Burnout and Work Demands Predict Reduced Job Satisfaction in Health Professionals Working In a Surgery Clinic.
Burnout syndrome develops in health professionals (HPs) as a result of exposure to chronic emotional and interpersonal workplace stressors. Research demonstrates the links between burnout, work demands, and job satisfaction in hospital HPs. To examine the associations between burnout, work demands and job satisfaction, and to demonstrate the mediation effect of emotional exhaustion on the relationship between work demands and job satisfaction in surgery clinic HPs. Maslach Burnout Inventory was used for assessment of burnout. Work demands and job satisfaction were measured with Hospital Experience Scale and Job Satisfaction Survey, respectively. In order to examine the role of emotional exhaustion, depersonalization, and work demands, controlling for age, hospital tenure, and unit tenure, a hierarchical multiple regression models were tested for each job satisfaction factor. Job satisfaction was negatively predicted by emotional exhaustion. Certain types of work demands negatively predicted different factors of job satisfaction. Emotional exhaustion was a significant partial mediator of the relationship between work demands and job satisfaction. Adequate management of work demands, particularly excessive workload, time pressure, and lack of staff can lead to prevention of burnout and reduced job satisfaction in surgery clinic HPs, and contribute to better quality of patient care.


[Study of pedicle screw placement assisted by intraoperative three-dimensional navigation in lumbar vertebrae with axial rotation].
To evaluate the effect of axial rotation of lumbar vertebrae on the accuracy of pedicle screw placement using the traditional method, as well as to assess the value of intraoperative three-dimensional (3D) navigation in improving the accuracy. Sixteen lumbar simulation models at different degrees of axial rotation (0°, 5°, 10° and 20°), with every four assigned with the same degree, were equally divided into two groups (traditional method group and intraoperative 3D navigation group). Random placement of pedicle screws was carried out, followed by CT scan postoperatively. Then the outer pedicle cortex contours were depicted from reconstructed sectional pedicle images using Photoshop. The accuracy of pedicle screw placement was evaluated by determining the interrelationship between screw trajectory and pedicle cortex (qualitative) and measuring the shortest distance from pedicle screw axis to outer cortex of the pedicle (quantitative). Eighty pedicle screws were implanted respectively in each group. In traditional method group, statistical difference existed in the accuracy of pedicle screw placement at different axial rotational degrees (P < 0.05). With degrees increasing, the accuracy declined. The accuracy of intraoperative 3D navigation group was higher than traditional method group in vertebrae with axial rotation (P < 0.01). In qualitative evaluation, the accuracy of the two methods had statistical difference when the degree was 20°, and in quantitative evaluation, statistical difference existed in 5°, 10° and 20° of vertebral axial rotation. Screw malposition can be caused by vertebral axial rotation in lumbar spine using traditional method. Accuracy of pedicle screw placement declines with the increase of axial rotational degrees. However, the accuracy can be improved by using intraoperative 3D navigation.


Detection of intrauterine viral infection using the polymerase chain reaction.
Intrauterine viral infection commonly presents as nonimmune hydrops fetalis or intrauterine growth restriction. Cytomegalovirus (CMV) and parvovirus are commonly recognized causes of fetal infection using serology and cultures. We used the polymerase chain reaction (PCR) to evaluate the frequency of fetal viral infection and the associated clinical course and outcome. Specimens (amniotic fluid, fetal blood, pleural fluid, tissue) from 303 abnormal pregnancies at risk for viral infection and 154 controls were analyzed using primers for CMV, herpes simplex virus, parvovirus B19, adenovirus, enterovirus, Epstein-Barr virus, and respiratory syncytial virus. Viral genome was detected in 144/371 samples (39%) or 124/303 patients (41%), with adenovirus (n = 74 patients; 24%), CMV (n = 30 patients; 10%), and enterovirus (n = 22 patients; 7%) most common. Only 4/154 (2.6%), unaffected control patients' samples were PCR positive. We conclude that diagnosis of fetal viral infection by PCR is common in abnormal pregnancies. Adenovirus and enterovirus may cause fetal infection that have been previously unrecognized.


[Synthesis of n-hexanoylmethylene triphenylphosphorane].
An efficient synthesis of n.hexanoylmethylenetriphenylphosphorane (II), a fundamental intermediate for obtaining prostanoic products, is described. The crucial intermediate in the synthesis is the 2-keto-n.heptyltriphenylphosphonium chloride (VII), which is prepared via a very precise procedure.


Radiobiologically optimized couch shift: A new localization paradigm using cone-beam CT for prostate radiotherapy.
To present a novel positioning strategy which optimizes radiation delivery by utilizing radiobiological response knowledge and evaluate its use during prostate external beam radiotherapy. Five patients with low or intermediate risk prostate cancer were evaluated retrospectively in this IRB-approved study. For each patient, a VMAT plan with one 358° arc was generated on the planning CT (PCT) to deliver 78 Gy in 39 fractions. Five representative pretreatment cone beam CTs (CBCT) were selected for each patient. The CBCT images were registered to PCT by a human observer, which consisted of an initial automated registration with three degrees-of-freedom, followed by manual adjustment for agreement at the prostate/rectal wall interface. To determine the optimal treatment position for each CBCT, a search was performed centering on the observer-matched position (OM-position) utilizing a score function based on radiobiological and dosimetric indices (EUDprostate, D99prostate, NTCPrectum, and NTCPbladder) for the prostate, rectum, and bladder. We termed the optimal treatment position the radiobiologically optimized couch shift position (ROCS-position). The dosimetric indices, averaged over the five patients' treatment plans, were (mean ± SD) 79.5 ± 0.3 Gy (EUDprostate), 78.2 ± 0.4 Gy (D99prostate), 11.1% ± 2.7% (NTCPrectum), and 46.9% ± 7.6% (NTCPbladder). The corresponding values from CBCT at the OM-positions were 79.5 ± 0.6 Gy (EUDprostate), 77.8 ± 0.7 Gy (D99prostate), 12.1% ± 5.6% (NTCPrectum), and 51.6% ± 15.2% (NTCPbladder), respectively. In comparison, from CBCT at the ROCS-positions, the dosimetric indices were 79.5 ± 0.6 Gy (EUDprostate), 77.3 ± 0.6 Gy (D99prostate), 8.0% ± 3.3% (NTCPrectum), and 46.9% ± 15.7% (NTCPbladder). Excessive NTCPrectum was observed on Patient 5 (19.5% ± 6.6%) corresponding to localization at OM-position, compared to the planned value of 11.7%. This was mitigated with radiobiologically optimized localization, resulting in a reduced NTCPrectum value of 11.3% ± 3.5%. Overall, the treatment position optimization resulted in similar target dose coverage with reduced risk to rectum. These encouraging results illustrate the potential advantage of applying radiobiologically optimized correction for online image-guided radiotherapy of prostate patients.


Asbestos-related lung cancers: A retrospective clinical and pathological study.
Exposure to asbestos results in serious risks of developing mesothelioma and lung cancer. The link between asbestos exposure and lung carcinoma is well established. Nevertheless, precise histopathological data are poorly considered when investigating the asbestos-cancer link in a compensatory approach. In the present study, we aim to describe the features of individuals with compensated lung cancer who were referred to an occupational disease center, regarding occupational exposure to asbestos, smoking history and pathological data. We led a retrospective study of compensated ARLC cases seen in our occupational disease center between 2003 and 2013. A total of 146 men were included (mean age at diagnosis, 63.2 years) of whom approximately 90% were heavy current or former smokers (mean value, 30.4 packs/year). The major industries associated with the lung cancer cases were shipbuilding (69.9%), and building construction (7.5%) in this harbor region. The results of the present study showed that lung upper lobe was most prevalent (61.6%) and an excess of adenocarcinoma was found (45.9%), followed by squamous cell carcinoma (38.4%) as well as thoracic sarcomas (2.1%). Neoplasm was not histologically proven in 6.8% of the cases. Subsequent pathology examinations also reclassified 2 tumors as metastases from esophageal and laryngeal origins. In conclusion, smoking prevention should be encouraged in asbestos-exposed workers as reflected by the number of smokers with asbestos-related lung cancer. Thus, histological data should be considered further to evaluate the potent relationship between asbestos exposure and lung malignancy, especially in a compensatory approach.


High-resolution real-time ultrasonography. Diagnosis and follow-up of jugular and subclavian vein thrombosis.
Thrombosis of the internal jugular and subclavian veins was demonstrated by high-resolution real-time ultrasonography in eight patients. The sonographic findings were an intraluminal mass of low or mild amplitude echoes, loss of respiratory rhythmicity and venous pulsation, absence of vein response to respiratory maneuvers (Valsalva and sniff test) and incompressibility of the thrombotic jugular vein. Follow-up examinations after anticoagulant and local streptokinase therapy allowed monitoring of the treatment. High-resolution ultrasonography is a useful noninvasive technique for the diagnosis and follow-up of therapy in thrombosis of the jugular and subclavian veins.


Synthesis of poly(glutamic acid)-tyramine hydrogel by enzyme-mediated gelation for controlled release of proteins.
An in situ-formed hydrogel was synthesized by enzymatic cross-linking of poly(γ-glutamic acid)-tyramine conjugates (PGA-Tyr) using horseradish peroxidase (HRP) and hydrogen peroxide (H2O2). The gelation time ranged from 25 s to 5 min was accomplished by tuning the concentration of HRP, H2O2/Tyr molar ratio and the degree of substitution (DS) of Tyr groups. The storage modulus (G'), cross-link density, and mesh size can be tailored by controlling the H2O2/Tyr ratio and DS. The rheological analysis indicated that the storage modulus (G') can be tailored from approximately 40 to over 1100 Pa with the increasing H2O2/Tyr ratio and DS. The bovine serum albumin (BSA) was used as model protein and encapsulated into the hydrogel during the enzyme-mediated cross-linking reaction. Controlled release of BSA in vitro from the PGA-Tyr hydrogel was obtained. The release rate and cumulative release amount of encapsulated BSA were manipulated by controlling the H2O2/Tyr ratio and DS. More than 90% of encapsulated BSA was released from the hydrogel with low cross-link density and lager mesh size in 60 h, while only 68% of BSA was released from the hydrogel with high cross-link density and small mesh size. The results indicated that the PGA-Tyr hydrogel is a promising material for the controlled release of therapeutic protein or peptides.


The influence of intraduodenal administration of pancreatic juice on the bile-induced pancreatic secretion and immunoreactive secretin release in man.
The exocrine pancreatic secretion of water, bicarbonate, amylase, and protein and the plasma levels of immunoreactive secretin (IRS) were studied after intraduodenal infusions of bile and pancreatic juice. Pancreatic secretion was obtained by endoscopic cannulation of the main pancreatic duct. Bile and pancreatic juice were infused into the duodenum through separate catheters attached to the outside of the duodenoscope. The unstimulated secretion was collected for 20 min. After intraduodenal stimulation of the pancreatic secretion with a nearly neutral solution of dried cattle bile, juice was collected for another 20-min period. Then, pure pancreatic juice was infused into the duodenum. It was shown that pancreatic juice reduced the flow rate and output of bicarbonate, amylase, and protein significantly (p less than 0.05). A significant reduction in plasma concentration of IRS (p less than 0.05) was also found. In the controls, i.e., when no pancreatic juice was instilled into the duodenum, a further increase in flow rate, bicarbonate secretion, and IRS was found. It is concluded that the exocrine pancreatic secretion and IRS release induced by intraduodenal administration of bile may be depressed by reinfusions of pancreatic juice. The corresponding effect on bicarbonate secretion and IRS release found in this study supports the view that secretin may play an important role in the exocrine pancreatic secretion induced by intraduodenal infusion of bile.


A comparison of veterinary students enrolled and not enrolled in an animal-welfare course.
An online survey was conducted to compare 46 veterinary students who previously enrolled in a discussion-based animal-welfare elective with 45 veterinary students who did not take the course. Students were asked a series of questions about their attitudes toward animal welfare and were presented with animal-use scenarios that had not previously been discussed in the elective course: greyhound racing, veal calf production, and the use of genetically engineered mice in research. For each scenario, students' actual knowledge was scored on the basis of open-ended factual questions. Students were also asked how comfortable they were with educating themselves about each topic and to describe factors they would use to evaluate the welfare of animals in each scenario. Factors were classified as being associated with (a) biological functioning, (b) ability to exist in a natural state, or (c) measures of affective state or feelings. There was no significant difference in actual knowledge of the three scenarios between students who took the course and those who did not. Students who took the course were significantly more likely to be comfortable about educating themselves on each of the three animal-use scenarios and scored significantly higher in identifying welfare-affecting factors than students who did not take the course. The results suggest that this approach to instruction is an effective way to teach veterinary students about how to educate themselves about animal-welfare issues and to increase their confidence in appropriately evaluating novel animal-welfare topics.


Perinatal quality of life: is it important for childbearing women?
Acknowledgement of and support for women's psychological and social health and wellbeing across the childbearing spectrum is a core aspect of contemporary maternity care provision. These broader definitions of health and wellbeing have stimulated a growing interest in and acknowledgement of the concept of quality of life as important in pregnant and postnatal women. Accruing evidence would suggest that a number of aspects of the childbearing experience, linked to physiological change, physical demand, clinical events, outcomes and complications and emotional transition across the perinatal period, are relevant to a woman's perceived quality of life. In addition, those perceptions of quality of life may have further implications for both physical and psychological wellbeing. It could be argued that accurate assessment of quality of life, however, requires reliable tools that have been either designed for or validated in childbearing populations. This paper briefly presents some of the issues related to quality of life in pregnancy and the postnatal periods and discusses some of the available measures to assess quality of life in childbearing women.


Pediatric psychopharmacology outside the U.S.A.
To obtain information on the use of psychotropic drugs children outside the U.S.A., 251 questionnaires were mailed to institutions in 53 countries. Seventy-three responses from 34 countries were analyzed. The percentage of patients receiving drugs under the care of these respondents ranged from 0 to 100% (mean 39%). A total of 56 different drugs were selected for eleven psychiatric disorders. No regional differences were apparent, except for infrequently used drugs. Respondents differed widely in the number of drugs selected and maximum dosages. The most popular drugs used in most disorders were diazepam, thioridazine, chlorpromazine, chlordiazepoxide, imipramine, amitriptyline, haloperidol and methylphenidate. Highest agreements among respondents were for imipramine in enuresis, diazepam in anxiety, chlorpromazine in psychosis and thioridazine in hyperkinesis. The results of this survey illustrate important problems in interpreting cross-cultural data in pediatric psychopharmacology, and recommendations for future research are made.


AgGa2 PS6 : A New Mid-Infrared Nonlinear Optical Material with a High Laser Damage Threshold and a Large Second Harmonic Generation Response.
To develop new mid-infrared (MIR) nonlinear optical (NLO) materials, which can overcome the low laser damage threshold (LDT) of the commercial MIR-NLO crystals (AgGaS2 , AgGaSe2 and ZnGeP2 ) and simultaneously keep the large NLO susceptibility, is necessary for high-power MIR laser frequency conversion technology. To improve the LDT, a new strategy of increasing lattice stability was adopted. Here, the strongly covalent structural unit of the PS4 tetrahedron was introduced into AgGaS2 (AGS), and that led to the isolation of the first compound in AgI -GaIII -PV -S system, namely, AgGa2 PS6 (Cc). It retains a large SHG efficiency (1.0×AGS) with phase-matchable ability, and also exhibits an improved LDT (5.1×AGS), indicating AgGa2 PS6 is a new promising MIR-NLO crystal. Moreover, a novel 3D framework of [Ga2 PS6 ]- , with triangular-shaped channels, as well as interesting single triangular geometry of AgS3 -both of which are very rare in reported sulfides-was discovered in AgGa2 PS6 . Furthermore, theoretical calculations, and lattice energy and thermal expansions analyses suggest that the PS4 group makes a large contribution to the large SHG efficiency and high LDT.


C-erbB-2 oncogene protein in in situ and invasive lobular breast neoplasia.
Lobular carcinoma in situ (LCIS) has uncertain malignant potential; biologic markers that will identify patients at risk for a poor clinical outcome have been sought actively. Amplification of the c-erbB-2 protooncogene has been correlated with poor prognosis in invasive mammary carcinoma, and immunohistochemical evaluation for expression of the oncogene protein has been correlated with gene amplification. The authors retrospectively evaluated 62 cases of lobular neoplasia for expression of the c-erbB-2 gene product on formalin-fixed, deparaffinized sections, using two monoclonal anti-erbB-2 (p185) antibodies (c-neu Ab3 and m-erb) and one polyclonal anti-erbB-2 antibody (pAb 1) by the avidin-biotin-peroxidase method. All 62 cases were negative with the pAb 1 antibody; one of 62 cases was weakly positive with the c-neu Ab3 in a membranous pattern. Expression of c-erbB-2 gene product was identified on adjacent invasive ductal carcinoma in one case and in adjacent ductal carcinoma in situ in another. None of 15 cases if infiltrating lobular carcinoma was positive with either of the two anti-c-erbB-2 antibodies. Strong positivity was found on benign epithelium in one case, demonstrating epitheliosis. In summary, evidence of expression of the c-erbB-2 gene product was found in one of 57 cases of LCIS and none of 15 cases of invasive lobular carcinoma. This suggests that, in contrast to reported data concerning intraductal and invasive ductal carcinoma, c-erbB-2 oncogene amplification and/or overexpression does not play a significant role in the progression of lobular breast neoplasia.


Comorbid psychiatric diagnoses and their association with cocaine-induced psychosis in cocaine-dependent subjects.
Comorbidity between drug abuse and mental illness is very common, but the association of such comorbidity with specific responses to drugs of abuse remains obscure. The current study examined the relationship between the presence of non-psychotic Axis I psychiatric diagnoses and the frequency and severity of cocaine-induced psychosis. We interviewed 243 unrelated cocaine-dependent adults [37% European American (EA), 52.3% African American (AA); 58.8% male] using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) to establish DSM-IV diagnoses, and two instruments for the identification of cocaine-induced paranoia, the Cocaine Experience Questionnaire (CEQ) and the Scale for Assessment of Positive Symptoms for Cocaine-Induced Psychosis (SAPS-CIP). Comorbid substance use and psychiatric disorders were common in this cocaine-dependent sample. Ninety percent of subjects met criteria for substance use disorders other than cocaine dependence; common non-substance-use disorders included antisocial personality disorder (ASPD), adult ASPD, major depression, and attention deficit-hyperactivity disorder (ADHD). Comorbid opioid dependence was more common in EA subjects than in AA participants. After correction for multiple comparisons, a lifetime diagnosis of ADHD was associated with the categorical presence of CIP (p = 0.007), as well as significantly more severe CIP symptoms. Comorbid substance use and psychiatric disorders are very common among individuals with cocaine dependence. Comorbid ADHD increases the odds of an individual endorsing CIP, suggesting some common basis for these phenomena.


Priapism secondary to perineal abscess in a dog - a case report.
A 7-year-old intact male Boxer was referred to our services at the Veterinary Teaching Hospital of the University of Trás-os-Montes and Alto Douro, suffering from a persistently erect penis (including the bulbus glandis) that had been exposed for several days. Radiographic and ultrasonographic examinations detected a 5.0 x 3.5 cm mass located dorso-laterally to the urinary bladder. The microbial culture of the mass revealed Staphylococcus spp. At that time, we suspected the involvement of an abscess in the origin of the priapism. Medical and surgical treatments were promptly instituted, which allowed for penile withdrawal into the prepuce; however, the resolution of the penile erection was not accomplished in the following days and penile amputation was required. Histological evaluation of the excised penis revealed extensive infarction of the erectile tissue of the pars longa and bulbus glandis, and also of the blood vessels of the penis. Following penile amputation and antimicrobial therapy, the animal fully recovered. Ultimately, the animal died as a consequence of gastric torsion. At necropsy, some lesions compatible with a previous perforation of the intestinal wall were recorded. The data gathered from the anamnesis, the physical and imaging examinations, along with the post-mortem findings, allowed us to conclude that in this clinical case the primary cause of priapism was a perineal abscess due to bowel perforation.


Local hyperthermia of the prostate gland for the treatment of benign prostatic hypertrophy and urinary retention.
Local hyperthermia of the prostate was used to treat 72 patients who had an indwelling catheter because of urinary retention caused by benign prostatic hypertrophy. One month after completion of treatment 50% of patients were able to dispense with the catheter and 1 year later 40% remained catheter-free. The best results were achieved in patients who underwent 6 to 10 treatment sessions in conjunction with cyproterone acetate 50 mg tid administered during the treatment period only.


[Applications and spproved projects of general program, young scientist fund and fund for less developed region of national natural science funds in discipline of Chinese materia medica, NSFC in 2011].
The applications accepted and approved by general program, young scientist fund and fund for less developed region of national natural science funds in the discipline of Chinese materia medica, NSFC in 2011 have been introduced. The character and problems in these applications have been analyzed to give a reference to the scientists in the field of Chinese material medica.


Unravelling the scent of vetiver: identification of character-impact compounds.
Vetiver oil is a highly esteemed basic ingredient of modern perfumery, but the nature of the constituents that really impart its typical and most sought woody-earthy scent has remained controversial. Indeed, vetiver oil is considered as one of the most complex essential oils, being mostly composed of several hundreds of sesquiterpene derivatives with a large structural diversity. Its complexity has hindered the direct identification of its odoriferous components. We thus aimed at using a combination of GC×GC/MS and GC-Olfactometry in order to identify most of its odor-impact constituents. The olfactory analysis of vetiver oil and vetiveryl acetate revealed a huge variety of odors in both products. While khusimone has almost unanimously been recognized as the most characteristic vetiver odorant, we have identified several even more important contributors to the typical vetiver character.


Regulation of muscle contraction and relaxation in heart.
The calcium uptake and release machinery in heart SR have been characterized: (1) The calcium pump membrane is involved in energized Ca2+ uptake enabling muscle to relax. The calcium pump protein (CPP) in heart SR is modulated by protein kinase phosphorylation of phospholamban lowering the KCa2+. We conclude that in the membrane, phospholamban elevates KCa2+ of calcium pump protein. Phosphorylation of phospholamban attenuates the influence of phospholamban. In the limit, the intrinsic KCa2+ of calcium pump protein in heart and skeletal muscle are approximately the same. (2) The junctional face membrane is involved in calcium release which triggers muscle contraction. Ryanodine is a specific modulator of the Ca2+ release channels of SR which are involved in excitation-contraction coupling. The ryanodine receptor has been isolated, found to be equivalent to the feet structures, and on reconstitution into bilayers, identified as the calcium release channel of SR. The calcium release channel of SR is closed by ruthenium red and Mg2+ and opened by Ca2+ and ATP and low ryanodine concentration. The calcium release channel of SR is not effected by drugs such as nitrendipine, diltiazem and D-600 which modulate the slow inward Ca2+ channel of the plasmalemma/transverse tubule. (3) The calcium release channels from heart and skeletal muscle SR are similar but not identical (Table IV). Important differences distinguish the calcium release machinery in heart from that of skeletal muscle. 1. In heart there are two sources of calcium fluxes: a) extracellular Ca2+ enters via the plasmalemma slow inward calcium current; and b) "Ca2+ induced Ca2+ release" from SR. In skeletal muscle, SR is the single main source of calcium which enters via "Depolarization induced calcium release". 2. The calcium release channel from heart SR has a lower Mr approximately 340,000 vs 360,000 for skeletal muscle. 3. Ryanodine binding in cardiac SR is distinct from that in skeletal muscle (Fig. 7). 4. The isolated calcium release channel from heart SR is more sensitive to Ca2+ for calcium release (Hymel et al. 1988c). Significant progress has been achieved in identifying the calcium release channel of SR in heart and skeletal muscle. The focus of excitation-contraction coupling now shifts to defining the precise nature of the coupling of excitation to contraction.


Energetics of Stone-Wales defects in 4 A carbon nanotubes.
Density functional calculations have been performed to study the formation of Stone-Wales defects in 4 A single-wall carbon nanotubes, which were firstly synthesized inside the AFI zeolite template. The minimum energy paths from perfect tubes to defect-containing ones are calculated by the nudged elastic band method. It is found that the C--C bonds "along" the tube axis are more likely to be rotated than those bonds "around" the circumference. There is a marked chirality dependence of the formation barriers, which are found to be lower than that of graphite. Our results may raise a question on the origin of superconductivity observed in these 4 A tubes.


Morphological transformation of immortalized hamster dermal fibroblasts following treatment with simple alkylating carcinogens.
We have examined the mechanism of transformation of a line of immortalized hamster dermal fibroblasts (4DH2 cells) following treatment with the simple alkylating agents, N-methyl-N-nitrosourea (MNU), N-ethyl-N-nitrosourea (ENU) and dimethyl sulphate (DMS). Treatment of 4DH2 cells with the potent point mutagens MNU and ENU gave rise to a spectrum of foci of different sizes, including progressively growing large foci and compact small foci. In contrast, treatment with the weak point mutagen DMS produced mostly large foci. The ability of cell lines derived from morphologically transformed foci to grow in soft agar in general reflects their original size. Thus most cell lines derived from large foci grew in soft agar while most lines derived from small foci did not. Transfection of cellular DNAs into the parent 4DH2 cell line and into NIH3T3 mouse fibroblasts has revealed the presence of dominantly acting transforming genes in the chemically transformed cell lines. Thus DNA from five of six cell lines derived by culturing large foci and from one of three cell lines derived by culturing small foci induced efficient morphological transformation of the recipient cells. Southern analyses of DNA from primary and secondary transfectants showed that several of the transforming genes transferred in these experiments were not closely related to H-ras, K-ras or N-ras.


12-month follow-up analysis of a multicenter, randomized, prospective trial in de novo liver transplant recipients (LIS2T) comparing cyclosporine microemulsion (C2 monitoring) and tacrolimus.
The LIS2T study was an open-label, multicenter study in which recipients of a primary liver transplant were randomized to cyclosporine microemulsion (CsA-ME) (Neoral) (n = 250) (monitoring of blood concentration at 2 hours postdose) C2 or tacrolimus (n = 245) (monitoring of trough drug blood level [predose]) C0 to compare efficacy and safety at 3 and 6 months and to evaluate patient status at 12 months. All patients received steroids with or without azathioprine. At 12 months, 85% of CsA-ME patients and 86% of tacrolimus patients survived with a functioning graft (P not significant). Efficacy was similar in deceased- and living-donor recipients. Significantly fewer hepatitis C-positive patients died or lost their graft by 12 months with CsA-ME (5/88, 6%) than with tacrolimus (14/85, 16%) (P < 0.03). Recurrence of hepatitis C virus in liver grafts was similar in each group. Based on biopsies driven by clinical events, the mean time to histological diagnosis of hepatitis C virus recurrence was significantly longer with CsA-ME (100 +/- 50 days) than with tacrolimus (70 +/- 40 days) (P < 0.05). Median serum creatinine at 12 months was 106 mumol/L with CsA-ME and with tacrolimus. More patients who were nondiabetic at baseline received antihyperglycemic therapy in the tacrolimus group at 12 months (13% vs. 5%, P < 0.01). Of patients who were diabetic at baseline, more tacrolimus-treated individuals required anti-diabetic treatment at 12 months (70% vs. 49%, P = 0.02). Treatment for de novo or preexisting hypertension or hyperlipidemia was similar in both groups. In conclusion, the efficacy of CsA-ME monitored by blood concentration at 2 hours postdose and tacrolimus in liver transplant patients is equivalent to 12 months, and renal function is similar. More patients required antidiabetic therapy with tacrolimus regardless of diabetic status at baseline.


Affair With Triphasic Waves-Their Striking Presence, Mysterious Significance, and Cryptic Origins: What are They?
Triphasic waves, which have been recorded in the EEG of encephalopathy for more than 50 years, remain clearly identifiable but historically purportedly of uncertain significance. Initially described with liver failure and high serum ammonias, they came to be reported in an ever-expanding list of metabolic, toxic, and structural conditions. Often a dynamic finding (in which the occurrence of triphasic waves might increase or decrease with stimulation or arousal of the patient during EEG), there has been increasing insight into their correlation with multiple concurrent conditions, including subcortical white-matter disease, infections and metabolic disturbances, and their prognostic significance. There are sparse data, but there is active controversy into their confusion for, or occurrence in, nonconvulsive status epilepticus. This review and commentary discuss our current understanding of triphasic waves and the newer areas of contention surrounding this mysterious EEG morphology.


[Effects of miR-382 on cell migration, invasion and proliferation of gastric cancer cell lines MGC-803].
Objective: To investigate the effects of miR-382 on cell migration, invasion and proliferation of gastric cancer cell lines MGC-803. Methods: The level of miR-382 expression was detected by real-time RT-PCR in 50 paired gastric cancer tissues and their adjacent normal tissues. miR-382 overexpression was achieved by transfection of construct pcDNA-miR-382 into MGC-803 cells. The migration, invasion and proliferation of MGC-803 cells were detected by the scratch wound assay, Transwell and CCK-8, respectively. Results: miR-382 was decreased in 41 cases (82%) of gastric cancer tissues compared to their control. Furthermore, overexpression of miR-382 effectively inhibited the migration, invasion and proliferation of MGC-803 cells(P<0.05). Conclusion: Down-regulation of miR-382 has a correlation with the progression of gastric cancer. Up-regulation of miR-382 can inhibit the migration, invasion and proliferation of MGC-803 cells.


Contamination of selected heavy metals in Limnothrissa miodon (Boulenger, 1906) in the four strata of Lake Kariba Zambia: are the consumers at risk?
Pollution of aquatic ecosystems is one of the major challenges affecting many countries of the world. Heavy metal pollutants, in particular, threaten the life of aquatic organisms (fauna and flora) and, more importantly, humans who consume aquatic products as a critical source of proteins. In the present study, the concentrations of selected heavy metals (cobalt- Co, Chromium-Cr, nickel- Ni and manganese- Mn) in Limnothrissa miodon, locally known as 'Kapenta' were assessed using the Microwave Plasma Atomic Emission Spectrometer (MP AES) 4200 at the Zambia Agricultural Research Institute (ZARI). The fish was collected from Lake Kariba, Zambia, which is divided into four fisheries management strata (I, II, III, and IV). The health risks to consumers were evaluated using the Estimated Daily Intake (EDI), Target Hazard Quotient (THQ) and Hazard Index (HI). Analysis of variance (ANOVA) was used to assess the difference in the means of heavy metal concentration across the four strata for each element. The concentrations of all the heavy metal elements were within the permissible limits considered to be safe for human consumption based on the Food and Agriculture Organization (FAO) standards. However, the concentration of individual heavy metal elements varied significantly across the strata with stratum I and II showing higher levels in general except for Mn which was highest in stratum II and III compared with the other strata. Furthermore, Mn concentration was the highest in all the strata and the highest concentration was observed in the fish from stratum II. The EDIs, THQs and HIs of each heavy metal element did not show any threat to consumers of the fish from the lake. Further studies are required to better understand the potential sources of heavy metals and to regularly monitor existing activities that may elevate the concentration levels.


G protein pathways.
The heterotrimeric guanine nucleotide-binding proteins (G proteins) are signal transducers that communicate signals from many hormones, neurotransmitters, chemokines, and autocrine and paracrine factors. The extracellular signals are received by members of a large superfamily of receptors with seven membrane-spanning regions that activate the G proteins, which route the signals to several distinct intracellular signaling pathways. These pathways interact with one another to form a network that regulates metabolic enzymes, ion channels, transporters, and other components of the cellular machinery controlling a broad range of cellular processes, including transcription, motility, contractility, and secretion. These cellular processes in turn regulate systemic functions such as embryonic development, gonadal development, learning and memory, and organismal homeostasis.


Time and the structuring of ritual performance in the xenotransplantation debate.
Advancements in biotechnology provoke fundamental questions about the relationship of humans to the natural world. A crisis arises as the knowledge, practice, and policies concerning biotechnology grow further out of step with each other. This paper examines the role of ritual performance as a means of resolving this crisis, uniting the organic with the socio-moral aspects of science, technology and regulatory policy. Ritual performance is evident in the public discussions of the United States' Secretary's Advisory Committee on Xenotransplantation (SACX). In an attempt to understand the cultural responses to new knowledge, this paper examines the transcripts of several SACX meetings for its ritual elements and references to authority. We find that time is used by scientists to structure ritual performance in a way that guides public policy and attitudes toward xenotransplantation.


Case report: primary hepatic lymphoma associated with chronic liver disease.
We report on a case of primary hepatic lymphoma that developed in a patient with chronic hepatitis C. Given that Japan is an area endemic for both hepatitis B and C viruses, we reviewed 51 Japanese cases of primary hepatic lymphoma, addressing the question as to whether the Japanese cases have unique characteristics and whether there is a causal relationship to the presence of chronic liver disease. Primary hepatic lymphoma most commonly affected middle-aged males. Presenting symptoms and physical findings were non-specific. Aminotransferases tended to stay in the low range compared with marked increases in lactate dehydrogenase. Sixteen patients (31%) had chronic liver disease, eight had liver cirrhosis and eight had chronic hepatitis, suggesting that there is a possible aetiological link between chronic liver disease and primary hepatic lymphoma.


Covalent Co-O-V and Sb-N Bonds Enable Polyoxovanadate Charge Control.
The formation of [{CoII(teta)2}{CoII2(tren)(teta)2}VIV15SbIII6O42(H2O)]·ca.9H2O [teta = triethylenetetraamine; tren = tris(2-aminoethyl)amine] illustrates a strategy toward reducing the molecular charge of polyoxovanadates, a key challenge in their use as components in single-molecule electronics. Here, a V-O-Co bond to a binuclear Co2+-centered complex and a Sb-N bond to the terminal N atom of a teta ligand of a mononuclear Co2+ complex allow for full charge compensation of the archetypal molecular magnet [V15Sb6O42(H2O)]6-. Density functional theory based electron localization function analysis demonstrates that the Sb-N bond has an electron density similar to that of a Sb-O bond. Magnetic exchange coupling between the VIV and CoII spin centers mediated via the Sb-N bridge is comparably weakly antiferromagnetic.


mRNA Delivery Platform Based on Bacterial Outer Membrane Vesicles for Tumor Vaccine.
The rapid display and delivery method for customized tumor mRNA vaccines is limited. Herein, bacteria-derived outer membrane vesicles (OMVs) are employed as an mRNA delivery platform by surface engineering of an RNA-binding protein, L7Ae. OMV-L7Ae can rapidly adsorb boxC/D sequence-labeled mRNA antigens through L7Ae-boxC/D binding and deliver them into HEK-293T and dendritic cells. This platform provides an mRNA delivery technology distinct from lipid nanoparticles (LNPs) for personalized mRNA tumor vaccination and with a Plug-and-Display strategy suitable for rapid preparation of the personalized mRNA tumor vaccine against varied tumor antigens. Key features OMVs are employed as an mRNA delivery platform through L7Ae-boxC/D binding.


Prevalence of Impacted Teeth and Pattern of Third Molar Impaction among Kerala Population a Cross Sectional Study.
When a tooth does not erupt to the normal functional position, the tooth is said to be impacted. Impaction can be partial or complete which has many problems associated with it and adjacent tooth. To assess the prevalence of impaction and pattern of mandibular impaction among adults in Ernakulum district, Kerala. Retrospective data were analyzed using panoramic radiographs of 1,500 subjects were correlated with demographic details age and gender. Two independent investigators carried out the research independently. Data were analyzed using SPSS. The prevalence of teeth impaction was 22.0%. A total of 330 subjects presented with at least one impacted tooth. Mandibular third molars were the most commonly impacted tooth (17.46%). The mesioangular orientation was the most common pattern. There was no gender difference in prevalence of impaction (P >.05). Twenty two percent among Kerala population. The mandibular wisdom teeth were the most commonly impacted teeth. Mesioangular orientation was the most common pattern. No association was found between impacted teeth as per gender.


Patients' beliefs about the causes of heart disease: relationships with risk factors, sex and socio-economic status.
Patients' beliefs about the causes of their heart disease (causal attributions) are important to effective medical communication, psychological adaptation, and adherence to advice. We assessed the extent to which causal attributions relate to risk factors, sex and socio-economic status in men and women diagnosed with acute coronary syndrome. We conducted an interview and questionnaire study of 171 acute coronary syndrome patients assessed within 5 days of admission to three hospitals in the London area. Patients rated beliefs in the role of 16 factors in causing their heart disease. Associations between attributions and risk factors were assessed, and differences in beliefs by sex and socio-economic status (defined by educational attainment) analysed. The most common attributions were to stress, smoking, high blood pressure, chance or bad luck, and heredity. Attributions were strongly associated with risk factors: 90% of smokers attributed heart disease to smoking, compared with 0% never smokers; 90.4% of hypertensives attributed heart disease to high blood pressure, 72.2% of patients with a positive family history to heredity, 85% of obese patients to being overweight, and 49% of sedentary patients to lack of exercise. Attributions to stress were related both to current mood and reports of recent life stress. There were few sex differences, but higher socio-economic status patients were more likely to attribute heart disease to heredity and genetic factors. Causal beliefs about heart disease are strongly associated with risk factors. Effective communication about modifiable risk factors may influence causal beliefs and stimulate lifestyle change, thereby promoting secondary prevention.


Prevalence of unmet contraceptive need among Egyptian women: a community-based study.
An estimated 17% of married women in the developing world still have an unmet need for contraception. This study aimed to measure the prevalence and reasons for unmet contraceptive need among married women in the childbearing period in an underprivileged district in Eastern Cairo. A cluster survey of 2340 women in the Marg district of Eastern Cairo was performed. Socio-demographic data and data on both past and present contraceptive use were obtained by interview questionnaire. The prevalence of unmet need was 7.4%; 53.4% for limiting and 46.6% for spacing. Experience of side effects from contraceptive use, and fear of side effects, was highly prevalent among women with unmet need. In addition, a large proportion of women with unmet need perceived themselves not to be at risk for conceiving. A substantial proportion of women in Cairo have unmet contraceptive need. Efficient counseling of women about contraception may help reduce this high prevalence.


SARS-CoV-2 Spike Protein Mutations in Different Variants: A Comparison Between Vaccinated and Unvaccinated Population in Western Amazonia.
The increased transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has generated variants of concern (VOCs) throughout the pandemic, responsible for waves of cases worldwide. To monitor mutations in the S gene of SARS-CoV-2 in different variants, we evaluated 1497 individuals with COVID-19 in western Amazonia in the period April 2021 to July 2022. The epidemiological and clinical data of the individuals were collected; subsequently, the samples were extracted using a commercial kit, the viral load was assessed, and viral genomes were sequenced. We analyzed the quality and mutations of the genomes and maximum likelihood phylogenetic inference. However, 3 main clusters were observed, referring to Gamma (52.91%), Delta (24.38%), and Omicron (20.38%) VOCs with wide distribution in all health regions of the Rondônia state. Regarding the vaccination profile, there was a higher percentage of unvaccinated and partially vaccinated individuals, with more representatives by the Gamma variant. A total of 1412 sequences were suitable for mutation analysis in the S gene region. The Omicron VOC showed 38 mutations, with the Delta and Gamma variants with 16 and 17, respectively. The VOC Omicron and Gamma shared 4 mutations E484K, H655Y, N501Y, and N679K with high frequency, and Delta and Omicron 2 mutations (T478K and T95I). Regarding the comparison between the frequency of mutations for each variant concerning the vaccination groups, there were no changes in mutations for each group. In conclusion, the study showed a temporal increase in mutations and subvariants for characterized strains. Furthermore, the vaccination profile did not impact significant changes in the mutational profile yet remains a determining factor for severe disease.


The experiences of mothers of pediatric surgery children--a qualitative analysis.
The purpose of this study was to explore the experiences of mothers of children admitted in the pediatric surgery ward. Respondents consisted of a convenience sample of 10 mothers. Data were collected through in-depth interview and were analyzed based on the synthetic approach to grounded theory analysis. The core category that emerged from the analysis was "staying hopeful that the child is alright." The categories identified include discovering the condition, questioning God, seeking information, trusting the health care system, coming to terms, desiring to participate in the care of the child, and maintaining quality of care. Implications for health professionals include a need for thorough assessment and anticipatory guidance to the parents. Limitations of the study and recommendations for future research are also given.


Reference range of total serum homocysteine level and dietary indexes in healthy Greek schoolchildren aged 6-15 years.
Elevated total serum homocysteine (tHcy) may be a possible risk factor for CVD. A 5 micromol/l increase in tHcy is associated with an approximately 70 % increase in relative risk of CVD in adults. Data for children and adolescents are, however, limited. The purpose of the present study was to provide a reference range for tHcy and investigate any relationship between tHcy and nutritional indexes in a Greek paediatric population. tHcy, folate, vitamin B12 levels and dietary indexes were measured in 520 healthy schoolchildren (274 boys, 246 girls) aged 6-15 years. As in adults, the tHcy distribution skewed to the right, with a geometric mean for both genders of 7.4 (range 3.4-29 micromol/l). Concentrations were lower in young children and increased with age. No statistically significant difference in tHcy level was observed between gender. The 95th percentiles for the three age groups were as follows: 6-9 years, 9.98 micromol/l; 10-12 years, 10.62 micromol/l; 13-15 years, 14.4 micromol/l. Using Pearson's coefficient analysis, tHcy level was correlated with age, serum folate, BMI and systolic blood pressure. Dietary analysis showed that folate, vitamin B12 and fibre intake were inversely related with tHcy; conversely, sugar and fat were positively associated with tHcy. However, in multiple linear regression analysis, only age (odds ratio 0.246, P < 0.05) and folate (odds ratio -0.346, P < 0.05) were significantly and independently associated with tHcy. This study provides age-specific reference data regarding tHcy concentration in a Greek paediatric population. tHcy levels increased as a function of age. Serum folate levels were significantly and independently associated with tHcy levels.


Pyruvate dehydrogenase complex deficiency with multiple minor anomalies.
Pyruvate dehydrogenase complex (PDHC) deficiency is known to cause congenital lactic acidosis. The case of a 9-month-old female infant with PDHC deficiency caused by a mutation in exon 11 of the pyruvate dehydrogenase (PDH) E1 alpha gene is described. Her facial features were as follows: frontal bossing, upslanting palpebral fissures, a short upturned nose, a long philtrum and low set ears. These anomalies are characteristic not only of a malformation syndrome or chromosomal aberration, but also of PDHC deficiency. Because PDHC deficiency requires early treatment, metabolic disorders should be kept in mind in a patient with dysmorphic features. Further, she had multiple minor anomalies including bilateral inguinal herniae, an umbilical hernia and small hands and feet, which have not been described in previous reports.


Identifying organisms.
Defenders of human, embryonic, destructive stem-cell research and early abortion typically argue for their position by showing that you and I do not come into existence at conception but rather at some point after. Eugene Mills has provided an ingenious argument that you and I could not have come into existence at conception. I argue against Mills's argument on two counts: first, his argument depends upon a cursory limning of human conception, and when fuller details are considered, a premise in his argument is undercut. Second, Mills's argument invites us to ask questions about how to identify individual organisms. Given a fuller description of human conception and some plausible metaphysical principles, I argue that Mills should hold instead that you and I do in fact come into being at conception. One way to argue that early abortions are permissible is to argue against the view that you and I come into existence at conception. Most abortion rights defenders argue for this conclusion by noting that in order for you and I to exist, there must be developed psychological capacities. Eugene Mills takes a different route and argues that you and I could not come into existence at conception because that would mean being identical to an egg - which he rightly notes we cannot be. I argue against Mills in this article.


The Impact of SARS-CoV-2 Lineages (Variants) and COVID-19 Vaccination on the COVID-19 Epidemic in South Africa: Regression Study.
Emerging SARS-CoV-2 variants have been attributed to the occurrence of secondary, tertiary, quaternary, and quinary COVID-19 epidemic waves threatening vaccine efforts owing to their immune invasiveness. Since the importation of SARS-CoV-2 in South Africa, with the first reported COVID-19 case on March 5, 2020, South Africa has observed 5 consecutive COVID-19 epidemic waves. The evolution of SARS-CoV-2 has played a major role in the resurgence of COVID-19 epidemic waves in South Africa and across the globe. We aimed to conduct descriptive and inferential statistical analysis on South African COVID-19 epidemiological data to investigate the impact of SARS-CoV-2 lineages and COVID-19 vaccinations in South African COVID-19 epidemiology. The general methodology involved the collation and stratification, covariance, regression analysis, normalization, and comparative inferential statistical analysis through null hypothesis testing (paired 2-tailed t tests) of South African COVID-19 epidemiological data. The mean daily positive COVID-19 tests in South Africa's first, second, third, fourth, and fifth COVID-19 epidemic wave periods were 11.5% (SD 8.58%), 11.5% (SD 8.45%), 13.3% (SD 9.72%), 13.1% (SD 9.91%), and 14.3% (SD 8.49%), respectively. The COVID-19 transmission rate in the first and second COVID-19 epidemic waves in South Africa was similar, while the COVID-19 transmission rate was higher in the third, fourth, and fifth COVID-19 epidemic waves than in the aforementioned waves. Most COVID-19 hospitalized cases in South Africa were in the general ward (60%-79.1%). Patients with COVID-19 on oxygen were the second-largest admission status (11.2%-16.8%), followed by patients with COVID-19 in the intensive care unit (8.07%-16.7%). Most patients hospitalized owing to COVID-19 in South Africa's first, second, third, and fourth COVID-19 epidemic waves were aged between 40 and 49 years (16.8%-20.4%) and 50 and 59 years (19.8%-25.3%). Patients admitted to the hospital owing to COVID-19 in the age groups of 0 to 19 years were relatively low (1.98%-4.59%). In general, COVID-19 hospital admissions in South Africa for the age groups between 0 and 29 years increased after each consecutive COVID-19 epidemic wave, while for age groups between 30 and 79 years, hospital admissions decreased. Most COVID-19 hospitalization deaths in South Africa in the first, second, third, fourth, and fifth COVID-19 epidemic waves were in the ages of 50 to 59 years (15.8%-24.8%), 60 to 69 years (15.9%-29.5%), and 70 to 79 years (16.6%-20.7%). The relaxation of COVID-19 nonpharmaceutical intervention health policies in South Africa and the evolution of SARS-CoV-2 were associated with increased COVID-19 transmission and severity in the South African population. COVID-19 vaccination in South Africa was strongly associated with a decrease in COVID-19 hospitalization and severity in South Africa.


Novel mutations of the FRMD7 gene in X-linked congenital motor nystagmus.
Congenital motor nystagmus (CMN) is a relatively common oculomotor disorder characterized by bilateral uncontrollable ocular oscillations. Recently, the FRMD7 gene mutation has been identified as the genetic cause of CMN. The purpose of this study was to identify mutations of the FRMD7 gene in Chinese patients with CMN. Clinical data and genomic DNA of three Chinese CMN families were collected after informed consent. Genescan by two-point linkage analysis combined with haplotype analysis was performed and mutation screening of the FRMD7 gene was conducted by direct sequencing. Maximum two-point LOD scores of 2.00, 1.76, and 1.16 at theta=0.00 were obtained with markers in proximity to the FRMD7 gene on chromosome Xp26 in the three CMN families. Mutation screening in the FRMD7 gene identified two novel missense mutations (c.781C>G and c.886G>C) and one reported nonsense mutation (c.1003C>T). These nucleotide alterations were not seen in unaffected members of the families or in 100 unrelated control subjects. This study widens the mutation spectrum of the FRMD7 gene.


Diagnostic accuracy of glycosylated hemoglobin in chinese patients with gestational diabetes mellitus: a meta-analysis based on 2,812 patients and 5,918 controls.
The accuracy of glycosylated hemoglobin (HBA1c) detection for the diagnosis of gestational diabetes mellitus (GDM) has been extensively studied in the Chinese population, but the exact role of these detections remains controversial. The present meta-analysis was performed to establish the overall accuracy of HBA1c for the diagnosis of Chinese patients with GDM. After a systematic review of related studies, the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and other measures about the accuracy of HBA1c in the diagnosis of GDM were pooled using random-effects models. The summary receiver operating characteristic (SROC) curve analysis was used to summarize the overall test performance. Forty-one studies included 2812 Chinese patients with GDM and 5918 controls were included in our meta-analysis. The summary estimates for HBA1c in the diagnosis of GDM in the studies included were as follows: sensitivity 0.762 (95% confidence interval [CI]: 0.746-0.777), specificity 0.917 (95% CI: 0.910-0.924), PLR 8.21 (95% CI: 3.77-17.89), NLR 0.20 (95% CI: 0.09-0.44), and DOR 41.40 (95% CI: 11.47-149.38). Our data showed that the SROC curve is positioned near the desirable upper left corner of the SROC curve, while the area under curve (AUC) was 0.93 with a Q* value of 0.865. Measurement of HBA1c is likely to be a useful diagnostic tool for confirming GDM. The results of HBA1c should be interpreted in parallel with clinical findings and the results of conventional tests.


Transforming growth factor β1 (TGFβ1) and vascular endothelial growth factor (VEGF) in the blood of healthy people and patients with Graves' orbitopathy--a new mechanism of glucocorticoids action?
The first part of this paper is related to healthy people and presents concentrations of TGFβ1 and VEGF in blood (with and without dividing data with respect to sex), their single measurement values (at 8 am), Mean Daily Concentrations (MDC), Area Under the Curves (AUC; total daily secretion), and circadian rhythm. The second part of the work is related to Graves' orbitopathy (GO). The aim of the study were: 1) to determine the physiological pattern of TGFβ1 and VEGF secretion; 2) to compare the serum TGFβ1 and VEGF circadian profile in newly diagnosed thyreotoxic patients with active GO and healthy controls (H); and 3) to estimate the influence of high-dose intravenous methylprednisolone pulse therapy (MP) on TGFb1 and VEGF blood levels in GO. Twenty-two healthy (H) subjects and 16 hyperthyroid GO patients were treated with MP (6 g/14 days) and followed up by ophthalmological assessment. Blood was collected before and after 2 weeks MP-therapy. TGFβ1 and VEGF levels were determined by the ELISA method. No difference was observed in the concentrations of TGFβ1 and VEGF in the blood of healthy women and men - in further analysis, a combined healthy male and female cohort was used (H). While the absence of circadian rhythms in the concentrations of TGFβ1 and VEGF allows the application of a single measurement approach, MDC and AUC measurements were found to be more precise. There were no differences in TGFβ1 MDC/AUC between GO and H. VEGF MDC/AUC in GO were higher than in H. MP-therapy increased TGFb1 MDC/AUC, thus in GO after MP, the TGFβ1 MDC/AUC were higher than in H. There were no differences in VEGF MDC/AUC during MP-therapy. MP-therapy was effective in 15/16 patients. 1. MP-therapy increases MDC and AUC of TGFβ1. The effectiveness of MP-therapy in patients with active GO may be related to its influence on TGFβ1 concentrations in blood. The results suggest the existence of a new mechanism of glucocorticoids action, consisting of an increase in the secretion of TGFβ1.2. The elevated serum VEGF in thyreotoxic patients with active GO may reflect long-standing autoimmune processes in orbital and thyroid tissues and intensified angiogenesis in the thyroid gland.


Ocular findings in patients with oculocutaneous albinism type ia with G47D tyrosinase gene mutation in Puerto Rico: a case report.
Previous studies have suggested that the G47D mutation leads patients to develop Oculocutaneous albinism (OCA) type IA. This mutation has been described in the Canary Islands. Historically, there has been a migration from the Canary Islands to some regions of Puerto Rico. To report on the ocular findings of two Puerto Rican patients with OCA IA due to the G47D Tyrosinase gene mutation. PATIENT AND FINDINGS: Two unrelated patients with OCA underwent a comprehensive eye examination and were referred for genetic analysis. Patients had almost total iris transillumination, clear lenses, foveal hypoplasia with transparent maculae, and albinotic mid peripheries. Both patients had nystagmus, and only one patient had strabismus. Patients with the G47D muta- tion leading to OCA IA have poor visual acuities and poorly pigmented phenotypic ophthalmic findings. Further studies comparing ocular findings in patients th several mutations leading to OCA IA are warranted. To our knowledge this is the first report on ocular findings in Puerto Rican patients with OCA type IA with the rare G47D mutation.


Effects of Zn2+ on the activity and binding of the mitochondrial ATPase inhibitor protein, IF1.
Zn2+ caused a noninhibitory binding of IF1 to mitochondrial membranes in both rabbit heart SMP and intact rabbit heart mitochondria. This Zn(2+)-induced IF1 binding required the presence of at least trace amounts of MgATP and was essentially independent of pH between 6.2 and 8.2. Addition of Zn2+ after the formation of fully inhibited IF1-ATPase complexes very slowly reversed IF1-mediated ATPase inhibition without causing significant IF1 release from the membranes. When Zn2+ was added during the state 4 energization of ischemic mitochondria in which IF1 was already functionally bound, it slowed somewhat energy-driven ATPase activation. This slowing was probably due to the fairly large depressing effect Zn2+ had upon membrane potential development, but Zn2+ did not decrease the degree of ATPase activation eventually reached at 20 min of state 4 incubation. Zn2+ also preempted normal IF1 release from the membranes, causing what little inhibitor that was released to rebind to the enzyme in noninhibitory IF1-ATPase complexes. The data suggest that IF1 can interact with the ATPase in two ways of through two kinds of sites: (a) a noninhibitory interaction involving a non-inhibitory IF1 conformation and/or an IF1 docking site on the enzyme and (b) an inhibitory interaction involving an inhibitory IF1 conformation and/or a distinct ATPase activity regulatory site. Zn2+ appears to have the dual effect of stabilizing the noninhibitory IF1-ATPase interaction and possibly a noninhibitory IF1 conformation while concomitantly preventing the formation of an inhibitory IF1-ATPase interaction and possibly an inhibitory IF1 conformation, regardless of pH. While the data do not rule out direct effects of Zn2+ on either free IF1 or the free enzyme, they suggest that Zn2+ cannot interact readily with either the inhibitor or the enzyme once functional IF1-ATPase complexes are formed.


[Validation of a new method for measurement of pulmonary blood volume (author's transl)].
The pulmonary blood volume (Q) can be measured by dye injection in the pulmonary artery (PA) and in the left atrium (LA) and by sampling in the brachial artery (double injection - single sampling method). We propose to replace the injection in the LA, for which a left heart catheterization is needed, by a pulmonary wedge injection (PW). No significant difference was found between the first and the second method in twenty-four measurements in six anesthetized and artificially ventilated dogs kept in steady hemodynamic state : QPW (1) equals 0.009 + 1.106 QLA (r equals 0.935). The results are independent of the capillary injection site. In man, the indirect validation was made by unilateral occlusion of a main pulmonary artery, allowing blood volume measurement of the occluded lung by two methods, one of them independent of the "capillary" injection. The results of both methods are comparable and highly correlated (r equals 0.86). The range of the values of pulmonary blood volume in sixteen normal supine subjects, at rest, was similar to that of other authors, whichever the technique they used (394 plus or minus 114 ml, 268 plus or minus 59 ml m-2). The reproducibility of the results was comparable. In five subjects, pulmonary blood volume did not change during a moderate muscular excerise in the supine position (57 watts). The pulmonary wedge injection in man can replace the LA injection of the double injection - single sampling method, without loss of precision nor effect on reproducibility.


Regulation of alcoholic fermentation in batch and chemostat cultures of Kluyveromyces lactis CBS 2359.
Kluyveromyces lactis is an important industrial yeast, as well as a popular laboratory model. There is currently no consensus in the literature on the physiology of this yeast, in particular with respect to aerobic alcoholic fermentation ('Crabtree effect'). This study deals with regulation of alcoholic fermentation in K. lactis CBS 2359, a proposed reference strain for molecular studies. In aerobic, glucose-limited chemostate cultures (D = 0.05-0.40 h-1) growth was entirely respiratory, without significant accumulation of ethanol or other metabolities. Alcoholic fermentation occurred in glucose-grown shake-flask cultures, but was absent during batch cultivation on glucose in fermenters under strictly aerobic conditions. This indicated that ethanol formation in the shake-flask cultures resulted from oxygen limitation. Indeed, when the oxygen feed to steady-state chemostat cultures (D = 0.10 h-1) was lowered, a mixed respirofermentative metabolism only occurred at very low dissolved oxygen concentrations (less than 1% of air saturation). The onset of respirofermentative metabolism as a result of oxygen limitation was accompanied by an increase of the levels of pyruvate decarboxylase and alcohol dehydrogenase. When aerobic, glucose-limited chemostat cultures (D = 0.10 h-1) were pulsed with excess glucose, ethanol production did not occur during the first 40 min after the pulse. However, a slow aerobic ethanol formation was invariably observed after this period. Since alcoholic fermentation did not occur in aerobic batch cultures this is probably a transient response, caused by an imbalanced adjustment of enzyme levels during the transition from steady-state growth at mu = 0.10 h to growth at mu max. It is concluded that in K. lactis, as in other Crabtree-negative yeasts, the primary environmental trigger for occurrence of alcoholic fermentation is oxygen limitation.


Ten new species of Calonectria from Indonesia and Vietnam.
Vietnam and Indonesia have rapidly growing and extensive plantation forestry programs, especially of Acacia spp. and Eucalyptus spp. As these plantations expand, the threat from pests and diseases also increases. Calonectria species are among those pathogens causing diseases of trees in plantations and nurseries in these countries. Extensive surveys were conducted across plantations and nurseries of Vietnam and parts of Indonesia, where a large number of Calonectria isolates were retrieved from diseased leaves and soils associated with symptomatic trees. The aim of this study was to identify and resolve the phylogenetic relationships among these isolates using DNA sequence comparisons of four gene regions as well as morphological characters. From a collection of 165 isolates, the study revealed five known and 10 undescribed species. The relatively high diversity of Calonectria species found in this study supports the view that many more species in this genus remain to be discovered in other areas of Southeast Asia.


Wrasses of the Galápagos Islands, with the description of a new deepwater species of Halichoeres (Perciformes: Labridae).
Halichoeres raisneri, new species, is described from three specimens captured by the Johnson Sea Link submersible at 114-125 m off Wolf Island, Galápagos. Distinctive features of the new species include a dorsally projecting fleshy flap along the posterior three-quarters of the upper lip and the absence of a canine tooth at the corner of the upper jaw. The body color of freshly caught females is pale pink with two yellow stripes and five prominent pink spots above the uppermost stripe. Similarities between the new species and other labrids are discussed, and a key to the 16 nominal species of Labridae known from the Galápagos Islands is provided. Decodon melasma is recorded from the Archipelago for the first time.


Clinical experience of a subcutaneously anchored sutureless system for securing central venous catheters.
This article reports the results of three prospective clinical studies conducted in a university hospital regarding the efficacy, safety and cost effectiveness of a subcutaneously anchored sutureless system for securing central venous catheters. The results were favourable to the adoption of such a device, and the analysis of the data allowed the authors to define those categories of patients where the device should have the most benefit: neonates, children, non-compliant older patients with cognitive difficulties, patients with skin abnormalities that may reduce the effectiveness of a skin-adhesive sutureless securement system, patients who are candidates for having a peripherally inserted central catheter (PICC) in place for more than 8 weeks, and any other category of patients with a recognised high risk of catheter dislodgement.


Penumopericardium due to transdiaphragmatic perforation of a gastric ulcer.
A 65-year-old man presented with cardiogenic shock and massive pneumopericardium. A gastropericardial fistula due to transdiaphragmatic penetration of a large fundal ulcer was documented radiographically and confirmed at autopsy. Previously recorded cases of penumopericardium complicating gastric ulcers or other diseases of the digestive tract are briefly reviewed.


A global burden of gastric cancer: the major impact of China.
Gastric cancer (GC) is a highly aggressive cancer and a major cause of cancer-related deaths worldwide. Approximately half of the world's GC cases and deaths occur in china. GC presents challenges in early diagnosis and effective therapy due to a lack of understanding of the underlying molecular biology. The primary goals of this review are to outline current GC research in china and describe future trends in this field. Areas covered: This review mainly focuses on a series of GC-related advances China has achieved. Considerable progress has been made in understanding the role of H. pylori in GC by a series of population-based studies in well-established high-risk areas; A few germline and somatic alterations have been identified by 'omics' studies; Studies on the mechanisms of malignant phenotypes have helped us to form an in-depth understanding of GC and advance drug discovery. Moreover, identification of potential biomarkers and targeted therapies have facilitated the diagnosis and treatment of GC. However, many challenges remain. Expert commentary: To combat GC, sufficient funding is important. More attention should be paid on early diagnosis and the discovery of novel efficient biomarkers and the development of biomarker-based or targeted therapeutics in GC.


Midline glossectomy and epiglottidectomy for obstructive sleep apnea syndrome.
Obstructive sleep apnea syndrome is caused by narrowing of the pharyngeal airway and loss of dilator tone during sleep. In patients with severe apnea surgical correction often requires attention to both the oropharynx and hypopharynx. Tongue reduction surgery has been described for persistent apnea after failure of palatal surgery. We describe our experience with midline glossectomy with epiglottidectomy in 12 patients with a mean age of 48.8 +/- 14.2 years and body mass index of 36.0 +/- 8.8 kg/m2. Response to treatment was defined as a postoperative respiratory disturbance index (RDI) below 20. Three patients (25%) responded to treatment. The mean apnea index decreased from 48.9 to 35.7, RDI decreased from 73.3 to 46.6, and lowest oxygen saturation increased from 65.9 to 77.9%. RDI in responders decreased from 69.7 to 10. Midline glossectomy with epiglottidectomy has variable results, yet is effective in selected patients with hypopharyngeal narrowing related to macroglossia.


[Coronary vasospasm secondary to subcutaneous administration of sumatriptan].
We present the case of a 38-year-old woman with no previous history of coronary heart diseases, who suffered from cluster headaches and had undergone a subcutaneous sumatriptan treatment for two years. With no previous history of underlying ischaemic heart diseases or Prinzmetal's angina or any other significant coronary diseases supported by an angiographic exam, the patient suffered from an episode of coronary vasospasm following a subcutaneous administration of sumatriptan. Therefore particular care should be placed when subcutaneous sumatriptan is administered to patients who experienced chest pain or other related symptoms after the use of the drug.


Spouse's functional disability and mortality: The Ohsaki Cohort 2006 Study.
Caregiver burden is known to negatively affect a partner's health. Given the important role of physical and mental stress in mortality, a higher caregiver burden might be associated with an increased incidence of fatal events. However, previous studies of the effects of the partner's caregiving on mortality have shown inconsistent results. Thus, the purpose of the present longitudinal study was to determine if there is an association between a spouse's functional disability and mortality in the older Japanese population. A baseline survey was carried out with 7598 participants in 2006. Information on the date of functional disability, death or emigration was retrieved from the Ohsaki City government. Functional disability was defined as receiving a certification for long-term care insurance in Japan. After a follow-up period of a maximum of 87 months, 1316 of the participants died and Cox regression analysis with adjustment for confounding factors was used to assess mortality after the incidence of functional disability in a spouse. The multivariate adjusted hazard ratio for mortality was 1.78 (95% confidence interval 1.52-2.08, P < 0.01) in those whose spouses had functional disabilities compared with those with spouses who did not have functional disabilities. The mortality was consistently higher, irrespective of age group or sex. These results imply that caregiver burden might increase stress responses and lead to increased mortality; therefore, enhancement of support systems, including long-term care, housing and livelihood support services, for those with disability and their spouses might be important for preventing deaths. Geriatr Gerontol Int 2019; 19: 774-779.


Effect of Segment Length and Number of Osteotomy Sites on Cancellous Bone Perfusion in Free Fibula Flaps.
Indocyanine green (ICG) videoangiography is routinely used to evaluate skin and organ perfusion and to assess patency rates of microvascular anastomoses. This study uses ICG angiography as a novel approach to qualitatively and quantitatively evaluate bone perfusion of microvascular fibula grafts intraoperatively and to assess the effect of fibula segment length and number of osteotomies on bone perfusion. All patients planned for mandible reconstruction using a microvascular fibula graft between January 2013 and May 2017 were considered for this study. ICG videoangiography of cancellous bone perfusion was performed using a handheld ICG camera. Videos were analyzed, and a perfusion curve was generated. Peak enhancement, time to peak, slope, and wash-in area under the curve were extracted; rise time, wash-in rate (WiR), and wash-in perfusion index were calculated. Results were statistically analyzed with regard to distal fibula segment length and number of osteotomy sites. Thirty-nine patients (age 59 ± 8 years) were included in the study. Mandible reconstruction was achieved with 1 (n = 15), 2 (n = 13), or 3 (n = 11) fibula segments. The WiR was 6.4 ± 2.3 and 4.4 ± 0.2 before and after proximal osteotomy, respectively. The wash-in perfusion index was 114.2 ± 48.4 before and 84.4 ± 20.0 after proximal osteotomy. Bone perfusion was significantly reduced after additional proximal osteotomies. Both the segment length and number of proximal osteotomies correlated with bone perfusion, with longer segments and fewer osteotomies showing higher perfusion. This study demonstrates the feasibility of cancellous bone perfusion analysis using ICG and can serve as a basis for future bone perfusion studies. Additional osteotomies and short segment length negatively affects cancellous bone perfusion of the distal fibula segment in free fibula flaps. The extent to which the observed decrease in arterial inflow to the distal fibula segment affects the further course of healing needs to be addressed in future studies.


Estimation of Glomerular Filtration Rate in Elderly Chronic Kidney Disease Patients: Comparison of Three Novel Sophisticated Equations and Simple Cystatin C Equation.
Estimating glomerular filtration rate (GFR) in elderly patients is a problem, since they are poorly represented in studies developing GFR equations. Serum cystatin C is a better indicator of GFR than serum creatinine in elderly patients. Therefore the aim of our study was to compare frequently used serum cystatin C based GFR equations with a gold standard (51 CrEDTA clearance) in elderly chronic kidney disease (CKD) patients. 106 adult Caucasian patients, older than 65 years (58 women, 48 men; mean age 72.5 years), were included. In each patient 51 CrEDTA clearance, serum creatinine (IDMS traceable method) and serum cystatin C (immunonephelometric method) were determined. GFR was estimated using the Simple cystatin C, CKD-EPI cystatin C, CKD-EPI creatinine-cystatin C and BIS2 equation. Mean serum creatinine of our patients was 141.4 ± 41.5 μmol/L, mean serum cystatin C 1.79 ± 0.6 mg/L, mean 51 CrEDTA clearance was 52.2 ± 15.9 mL/min per 1.73 m2 . Statistically significant correlations between 51 CrEDTA clearance and all formulas were found (P < 0.0001). In the receiver operating characteristic (ROC) curve analysis (cut-off for GFR 45 mL/min per 1.73 m2 ) no significant differences in diagnostic accuracy between all the before mentioned equations were found. Bland-Altman analysis for the same cut-off showed that CKD-EPI creatinine-cystatin C and BIS2 equation underestimated and CKD-EPI cystatin C and Simple cystatin C equation overestimated measured GFR. All equations lacked precision. Analysis of ability to correctly predict patient's GFR below or above 45 mL/min per 1.73 m2 showed similar ability for all equations (P = 0.24-0.89). All equations are equally accurate for estimating GFR in elderly Caucasian CKD patients. For daily practice Simple cystatin C equation is most practical.


Joint Sparse Representation and Robust Feature-Level Fusion for Multi-Cue Visual Tracking.
Visual tracking using multiple features has been proved as a robust approach because features could complement each other. Since different types of variations such as illumination, occlusion, and pose may occur in a video sequence, especially long sequence videos, how to properly select and fuse appropriate features has become one of the key problems in this approach. To address this issue, this paper proposes a new joint sparse representation model for robust feature-level fusion. The proposed method dynamically removes unreliable features to be fused for tracking by using the advantages of sparse representation. In order to capture the non-linear similarity of features, we extend the proposed method into a general kernelized framework, which is able to perform feature fusion on various kernel spaces. As a result, robust tracking performance is obtained. Both the qualitative and quantitative experimental results on publicly available videos show that the proposed method outperforms both sparse representation-based and fusion based-trackers.


Comparison of the clinical characteristics and outcomes of bloodstream infections caused by Raoultella species and Klebsiella pneumoniae.
Background: There have been few clinical studies of Raoultella infections but Raoultella is potentially virulent and multidrug resistant. The aims of the study were to compare the clinical characteristics and outcomes of patients with Raoultella and Klebsiella pneumoniae bloodstream infections (BSIs).Methods: We retrospectively reviewed the records of patients with Raoultella and K. pneumoniae BSIs admitted to a tertiary hospital between 2008 and 2017.Results: A total of 37 cases of Raoultella BSIs were identified and matched to 160 cases of K. pneumoniae BSIs by age and sex using propensity score matching. Patients with Raoultella BSIs were more likely to have underlying biliary tract disease (54.1% versus 24.4%; p < .001) and have a community-acquired infection (62.2% versus 43.1%; p = .04) than those with K. pneumoniae BSIs. Intra-abdominal infection was the most common primary focus of infection. Biliary tract infection (64.9% versus 38.8%; p = .004) and pancreatitis (13.5% versus 3.8%; p = .03) were more common in patients with Raoultella BSIs. Raoultella isolates exhibited significantly higher susceptibility to aztreonam, cefepime, and cefotaxime. The 14-day and 30-day mortality rates were lower among the patients with Raoultella BSIs but did not differ significantly between groups (11% versus 22%; p = .16 and 11% versus 26%; p = .08 for Raoultella and K. pneumoniae BSIs, respectively).Conclusion:Raoultella spp. BSI more likely to occur in patients with underlying biliary tract disease and in community settings compared with K. pneumoniae BSIs. Biliary tract infection was the most common primary focus of Raoultella BSIs.


Bacillary necrosis, a disease of larval and juvenile bivalve mollusks. I. Etiology and epizootiology.
Tubiash, Haskell S. (U.S. Bureau of Commercial Fisheries, Milford, Conn.), Paul E. Chanley, and Einar Leifson. Bacillary necrosis, a disease of larval and juvenile bivalve mollusks. I. Etiology and epizootiology. J. Bacteriol. 90:1036-1044. 1965.-Lethal bacterial infections of a variety of hatchery-spawned bivalve mollusk larvae and juveniles have been studied. The symptoms of the disease and the course of the infection are described. Four biotypes and five antigenic types of bacteria, pathogenic for the larvae of five species of bivalve mollusks, were isolated and described in some detail. All are gram-negative motile rods. Comparative studies were made of a fairly large number of similar bacteria isolated from presumably normal marine fauna. None of these was pathogenic for the bivalve larvae nor did they have antigens in common with the pathogenic group. The four biotypes had a number of characteristics in common that rarely were present in other cultures from marine fauna. Several antibiotic preparations proved to be of value in the treatment and control of the infection.


Minimal size of coffee ring structure.
A macroscopic evaporating water droplet with suspended particles on a solid surface will form a ring-like structure at the pinned contact line due to induced capillary flow. As the droplet size shrinks, the competition between the time scales of the liquid evaporation and the particle movement may influence the resulting ring formation. When the liquid evaporates much faster than the particle movement, coffee ring formation may cease. Here, we experimentally show that there exists a lower limit of droplet size, D(c), for the successful formation of a coffee ring structure. When the particle concentration is above a threshold value, D(c) can be estimated by considering the collective effects of the liquid evaporation and the particle diffusive motion within the droplet. For suspended particles of size approximately 100 nm, the minimum diameter of the coffee ring structure is found to be approximately 10 microm.


Effect of pyrazoloquinoline derivatives on the growth of Leishmania donovani promastigotes.
A screening study was conducted to examine the effect of a series of synthesized pyrazoloquinoline derivatives on the growth of Leishmania donovani promastigotes. Sixteen compounds were tested, ten of which showed an inhibitory effect on the growth of promastigotes. Compound 1 demonstrated potent antileishmanial activity, followed by compounds 3 and 7. Some compounds showed less significant activities, while others exhibited little or no activity. Some of these compounds may be potential candidates for future treatment of leishmaniasis.


Predictors of Coronary Artery Disease in Heart Failure with Reduced Ejection Fraction at the Aga Khan University Hospital in Nairobi.
There appears to be an epidemiological transition in the etiology of heart failure in sub-Saharan Africa (SSA) in parallel with a steady increase in risk factors for coronary artery disease (CAD). SSA has limited access to heart failure and CAD diagnostics, limiting the number of patients who receive optimal care. Our objectives were to study the predictors of coronary artery disease among patients with heart failure with reduced ejection fraction (HFrEF) and develop a model to assist clinicians in determining the likelihood of CAD before cardiac catheterization. This was a retrospective study at the Aga Khan University Hospital, Nairobi, which is equipped with diagnostic capabilities for heart failure and coronary artery assessment. We evaluated patients with HFrEF based on echocardiographic data over a 12-year period. Patients with coronary anatomical evaluation data were included. A multivariable model of CAD was generated using stepwise logistic regression. Of the 1329 patients screened, 514 met the inclusion criteria. The mean age was 61.0 ± 12.8 years. There were 381 male cases (75.2%), and the predominant race was African, numbering 386 (75.2%). Most patients, 97%, were evaluated through conventional coronary angiography. Further, 310 (60.3%) cases had significant CAD. The prevalence of CAD in HFrEF was 52.3% in Africans, 85% in Asians, and 79% in Caucasians. In the multivariable logistic regression, the odds of having significant CAD was higher among participants with diabetes mellitus (aOR: 1.86; 95%CI: 1.15-3.03), Q waves (aOR: 2.12; 95%CI: 1.12-4.10), significant ST segment deviation (aOR: 4.14; 95%CI: 2.23-8.03), and regional wall motion abnormalities on echocardiogram (aOR: 6.53; 95%CI: 3.94-11.06). In this population, CAD was a major etiology in HFrEF among the African population. The most powerful predictors of CAD were type 2 diabetes, the presence of pathological Q waves, or ST segment shift on a 12-lead electrocardiogram, and regional wall motion abnormality on 2D echocardiogram. There is an epidemiological transition in the cause of heart failure in sub-Saharan Africa (SSA) in keeping with the steady increase in cardiovascular risk factors for coronary artery disease (CAD).The prevalence of CAD in African patients with heart failure with reduced ejection fraction (HFrEF) was 52.3%.In the multivariable logistic regression, diabetic mellitus, pathological Q waves, significant ST segment deviation, and regional wall motion abnormalities were significantly associated with CAD.


Immunosuppression in Donation After Circulatory Death Liver Transplantation: Can Induction Modify Graft Survival?
Recipients of donation after circulatory death (DCD) LTs historically have an increased risk of graft failure. Antibody induction (AI) with antithymocyte globulin (ATG) or anti-interleukin 2 receptor (anti-IL2R) immunotherapy may decrease the incidence of graft failure by mitigating ischemia/reperfusion injury. A retrospective review of the United Network for Organ Sharing (UNOS) database for LTs between 2002 and 2015 was conducted to determine whether ATG or anti-IL2R AI was associated with graft survival in DCD. A secondary endpoint was postoperative renal function as measured by estimated glomerular filtration rate at 6 and 12 months. Among DCD recipients, ATG (hazard ratio [HR] = 0.71; P = 0.03), but not anti-IL2R (HR = 0.82; P = 0.10), was associated with a decrease in graft failure at 3 years when compared with recipients without AI. ATG (HR = 0.90; P = 0.02) and anti-IL2R (HR = 0.94; P = 0.03) were associated with a decreased risk of graft failure in donation after brain death (DBD) liver recipients at 3 years compared with no AI. When induction regimens were compared between DCD and DBD, only ATG (HR = 1.19; P = 0.19), and not anti-IL2R (HR = 1.49; P < 0.01) or no AI (HR = 1.77; P < 0.01), was associated with similar survival between DCD and DBD. In conclusion, AI therapy with ATG was associated with improved longterm liver allograft survival in DCD compared with no AI. ATG was associated with equivalent graft survival between DCD and DBD, suggesting a beneficial role of immune cell depletion in DCD outcomes.


Hybrid zone of a tree in a Cerrado/Atlantic Forest ecotone as a hotspot of genetic diversity and conservation.
The Cerrado, the largest Neotropical savanna, and the Brazilian Atlantic Forest form large ecotonal areas where savanna and forest habitats occupy adjacent patches with closely related species occurring side by side, providing opportunities for hybridization. Here, we investigated the evolutionary divergence between the savanna and forest ecotypes of the widely distributed tree Plathymenia reticulata (n = 233 individuals). Genetic structure analysis of P. reticulata was congruent with the recognition of two ecotypes, whose divergence captured the largest proportion of genetic variance in the data (F CT = 0.222 and F ST = 0.307). The ecotonal areas between the Cerrado and the Atlantic Forest constitute a hybrid zone in which a diversity of hybrid classes was observed, most of them corresponding to second-generation hybrids (F2) or backcrosses. Gene flow occurred mainly toward the forest ecotype. The genetic structure was congruent with isolation by environment, and environmental correlates of divergence were identified. The observed pattern of high genetic divergence between ecotypes may reflect an incipient speciation process in P. reticulata. The low genetic diversity of the P. reticulata forest ecotype indicate that it is threatened in areas with high habitat loss on Atlantic Forest. In addition, the high divergence from the savanna ecotype suggests it should be treated as a different unit of management. The high genetic diversity found in the ecotonal hybrid zone supports the view of ecotones as important areas for the origin and conservation of biodiversity in the Neotropics.


Primate malaria of human importance.
Nonhuman primate (NHP) malaria poses a major threat to the malaria control programs. The last two decades have witnessed a paradigm shift in our understanding of the malaria caused by species other than the traditionally known human Plasmodium species - Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale. The emergence of the malaria parasite of long-tailed macaque monkeys, Plasmodium knowlesi, as the fifth malaria species of humans has made the scientific community consider the risk of other zoonotic malaria, such as Plasmodium cynomolgi, Plasmodium simium, Plasmodium inui, and others, to humans. The development of knowledge about P. knowlesi as a pathogen which was earlier only known to experimentally cause malaria in humans and rarely cause natural infection, toward its acknowledgment as a significant cause of human malaria and a threat of malaria control programs has been made possible by the use of advanced molecular techniques such as polymerase chain reaction and gene sequencing. This review explores the various aspects of NHP malaria, and the association of various factors with their emergence and potential to cause human malaria which are important to understand to be able to control these emerging infections.


Modified Nauta and Fink-Heimer procedures with special reference to the demonstration of monoaminergic pathways in the central nervous system.
Modifications of the selective silver impregnation methods of Nauta and Fink-Heimer are described. Both procedures were tested in wide variety of species: from reptiles to carnivores, as well as in human autoptic cases. The modified Nauta procedure is recommended as a method of choice for tracing axonal trajectories due to an improved impregnation selectivity of the degenerating axoplasm. Its use for the demonstration of monoaminergic (NA, DA, 5-HT) pathways, however, remains limited. The modified Fink-Heimer procedure demonstrates successfully the degeneration of axons, and especially--the thin preterminal arborizations, as well as the terminal boutons in many fiber systems studied, including the nigrostriatal, raphe-nigral, and coerulocortical tracts. Both methods provide an additional cytoarchitectonic orientation due to a counterstain of nerve cell bodies with cresylechtviolett.


The effect of enteral nutrition on adipokines in patients with acute pancreatitis.
The mechanism behind the beneficial effects of enteral nutrition (EN) for patients with acute pancreatitis (AP) is largely unknown. Adipokines, as mediators of metabolism and inflammation, may be a possible mechanism. The study aimed to investigate the effect of EN on adipokines early in the course of AP. Patients with AP were randomised to EN or nil-by-mouth (NBM). Blood samples were taken on the first 4 d of admission and adipokine concentrations for adiponectin, leptin, omentin, resistin and visfatin were determined by ELISA assays. A linear mixed model analysis was run to determine differences in adipokine concentrations between the two study groups. A total of thirty-two patients were included in the study. Omentin concentrations were significantly higher in patients who received EN compared with NBM across the first 4 d of admission (mean difference: 11·6 (95 % CI 1·0, 22·3) ng/ml; P = 0·033). Leptin concentrations were significantly higher in patients who received EN compared with NBM after adjusting for age, sex and BMI (mean difference: 2·3 (95 % CI 0·1, 4·5) ng/ml; P = 0·037). No significant difference in adiponectin, resistin or visfatin concentrations were observed between the two study groups. EN significantly increases omentin and leptin concentrations in AP. Future research should be directed towards understanding whether these adipokines are responsible for the therapeutic benefits of EN.


Use of new imaging in detecting and monitoring ocular manifestations of the mucopolysaccharidoses.
The aim of this review is to summate the eye involvement in patients with mucopolysaccharidoses (MPS) using current ocular imaging techniques, their advantages and disadvantages and how they may aid diagnosis, management and monitoring. We critically reviewed the current literature surrounding MPS and recent imaging technology as well as histology. Primary searches of PubMed and Web of Science were performed. We reviewed all papers on the topic published and summarized the findings of each medical device as well as the advantages and disadvantages of using these for the MPS patient. We discussed the potential of each of these devices to monitor potential ocular pathology in the MPS cohorts in the order of MPS subtype. We reviewed imaging techniques involving use of the Iris Camera, Pentacam, Optical Coherence Tomography (OCT) as well as ultrasound and Heidelberg OCT. The need for reliable objective quantification of eye findings in MPS has led to utilization of new imaging technologies described here, and future use will enhance our understanding of the unique eye features in MPS. In particular, we note that the Pentacam and iris camera are able to provide objective measurements of corneal haze and monitor ocular response to treatment.


Do conditional reinforcers count?
Six pigeons were trained on a procedure in which seven components arranged different food-delivery ratios on concurrent variable-interval schedules each session. The components were unsignaled, lasted for 10 food deliveries, and occurred in random order with a 60-s blackout between components. The schedules were arranged using a switching-key procedure in which two responses on a center key changed the schedules and associated stimuli on two side keys. In Experiment 1, over five conditions, an increasing proportion of food deliveries accompanied by a magazine light was replaced with the presentation of the magazine light only. Local analyses of preference showed preference pulses toward the alternative that had just produced either a food-plus-magazine-light or magazine-light-only presentation, but pulses after food deliveries were always greater than those after magazine lights. Increasing proportions of magazine lights did not change the size of preference pulses after food or magazine-light presentations. Experiment 2 investigated the effects of correlations between food ratios and magazine-light ratios: In Condition 6, magazine-light ratios in components were inversely correlated (-1.0) with food ratios, and in Condition 7, magazine-light ratios were uncorrelated with food ratios. In Conditions 8 and 9, pecks also produced occasional 2.5-s flashes of a green keylight. In Condition 8, food and magazine-light ratios were correlated 1.0 whereas food and green-key ratios were correlated -1.0. In Condition 9, food and green-key ratios were correlated 1.0 whereas food and magazine-light ratios were correlated -1.0. Preference pulses toward alternatives after magazine lights and green keys depended on the correlation between these event ratios and the food ratios: If the ratios were correlated +1.0, positive preference pulses resulted; if the correlation was -1.0, preference pulses were negative. These results suggest that the Law of Effect has more to do with events signaling consequences than with strengthening responses.


Quantum antidot formation and correlation to optical shift of gold nanoparticles embedded in MgO.
Quantum antidots are subnanometer scale vacancy clusters, the localized electronic structure of which can significantly alter the properties of a nanomaterial. We use positron spectroscopy to study vacancy clusters generated during the formation of gold nanoparticles via ion implantation in an MgO matrix. We observed that quantum antidots are associated with the nanoparticle surfaces after annealing in an O2 atmosphere, but not after annealing in a H2 atmosphere. In the former case, the presence of quantum antidots bound to the gold nanoparticles correlates with the redshift of the gold surface plasmon resonance, thus allowing an explanation for the redshift based on the transfer of electrons away from the metal particles.