk behavior, which might suggest the need for targeting this behavior during the further interventions. The results of the study suggest a visible potential benefit to drug users and communities that could be gained through the wide scale implementation of harm reduction programs in Georgia.


High-dose VP-16-213 monotherapy for refractory germinal malignancies: a phase II study.
VP-16-213 at standard dose is one of the more active agents for the treatment of germ cell tumors. In previous phase I studies, VP-16-213 has been investigated in suprastandard dose when hematopoietic reconstitution was assured by autologous bone marrow transplantation (ABMT). This phase II study was performed to explore the possibility that an augmented dose of VP-16-213 may be more active than standard dose against germ cell tumors. Eleven patients with progressive refractory germ cell tumors were treated with high-dose VP-16-213: 2,400 mg/m2 with ABMT every three to four weeks followed by 1,200 mg/m2 without ABMT. Seven patients had received VP-16-213 at standard dose prior to high-dose VP-16-213. Toxicity to high-dose VP-16-213 included severe myelosuppression, nausea, vomiting, alopecia, mucositis, and hepatitis. Of 10 evaluable patients, two complete responses and four partial responses, all of short duration, were obtained. However, some patients unresponsive to standard-dose VP-16-213 exhibited responses to the augmented-dose VP-16-213. Therefore, although more myelosuppressive, VP-16-213 may have increased activity against germ cell tumors when administered at augmented dose. High-dose VP-16-213 may be considered in designing new approaches for initial management of patients with germ cell tumors not expected to be cured with standard chemotherapy.


Control of steroid synthesis in adrenal fasciculata cells.
The control of steroid synthesis in adrenal fasciculata cells is considered in terms of two types of control by ACTH: control of cholesterol availability to inner mitochondrial cytochrome P-450scc. This process controls total steroid synthesis and is rapidly activated by ACTH. The several steps in cholesterol transfer are examined. partitioning of metabolism by means of competition between enzymes for limiting amounts of steroid intermediates. Changes in such competition determine the ratio of steroid products from the adrenal cells. Such changes typically are a slower response to ACTH. A critical aspect of such competition is the modulation of multiple activity P-450 cytochromes: P-450(17 alpha) (17 alpha-hydroxylation and 17,20 lyase) and P-450(11 beta) (11 beta- and 18-oxidases). Factors such as substrate binding, electron transfer steps and lipid environment are considered in addition to new enzyme synthesis. The ACTH stimulation of steroid synthesis in bovine adrenal cell primary cultures is examined as a model for both types of regulation.


Quadratic String Method for Locating Instantons in Tunneling Splitting Calculations.
The ring-polymer instanton (RPI) method is an efficient technique for calculating approximate tunneling splittings in high-dimensional molecular systems. In the RPI method, tunneling splitting is evaluated from the properties of the minimum action path (MAP) connecting the symmetric wells, whereby the extensive sampling of the full potential energy surface of the exact quantum-dynamics methods is avoided. Nevertheless, the search for the MAP is usually the most time-consuming step in the standard numerical procedures. Recently, nudged elastic band (NEB) and string methods, originaly developed for locating minimum energy paths (MEPs), were adapted for the purpose of MAP finding with great efficiency gains [ J. Chem. Theory Comput. 2016 , 12 , 787 ]. In this work, we develop a new quadratic string method for locating instantons. The Euclidean action is minimized by propagating the initial guess (a path connecting two wells) over the quadratic potential energy surface approximated by means of updated Hessians. This allows the algorithm to take many minimization steps between the potential/gradient calls with further reductions in the computational effort, exploiting the smoothness of potential energy surface. The approach is general, as it uses Cartesian coordinates, and widely applicable, with computational effort of finding the instanton usually lower than that of determining the MEP. It can be combined with expensive potential energy surfaces or on-the-fly electronic-structure methods to explore a wide variety of molecular systems.


Awareness of palliative medicine among Pakistani doctors: a survey.
To establish the awareness of palliative medicine in Pakistani doctors through a questionnaire. A questionnaire was developed after consultation with the professionals working in palliative medicine. It was distributed, by hand, to a convenience sample of doctors who worked at various teaching hospitals in Pakistan. The distribution and collection of questionnaires was carried out within six months. The results suggested that 74% doctors felt that cancer was the commonest reason for the palliative care teams to be involved. Forty five percent mentioned tht pain control was their prime job; 54% said that they had some experience of palliative medicine; 64% wanted to be involved in palliative medicine; 60% thought that they broke bad news properly to the patients; 59% were satisfied with their own performance while dealing with an incurable patient (57% said that they had heard about a hospice). There was a wide range of drugs for the cancer pain. Amongst Pakistani doctors, there is a lack of training in palliative medicine. A significant number of doctors are interested and they are willing to have more training in pain control, breaking bad news, communication skills and terminal care.


Chondroitin sulfate protects SH-SY5Y cells from oxidative stress by inducing heme oxygenase-1 via phosphatidylinositol 3-kinase/Akt.
We investigated the mechanism of the neuroprotective properties of chondroitin sulfate (CS), an endogenous perineuronal net glycosaminoglycan, in human neuroblastoma SH-SY5Y cells subjected to oxidative stress. Preincubation with CS for 24 h afforded concentration-dependent protection against H2O2-induced toxicity (50 microM for 24 h) measured as lactic dehydrogenase released to the incubation media; cell death was prevented at the concentrations of 600 and 1000 microM. Cell death caused by a combination of 10 microM rotenone plus 1 microM oligomycin-A (Rot/oligo) was also reduced by CS at concentrations ranging from 0.3 to 100 microM; in this toxicity model, maximum protection was achieved at 3 microM (48%). No significant protection was observed in a cell death model of Ca2+ overload (70 mM K+, for 24 h). H2O2 and Rot/oligo generated reactive oxygen species (ROS) measured as an increase in the fluorescence of dichlorofluorescein diacetate-loaded cells. CS drastically reduced ROS generation induced by both H2O2 (extracellular ROS) and Rot/oligo (intracellular ROS). CS also increased the expression of phosphorylated Akt and heme oxygenase-1 by 2-fold. The protective effects of CS were prevented by chelerythrine, 2-(4-morpholinyl)-8-phenyl-4H-1-benzopyran-4-one (LY294002), cycloheximide, and Sn(IV)-protoporphyrin IX. Taken together, these results show that CS can protect SH-SY5Y cells under oxidative stress conditions by activating protein kinase C, which phosphorylates Akt that, via the phosphatidylinositol 3-kinase/Akt pathway, induces the synthesis of the antioxidant protein heme oxygenase-1.


[Economic burden of methicillin-resistant Staphylococcus aureus bacteremia in critical care patients in hospitals in Bogotá].
Resistant infections, especially those involving the bloodstream, are associated with a greater use of resources. Their estimates are variable and depend on the methodology used. Staphylococcus aureus is the main pathogen isolated in blood in our hospitals. There is no consolidated data about economic implications of methicillin-resistant S. aureus infection. To describe the cost of care of methicillin-resistant S. aureus bacteremia in a reference population from nine hospitals in Bogotá. Materials y methods: A multicenter cohort study included 204 patients in a 1:1 ratio according to resistance. Direct medical costs were calculated from hospitalization bills, while the bacteremia period was calculated by applying microcosting based on standard fares. We found no significant differences between groups in demographic and clinical characteristics, except for resistance risk factors. Fifty-three percent of patients died during hospitalization. Hospital stay and total invoiced value during hospitalization were significantly higher in the group with methicillin-resistant S. aureus bacteremia. For this group, higher costs in ICU stay, antibiotics use, intravenous fluids, laboratory tests and respiratory support were recorded. A crude increase of 31% and an adjusted increase of 70% in care costs associated with methicillin resistance were registered. Our study supports decision makers in finding and funding infection prevention programs, especially those infections caused by resistant organisms.


Implementation of Total Laparoscopic Hysterectomy As the Default Technique and Lessons Learnt.
Introduction Concerns about surgical complications and the paucity of surgical audits have been named as reasons for the slow implementation of total laparoscopic hysterectomy (TLH) in New Zealand and Australia, despite a majority of gynaecologists who would like to offer this less-invasive approach to their patients. Material and methods This study aims to assess the implementation of TLH as the default method of hysterectomy at a private institution in the Waikato region of New Zealand, and to identify factors related to the perioperative complications and to the failure to accomplish the above procedure laparoscopically in an unselected population. We present 1,287 cases collected over fourteen years with an emphasis on demographics, outcomes, indications for surgery, laparoscopic completion of the surgical procedure and perioperative major complications. Results One hundred and fifty patients (11.7%) were nulliparous and 378 patients (29.4%) had a history of the previous laparotomy. The mean theatre time and SD was 144.84 ± 20.48 min; the mean blood loss was 137.24 ± 69 mL; the mean hospital stay was 2.07 ± 0.31 days; the median uterine weight was 177 g and the biggest uterus removed laparoscopically weighed 1,510 g. Twelve cases were converted to laparotomy (0.93%). The uterine weight had a statistically significant association with the conversion rate. The main indications for surgery were menorrhagia and/or recurrent dysmenorrhoea in 662 patients (51.4%) and fibroid uterus in 228 patients (17.7%). Six patients (0.47%) required blood transfusions. There was a total of 74 perioperative complications (5.7%) and 16 major complications (1.24%). BMI and uterine weight had a statistically significant association with major complication rates. Seven patients (0.54%) were re-operated as a result of a complication. Conclusion The implementation of TLH as default is achievable and is a safe surgical option. BMI and uterine weight are factors associated significantly with major complications or conversion to laparotomy.


Ligament reconstruction with tendon interposition arthroplasty for first carpometacarpal joint osteoarthritis.
Ligament reconstruction tendon interposition (LRTI) is the most commonly performed surgical procedure for first carpometacarpal joint osteoarthritis. The purpose of this study was to examine the radiographic and clinical outcomes of LRTI arthroplasty and document the clinical results based on metacarpal subsidence. From January 2008 to January 2011, 19 patients (21 thumbs) underwent surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radialis (FCR) in Kleinert Kutz Hand Care Center of Louisville University, USA. The follow-up period was an average of 13.9 months. Pain, grip strength, tip pinch strength, range of motion, and radiographic measurements were recorded. Based on first metacarpal subsidence, the cases were classified in to mild, moderate, and severe. Clinical outcomes of the groups were evaluated and compared. Grip strength improved from 18.6 kg to 20.5 kg, and tip pinch strength increased from 4.4 kg to 4.5 kg after the surgery. Radial abduction and palmar abduction improved after surgery. Radial abduction increased from 55.7° to 60.6° and palmar abduction improved from 56.7° to 63.5° after the procedure. Visual analogue scores (VAS) were significantly reduced, from 6.6 to 0.5. Compared with the preoperative radiographs the first metacarpal had subsided about 54.6% of the arthroplasty space. The height of arthroplasty space and index of the arthroplasty space significantly decreased from 12.4 mm to 5.6 mm and from 0.27 to 0.12 respectively. Between the various groups (mild, moderate and severe metacarpal subsidence), there was no difference in grip strength, tip pinch strength, thumb range of motion, and VAS. Ligament reconstruction tendon interposition arthroplasty resulted in excellent relief of pain and increase in range of motion. However, LRTI cannot maintain the arthroplasty space. Compared with the preoperative radiographs, the metacarpal subsided more than 50%. The amount of first metacarpal subsidence has no bearing on the results.


Coronary artery surgery: conventional coronary artery bypass grafting versus off-pump coronary artery bypass grafting.
Coronary revascularization has become the principal treatment modality in patients with severe coronary artery disease. The broader application of percutaneous coronary interventions in patients with multivessel disease and the recent introduction of drug-eluting stents have both lead to a decline in the number of patients referred for surgical revascularization. Conventional coronary artery bypass grafting using cardiopulmonary bypass is an excellent treatment, however less invasive surgical approaches such as off-pump coronary artery bypass grafting have appeared in the past few years. The exact role of off-pump coronary artery bypass grafting is still vaguely defined and being critically evaluated. Our aim is to provide an objective review of the recent literature in regard to surgical outcomes. A critical review of all relevant clinical series from May 2003 to May 2005 was conducted. Current prospective data suggests that both techniques have similar rates of mortality, in regard to morbidity, multiple prospective studies suggest a decrease in stroke rates for off-pump coronary artery bypass grafting. The incidence of postoperative myocardial infarction does not appear to differ between techniques. When analyzed carefully, the results presented herein seem to indicate that both techniques provide similar rates for long-term patency and freedom from surgical reintervention. Coronary artery bypass grafting and off-pump coronary artery bypass grafting are both safe and beneficial in patients with multivessel coronary artery disease. It appears that elderly patients with additional co-morbid risk factors may benefit most from off-pump coronary artery bypass grafting. It has become increasingly apparent that off-pump coronary artery bypass grafting can be performed safely in reference centers.


Toward quantum Monte Carlo forces on heavier ions: Scaling properties.
Quantum Monte Carlo (QMC) forces have been studied extensively in recent decades because of their importance with spectroscopic observables and geometry optimization. Here, we benchmark the accuracy and computational cost of QMC forces. The zero-variance zero-bias (ZVZB) force estimator is used in standard variational and diffusion Monte Carlo simulations with mean-field based trial wavefunctions and atomic pseudopotentials. Statistical force uncertainties are obtained with a recently developed regression technique for heavy tailed QMC data [P. Lopez Rios and G. J. Conduit, Phys. Rev. E 99, 063312 (2019)]. By considering selected atoms and dimers with elements ranging from H to Zn (1 ≤ Zeff ≤ 20), we assess the accuracy and the computational cost of ZVZB forces as the effective pseudopotential valence charge, Zeff, increases. We find that the costs of QMC energies and forces approximately follow simple power laws in Zeff. The force uncertainty grows more rapidly, leading to a best case cost scaling relationship of approximately Zeff 6.5(3) for diffusion Monte Carlo. We find that the accessible system size at fixed computational cost scales as Zeff -2, insensitive to model assumptions or the use of the "space warp" variance-reduction technique. Our results predict the practical cost of obtaining forces for a range of materials, such as transition metal oxides where QMC forces have yet to be applied, and underscore the importance of further developing force variance-reduction techniques, particularly for atoms with high Zeff.


Selective breeding for high and low antibody responses to inactivated Newcastle disease virus in Japanese quails.
Two lines of Japanese quail were divergently selected for high and low antibody responses after being twice injected at 4 and 6 weeks of age with inactivated Newcastle disease virus antigen. After seven generations of selection, the serum antibody level in the high line was 24% greater than the level in the unselected control lines, whereas the low line antibody level was approximately 37% less than that in the control line. The estimated heritability (H2S + D) was approximately .12 +/- .50. The realized h2, calculated from coefficient of regression formula on seven generations (G3 to G9 ), was .07.


[The seasonal patterns of surgical morbidity of the maxillofacial area under the climatic conditions of the city of Derbent].
Analysis of 724 case histories over many years permitted the author to distinguish the seasonal regularities in the development of various stomatological diseases, differing by the etiology and pathogenesis: furuncles on the face, mandibular fractures, and lymphadenitis of the maxillofacial area and neck. Under the climatic conditions of the town of Derbent a seasonal rise in the incidence of furuncles of the face is observed in July, August, and September, that of mandibular fractures in May, and July, and of lymphadenitis in January, February, July, and August.


EPR and HPLC Investigation of Pigments in Thai Purple Rice.
We investigated the pigments in Thai purple rice using electron paramagnetic resonance (EPR), X-band (9 GHz) EPR imaging (EPRI), and HPLC. The location and spatial distribution of the paramagnetic species in purple and white rice were determined by EPR and EPRI. EPR primarily detected three paramagnetic species in purple rice, which were identified as stable radicals, Mn2+, and Fe3+ based on the gvalues and hyperfine components of the EPR signals. Subsequent noninvasive two-dimensional (2D) EPRI revealed that these stable radicals are primarily located in the pigmented region of purple rice, while very few radicals were observed in the interior of the rice. HPLC revealed that the major compounds were cyanidin-3-O-glucoside and peonidin-3-O-glucoside. Scavenging activities, EPR, and EPR imaging results indicate that the stable radicals contain the radical state of anthocyanins and are mostly found within the pigmented embryo region of purple rice. They could be either associated with scavenging activities or could be one of the products of their oxidative decomposition.


Construction of the BAC Library of Small Abalone (Haliotis diversicolor) for Gene Screening and Genome Characterization.
The small abalone (Haliotis diversicolor) is one of the most important aquaculture species in East Asia. To facilitate gene cloning and characterization, genome analysis, and genetic breeding of it, we constructed a large-insert bacterial artificial chromosome (BAC) library, which is an important genetic tool for advanced genetics and genomics research. The small abalone BAC library includes 92,610 clones with an average insert size of 120 Kb, equivalent to approximately 7.6× of the small abalone genome. We set up three-dimensional pools and super pools of 18,432 BAC clones for target gene screening using PCR method. To assess the approach, we screened 12 target genes in these 18,432 BAC clones and identified 16 positive BAC clones. Eight positive BAC clones were then sequenced and assembled with the next generation sequencing platform. The assembled contigs representing these 8 BAC clones spanned 928 Kb of the small abalone genome, providing the first batch of genome sequences for genome evaluation and characterization. The average GC content of small abalone genome was estimated as 40.33%. A total of 21 protein-coding genes, including 7 target genes, were annotated into the 8 BACs, which proved the feasibility of PCR screening approach with three-dimensional pools in small abalone BAC library. One hundred fifty microsatellite loci were also identified from the sequences for marker development in the future. The BAC library and clone pools provided valuable resources and tools for genetic breeding and conservation of H. diversicolor.


Transposon-mediated insertional mutagenesis revealed the functions of animal cellulose synthase in the ascidian Ciona intestinalis.
Tunicates are the only animals that perform cellulose biosynthesis. The tunicate gene for cellulose synthase, Ci-CesA, was likely acquired by horizontal transfer from bacteria and was a key innovation in the evolution of tunicates. Transposon-based mutagenesis in an ascidian, Ciona intestinalis, has generated a mutant, swimming juvenile (sj). Ci-CesA is the gene responsible for the sj mutant, in which a drastic reduction in cellulose was observed in the tunic. Furthermore, during metamorphosis, which in ascidians convert the vertebrate-like larva into a sessile filter feeder, sj showed abnormalities in the order of metamorphic events. In normal larvae, the metamorphic events in the trunk region are initiated after tail resorption. In contrast, sj mutant larvae initiated the metamorphic events in the trunk without tail resorption. Thus, sj larvae show a "swimming juvenile" phenotype, the juvenile-like trunk structure with a complete tail and the ability to swim. It is likely that ascidian cellulose synthase is required for the coordination of the metamorphic events in the trunk and tail in addition to cellulose biosynthesis.


Peer-based professional development viewed through the lens of transformative learning.
The goal of professional development is improved practice through change-changes in ways of doing or thinking about one's work. Traditional approaches, including group instruction and individualized coaching, emphasize the unidirectional flow of information from expert to novice. This article foregrounds a nontraditional peer-based modality, the peer learning partnership, which promotes joint reflection and reciprocal learning between professionals. A qualitative case study of a peer-based community college faculty development initiative reveals participants' perceptions of the role peer partnering played in their learning. Findings are discussed relative to selected theories, specifically transformative learning. Recommendations are offered on using peer-based approaches for professional development and transformation.


Chromosome-wise dissection of the genome of the extremely big mouse line DU6i.
The extreme high-body-weight-selected mouse line DU6i is a polygenic model for growth research, harboring many small-effect QTL. We dissected the genome of this line into 19 autosomes and the Y chromosome by the construction of a new panel of chromosome substitution strains (CSS). The DU6i chromosomes were transferred to a DBA/2 mice genetic background by marker-assisted recurrent backcrossing. Mitochondria and the X chromosome were of DBA/2 origin in the backcross. During the construction of these novel strains, >4000 animals were generated, phenotyped, and genotyped. Using these data, we studied the genetic control of variation in body weight and weight gain at 21, 42, and 63 days. The unique data set facilitated the analysis of chromosomal interaction with sex and parent-of-origin effects. All analyzed chromosomes affected body weight and weight gain either directly or in interaction with sex or parent of origin. The effects were age specific, with some chromosomes showing opposite effects at different stages of development.


Blocking Dectin-1 prevents colorectal tumorigenesis by suppressing prostaglandin E2 production in myeloid-derived suppressor cells and enhancing IL-22 binding protein expression.
Dectin-1 (gene Clec7a), a receptor for β-glucans, plays important roles in the host defense against fungi and immune homeostasis of the intestine. Although this molecule is also suggested to be involved in the regulation of tumorigenesis, the role in intestinal tumor development remains to be elucidated. In this study, we find that azoxymethane-dextran-sodium-sulfate-induced and ApcMin-induced intestinal tumorigenesis are suppressed in Clec7a-/- mice independently from commensal microbiota. Dectin-1 is preferentially expressed on myeloid-derived suppressor cells (MDSCs). In the Clec7a-/- mouse colon, the proportion of MDSCs and MDSC-derived prostaglandin E2 (PGE2) levels are reduced, while the expression of IL-22 binding protein (IL-22BP; gene Il22ra2) is upregulated. Dectin-1 signaling induces PGE2-synthesizing enzymes and PGE2 suppresses Il22ra2 expression in vitro and in vivo. Administration of short chain β-glucan laminarin, an antagonist of Dectin-1, suppresses the development of mouse colorectal tumors. Furthermore, in patients with colorectal cancer (CRC), the expression of CLEC7A is also observed in MDSCs and correlated with the death rate and tumor severity. Dectin-1 signaling upregulates PGE2-synthesizing enzyme expression and PGE2 suppresses IL22RA2 expression in human CRC-infiltrating cells. These observations indicate a role of the Dectin-1-PGE2-IL-22BP axis in regulating intestinal tumorigenesis, suggesting Dectin-1 as a potential target for CRC therapy.


[Further research into the formation of the "vitality and adequacy of emotion-emotional blunting" relationship in paranoid schizophrenia].
A sample of 100 paranoidal schizophrenic patients were assessed. Scales of "vitality and the adequacy of emotion" and "emotional blunting" which are described in a separate paper were used. At the beginning attention was focused on the fact that several synonimous terms are used to describe the blunting of emotion (flatness of affect, blunted or inappropriate affect, presence of affect as opposed to flatness). The results indicate that in only a very few cases the intensity of both studied qualities was negligible, however in the majority of the cases it appeared that the quality of "vitality" and its opposite is present. In 62 patients the emotional blunting was moderate. Emotional vitality in these cases remained in the wide range from moderate to significant. Both factors may be considered to be additional factors on the basis of the size and type of correlation. The coefficient of both Scales is expressed by r = -0.77. The correlation between the studied proportion and the syntonic-autistic proportion is expressed by r = 0.69. The cases of emotional blunting which occurred at different levels of intensity were generally accompanied by relative vitality and adequate emotional reaction. The formation of the studied proportion and in particular the high correlation coefficient between this proportion and the syntonic-autistic proportion suggests that autistic schizophrenia and syntonic schizophrenia form two basic subgroups of paranoidal schizophrenia.


Hyperspectral Image Classification for Land Cover Based on an Improved Interval Type-II Fuzzy C-Means Approach.
Few studies have examined hyperspectral remote-sensing image classification with type-II fuzzy sets. This paper addresses image classification based on a hyperspectral remote-sensing technique using an improved interval type-II fuzzy c-means (IT2FCM*) approach. In this study, in contrast to other traditional fuzzy c-means-based approaches, the IT2FCM* algorithm considers the ranking of interval numbers and the spectral uncertainty. The classification results based on a hyperspectral dataset using the FCM, IT2FCM, and the proposed improved IT2FCM* algorithms show that the IT2FCM* method plays the best performance according to the clustering accuracy. In this paper, in order to validate and demonstrate the separability of the IT2FCM*, four type-I fuzzy validity indexes are employed, and a comparative analysis of these fuzzy validity indexes also applied in FCM and IT2FCM methods are made. These four indexes are also applied into different spatial and spectral resolution datasets to analyze the effects of spectral and spatial scaling factors on the separability of FCM, IT2FCM, and IT2FCM* methods. The results of these validity indexes from the hyperspectral datasets show that the improved IT2FCM* algorithm have the best values among these three algorithms in general. The results demonstrate that the IT2FCM* exhibits good performance in hyperspectral remote-sensing image classification because of its ability to handle hyperspectral uncertainty.


[Influence of external electric current on the spatial distributions of porosity and fractional dimension of biofilms].
The spatial distributions of porosity and fractional dimension of autotrophic and heterotrophic/autotrophic biofilms applied by direct current in the range of 0-25 A/m2 were investigated by using the micro-slicing technique and image analysis. The results showed that the porosities of the autotrophic and heterotrophic/autotrophic biofilms respectively decreased from ca. 92% and 96% in the top layer to ca. 54% in the bottom layer while the fractional dimensions increased from 1.1 and 1.05 in the top layer to 1.4 in the bottom layer in the absence of current. The increase in the current density decreased the porosities and increased the fractional dimensions in the top layers. In the deeper layers, the current had insignificant influence on the porosity and fractional dimension.


Acute aortic dissection associated with cystic medial necrosis of unknown etiology.
A 61-year-old man without a Marfan-like phenotype was admitted to the hospital because of acute Stanford type A aortic dissection. The patient underwent surgical repair with total arch replacement. Histological examination of the excised aorta showed a connective tissue abnormality, which could have contributed to the development of aortic dissection. The cause of the connective tissue abnormality could not be determined through physical examination. Recently, however, many novel gene mutations have been found to be related to aortic diseases that do not always produce physical signs and symptoms. In this case, unknown causes of connective tissue abnormalities might be existed.


Generating data in models including direct and maternal dominance effects.
Algorithms are presented to simulate multiple generations of animal data by a model including direct additive genetic, maternal additive genetic, direct dominance, maternal dominance and permanent environmental effects. Dominance effects were computed as parental subclasses. Testing involved five single trait models that included direct contemporary group and direct additive effects, and different combinations of maternal, permanent environmental, and dominance effects. Simulated populations included 5 generations of animals and 20 contemporary groups per generation. The base population contained 200 sires and 600 dams. Variance components were estimated by Average-Information Restricted Maximum Likelihood (AIREML). No significant bias was observed. The simulation algorithms can be used in research involving dominance models, such as evaluation of mating systems exploiting special combining abilities of prospective parents.


The function of factor XI in tissue factor-initiated thrombin generation.
The influence of plasma and platelet factor (F)XI on thrombin generation initiated with 10 pm tissue factor (TF) in a synthetic coagulation model was evaluated in the presence of either 2 x 108 mL-1 platelets or the equivalent (2 microm) phospholipids. In either system, with all proteins present at physiological concentrations, FXI (30 nm) had no effect on thrombin generation. With phospholipids in the absence of FXI, an increase in vitamin K-dependent proteins (VKDP) (up to 500%) significantly prolonged the initiation phase of thrombin generation and decreased maximum thrombin levels. The inhibition was principally caused by the elevated prothrombin and FIX concentrations. When 30 nm FXI was added with elevated VKDP and phospholipids, the initiation phase was decreased and the maximum thrombin levels generated substantially increased. In experiments with platelets (with and without plasma FXI), an increase in VKDP had little effect on the initiation phase of thrombin generation. These data indicate that (i) FXI has no effect on thrombin generation at 10 pm TF and physiological concentrations of VKDP; (ii) platelets and plasma FXI are able to compensate for the inhibitory effects of elevated VKDP.


Lobosporangium, a new name for Echinosporangium Malloch, and Gamsiella, a new genus for Mortierella multidivaricata.
Lobosporangium is proposed as a new name for Echinosporangium Malloch, a later homonym of Echinosporangium Kylin. Lobosporangium transversale was isolated from arid soils on three occasions between 1964 and 1968 but has not been reported again. Observations on sporangium development in culture revealed rapid sporangiospore germination, rapidly growing hyphae forming anastomoses, threefold dichotomously branching aerial sporangiophores and formation of clusters of eight sporangia. The sporangia of L. transversale are illustrated, and the placement of Lobosporangium in the Mortierellaceae is discussed. A new genus, Gamsiella, is proposed that is based on Mortierella multidivaricata. Sporangial ontogeny of Gamsiella is compared with that presented here for Lobosporangium.


Role of MDCT in the diagnosis of hepatocellular carcinoma in patients with cirrhosis undergoing orthotopic liver transplantation.
The purpose of this study was to assess the diagnostic performance of MDCT in the detection of hepatocellular carcinoma in patients with cirrhosis undergoing orthotopic liver transplantation. Eighty-eight consecutively registered patients who underwent MDCT 6 months before liver transplantation were evaluated. The original reports were analyzed, and the CT images were retrospectively reevaluated independently by two radiologists who made the final interpretation in consensus. The imaging findings were correlated with histopathologic findings in the explanted livers on a patient-by-patient and a lesion-by-lesion basis. Histopathologic examination revealed 139 hepatocellular carcinomas in 48 of the 88 patients. MDCT correctly depicted 89 of 139 hepatocellular carcinomas (sensitivity, 64%) at the original examination and 102 at reevaluation (sensitivity, 73.3%). Patient-by-patient analysis showed a specificity of 75% in the original reports and of 77.5% at reevaluation. A large number of false-positive nodules were found, most (59.2%) of them being smaller than 1 cm in diameter. MDCT has reasonable sensitivity in the detection of hepatocellular carcinoma in patients with cirrhosis who undergo liver transplantation. Attention should be paid, however, to avoiding overestimation of the extent of disease.


Image plate characterization and absolute calibration to low kilo-electron-volt electrons.
We report on the characterization of an image plate and its absolute calibration to electrons in the low keV energy range (1-30 keV). In our case, an Agfa MD4.0 without protection layer was used in combination with a Fuji FLA7000 scanner. The calibration data are compared to other published data and a consistent picture of the sensitivity of image plates to electrons is obtained, which suggests a validity of the obtained calibration up to 100 keV.


Trends in prescribing of non-steroidal anti-inflammatory drugs in patients with cardiovascular disease: influence of national guidelines in UK primary care.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain, but have potential side effects in patients with cardiovascular disease (CVD). To determine trends in NSAIDs prescribing between 2002 and 2010 in patients with CVD, and ascertain whether prescribing patterns changed following publication of major national (the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Clinical Excellence (NICE)) guidance to GPs. This was an observational database study of adult patients in 11 practices (Staffordshire, England). NSAIDs were categorised into basic, COX-2 and topical. Study duration was divided on a quarterly basis from 2002-quarter-1 to 2010q4. CVD patients were identified using pre-defined Read Codes recorded in the two years prior to each quarter. Quarterly prevalence was determined. Times of significant changes in prescribing trends were determined using Joinpoint Regression, and compared to dates of the five major guidelines (in 2004q4, 2005q1, 2005q3, 2006q4, 2008q1). In CVD patients, the prescription of basic NSAIDs showed a decreasing trend throughout the study period, from 774 (95% CI, 691-863) per 10000 patients in 2002q1 to 245 (204-291) in 2010q4. COX-2 prescribing increased from 232/10000 (187-286) in 2002q1 to 403/10000 (348-464) in 2004q3. Prescribing then fell sharply to 102/10000 (76-134) in 2005q2 before stabilising around 55/10000. Topical NSAIDs prescribing showed a steady increase, starting at 115/10000 (108-123) in 2002q1 and ending at 270/10000 (258-281) in 2010q4. Similar trends were observed in patients without CVD, particularly a sharp drop in COX-2 prescribing also occurred from 2004q4 when initial MHRA guidance was issued. Despite guidelines and a trend toward decreased prescribing, the use of potentially harmful NSAIDs continued in CVD patients. The MHRA directives potentially might have affected patients without CVD who may have inappropriately restricted their use of COX-2.


Overview: Mechanism and Control of a Prosthetic Arm.
Continuous growth in industrialization and lack of awareness in safety parameters the cases of amputations are growing. The search of safer, simpler and automated prosthetic arms for managing upper limbs is expected. Continuous efforts have been made to design and develop prosthetic arms ranging from simple harness actuated to automated mechanisms with various control options. However due the cost constraints, the automated prosthetic arms are still out of the reach of needy people. Recent data have shown that there is a wide scope to develop a low cost and light weight upper limb prosthesis. This review summarizes the various designs methodologies, mechanisms and control system developed by the researchers and the advances therein. Educating the patient to develop acceptability to prosthesis and using the same for the most basic desired functions of human hand, post amputation care and to improve patient's independent life is equally important. In conclusion it can be interpreted that there is a wide scope in design in an adaptive mechanism for opening and closing of the fingers using other methods of path and position synthesis. Simple mechanisms and less parts may optimize the cost factor. Reduction in the weight of the prosthesis may be achieved using polymers used for engineering applications. Control system will remain never ending challenge for the researchers, but it is essential to maintain the simplicity from the patients perspective.


Myeloperoxidase deficiency induces MIP-2 production via ERK activation in zymosan-stimulated mouse neutrophils.
Myeloperoxidase (MPO), a major constituent of neutrophils, catalyzes the production of hypochlorous acid (HOCl) from hydrogen peroxide (H2O2) and chloride anion. We have previously reported that MPO-deficient (MPO(-/-)) neutrophils produce greater amount of macrophage inflammatory protein-2 (MIP-2) in vitro than do wild type when stimulated with zymosan. In this study, we investigated the molecular mechanisms governing the up-regulation of MIP-2 production in the mutant neutrophils. Interestingly, we found that zymosan-induced production of MIP-2 was blocked by pre-treatment with U0126, an inhibitor of mitogen-activated protein kinase/extracellular-signal-regulated kinase (ERK), and with BAY11-7082, an inhibitor of nuclear factor (NF)-κB. Western blot analysis indicated that U0126 also inhibited the phosphorylation of p65 subunit of NF-κB (p65), indicating that MIP-2 was produced via the ERK/NF-κB pathway. Intriguingly, we found that ERK1/2, p65, and alpha subunit of inhibitor of κB (IκBα) in the MPO(-/-) neutrophils were phosphorylated more strongly than in the wild type when stimulated with zymosan. Exogenous H2O2 treatment in addition to zymosan stimulation enhanced the phosphorylation of ERK1/2 without affecting the zymosan-induced MIP-2 production. In contrast, exogenous HOCl inhibited the production of MIP-2 as well as IκBα phosphorylation without affecting ERK activity. The zymosan-induced production of MIP-2 in the wild-type neutrophils was enhanced by pre-treatment of the MPO inhibitor 4-aminobenzoic acid hydrazide. Collectively, these results strongly suggest that both lack of HOCl and accumulation of H2O2 due to MPO deficiency contribute to the up-regulation of MIP-2 production in mouse neutrophils stimulated with zymosan.


Bioavailability studies and the clinical pharmacologist: correlation of drug distribution with clinical effects.
Bioavailability studies can be interpreted only when clinical information is available which correlates drug distribution with both efficacious and toxic clinical effects. The clinical pharmacologist should be instrumental in the development of safe and effective drug therapy by the systematic application of well designed clinical trials, the clear definition of therapeutically desirable clinical responses, and the development and application of improved techniques of measuring these effects.


Psychiatric treatment in jail: an experiment in health-care delivery.
The author discusses the source of referral, psychiatric diagnosis, and treatment of 539 inmates who were referred for psychiatric treatment in two metropolitan jails. Almost one-third of the patients were evaluated within 24 hours of their being booked into jail. Manifestly disordered and violent behavior accounted for 50 per cent of the referrals; almost half the patients were diagnosed as schizophrenic or manic. The author emphasizes the importance of a close working relationship with the custody staff to facilitate identifying inmates who need psychiatric treatment.