Impact of Sickle Cell Disease on Academic Performance: A Cross Sectional Study.
Sickle cell disease (SCD) is a multisystemic disease that results in diverse clinical manifestations in the form of acute and chronic complications. This study aims to assess the academic achievements of patients with SCD. A cross-sectional study was a study conducted among adult patients with SCD from the eastern province of Saudi Arabia, where SCD is more widespread than in other regions. A total of ninety patients with SCD, whose median age was 32.33 ± 11.84, were retrospectively evaluated. Of the total number, 32 (35.5%) did not obtain a secondary higher education certificate, and five (3.3%) were illiterate. Sixty-three (70%) of the patients were female, indicating no significant association between gender and education level (p-value > 0.05). The patients' mean annual hospitalizations and emergency visits totaling 4.7 and 8.43, respectively, were not significantly associated with education (p-value > 0.05). Throughout the patients' lives, mean blood transfusions and ICU admissions occurred 6.29 and 2.75 times, respectively, which were not significantly associated with education level (p-value > 0.05). However, education was inversely proportional to a history of splenectomy and cholecystectomy (p < 0.05). Laboratory parameters (hemoglobin level, WBC, platelets, and hemoglobin F) showed no significant associations with education level (p-value > 0.05). Patients with sickle-thalassemia exhibited a trend of being better-educated than those without the diseases, but the difference did not reach statistical significance (p-value > 0.05). A linear regression analysis revealed no significant associations among clinical and laboratory parameters. SCD is a multisystemic disease that impacts socioeconomic status, learning ability, and academic achievements. More research is needed to identify factors that predict poor performance. Additionally, intelligence quotient (IQ) and cognitive assessment should be incorporated into early screening programs for SCD in order to implement preventive measures and a thorough investigation of underlying causes.


[Comparative study of 2 commercial tests for the detection of HIV-1 antigens in blood and cerebrospinal fluid using immunoenzymology].
The authors have carried out, on 150 sera of patients seropositive for the human immunodeficiency virus type I (HIV I) and 11 cerebrospinal fluid of which 5 were patient infected by the HIV I, a comparative study of two commercial tests for the detection of HIV I antigen (Diagnostic Pasteur and Abbott laboratories). A much greater sensitivity was obtained with the specificity being practically identical for the sera with the two tests (100% with Abbott laboratories test, 96.11% with the diagnostic Pasteur test). 4 sera appeared "false negatives" with the Abbott Laboratories test; their optical density was situated between 80 and 100 p. cent of the cut-off level value, whereas that of the "real" negatives was situated between 30 and 60 p. cent of the cut-off level value. 10 of the 11 cerebrospinal fluids appeared false positive with the Diagnostic Pasteur. This seems to be connected with an insufficiency of saturation of protein receptors in the wells. The Diagnostic Pasteur test is not adapted for the detection of HIV I antigen in the body fluids with a weak protein concentration. Contrary to the results obtained with the Encavor test (Abbott laboratories) the analysis in western-blot does not show an inverse prevalence of anti p24 GAG antibodies with regard to antigen HIV I in seropositive patients. On the other hand, the statistical analysis of the positive HIV I sera which are at the same time antigen HIV I positive and antibodies HIV I positive suggests an earlier disappearance of anti p17 GAG antibodies than of anti p24 GAG antibodies.


An approach to mandibular reconstruction.
Mandibular reconstruction requires the restitution of both form and function. Proper preoperative planning, vascularized bone grafts, rigid fixation, flexibility of donor site choices, and restoration of labial, buccal, and lingual sulci lead to optimal reconstruction. We have used this approach in 38 patients; bony survival resulted in 37 and primary union in 35. A main limiting factor exists with individuals who have lost extensive amounts of soft tissue and muscle at the time of tumor resection or trauma. Only by attention to details in the preoperative, intraoperative, and postoperative phases can the best functional and aesthetic results be achieved.


A Digital Protein Microarray for COVID-19 Cytokine Storm Monitoring.
Despite widespread concern for cytokine storms leading to severe morbidity in COVID-19, rapid cytokine assays are not routinely available for monitoring critically ill patients. We report the clinical application of a machine learning-based digital protein microarray platform for rapid multiplex quantification of cytokines from critically ill COVID-19 patients admitted to the intensive care unit (ICU) at the University of Michigan Hospital. The platform comprises two low-cost modules: (i) a semi-automated fluidic dispensing/mixing module that can be operated inside a biosafety cabinet to minimize the exposure of technician to the virus infection and (ii) a 12-12-15 inch compact fluorescence optical scanner for the potential near-bedside readout. The platform enabled daily cytokine analysis in clinical practice with high sensitivity (<0.4pg/mL), inter-assay repeatability (~10% CV), and near-real-time operation with a 10 min assay incubation. A cytokine profiling test with the platform allowed us to observe clear interleukin-6 (IL-6) elevations after receiving tocilizumab (IL-6 inhibitor) while significant cytokine profile variability exists across all critically ill COVID-19 patients and to discover a weak correlation between IL-6 to clinical biomarkers, such as Ferritin and CRP. Our data revealed large subject-to-subject variability in a patient's response to anti-inflammatory treatment for COVID-19, reaffirming the need for a personalized strategy guided by rapid cytokine assays.


Relative merits of nuclear ribosomal internal transcribed spacers and mitochondrial CO1 and ND1 genes for distinguishing among Echinostoma species (Trematoda).
Cryptic species, belonging to the 37 collar-spine Echinostoma group, were distinguished using nuclear rDNA ITS (884 bases) and mtDNA CO1 (257 bases) and ND1 (530 bases) sequences. Sequences were obtained from five 37 collar-spine species, Echinostoma trivolvis, E. paraensei, E. caproni, E. revolutum and E. sp.I, a parthenogenetic isolate from Africa. Three geographic isolates of E. caproni were compared. Average sequence divergence among the 37 collar-spine species range from 2.2% in the rDNA ITS through 8% for the CO1 and 14% for the ND1. In addition, genes were sequenced from 2 non 37 collar-spine species, E. hortense and an undescribed Australian species, E. sp. (Aus). For each gene, distances of terminals from a predicted ancestral sequence were calculated. These indicated that ND1 is diverging significantly faster than the other 2 regions. In the CO1 gene most substitutions are synonymous and saturation has been reached for the majority of pairwise comparisons. The ND1 gene exhibits greater pairwise divergence but less evidence of saturation due to weaker conservation of first and second codon positions. The ITS has no amino acid coding constraints and displays no evidence of saturation. Although all 3 regions successfully distinguished the nominal species, ND1 appears to be the most informative region for investigating relationships within the 37 collar-spine group.


Appearance of common ultrasound artifacts in conventional vs. spatial compound imaging.
Abdominal sonographic artifacts produced by conventional and spatial compound sonographic imaging using linear and curved array transducers were compared. Spatial compound imaging produced multiple diverging ring-down artifacts from a single source with increasing width and decreasing intensity. Overlap of the diverging artifacts was conspicuous when the focal point was in the far field. Increased width and reduced intensity of acoustic shadowing artifacts was observed with spatial compound imaging. Edge shadowing was eliminated, or reduced. Diverging edge shadowing from the source of the artifact with reduced intensity was detected when the focal point was in the near field. There was no apparent difference of the acoustic enhancement artifact with spatial compound imaging. There was absence or reduction of clutter seen in the urinary bladder when using spatial compound imaging. The appearance of artifacts with spatial compound imaging is slightly different from those with conventional ultrasound imaging.


Plasmapheresis treatment in Guillain-Barré syndrome: potential benefit over intravenous immunoglobulin.
Guillain-Barré syndrome includes acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy, acute motor and sensory axonal neuropathy, Miller Fisher syndrome and acute pandysautonomia. Plasma exchange was the first treatment in Guillain-Barrd syndrome proven to be superior to supportive treatment alone and intravenous immunoglobulin was subsequently shown to be equally effective and is now commonly used as first-line treatment. We describe a 78-year-old woman who presented with a two-day history of progressive generalised weakness and left facial nerve palsy, preceded by a flu-like illness lasting for one week. A five-day course of daily immunoglobulin (0.4 g/kg/day) was commenced without benefit and progressive clinical deterioration. Seven days after completion of immunoglobulin treatment, plasma exchange was started with an exchange of about three litres of plasma every day for three days and every second day on two further occasions. A gradual improvement of respiratory function and peripheral muscle strength was observed after the first plasma exchange and on the eighth day the patient was weaned off mechanical ventilation. This case suggests that patients with severe Guillain-Barrd syndrome may benefit from plasma exchange after immunoglobulin treatment in refractory cases. Plasma exchange should be considered early in Guillain-Barrć syndrome cases with axonal involvement, and in the recurrent or familial Guillain-Barré syndrome forms.


A stability evaluation of a novel titanium dental implant/interconnected porous hydroxyapatite complex under functional loading conditions.
The aim of this study was to evaluate the stability of implant/interconnected porous calcium hydroxyapatite complex (implant/IPCHA-complex) under functional loading. Implant/IP-CHA-complexes were placed into the mandibles of four Beagle-Labrador hybrid dogs (complex-group). On the other side, an implant was placed directly (control-group). To subject the loading, the animals were fed a hard diet throughout the loading phase of 5 months. The implant stability quotients (ISQs) and bone implant contact (BIC), and histological evaluations were performed. The ISQs of implant/IP-CHA-complex was significantly lower at placement than that of the control-implant. On the other hand, there was no significant difference between in the groups during loading. The BIC measurements, there was no significantly difference between in both groups. Histologically, newly formed bone was observed in contact with most of the implant surface in the complex-group. An IP-CHA/implant-complex would be able to achieve both bone reconstruction and implant stability under functional loading conditions.


Lamotrigine treatment for post-stroke pathological laughing and crying.
Pathologic laughing and crying (PLC) is a common distressing and socially disabling condition in stroke patients. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have been increasingly recognized as the treatment of choice for pathologic crying (PC). However, little is known about etiologies and other treatment options for various clinical manifestations of PLC. This case report illustrates the beneficial effect of lamotrigine, a novel antiepileptic drug with antidepressant and mood-stabilizing properties in post-stroke PLC. A 60-year-old woman developed PLC after an ischemic stroke affecting the left frontal and temporal lobes. She was treated with lamotrigine initially at the dose of 50 mg a day, which was gradually increased to 100 mg a day over a 4-week period. There was a significant and rapid recovery in both laughing and crying components of PCL with lamotrigine treatment. The symptoms of pathologic laughing have shown a better response to lamotrigine than PC. Controlled investigations are needed to evaluate the beneficial as well as the differential effects of lamotrigine on PLC.


Contribution of relaxation technique training to the rehabilitation of myocardial infarction patients.
The usefulness of relaxation training (RT) in cardiac rehabilitation is assessed by comparing the changes before and after rehabilitation in two randomly divided groups, one with and the other without relaxation. The psychological effects of RT, in addition to the effects of exercise training, were studied. There is a substantial and positive result on well-being and on feelings of invalidity. Psychological improvement, as a result of exercise only, is not found. The benefits of RT occur more in persons with coronary-prone behavior pattern (type A). In some persons anxiety increases during rehabilitation (about 28%), regardless of RT. There is an indication that relaxation may lead to an increase of functional complaints in a small number of persons, possibly due to sensitization to bodily experiences.


Deep hypothermic intermittent circulatory arrest--an adjunct technique for operations on aneurysms involving the aortic arch.
Aneurysms involving the aortic arch were repaired in 12 patients using a technique known as deep hypothermic intermittent circulatory arrest (DHICA). This technique consists of repeated cycles of 20 min of circulatory arrest and 10 min of cerebral and systemic reperfusion. Aneurysms were of the following types: 2 true atherosclerotic aneurysm, 8 aortic dissections, and 2 traumatic aneurysm. There were 2 operative deaths caused by coagulopathy as a result of hepatic failure and difficulty with left ventricular venting. The frequency of circulatory arrest ranged from 2 to 5 cycles, and total circulatory arrest ranged from 20 to 71 min (mean 43.6 min). The lowest tympanic temperature ranged from 17.7 to 19.2 degrees C. No permanent cerebral complications occurred in 10 patients. We believe that this adjunct technique offers excellent results in the surgical treatment of aneurysms involving the aortic arch.


Examining Partnership Approaches for Engaging Fathers to Address Domestic Violence.
Little is known about partnerships fatherhood programs establish to engage fathers in addressing domestic violence (DV). The study aimed to (a) describe partnership activities between fatherhood programs and organizations that address DV, (b) highlight strategies for productive partnerships, and (c) identify areas in need of improvement for addressing DV. This study discusses findings from qualitative interviews with 27 individuals from 17 fatherhood and DV organizations across the United States including the variety of partnership activities used to prevent and address DV (e.g., conducting trainings or facilitating referrals); strategies for creating productive partnerships; and partnership areas that need further attention.


Patient engagement in a rapidly changing communication environment: reflections of a cancer survivor.
The shared decision-making paradigm calls for patients to become as knowledgeable as they can about their illnesses and treatment options. To foster their engagement, patients today have unprecedented access to an array of health information and communication applications facilitated by the Internet revolution. In this commentary, the author, a long-term cancer survivor, reflects on his recent experiences with heart disease and discusses how he has benefited from advances in communication technologies in his quest to become an informed patient, at the same time reminding the reader about the ever-enduring salience of the patient-clinician relationship.


Where Does Water Go During Hydraulic Fracturing?
During hydraulic fracturing millions of gallons of water are typically injected at high pressure into deep shale formations. This water can be housed in fractures, within the shale matrix, and can potentially migrate beyond the shale formation via fractures and/or faults raising environmental concerns. We describe a generic framework for producing estimates of the volume available in fractures and undamaged shale matrix where water injected into a representative shale site could reside during hydraulic fracturing, and apply it to a representative site that incorporates available field data. The amount of water that can be stored in the fractures is estimated by calculating the volume of all the fractures associated with a discrete fracture network (DFN) based on real data and using probability theory to estimate the volume of smaller fractures that are below the lower cutoff for the fracture radius in the DFN. The amount of water stored in the matrix is estimated utilizing two distinct methods-one using a two-phase model at the pore-scale and the other using a single-phase model at the continuum scale. Based on these calculations, it appears that most of the water resides in the matrix with a lesser amount in the fractures.


Bcl-2 protects against Abeta(25-35)-induced oxidative PC12 cell death by potentiation of antioxidant capacity.
A substantial body of data indicates that reactive oxygen intermediates (ROIs) are implicated in pathogenesis of diverse human diseases. Oxidative stress induced by ROIs often causes cell death via apoptosis that is regulated by a plenty of functional genes and their protein products. Bcl-2 is one such protein that blocks apoptosis induced by various death stimuli. In spite of extensive research, the molecular mechanisms underlying antiapoptotic function of Bcl-2 are not fully clarified. In the present work, we have investigated the role of bcl-2 in protecting against beta-amyloid (Abeta)-induced oxidative death in rat pheochromocytoma (PC12) cells. Transfection with the antiapoptotic bcl-2 gene rescued PC12 cells from apoptotic death induced by Abeta. Addition of an NF-kappaB inhibitor, such as pyrrolidine dithiocarbamate or N-tosyl-l-phenylalanine chloromethyl ketone, to the media aggravated Abeta-induced PC12 cell death. PC12 cells overexpressing bcl-2 exhibited higher levels of constitutively activated NF-kappaB compared with vector-transfected controls, which appear to be mediated by the elevated activation of Akt/protein kinase B. The ectopic expression of bcl-2 enhanced both the expression and the activity of catalase, which were attenuated by NF-kappaB blockers. These results suggest that NF-kappaB plays a role in bcl-2-mediated protection against Abeta-induced apoptosis in PC12 cells through augmentation of cellular antioxidant capacity.


Long-term subcutaneous interferon beta-1a therapy in patients with relapsing-remitting MS.
To conduct systematic long-term follow-up (LTFU) of patients in the Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis (PRISMS) study to provide up to 8 years of safety, clinical and MRI outcomes on subcutaneous (s.c.) interferon (IFN) beta-1a in relapsing-remitting multiple sclerosis (RRMS). The original cohort of 560 patients was randomized to IFNbeta-1a, 44 or 22 microg three times weekly (TIW) or to placebo; after 2 years, patients on placebo were rerandomized to active treatment and the blinded study continued for a further 4 years. The LTFU visit was scheduled 7 to 8 years after baseline. LTFU was attended by 68.2% of the original PRISMS study cohort (382/560 patients). 72.0% (275/382) were still receiving IFNbeta-1a s.c. TIW. Patients originally randomized to IFNbeta-1a 44 microg s.c. TIW showed lower Expanded Disability Status Scale progression, relapse rate and T2 burden of disease up to 8 years compared with those in the late treatment group. Brain parenchymal volume did not show differences by treatment group. Overall, 19.7% of patients progressed to secondary progressive MS between baseline and LTFU (75/381). No new safety concerns were identified and treatment was generally well tolerated. Despite the limitations inherent in any long-term study (for example, potential differences between returning and nonreturning patients), these results indicate that patients with relapsing-remitting multiple sclerosis can experience sustained benefit over many years from early interferon beta-1a subcutaneous therapy three times weekly compared with patients whose treatment is delayed. This effect was more apparent in the patients receiving the higher dose.


Evaluating the effectiveness of a micronutrient assessment tool for long-term total parenteral nutrition patients.
Monitoring parameters for patients receiving long-term home parenteral nutrition (HPN) should include assessment of micronutrient status to avoid deficiencies and potential excesses of any micronutrient. This evaluation examined the effectiveness of a standardized micronutrient assessment tool administered semiannually to long-term HPN consumers, for identifying signs/symptoms of a suspected deficiency or excess. All patients assessed were receiving long-term HPN from a single home-infusion provider. Of the 275 micronutrient assessments evaluated, 30 patients were found to have a suspected deficiency. Laboratory tests were ordered for 13 patients: deficiencies were confirmed in 6 patients, no deficiency was found in 4 patients, and 1 patient was not deficient in the suspected micronutrients but was found deficient in others. The micronutrient assessment tool is effective in determining the suspected presence of micronutrient deficiencies. All long-term HPN patients should receive ongoing monitoring by a home care clinician, including an assessment of micronutrient status, to ensure adequacy of the nutrition support regimen.


Lygistorrhinidae (Diptera: Bibionomorpha: Sciaroidea) in early Eocene Cambay amber.
One new genus and three new species of Lygistorrhinidae in early Eocene Cambay amber from India are described, which significantly increases our knowledge about this group in the Eocene. Lygistorrhina indica n. sp. is the oldest fossil known from this extant genus. Indorrhina sahnii n. gen. et sp. shows morphological similarities to each of the two extant genera Lygistorrhina and Asiorrhina. Palaeognoriste orientale is the third species known from a group that has only been recorded from Eocene Baltic amber before. The latter finding reveals faunal links between Cambay amber and the probably slightly younger Baltic amber, adding further evidence that faunal exchange between Europe/Asia and India took place before the formation of Cambay amber.


Changing trends in thyroid practice: understanding nodular thyroid disease.
To describe changes that have occurred between 1952 and 2002 in the evaluation and management of nodular thyroid disease. A 30-year personal experience, institutional contributions, and the related published literature on evaluation of thyroid function and evolving strategies for management of thyroid nodules are reviewed. Triiodothyronine (T(3)) was discovered in 1952, and measurement of plasma thyroxine by a competitive protein-binding technique became available in the 1960s. Late during that decade, the first radioimmunoassay for thyroid-stimulating hormone (TSH) was described, modified, and then used in clinical practice until the mid-1980s, when the more sensitive TSH assays became widely available. T(3) determination by radioimmunoassay was introduced early in the 1970s. Currently, sensitive thyroid function tests can detect early disease. In the general population, thyroid nodules have a prevalence higher than 50% after age 65 years, affecting more than 100 million people in the United States. Two important developments influenced thyroid nodule evaluation and management-- fine-needle aspiration (FNA) biopsy and ultrasonography. Because FNA biopsy has emerged as the most accurate test for nodule diagnosis, it has decreased the need for scanning and for thyroidectomy and thereby is likely to reduce health-care costs by more than $500 million annually in the United States. Thyroid ultrasonography is the imaging method of choice for evaluation of thyroid gland structure. Management of cytologically benign thyroid nodules remains controversial. TSH seems to be only one of many factors in pathologic thyroid growth. FNA, because of its diagnostic accuracy, should be the initial procedure used in nodule evaluation.


Amide Proton Transfer Imaging Allows Detection of Glioma Grades and Tumor Proliferation: Comparison with Ki-67 Expression and Proton MR Spectroscopy Imaging.
Prognosis in glioma depends strongly on tumor grade and proliferation. In this prospective study of patients with untreated primary cerebral gliomas, we investigated whether amide proton transfer-weighted imaging could reveal tumor proliferation and reliably distinguish low-grade from high-grade gliomas compared with Ki-67 expression and proton MR spectroscopy imaging. This study included 42 patients with low-grade (n = 28) or high-grade (n = 14) glioma, all of whom underwent conventional MR imaging, proton MR spectroscopy imaging, and amide proton transfer-weighted imaging on the same 3T scanner within 2 weeks before surgery. We assessed metabolites of choline and N-acetylaspartate from proton MR spectroscopy imaging and the asymmetric magnetization transfer ratio at 3.5 ppm from amide proton transfer-weighted imaging and compared them with histopathologic grade and immunohistochemical expression of the proliferation marker Ki-67 in the resected specimens. The asymmetric magnetization transfer ratio at 3.5 ppm values measured by different readers showed good concordance and were significantly higher in high-grade gliomas than in low-grade gliomas (3.61% ± 0.155 versus 2.64% ± 0.185, P = .0016), with sensitivity and specificity values of 92.9% and 71.4%, respectively, at a cutoff value of 2.93%. The asymmetric magnetization transfer ratio at 3.5 ppm values correlated with tumor grade (r = 0.506, P = .0006) and Ki-67 labeling index (r = 0.502, P = .002). For all patients, the asymmetric magnetization transfer ratio at 3.5 ppm correlated positively with choline (r = 0.43, P = .009) and choline/N-acetylaspartate ratio (r = 0.42, P = .01) and negatively with N-acetylaspartate (r = -0.455, P = .005). These correlations held for patients with low-grade gliomas versus those with high-grade gliomas, but the correlation coefficients were higher in high-grade gliomas (choline: r = 0.547, P = .053; N-acetylaspartate: r = -0.644, P = .017; choline/N-acetylaspartate: r = 0.583, P = .036). The asymmetric magnetization transfer ratio at 3.5 ppm may serve as a potential biomarker not only for assessing proliferation, but also for predicting histopathologic grades in gliomas.


Multiple-fluorophore-specie detection with a tapered Fabry-Perot fluorescence spectrometer.
A novel fluorescence spectrometer and method for the simultaneous detection of multiple-fluorophore species in a no-moving-parts, instantaneous manner is described. In the reported embodiment of the instrument, a tapered Fabry-Perot filter is used to spatially encode the fluorescence spectrum from a multiple-dye-containing test sample. Using a pseudoinverse reconstruction algorithm, we spectrally decode the particle concentration for each dye specie in the test sample. Experimental results are reported along with a theoretical treatment of the method.


Nurses' Experiences in Safe Handling of Chemotherapeutic Agents: The Taiwan Case.
Nurses are the least compliant with the guidelines for use of personal protective equipment (PPE) among health professionals. While the literature regarding nurses not following the guidelines focuses on nonuse of PPE, the experiences of using PPE from nurses' perspectives have not been examined. The aim of this study was to explore the concerns of nurses regarding their decision to use or not to use PPE in the cultural context of Taiwan. An ethnographic design was used, and ethnographic interviews of 57 nurses working with chemotherapy for more than 2 years were conducted. The participating nurses were observed in 2 accredited medical centers with oncology care teams in Taiwan. The constant comparison method was applied for data analysis, and cultural themes were generated from all transcripts. Wearing PPE was identified as an obstacle to professional image and performance. Nurses transformed safety into efficiency and prioritized social roles over professional roles. Experienced nurses, as insiders, believed that they have gained clinical wisdom to avoid occupational exposure to chemotherapy toxicity. This study explored the characteristics of clinical wisdom regarding PPE use in the context of Taiwanese chemotherapy care. Perceived professional image, efficiency on the job, PPE cost, and hospital rules influenced the use or nonuse of PPE by oncology care nurses. Acceptable nurse-patient ratios and refraining from chemotherapy toxicity exposure for pregnant and breast-feeding women are advocated for policy making. The experiential expertise of nurses should be shared as credible evidence in developing guidelines.


Understanding role of roots in plant response to drought: Way forward to climate-resilient crops.
Drought stress leads to a significant amount of agricultural crop loss. Thus, with changing climatic conditions, it is important to develop resilience measures in agricultural systems against drought stress. Roots play a crucial role in regulating plant development under drought stress. In this review, we have summarized the studies on the role of roots and root-mediated plant responses. We have also discussed the importance of root system architecture (RSA) and the various structural and anatomical changes that it undergoes to increase survival and productivity under drought. Various genes, transcription factors, and quantitative trait loci involved in regulating root growth and development are also discussed. A summarization of various instruments and software that can be used for high-throughput phenotyping in the field is also provided in this review. More comprehensive studies are required to help build a detailed understanding of RSA and associated traits for breeding drought-resilient cultivars.


The phenomenon of death: a study of Diploma in Higher Education nursing students' reality.
This study investigates Diploma in Higher Education nursing students' perceptions and experiences of the phenomenon of death. The sample size was eight students drawn from the adult branch. A phenomenological approach was used; data collection being via two focused group interviews/discussions. Four themes were identified which appeared to form the basis of the students' reality: knowing, reality, relationships and culture. The results suggest that self-knowledge and theoretical knowledge are important in the formation of their reality. The need to develop relationships with patients was identified as an important aspect of caregiving. Relationships with staff who offered support and guidance was seen as desirable. This was sometimes compromised by conflicting philosophies, but the desire to implement holistic care was apparent. The students appeared able to reflect with insight, openness and objectivity. They also appeared to be developing the ability to take an active part in the development of their own conceptual notions and perceptions. They did not appear to be disillusioned or socialized into roles they did not feel were appropriate. The need to maintain the educational input and reflective ability for the students is recommended. Names given to students in this study are fictitious. The study refers to the students as Diploma in Higher Education nursing students. This is often referred to as Project 2000.


Flow-through chemiluminescence sensor using immobilized histamine oxidase from Arthrobacter crystallopoietes KAIT-B-007 and peroxidase for selective determination of histamine.
A flow sensor with immobilized oxidases is proposed for the determination of histamine in fish meat. Chemiluminometric measurement of histamine was based on the luminol reaction with hydrogen peroxide produced by immobilized histamine oxidase (EC 1.4.3.-.) and peroxidase (EC 22.214.171.124.) within a flow cell. Histamine oxidase was found in cells of Arthrobacter crystallopoietes KAIT-B-007 isolated from soil. The oxidase and peroxidase were coimmobilized covalently on tresylated hydrophilic vinyl polymer beads and packed into transparent PTFE; the tubing was used as the flow cell. One assay for histamine was done at intervals of 2 min without carryover. The calibration curve for histamine was linear from 0.1 microM to 50 microM. The response was reproducible within 1.25% of the relative standard deviation for 115-replicate injections of 50 microM histamine. The sensor system was applied to the determination of histamine in fish meat extracts.


Community-academic partnerships: a "community-first" model to teach public health.
Physicians face complex public health issues in clinical practice today. We describe an innovative "community-first" model that teaches public health to medical students. The United Way of Chittenden County Volunteer Center (UWCCVC) in the State of Vermont, U.S.A., was chosen as the focal point for projects because of its documented history, success, and credibility. A simple form, sent to local community agencies, facilitated participation and identified Healthy People 2010 focus areas as the public health framework. Community agencies identified the health needs of populations that were served through this process. Projects were subsequently jointly developed and following student completion, assessed jointly by university faculty and community agency mentors. A total of 41 projects have been completed, spanning 11 different areas of Healthy People 2010. Many different local community agencies have participated. An annual poster session is held at project completion. Assessment includes both faculty mentor and community agency assessment of student groups' progress and project quality. Community agencies are surveyed following project completion. Nearly all community agencies agreed that projects benefited the populations served and anticipated continuing the partnership. Putting community public health needs first, in developing projects, was critical to success. This "community-first" model provides opportunities to teach public health and benefit health in local communities.


Discordance in clinical versus pathological staging in breast cancer: Are we undermining the significance of accurate preoperative staging in the present era?
The present era of individualized treatment for breast cancer is influenced by the initial disease status including the anatomical extent, grade, and receptor status. An accurate preoperative staging is the basis of treatment planning and prognostication. Our study aims to determine the discordance between the preoperative clinical and the postoperative pathological stages of breast cancer patients. The medical records of all non-metastatic breast cancer patients from January 2017 to December 2018 who underwent upfront surgery were reviewed. They were staged as per the eighth AJCC and the concordance between the clinical (c) and pathological T (tumor), N (nodal), and final AJCC stage was studied. A Chi-square test was used to determine factors that significantly correlate with disease discordance. A total of 307 breast cancer patients were analyzed. Among these, 43.3% were hormone receptor-positive, 30.6% were Her2 positive and 26% were triple-negative. Overall stage discordance was seen in 48.5% (n = 149) patients (upstaging in 22.1%, downstaging in 26.4%). The discordance rate was 48.9% for T stage (cT versus pT) and 57.4% for N stage (cN versus pN). Among patients with clinically node-negative disease, 53.4% were found to have positive nodes on histopathology, while 27.2% had vice versa. Overall, the factors associated with upstaging were ER-positive, Her2 positive and triple-negative status (all p < 0.05), while none of the factors showed significant association with downstaging. About half of breast cancer patients had discordance between clinical and pathological staging with higher discordance in the nodal stage. This changes the disease prognosis, and may also affect the offered surgical treatment and radiotherapy. Thus highlighting the need for a precise pre-operative staging. Also, this information will aid clinicians in discussions with patients, keeping in mind the likelihood of change in disease staging and management.


Antiepileptic drug discovery: lessons from the past and future challenges.
Historically, most antiepileptic drugs (AEDs) have been discovered either by serendipity, or the screening of compounds using acute seizure models. However, an increasing understanding of the molecular mechanisms underlying epileptogenesis has led to more rational approaches to drug discovery, which have focused on either enhancing inhibitory gamma-amino butyric acid (GABA)-ergic, or antagonizing excitatory glutamatergic, neurotransmission. Unfortunately, AEDs generated using such strategies have poor efficacy and safety profiles, as they interfere with normal cell processes, while ignoring the complex underlying pathophysiology of epilepsy. Recently, however, the use of new epilepsy models has led to the discovery of levetiracetam, an AED with a truly unique mechanism of action, devoid of anticonvulsant activity in normal animals, but with potent seizure suppression in genetic and kindled chronic epilepsy models, and an unusually high safety margin. The recent identification of brivaracetam and seletracetam, which optimize this unique mechanism of action, may further improve the medical management of epilepsy. The experience with levetiracetam, brivaracetam and seletracetam reveals that new experimental epilepsy models can detect AEDs possessing a unique mechanism of action and thereby target the future challenge of providing clinicians novel additions to the current armamentarium of AEDs.


Modeling evidence accumulation decision processes using integral equations: Urgency-gating and collapsing boundaries.
Diffusion models of evidence accumulation have successfully accounted for the distributions of response times and choice probabilities from many experimental tasks, but recently their assumption that evidence is accumulated at a constant rate to constant decision boundaries has been challenged. One model assumes that decision-makers seek to optimize their performance by using decision boundaries that collapse over time. Another model assumes that evidence does not accumulate and is represented by a stationary distribution that is gated by an urgency signal to make a response. We present explicit, integral-equation expressions for the first-passage time distributions of the urgency-gating and collapsing-bounds models and use them to identify conditions under which the models are equivalent. We combine these expressions with a dynamic model of stimulus encoding that allows the effects of perceptual and decisional integration to be distinguished. We compare the resulting models to the standard diffusion model with variability in drift rates on data from three experimental paradigms in which stimulus information was either constant or changed over time. The standard diffusion model was the best model for tasks with constant stimulus information; the models with time-varying urgency or decision bounds performed similarly to the standard diffusion model on tasks with changing stimulus information. We found little support for the claim that evidence does not accumulate and attribute the good performance of the time-varying models on changing-stimulus tasks to their increased flexibility and not to their ability to account for systematic experimental effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


A Platform to Enable the Pharmacological Profiling of Small Molecules in Gel-Based Electrophoretic Mobility Shift Assays.
We describe a polyacrylamide gel casting cassette that overcomes limitations of commercially available gel electrophoresis equipment. This apparatus molds a single polyacrylamide gel that can evaluate more than 200 samples in parallel, is loaded with a multichannel pipettor, and is flexible with respect to composition of the separating matrix. We demonstrate its use to characterize inhibitors of enzymes that modify protein and nucleic acid substrates. Throughputs of greater than 1000 samples per day were achieved when this system was paired with a quantitative laser-based imaging system, yielding data of remarkable quality.


The relationships between atherosclerosis, heart disease, type 2 diabetes and dementia.
Type 2 diabetes in the elderly is associated with increased incidence of vascular disease, particularly, atherosclerosis of large blood vessels. Together with other risk factors such as dyslipidemia, atherosclerosis increases the risk for coronary heart disease and stroke. Most studies that have examined the impact of type 2 diabetes and other heart disease risk factors on cognitive functions do not provide evidence that heart disease risk factors (with the possible exception of triglycerides) further increase the likelihood of observing cognitive deficits in diabetic patients. However, none of these studies used imaging techniques to evaluate atherosclerosis or evidence of cerebrovascular disease, such as infarctions. The few studies that have included brain imaging suggest that evidence of cerebrovascular disease further increases the risk for dementia in diabetic patients. The results of longitudinal studies suggest that diabetes is an independent risk factor for cognitive decline and dementia. The pattern of neuropsychological performance observed in type 2 diabetic patients appears to be the result of multiple interacting processes developing over time. In addition to the detrimental effects of protracted impaired glucose regulation on the central nervous system, type 2 diabetes pathology also encompasses the detrimental effects of associated complications such as cerebrovascular disease, which is likely the main cause of the observed processing speed/reaction time decrements.


[Posterior variant of Alzheimer's disease and other atypical symptom pictures].
Neuropathologically confirmed Alzheimer's disease may begin with symptoms other than memory problems, for instance visual perceptual disorders, difficulties in linguistic functions and expression in spoken language or executive functioning, occasionally even with behavioral symptoms. Among the forms of Alzheimer's disease appearing with atypical symptoms, the best know is the so-called posterior variant. The diagnosis is based on neuropsychological examination and findings in imaging. Additional diagnostic help is provided by the determination of markers for Alzheimer's disease in cerebrospinal fluid, as changes in markers correspond to the findings in traditional Alzheimer's disease.


Effects of perioperative factors and hip geometry on hip abductor muscle strength during the first 6 months after anterolateral total hip arthroplasty.
[Purpose] The importance and effect of hip joint geometry on hip abductor muscle strength are well known. In addition, other perioperative factors are also known to affect hip abductor muscle strength. This study examined the relative importance of factors affecting hip abductor muscle strength after total hip arthroplasty. [Subjects and Methods] The subjects were 97 females with osteoarthritis scheduled for primary unilateral THA. The following variables were assessed preoperatively and 2 and 6 months after surgery: isometric hip abductor strength, radiographic analysis (Crowe class, postoperative femoral offset (FO)), Frenchay Activities Index, compliance rate with home exercise, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and demographic data. Factors related to isometric hip abductor muscle strength 2 and 6 months after surgery were examined. [Results] Significant factors related to isometric hip abductor muscle strength at 2 and 6 months after surgery were, in extraction order: 1. isometric hip abductor muscle strength in the preoperative period; 2. BMI; and 3. the JHEQ mental score at 2 and 6 months after surgery. [Conclusion] Preoperative factors and postoperative mental status were related to postoperative isometric hip abductor strength. FO was not extracted as a significant factor related to postoperative isomeric hip abductor strength.


Determining pesticide residues in wheat flour by ultrahigh-performance liquid chromatography/quadrupole time-of-flight mass spectrometry with QuEChERS extraction.
Pesticides are used to increase crop yields and preserve quality by protecting crops against pests; however, their overuse can adversely affect human health and the environment. Herein, we report the development of a multi-pesticide screening method using optimized QuEChERS coupled with liquid chromatography/quadrupole time-of-flight (QTOF) mass spectrometry for the analysis of 13 pesticides in wheat flour. Mass accuracies with errors of less than 2.4 ppm were obtained for all analysed pesticides, and the method provided satisfactory recovery and linearity. Repeatabilities of 0.3-12.7% and reproducibilities of 2.5-15.2% were observed in full-scan TOF mode. The performance of the developed full-scan TOF method was compared to that obtained in high-resolution multiple reaction monitoring (MRM-HR) mode. The limits of quantification for the full-scan TOF and MRM-HR modes ranged from 2 to 10, and 3 to 9 μg kg-1, respectively. The two quantification methods exhibited high sensitivities (limit of detections: 1-3 μg kg-1 in full-scan TOF, and 1-3 μg kg-1 for MRM-HR mode). No pesticide residues were detected when the developed method was applied to 22 real wheat flour samples.


Evaluation of risk factors, diagnosis and treatment in carcinoma breast--a retrospective study.
Breast cancer is becoming more common in societies that hitherto enjoyed a low incidence of the disease. In countries like Nepal, it is one of the common malignancies in females, and its incidence is increasing with changing lifestyles, demographic and socioeconomic profiles. Ignorance on the part of the patient, lack of screening programmes and diagnostic facilities combine to increase the morbidity and mortality. This study was done to determine the risk factors, assess common modes of presentation in breast malignancies, and to evaluate treatment modalities commonly employed to manage them. A retrospective analysis of new cases of carcinoma breast admitted to BP Koirala Institute of Health Sciences over a period of 5 years (April 2000-February 2005) was carried out. A total of 75 cases were studied to collect data on risk factors, clinical profile and treatment. Old cases and those with inadequate documentation were excluded. There were 70 females and 5 males; the mean age was 62.6 years in males and 45.7 years in females. The age at menarche ranged from 11-16 years, the mean being 13.47 years. Among the females, 45.71% were post-menopausal. History of breast carcinoma in first-degree relatives was present in 6.67% of the patients. The mean duration of symptoms before presentation was 13.6 months, most patients presenting with a painless lump. The majority of tumours were in the upper outer quadrant (36%), with 88% of patients presenting in Stage III and IV. Surgery was performed in 46 patients, 65.22% underwent Modified radical mastectomy, and chemotherapy was provided to 33 patients. Combination therapy was given to 16 patients. Breast cancer occurred mostly in middle-aged, married, multiparous females, most of whom presented at an advanced stage. Modified radical mastectomy was the most commonly performed operation.


The role of colony stimulating factors, interleukin 1 and stromal extracellular matrix in the regulation of stem cell development.
In recent years increasing attention has been paid to elucidating the way in which stem cell development is regulated. There have been essentially two in vitro approaches to the problem. In the first approach, haemopoietic stem cells have been cultured on adherent bone marrow stroma (long-term bone marrow culture): this has revealed the importance of stromal-stem cell interactions. In the second approach haemopoietic cells have been cultured in short-term clonogenic systems: this has shown the importance of a group of growth factors, the colony stimulating factors (CSFs). Work carried out by our group has provided a link between these two systems, as heparan sulphate a component of the stromal extra-cellular matrix is able to bind CSFs and present them to the stem cells in an active form. Furthermore, we have shown that synergistic interactions between combinations of CSFs, or between CSFs and IL-1 have a potentially critical role to play in stem cell development, due to their ability to stimulate a proportion of IL-3 responsive, multi-potential cells. This provides a possible explanation for the growth and development of stem cells in association with stromal cells in the apparent absence of IL-3 production by stroma.


Molecular phylogeny of the butterfly genus Polytremis (Hesperiidae, Hesperiinae, Baorini) in China.
The genus Polytremis, restricted to the continental part of the southeastern Palaearctic and northern Oriental regions, is one of the largest and most diverse lineages of the tribe Baorini. Previous studies on the genus were focused mainly on morphological classification and identification of new species. Due to the lack of effective and homologous traits of morphology, there were many challenges in the traditional classification. In this report, we reconstruct the phylogeny to provide a solid framework for these studies and to test the traditional limits and relationships of taxa. We sequenced a mitochondrial and three nuclear gene fragments, coupled with an evaluation of traditional morphological characters, to determine the phylogenetic relationships for a total of 15 species representing all major species groups of the Polytremis genus in China, and to elucidate their taxonomic status. Analysis of mitochrondial and nuclear DNA showed considerable congruent phylogenetic signal in topology at the inter-species level. We found strong support for the monophyly of Polytremis and some clades were recognized with morphological data. Thus, the COI sequence in our study could be used as a DNA barcode to identify almost all members of the genus. However, incongruences of phylogenetic analyses occurred: in contrast to the phylogenetic trees of mitochondrial COI, it was not possible for nuclear rDNA to discriminate P. gotama from P. caerulescens, suggesting a possible recent separation of these two species. Additionally, P. theca was the only species with a greater intra-specific genetic distance compared to some inter-specific genetic distances in this study and some problems associated with the cryptic diversity of the species are discussed. The results of this study will helpful to reveal the causes of the high degree of diversity of butterflies, and possibly other groups of insects in China.


Preeclampsia and eclampsia-specific maternal mortality in Bangladesh: Levels, trends, timing, and care-seeking practices.
Despite improvements in many health indicators, maternal mortality has plateaued in Bangladesh. Achieving the global target of reductions in maternal mortality and the associated Sustainable Development Goals will not be possible without actions to prevent deaths due to preeclampsia/eclampsia. Here we examined the levels, trends, specific causes, timing, place, and care-seeking behaviours of women who died due to these two causes. We used nationally representative Bangladesh Maternal Mortality and Health Care Surveys (BMMSs) conducted in 2001, 2010, and 2016 to examine levels and trends of deaths due to preeclampsia/eclampsia. We based the analysis of specific causes, timing, and place of preeclampsia/eclampsia deaths, and care seeking before the deaths on 41 such deaths captured in the 2016 survey. We also used BMMS 2016 survey verbal autopsy (VA) questionnaire to highlight stories that put faces to the numbers. The preeclampsia/eclampsia-specific mortality ratio decreased from 77 per 100 000 live births in the 2001 BMMS to 40 per 100 000 live births in the 2010 BMMS, yet halted in the 2016 BMMS at 46 per 100 000 live births. Although preeclampsia/eclampsia accounted for around one-fifth of all maternal deaths in the 2010 BMMS, in the 2016 BMMS, the percentage contribution reached the 2001 BMMS level of 24%. An analysis of the VA questionnaire's open section showed that almost all such death cases left their homes to seek care; however, most had to visit more than one facility before they died, indicating an unprepared health system. A cluster of preeclampsia/eclampsia-specific mortality observed during the first trimester, during delivery, and within 48 hours of birth indicates a need for preconception health check-ups and strengthened facility readiness. Awareness of maternal complications, proper care seeking, and healthy reproductive practices, like family planning to space and limit pregnancy through client-supportive counselling, may be beneficial. Improving regular and emergency maternal services readiness is also essential.


Optimal septum alignment of the Figulla Flex occluder to the atrial septum in patients with secundum atrial septal defects.
To investigate the implantation safety, anatomic performance and septal alignment of the Occlutech Figulla Flex occluder (FFO) device, an atrial septal defect (ASD) closure device with specific left-sided deployment characteristics and right-sided septal alignment properties. Between January 2011 and December 2013 we prospectively collected the change of orientation of the device to the septum during the release process and the feasibility of implantation of the FFO in 122 patients. The mean age was 10.7 years (±10.2), weight 32.9 kg (±20.3), and height 129.4 cm (±30). Devices used were 9 (n=13), 10.5 (n=16), 12 (n=16), 15 (n=39), 18 (n=17), 21 (n=8), 24 (n=5), 27 (n=7) and 30 mm (n=3) in size. No additional implantation techniques were required. Before release, the mean angles of the left and right-sided discs were 29.2° (±9.9°) and 43.4° (±9.2°) to the body axis, and 18.7° (±8.7°) and 27.0° (±10°) immediately thereafter. Thus, there was only a slight change in orientation of the left-sided (10.6°±7.5°) and right-sided (16.3°±7.9°) discs. The design of this occluder system results in an ideal septum alignment which increases its feasibility as well as patient safety during implantation.


Allergic contact dermatitis from modified colophonium in wound dressings.
This study concerns a 69-year-old female patient with a longstanding history of venous ulcerations on both lower legs and multiple sensitivities, who developed eczematous lesions with the hydrocolloid dressing Combiderm (Convatec Ltd., a Bristol-Myers Squibb division, Ickenham, Middlesex, UK). Epicutaneous tests were positive to this dressing and to a modified colophonium derivative, i.e. glyceryl rosinate, however not to the unmodified colophonium from the standard series. A review of the literature showed several case reports about sensitization to similar hydrocolloids being distributed under various brand names in different countries and which contain the pentaerythritol ester of the hydrogenated rosin as the tackifying agent. Some of the patients described did, while others did not, react to colophonium but only to a modified derivative. In our patient, the reaction to glyceryl rosinate most probably represent cross-sensitivity with the modified colophonium derivative used in Combiderm, the presence (but not the exact nature) of which was showed by the company. In patients where allergic contact dermatitis from hydrocolloid dressings is strongly suspected and colophonium tests negatively, patch testing to modified colophonium derivatives should therefore be performed. As the complete composition of wound dressings is most often unknown, we urgently advocate legal requirements for labelling of those and in fact all medically used devices.


Identification of a de novo mutation in TLK1 associated with a neurodevelopmental disorder and immunodeficiency.
The Tousled-like kinases 1 and 2 (TLK1/TLK2) regulate DNA replication, repair and chromatin maintenance. TLK2 variants are associated with 'Intellectual Disability, Autosomal Dominant 57' (MRD57), a neurodevelopmental disorder (NDD) characterized by intellectual disability (ID), autism spectrum disorder (ASD) and microcephaly. Several TLK1 variants have been reported in NDDs but their functional significance is unknown. A male patient presenting with ID, seizures, global developmental delay, hypothyroidism, and primary immunodeficiency was determined to have a novel, heterozygous variant in TLK1 (c.1435C>G, p.Q479E) by genome sequencing (GS). Single cell gel electrophoresis, western blot, flow cytometry and RNA-seq were performed in patient-derived lymphoblast cell lines. In silico, biochemical and proteomic analysis were used to determine the functional impact of the p.Q479E variant and previously reported NDD-associated TLK1 variant, p.M566T. Transcriptome sequencing in patient-derived cells confirmed expression of TLK1 transcripts carrying the p.Q479E variant and revealed alterations in genes involved in class switch recombination and cytokine signaling. Cells expressing the p.Q479E variant exhibited reduced cytokine responses and higher levels of spontaneous DNA damage but not increased sensitivity to radiation or DNA repair defects. The p.Q479E and p.M566T variants impaired kinase activity but did not strongly alter localization or proximal protein interactions. Our study provides the first functional characterization of TLK1 variants associated with NDDs and suggests potential involvement in central nervous system and immune system development. Our results indicate that, like TLK2 variants, TLK1 variants may impact development in multiple tissues and should be considered in the diagnosis of rare NDDs.


[Desloratadine for chronic idiopathic urticaria].
Chronic idiopathic urticaria (CIU) is a common and frustrating disorder defined as a regular recurrence of hives for a period of more than 6 weeks, and has a major impact on patients' daily quality of life--H1 receptor antagonists are considered to be particularly effective in reducing pruritus, and are recommended as first-line treatment in patients with CIU. However, the efficacy of the treatment is insufficient. To evaluate the efficacy of desloratadine in CIU in Israeli patients. An open label multicenter study in 10 centers in Israel. Upon completion of 3-14 days screening for eligibility, eligible patients were given desloratadine 5 mg for 4 weeks. The DLQI questionnaire and the severity of CIU were assessed at baseline and each week for 28 days. One hundred and four patients aged 19 to 85 years (mean +/- SD 45.6 +/- 15.6) who suffered from moderate CIU, despite previous treatment with anti-histamine agents, were selected and treated with desloratadine 5 mg daily for 28 days. There was significant improvement for dermatologic quality of life in each of 10 parameters and in work productivity, and significant decrease in CIU symptoms and signs including the number and size of hives. In the overall evaluation of treatment 51% of patients reported complete or marked relief and 20% had no relief. Adverse events were reported as mild in 10 patients and moderate to severe in 2 patients who discontinued the study due to headache. Desloratadine can be successfully used in the treatment of CIU.


FUS regulates RAN translation through modulating the G-quadruplex structure of GGGGCC repeat RNA in C9orf72-linked ALS/FTD.
Abnormal expansions of GGGGCC repeat sequence in the noncoding region of the C9orf72 gene is the most common cause of familial amyotrophic lateral sclerosis and frontotemporal dementia (C9-ALS/FTD). The expanded repeat sequence is translated into dipeptide repeat proteins (DPRs) by noncanonical repeat-associated non-AUG (RAN) translation. Since DPRs play central roles in the pathogenesis of C9-ALS/FTD, we here investigate the regulatory mechanisms of RAN translation, focusing on the effects of RNA-binding proteins (RBPs) targeting GGGGCC repeat RNAs. Using C9-ALS/FTD model flies, we demonstrated that the ALS/FTD-linked RBP FUS suppresses RAN translation and neurodegeneration in an RNA-binding activity-dependent manner. Moreover, we found that FUS directly binds to and modulates the G-quadruplex structure of GGGGCC repeat RNA as an RNA chaperone, resulting in the suppression of RAN translation in vitro. These results reveal a previously unrecognized regulatory mechanism of RAN translation by G-quadruplex-targeting RBPs, providing therapeutic insights for C9-ALS/FTD and other repeat expansion diseases.


Gold(I)-Catalyzed Substitution-Controlled Syntheses of Spiro[indoline-3,3'-pyrrolidine] and Spiro[indoline-3,3'-piperidine] Derivatives.
Spiro[indoline-3,3'-pyrrolidine] and spiro[indoline-3,3'-piperidine] derivatives were synthesized in a substitution-controlled manner under the catalysis of cationic gold(I) species in the presence of Hantzsch ester (HEH). The optimal reaction condition was determined by screening, and the functional group tolerances of these two pathways were examined by readily synthetic substrates. The endo and exo selectivities of these cyclizations were elucidated by density functional theory calculations, and a plausible mechanism for these transformations was proposed.


Family functioning and eating disorders treatment in a partial hospitalization program in adolescent females with eating disorders.
Previous research examining family functioning in eating disorder (ED) treatment has focused primarily on outpatient settings. However, few studies have examined this aspect in partial hospitalization programs. To address this gap, this study examined family functioning over the course of an ED partial hospitalization program (PHP) in adolescent females (M(SD) age = 15.66 (1.50)). Participants (n = 105) completed the Family Assessment Device and Eating Disorder Examination Questionnaire at treatment admission, 1-month post-admission, and discharge. Results from repeated measures analysis of variance indicated adolescents perceived an improvement in family functioning regarding Communication, Affective Responsiveness, and Behavioral Control through 1-year follow-up (p values < .05). Neither family functioning at admission nor change in family functioning in the first month correlated with any outcomes (weight, ED symptoms, and remission). Results support that family functioning does not contribute to ED severity, and that treatment can improve adolescent perception of family functioning. Given the importance of involving the family in ED treatment, identifying mediators of treatment outcomes is critical to improve treatment efficacy. Adolescents in a partial hospital program (PHP) for eating disorders (EDs) perceived improvements in their family communication, behavior, and ability to process appropriate emotions from admission to 1-year post-treatment, although these aspects did not significantly predict treatment outcomes. The findings provide helpful information for future research on adolescents with EDs in higher levels of care and underscore the importance of exploring mechanisms of family-based treatment in PHP.


Hematopoietic bone marrow within the proximal humeral epiphysis in normal adults: investigation with MR imaging.
The occurrence of hematopoietic bone marrow within the axial skeleton and meta-diaphyseal regions of long bones is well known. However, it has been generally accepted that hematopoietic marrow is not present within the epiphysis of long bones in normal adults. This study involved evaluation of marrow patterns in 96 patients presenting for shoulder magnetic resonance (MR) imaging examinations. Residual hematopoietic marrow was present within the proximal humeral metaphysis in 99% of patients and extended into the epiphysis in 62%. Epiphyseal hematopoietic marrow was more prominent in female subjects (P = .015) and showed correlation with prominence of hematopoietic marrow within the proximal humeral metaphysis (P = .01). The most characteristic pattern was a curvilinear distribution of hematopoietic marrow involving the subcortical region of the medial humeral head, though in some patients more centrally located patchy or globular regions of hematopoietic marrow were observed. These findings indicate that when signal intensity variations are observed within the epiphysis on MR images, the possibility of residual or reconverted hematopoietic marrow should be considered.


"Clusterization" and intermittency of temperature fluctuations in turbulent convection.
Temperature time traces are obtained in turbulent thermal convection at high Rayleigh numbers. Measurements are made in the midplane of the apparatus, near the sidewall but outside the boundary layer. A telegraph approximation for temperature traces is generated by setting the fluctuation amplitude to 1 or 0 depending on whether or not it exceeds the mean value. Unlike the standard diagnostics of intermittency, the telegraph approximation allows one to distinguish the tendency of events to cluster (clusterization) from their large-scale variability in amplitude. A qualitative conclusion is that amplitude intermittency might mitigate clusterization effects.


Beneath the surface.
Karina Jackson has designed an educational programme to give parents the information they need to care for their child's eczema.


Normal Expression of SRY-related HMG-BOX Gene 10 (SOX-10) in Recent and Old Cutaneous Scars is a Potential Mimicker of Desmoplastic Malignant Melanoma.
Desmoplastic malignant melanoma (DMM) is an amelanotic spindle cell proliferation that can be mistaken for a cutaneous scar. The distinction can be difficult in reexcisions because DMM is negative for conventional melanoma markers such as HMB-45 and Melan-A, and scars may be positive for S-100 protein and SOX-10. We compare a total of 12 DMM cases with 8 reexcision and 35 old non-reexcision cutaneous scars using SOX-10 immunohistochemical stains. Cell quantification was performed on captured images using ImageJ 1.51t. SOX-10 was expressed in DMM (100%, 12/12), and reexcision (75%, 6/8), atrophic (88%, 22/25), hypertrophic (100%, 8/8), and keloid-type (100%, 2/2) scars. The cellular density of SOX-10 positive cells in DMM (822.9±116.9 cells/mm, mean±SEM) was significantly higher than in any scar subgroup (hypertrophic: 188.4±20.40 cells/mm, atrophic: 83.78±11.13 cells/mm, reexcision: 96.72±30.13 cells/mm, P<0.0001). Hypercellular areas in reexcision scars showed dense positivity as hypocellular areas in DMM (upper limit for scars: 258.42 positive cells/mm vs. lower limit for DMM: 292.42 positive cells/mm). SOX-10 positive cells in scars are predominantly monomorphic and small following the overall directionality of the tissue. In contrast, DMM cells exhibited enlarged atypical nuclei with a haphazard distribution, invasion as single cells or in clusters, and tropism for adnexal structures (58%) and neurovascular bundles (67%). In conclusion, cutaneous scars contain SOX-10 positive cells. The evaluation of residual DMM needs careful attention to morphologic characteristics to avoid over-interpretation of SOX-10 immunostains.


Intravascular large B-cell lymphoma presenting as acute hemorrhagic cerebral infarct with delirium.
Intravascular large B-cell lymphoma (IVLBCL) is a cumbersome diagnosis to make in vivo, particularly because of its elusive nature and ability to be a relatively nonspecific 'great mimicker'. Although it frequently has skin manifestations, it often escapes diagnosis due to its angiotrophism and predilection for vessels that are difficult to biopsy (e.g., cerebral vasculature). IVLBCL can involve the vasculature of virtually any organ but typically spares the lymph nodes themselves, and likely due to defects in adhesion molecules, remains stationary in the vessels. Histologically, the malignant lymphocytes are large and mitotically active with prominent nucleoli. Immunohistochemically, the cells stain as B-cells. The disease has an overall poor prognosis. Here we present a case of IVLBCL diagnosed at autopsy that presented as a hemorrhagic frontal lobe infarct, which progressed to delirium.


Consequences of early adverse rearing experience(EARE) on development: insights from non-human primate studies.
Early rearing experiences are important in one's whole life, whereas early adverse rearing experience(EARE) is usually related to various physical and mental disorders in later life. Although there were many studies on human and animals, regarding the effect of EARE on brain development, neuroendocrine systems, as well as the consequential mental disorders and behavioral abnormalities, the underlying mechanisms remain unclear. Due to the close genetic relationship and similarity in social organizations with humans, non-human primate(NHP) studies were performed for over 60 years. Various EARE models were developed to disrupt the early normal interactions between infants and mothers or peers. Those studies provided important insights of EARE induced effects on the physiological and behavioral systems of NHPs across life span, such as social behaviors(including disturbance behavior, social deficiency, sexual behavior, etc), learning and memory ability, brain structural and functional developments(including influences on neurons and glia cells, neuroendocrine systems, e.g., hypothalamic-pituitary-adrenal(HPA) axis, etc). In this review, the effects of EARE and the underlying epigenetic mechanisms were comprehensively summarized and the possibility of rehabilitation was discussed.


Isobaric Tags for Relative and Absolute Quantitation (iTRAQ)-Based Proteomic Analysis of Hugan Qingzhi and Its Protective Properties against Free Fatty Acid-Induced L02 Hepatocyte Injury.
In previous research, Hugan Qingzhi, a traditional Chinese medicine, was shown to have protective effects against hepatic steatosis. However, its activity against non-alcoholic fatty liver disease (NAFLD) and the mechanisms by which it exerts its effects remain unknown. In the present study, the effects of Hugan Qingzhi on free fatty acid (FFA)-induced L02 cells were examined. The techniques of iTRAQ labeling, together with strong cation exchange-non-liquid chromatography-tandem mass spectrometry (SCX-non-LC-MS/MS) analysis and serum pharmacology, were used to evaluate the effects of Hugan Qingzhi-medicated serum on FFA-induced L02 hepatocyte injury. Results identified 355 differentially expressed proteins following FFA treatment, compared with a control group; 359 altered proteins in the Hugan Qingzhi high dose + FFA treatment group, compared with the FFA treatment group; and 365 altered proteins in the Hugan Qingzhi high dose + FFA treatment group, compared with the control group. Based on the Kyoto Encyclopedia of Gene and Genomes pathway enrichment analysis, it is concluded that several pathways including those of microbial metabolism in diverse environments, fatty acid metabolism, peroxisome proliferator activated receptor signaling, and mitogen-activated protein kinase signaling are closely associated with the effects of Hugan Qingzhi-medicated serum in FFA-induced L02 hepatocyte injury. Furthermore, several differentially expressed proteins, including heat shock protein 27 (HSP27), acetyl-CoA acetyltransferase 1, calnexin, and integrin-linked kinase, were validated by western blotting. A target-specific HSP27 siRNA was used to investigate further the function of HSP27, and it was found that HSP27 might have a key role in the observable effects of Hugan Qingzhi-medicated serum in FFA-induced L02 hepatocyte injury. The results not only confirmed that Hugan Qingzhi exhibits a significant protective effect in FFA-induced L02 hepatocyte injury, but also suggest insights into the mechanism of such protective effects.


Influence of long-term dietary administration of procymidone, a fungicide with anti-androgenic effects, or the phytoestrogen genistein to rats on the pituitary-gonadal axis and Leydig cell steroidogenesis.
Procymidone is a fungicide with anti-androgenic properties, widely used to protect fruits from fungal infection. Thereby it contaminates fruit products prepared for human consumption. Genistein-containing soy products are increasingly used as food additives with health-promoting properties. Therefore we examined the effects of long-term dietary administration (3 months) of the anti-androgen procymidone (26.4 mg/animal per day) or the phytoestrogen genistein (21.1 mg/animal per day) to rats on the pituitary-gonadal axis in vivo, as well as on Leydig cell steroidogenesis and on spermatogenesis ex vivo. The procymidone-containing diet elevated serum levels of LH and testosterone and, furthermore, Leydig cells isolated from procymidone-treated animals displayed an enhanced capacity for producing testosterone in response to stimulation by hCG or dibutyryl cAMP, as well as elevated expression of steroidogenic acute regulatory protein (StAR), cytochrome P450 side-chain cleavage (P450 scc) and cytochrome P450 17alpha (P450c17). In contrast, the rate of DNA synthesis during stages VIII and IX of spermatogenesis in segments of seminiferous tubules isolated from genistein-treated rats was decreased without accompanying changes in the serum level of either LH or testosterone. Nonetheless, genistein did suppress the ex vivo steroidogenic response of Leydig cells to hCG or dibutyryl cAMP by down-regulating their expression of P450 scc. Considered together, our present findings demonstrate that long-term dietary administration of procymidone or genistein to rats exerts different effects on the pituitary-gonadal axis in vivo and on Leydig cell steroidogenesis ex vivo. Possibly as a result of disruption of hormonal feedback control due to its anti-androgenic action, procymidone activates this endocrine axis, thereby causing hyper-gonadotropic activation of testicular steroidogenesis. In contrast, genistein influences spermatogenesis and significantly inhibits Leydig cell steroidogenesis ex vivo without altering the serum level of either LH or testosterone.


Age and adaptation to Ca and P deficiencies: 2. Impacts on amino acid digestibility and phytase efficacy in broilers.
A total of 1,152 straight-run hatchling Heritage 56M×fast feathering Cobb 500F broiler birds were used to determine Ca, age, and adaptation effects on apparent ileal digestibility of crude protein (AID of CP), amino acids (AID of AA) and phytase efficacy. Twelve treatments with 8 replicates, each were fed from 7 to 9 d (6 birds per replicate), 7 to 21 d (6 birds per replicate) and 19 to 21 d (3 birds per replicate) d of age. Diets were prepared with 3 Ca (0.65, 0.80, and 0.95%) and 2 non-phytate P, (0.20 and 0.40%) concentrations. A 6-phytase was added at 500 or 1,000 FTU/kg to the 0.20% nPP diet at each Ca concentration. The age and adaptation effects were determined by comparing the responses between birds fed from 7 to 9 and 19 to 21 d of age, 19 to 21, and 7 to 21 d of age, respectively. An age effect was observed regardless of Ca, nPP, or phytase concentration, with older birds (19 to 21 d) having greater apparent ileal digestibility (AID) of amino acids (AA) and CP than younger birds (7 to 9 d; P<0.05). Response to adaptation varied depending on Ca, nPP, and phytase concentrations. Constant lower AID of CP and AA was seen in adapted birds (7 to 21 d) compared to unadapted bird (19 to 21 d) when 0.20% nPP diets were fed at 0.95% Ca concentrations (P<0.05). At 0.40% nPP, there was no effect of adaptation on AID of CP and AA at any Ca concentration. Phytase efficacy was significantly lower in younger (7 to 9 d) compared to older birds (19 to 21 d; P<0.05), except at 0.65% Ca. Phytase inclusion increased AID of CP and AA regardless of Ca (P<0.05). In conclusion, the AID of CP and AA can be affected by diet, age, and adaptation.


Mindin serves as a tumour suppressor gene during colon cancer progression through MAPK/ERK signalling pathway in mice.
Mindin is important in broad spectrum of immune responses. On the other hand, we previously reported that mindin attenuated human colon cancer development by blocking angiogenesis through Egr-1-mediated regulation. However, the mice original mindin directly suppressed the syngenic colorectal cancer (CRC) growth in our recent study and we aimed to further define the role of mindin during CRC development in mice. We established the mouse syngeneic CRC CMT93 and CT26 WT cell lines with stable mindin knock-down or overexpression. These cells were also subcutaneously injected into C57BL/6 and BALB/c mice as well as established a colitis-associated colorectal cancer (CAC) mouse model treated with lentiviral-based overexpression and knocked-down of mindin. Furthermore, we generated mindin knockout mice using a CRISPR-Cas9 system with CAC model. Our data showed that overexpression of mindin suppressed cell proliferation in both of CMT93 and CT26 WT colon cancer cell lines, while the silencing of mindin promoted in vitro cell proliferation via the ERK and c-Fos pathways and cell cycle control. Moreover, the overexpression of mindin significantly suppressed in vivo tumour growth in both the subcutaneous transplantation and the AOM/DSS-induced CAC models. Consistently, the silencing of mindin reversed these in vivo observations. Expectedly, the tumour growth was promoted in the CAC model on mindin-deficient mice. Thus, mindin plays a direct tumour suppressive function during colon cancer progression and suggesting that mindin might be exploited as a therapeutic target for CRC.


Nonmagnetic hyperbaric chamber for in vivo NMR spectroscopy studies of small animals.
A description is given of the design, construction, and initial use of a polycarbonate resin hyperbaric chamber for in vivo NMR spectroscopy studies of anesthetized, ventilated rats in a horizontal bore 4.7 Tesla magnet. The chamber and its associated equipment, initially used for hyperbaric studies of rats in states of extreme hypercapnia, are also well suited for conventional hyperbaric studies, such as those related to hyperbaric oxygen therapy, oxygen toxicity, and diving. Basic technical challenges that required innovations involved: a) preservation of magnetic field homogeneity; b) avoidance of a metallic chamber body that would overload gradient and RF coils; c) physiological monitoring; and, d) remote control and stabilization of electromagnetic and physiologic factors (especially ventilatory stability) during pressure changes. A small paramagnetic bulk magnetic susceptibility shift from chamber-associated hyperbaric oxygen was observed when chamber oxygen tensions were only one atmosphere. High-quality NMR imaging and spectroscopy were demonstrated during hyperbaric conditions.


Perspective of Artificial Intelligence in Disease Diagnosis: A Review of Current and Future Endeavours in the Medical Field.
Artificial intelligence (AI) has demonstrated significant promise for the present and future diagnosis of diseases. At the moment, AI-powered diagnostic technologies can help physicians decipher medical pictures like X-rays, magnetic resonance imaging, and computed tomography scans, resulting in quicker and more precise diagnoses. In order to make a prospective diagnosis, AI algorithms may also examine patient information, symptoms, and medical background. The application of AI in disease diagnosis is anticipated to grow as the field develops. In the future, AI may be used to find patterns in enormous volumes of medical data, aiding in disease prediction and prevention before symptoms appear. Additionally, by combining genetic data, lifestyle data, and environmental variables, AI may help in the diagnosis of complicated diseases. It is crucial to remember that while AI can be a powerful tool, it cannot take the place of qualified medical personnel. Instead, AI ought to support and improve diagnostic procedures, enhancing patient care and healthcare results. Future research and the use of AI for disease diagnosis must take ethical issues, data protection, and ongoing model validation into account.


Application of 16S rRNA gene-targetted fluorescence in situ hybridization and restriction fragment length polymorphism to study porcine microbiota along the gastrointestinal tract in response to different sources of dietary fibre.
A total of 32 pigs of 15+/-0.38 kg body weight were fed for 6 weeks one of four diets differing in their source of dietary fibre. FISH was used to quantify the main bacterial groups in the pig gut using the following probes: Eub338, Bac303, Rfla729, Rbro730, Erec482, Fprau645, Prop853, Str493 and Lab158. FISH counts revealed important differences at four sites along the pig gastrointestinal tract, but we were unable to show differences related to diets. Stomach and jejunal samples gave total bacterial counts of 0.1-5.3 x 10(8) g(-1) of contents. In the stomach, streptococci and lactobacilli were predominant, and the clostridial cluster IX group was abundant (14-41% of total bacterial count). Clostridial cluster IX bacteria were present elsewhere in the gastrointestinal tract at 1-8%. The other groups were generally more abundant in the proximal colon and rectum: Bacteroides/Prevotella (5-10%), clostridial cluster XIVa (10-19%), and cluster IV relatives of Faecalibacterium prausnitzii (1-4%) and ruminococcus (4-10%). Restriction fragment length polymorphism profiles showed changes related to diet, with pigs fed wheat bran having the lowest richness of all diets (P=0.008).


Changes in cerebral oxygenation during cold (28 degrees C) and warm (34 degrees C) cardiopulmonary bypass using different blood gas strategies (alpha-stat and pH-stat) in patients undergoing coronary artery bypass graft surgery.
Impaired cerebral oxygenation, which is reflected by measuring jugular bulb oxygenation, is thought to play an important role in the development of neurological injury after cardiac operations with cardiopulmonary bypass (CPB). The effects of cardiopulmonary temperature and blood gas strategy on cerebral oxygenation are not fully appreciated. Sixty patients were randomly allocated into four equal groups (cold alpha-stat, cold pH-stat, warm alpha-stat and warm pH-stat) to compare the effect of these perfusion strategies on cerebral oxygenation monitored by jugular bulb oximetry [jugular bulb oxygen saturation (SjO(2)) and arterial-jugular bulb oxygen content difference (AjDO(2))]. Jugular bulb oxygen saturation and AjDO(2) were measured before CPB, after 5, 20, 40 min on CPB, at start and end of rewarming, 5 min before the end of CPB and 10 min after CPB. Two-way analysis of variance was used to model the lowest SjO(2) and highest AjDO(2) during CPB, with CPB temperature and blood gas management as contributing factors. Significant changes in SjO(2) were only related to the type of blood gas management, with no significant difference between warm and cold CPB patients. In addition, during rewarming, desaturation (SjO(2) </= 50%) occurred in seven patients of 30 in the alpha-stat groups and in one patient of 30 in the pH-stat groups (P = 0.021), and in five patients of 30 in the cold groups vs. three of 30 in the warm groups (P = 0.434). However, no significant changes were found in the highest AjDO(2) between the four groups. Cold CPB failed to offer any further brain protection in terms of better preservation of cerebral oxygenation than warm CPB. Therefore, warm CPB (34 degrees C) with different blood gas strategies appears to be a satisfactory alternative to cold CPB (28 degrees C).


High precision film dosimetry with GAFCHROMIC films for quality assurance especially when using small fields.
Treatment units for radiosurgery, brachytherapy, implementation of seeds, and IMRT generate small high dose regions together with steep dose gradients of up to 30%-50% per mm. Such devices are used to treat small complex-shaped lesions, often located close to critical structures, by superimposing several single high dose regions. In order to test and verify these treatment techniques, to perform quality assurance tasks and to simulate treatment conditions as well as to collect input data for treatment planning, a GAFCHROMIC film based dosimetry system for measuring two-dimensional (2-D) and three-dimensional (3-D) dose distributions was developed. The nearly tissue-equivalent radiochromic GAFCHROMIC film was used to measure dose distributions. A drum scanner was investigated and modified. The spectral emission of the light source and the filters together with the efficiency of the CCD filters for the red color were matched and balanced with the absorption spectra of the film. Models based on refined studies have been developed to characterize theoretically the physics of film exposure and to calibrate the film. Mathematical descriptions are given to calculate optical densities from spectral data. The effect of darkening has been investigated and is described with a mathematical model. The influence of the scan temperature has been observed and described. In order to cope with the problem of individual film inhomogeneities, a double irradiation technique is introduced and implemented that yields dose accuracies as good as 2%-3%. Special software routines have been implemented for evaluating and handling the film data.


Expanding Role of Orbital Decompression in Aesthetic Surgery.
Eye prominence is a source of cosmetic "deformity" for many patients not afflicted by Graves. To report our experience in using customized orbital decompression for purely aesthetic reason to reduce eye prominence in non-thyroid patients. Retrospective analysis of patients undergoing cosmetic orbital decompression by one surgeon. Surgical technique included customized graded orbital bony-wall decompression (lateral-wall, basin, medial-wall, posterior-strut) and intraconal fat removal using eyelid crease and/or caruncle incisions. Inclusion criteria included any patient with relative prominent eye due to non-thyroid etiology. Preoperative and postoperative photographs at longest follow-up were used for analysis. Outcome measures included patient satisfaction (via a written questionnaire) and complication rates. Etiologies of prominent eyes included congenital shallow orbits (14), congenital hypoplasia of malar-eminence (5), enlarged globe from high myopia (5), buphthalmos (1), and relative proptosis from contralateral enophthalmos (1). Concurrent procedures included lower eyelid-retractors lysis (5), periocular fat injection (3), tear-trough implant (3), canthoplasty (3), and periocular filler injection (3). Mean patient age was 33.8 years (range, 19-60 years). The average follow-up was 9 months (range, 6 months-4 years). All 26 patients (11 males, 15 females) had reduction in globe prominence. The mean reduction in axial globe position was 3.1 mm (range, 1.5-6.2 mm). Twenty-four of 26 patients were satisfied with the surgical outcome, with 2 patients complaining of sunken eyes. No case of permanent diplopia occurred. Orbital decompression may be done for cosmetic purpose, effectively and safely, to reduce eye prominence in non-thyroid patients by an experienced orbital surgeon. 4.


Engaging Stakeholders to Improve Care for Adults with Complex Health and Social Needs during a Public Health Emergency.
A public health emergency such as the COVID-19 pandemic exacerbates the already challenging environment facing adults with complex health and social needs (ACHSN) and the systems of care that support them. Between September 2020 and April 2021, 51 participants representing six different stakeholder groups were engaged using interviews, asynchronous Delphi surveys, and a virtual stakeholder meeting to learn from their perspectives about the greatest needs and possible solutions affecting ACHSN populations during the COVID-19 pandemic and to develop a prioritized research agenda to improve care for ACHSN populations. Mental health and financial concerns were strongly and consistently endorsed as the most important issues. Future research priorities identified included both macro systems research such as testing alternative state-level models of payment for physical and mental health care and research that could be conducted at a local level (such as identifying needs for patient care navigation services and testing models of care navigation).


Socioeconomic differences in fruit and vegetable consumption among middle-aged French adults: adherence to the 5 A Day recommendation.
Numerous studies support the protective effect of high fruit and vegetable consumption on chronic disease risk, mainly against cancer and cardiovascular diseases. The increase of fruit and vegetable intake has become a public health priority in many countries. The aim of the study was to investigate the relationships of socioeconomic, demographic, and behavioral factors with both quantity and variety of fruit and vegetable consumption. Fruit and vegetable intake was assessed using repeated 24-hour dietary records collected during a 2-year period from 4,282 French subjects (2,373 men and 1,909 women), aged 45 to 62 years, who participated in a large prospective study. Both education level and occupation categories were used as socioeconomic indicators. Logistic regression models were applied to assess factors related to meeting the 5 A Day fruit and vegetable recommendation. Covariance analyses were performed to compare the fruit and vegetable variety scores and the contributions of fruit and vegetables to the total daily diet cost across socioeconomic indicators within each sex. Meeting the 5 A Day recommendation was more likely in subjects aged 50 years and older, higher education levels, nonsmokers, moderate alcohol drinkers and in women engaging in regular physical activity. The odds ratio (95% confidence interval) for the lower vs higher education level was 0.70 (0.54 to 0.92) in men and 0.65 (0.48 to 0.85) in women. No significant difference was observed between occupation categories. A positive relationship between vegetable variety and education level was found in both sexes. Fruit variety was positively associated with both education and occupation categories, but only in men. The contribution of fruits to the total daily diet cost increased with occupation (P<0.02) and education (P<0.0001) in men, but decreased with occupation in women (P<0.05). Although cost constraints may explain the lower fruit and vegetable intake in lower socioeconomic groups, the relative influence of budgetary resources, nutrition knowledge, and social and environmental barriers in socioeconomic disparities need further investigation.


Altruism or Arousal in the Rat?
If rats are exposed successively to white noise, then to recorded rat squeals, or alternatively to squeals first and then white noise, and if, in both situations, they are allowed to shut off the auditory stimulation by applying pressure on a bar, they will touch the bar more frequently when exposed to white noise. The results indicate that the bar-pressing behavior is the expression of increased activity resulting from the increased stimulation.


Is there a consensus on antibiotic usage for dental implant placement in healthy patients?
This systematic review aimed to determine whether there is consensus for antibiotic prescription in healthy patients undergoing implant placement. A search of PubMed, Embase and Medline databases was conducted in January 2016 to find published journal articles on the use of antibiotics in implant placement, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were prospective human clinical trials investigating antibiotic usage during implant placement. Fifteen studies were deemed suitable. In 13 studies, no statistical difference was found between antibiotic use and the incidence of prosthetic failure, implant failure and early postoperative infections. These were rated as having low to high risk bias. Contrary results were reported in two studies, both of which were rated as having a high potential for bias. In conclusion, antibiotic use in healthy patients for the prophylaxis of surgical infection associated with dental implant placement does not appear to improve clinical outcomes. Practitioners should apply principles of antimicrobial stewardship and not use antibiotics as a routine measure in healthy patients.


Metrocoris sikkimensis sp. nov. (Hemiptera: Heteroptera: Gerridae) from northeastern India, with a key to species of the compar group occurring in India.
Metrocoris sikkimensis sp. nov. is described from Sikkim, northeastern India, compared with similar species, included in an identification key and its geographical distribution is mapped. This species is assigned to the Metrocoris compar group based on the venter of the body entirely blackish and the male fore femur slender and unarmed. It can be distinguished from other species of the group based on the dark mesosternum without yellow markings, by the apically curved male paramere without setae, and by the structure of male endosomal sclerites.


Development of an alkali chloride vapour-generating apparatus for calibration of ultraviolet absorption measurements.
A novel design of alkali chloride vapour-generating cell has been developed, which can serve as a calibration cell for quantitative ultraviolet absorption concentration measurements and meticulous spectral investigations of alkali compounds. The calibration cell was designed to provide alkali vapour of well-controlled concentrations and temperatures, and consisted of a sealed quartz cell measuring 0.4 m in length with a temperature-controlled reservoir containing solid alkali salt. The cell was placed in a furnace and the alkali vapours generated from the reservoir have direct access to the measuring chamber. Investigations of potassium chloride (KCl) were made on sublimated vapour at temperatures 650, 700, 750, 780, and 800 °C while the reservoir temperature was kept 50 °C lower to avoid condensation. The cell provides stable KCl vapour pressures, and the furnace provides a homogenous temperature profile along the cell. KCl vapour pressures are well characterised and conform the base for determination of the KCl concentration in the cell. The alkali chloride levels matched the concentration range of the absorption setup and indicated a previously employed calibration method to overestimate KCl concentrations. The KCl absorption cross sections for wavelengths λ=197.6 nm and λ=246.2 nm were calculated to be 3.4 × 10-17 and 2.9 × 10-17 cm2/molecule, respectively. The absorption cross section spectra did not show any structural differences with increasing temperature, which could indicate influence of dimers or significant changes of the population in the KCl vibrational states. The KCl absorption cross sections thus did not show any temperature dependence in the temperature region of 700-800 °C. Moreover, the applicability of the calibration cell for measurement of other alkali chlorides and hydroxides is discussed.


A medical humanities special study module on principles of medical theory and practice at the Charité, Humboldt University, Berlin, Germany.
The authors are members of a committee in charge of a special study module (SSM) entitled Principles of Medical Theory and Practice in a problem-based and integrated reformed curriculum track at the Charité, the medical school and university hospital of the Humboldt University, Berlin, Germany. The SSM contextualizes medicine by highlighting the societal contexts of the doctor-patient relationship and the medical profession. Integrating the humanities into medical education helps students develop an awareness of the strengths and limitations of modern medicine, develop their own personalities and sense of social responsibility, and generally broaden their outlook. Teachers in the SSM seminars are from different disciplines, such as the history of medicine, bioethics, sociology, anthropology, and complementary medicine. Once a week, one or two teachers meet with as many as 21 students per group for a 90-minute course. Twelve courses constitute a seminar. Students are required to participate in four seminars during five years of studies. They can choose different topics from a set range. Although this SSM has been largely successful, some problems have occurred. Results from the course evaluations and experiences show that the seminars differ from one another in many ways. Financial restraints and the departmental structure of the faculty have influenced implementation of the SSM. However, the SSM is a new concept and is continuously reviewed and renewed. Future plans will be to specify outcomes, continue to discuss reasonable seminar topics, establish continuous support and training for teachers, and motivate students to become actively involved in the seminar discussions.


Stroke following variceal sclerotherapy.
Paradoxical embolism via a patent foramen ovale (PFO) has been identified as a potential risk factor for ischaemic stroke. Such occurrences are associated with risk factors for deep vein thrombosis (DVT), e. g. pregnancy, immobilisation, and surgery of the lower limbs. A 54-year-old otherwise healthy female presented with acute onset motoric aphasia and brachiofacial right hemiparesis. The cranial computed tomography showed a left striatal ischaemic infarction. The patient's history revealed a variceal sclerotherapy with polydocanol 0,5% three days prior to the onset of symptoms. Echovist TCM doppler revealed a right-to-left shunt. A patent foramen ovale (PFO) was detected by transesophageal echocardiography. There was no evidence of DVT in bilateral lower-extremity venous duplex ultrasound scanning. Other potential risk factors of stroke including thrombophilia could not be identified. The patient was treated with a high dose regimen of heparin and a further anticoagulation treatment was recommended. This case suggests a probable causal relationship between variceal sclerotherapy and paradoxical embolism resulting in a stroke. Variceal sclerotherapy might be a potential, but rare risk of embolism.