Occipital inter-hemispheric approach for lateral ventricular trigone meningioma.
The optimal surgical approach for a trigone meningioma is still controversial. Here, we report two patients with trigone meningioma treated successfully via an occipital inter-hemispheric and trans-cortical approach in the lateral semi-prone position. A 53-year-old woman was admitted to a local hospital with sudden transient dizziness and vomiting. The CT brain scan demonstrated a right intra-ventricular tumour. She was therefore transferred to our hospital for surgical treatment. The other patient was a 67-year-old woman who was admitted to a local hospital after a traffic accident and a CT brain scan revealed an incidental right intra-ventricular tumour. After referral to our hospital, periodic MRI examinations revealed gradual tumour enlargement within a one-year period. Neither of the patients had any neurological deficits, including in the visual fields. The head of each patient was positioned so that the tumour-containing right ventricle was oriented downwards and laterally. An occipital inter-hemispheric approach was performed and using a navigation system, the tumour was identified about 1 cm in depth from the cortical surface. After the medial part of the tumour was debulked, the posterior and then the anterior choroidal blood supplies to the tumour were identified. Occlusion of these vessels achieved tumour haemostasis. The tumours were totally removed via a 1.5-cm cortical incision. Brain retraction was minimal because the right hemisphere was pulled down by gravity. Therefore, the para-splenial cisterns were easily accessed, resulting in early release of cerebrospinal fluid. Post-operative MRI showed complete removal of the tumour and the patients had no neurological deficits. Anti-epileptic medication was withdrawn one week after the operation. The occipital inter-hemispheric fissure lacks important bridging veins. The approach used and patient positioning minimized damage to the lateral aspect of the optic radiation and the corpus callosum. Except in patients with very large trigone meningiomas, this approach is useful for decreasing the risk of post-operative hemianopsia or epilepsy, and possibly speech disturbance, even in patients with a tumour in the dominant hemisphere.


Acupressure-acupuncture antiemetic prophylaxis in children undergoing tonsillectomy.
Acupuncture or acupressure at the Nei-Guan (P.6) point on the wrist produces antiemetic effects in awake but not anesthetized patients. The authors studied whether a combined approach using preoperative acupressure and intra- and postoperative acupuncture can prevent emesis following tonsillectomy in children. Patients 2-12 yr of age were randomly assigned to study or placebo groups. Two Acubands with (study) and two without (placebo) spherical beads were applied bilaterally on the P.6 points; non-bead- and bead-containing Acubands, respectively, were applied on the sham points. All Acubands were applied before any drug administration. After anesthetic induction, acupuncture needles were substituted for the beads and remained in situ until the next day. All points were covered with opaque tape to prevent study group identification. A uniform anesthetic technique was used; postoperative pain was managed initially with morphine and later with acetaminophen and codeine. Emesis, defined as retching or vomiting, was assessed postoperatively. Ondansetron was administered only after two emetic episodes at least 2 min apart. Droperidol was added if emesis persisted. One hundred patients were enrolled in the study. There were no differences in age, weight, follow-up duration, or perioperative opioid administration between groups. Retching occurred in 26% of the study patients and in 28% of the placebo patients; 51 and 55%, respectively, vomited; and 60 and 59%, respectively, did either. There were no significant differences between the groups. Redness occurred in 8.5% of acupuncture sites. Perioperative acupressure and acupuncture did not diminish emesis in children following tonsillectomy.


Safety and Effectiveness of Monochloramine Treatment for Disinfecting Hospital Water Networks.
The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling Legionella spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. Legionella spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.


Influence of thermal and lighting factors on human perception and work performance in simulated underground environment.
The utilization of underground working space in the rapidly developing global economy has broadened the scope of human activities. However, it has also brought new challenges to existing environmental construction strategies. The comfort and performance of the people inside a building are influenced by multiple factors. This study investigates the main factors affecting personnel perception and work performance, such as humidity, heat, and light, to guide the construction of underground working environments. Therefore, an experiment was designed and carried out in an artificial climate chamber to explore the differences in subjective evaluation, physiological parameters, and working performance of personnel under different thermal and lighting environments. The results show that air temperature has a significant effect on most subjective and objective parameters, while lighting has a weak effect. Air temperature and illumination are the two main environmental factors that affect comfort. Regression analysis shows that the recommended air temperature and illumination ranges are 22.0-27.3 °C and 545-1000 lx, respectively. This study also found that the interaction between color temperature and air temperature had significant effects on several evaluation parameters.


Dysfunction of the cortico-basal ganglia-cortical loop in a rat model of early parkinsonism is reversed by metabotropic glutamate receptor 5 antagonism.
This study examined the cellular correlates of the akinetic deficits produced in Wistar rats by discrete bilateral 6-hydroxydopamine (6-OHDA) striatal infusions in the dorsolateral striatum, mimicking the preferential denervation of the motor striatal territory in early symptomatic stage of Parkinson's disease (PD). Intraneuronal gene expression of cytochrome oxidase subunit I (COI), a metabolic index of neuronal activity, was increased in the subthalamic nucleus, substantia nigra pars reticulata and decreased in frontal cortical areas, but paradoxically unchanged in the striatum, globus pallidus, entopeduncular nucleus and ventrolateral thalamic nucleus. Neither preproenkephalin A nor preprotachykinin mRNA expression, markers of striatal projection neurons, were modified in the denervated striatal area despite 90% loss of dopamine (DA) terminals. Preproenkephalin A mRNA expression was however, decreased in the nondepleted striatal region, suggesting compensatory increase of dopamine tone from those spared areas. A chronic treatment with the metabotropic glutamate receptor 5 (mGluR5) antagonist 2-methyl-6-(phenylethylnyl)-pyridine (MPEP), which alleviated the akinetic disorders produced by the lesion, reversed the lesion-induced variations of COI gene expression, moderately increased this marker in the structures unaffected by the lesion and did not modify the striatal neuropeptides gene expression. These data suggest that the expression of akinetic deficits in early parkinsonism is associated with focused metabolic changes in the cortico-basal ganglia-cortical loop downstream of the striatum and pallidal complex.


Homicidal behavior and sleep apnea: a case report and medicolegal discussion.
This case report documents the use of sleep apnea as a criminal defense for a man who fatally shot his wife during his usual sleeping hours. The defendant, who had severe sleep apnea as determined by a clinical evaluation and a polysomnographic study, admitted to shooting his wife but claimed that he was asleep at the time. Two physicians testified for the defense that the sleep apnea was of sufficient severity that the defendant may have had a confusional arousal related to the sleep apnea in which he could have shot his wife accidentally. Another physician, testifying for the prosecution, found no evidence to support this defense after a review of the patient's history and polysomnographic records and a review of relevant literature which may have linked sleep apnea with sleep-related violence. In this case, there was substantial apparent motive for the murder, including a past history of spousal and child abuse and a note written by the victim around the time of the shooting describing her intention to take the children and leave the suspect. The jury rejected the sleep apnea defense, handing down a first-degree murder verdict. In the discussion, we briefly review medicolegal issues related to the case as well as prospective guidelines for the medicolegal assessment of future cases.


Intra-Kernel Reallocation of Proteins in Maize Depends on VP1-Mediated Scutellum Development and Nutrient Assimilation.
During maize (Zea mays) seed development, the endosperm functions as the major organ for storage of photoassimilate, serving to nourish the embryo. α-Zeins and globulins (GLBs) predominantly accumulate in the maize endosperm and embryo, respectively. Here, we show that suppression of α-zeins by RNA interference (αRNAi) in the endosperm results in more GLB1 being synthesized in the embryo, thereby markedly increasing the size and number of protein storage vacuoles. Glb genes are strongly expressed in the middle-to-upper section of the scutellum, cells of which are significantly enlarged by αRNAi induction. Elimination of GLBs caused an apparent reduction in embryo protein level, regardless of whether α-zeins were expressed or suppressed in the endosperm, indicating that GLBs represent the dominant capacity for storage of amino acids allocated from the endosperm. It appears that protein reallocation is mostly regulated at the transcriptional level. Genes differentially expressed between wild-type and αRNAi kernels are mainly involved in sulfur assimilation and nutrient metabolism, and many are transactivated by VIVIPAROUS1 (VP1). In vp1 embryos, misshapen scutellum cells contain notably less cellular content and are unable to respond to αRNAi induction. Our results demonstrate that VP1 is essential for scutellum development and protein reallocation from the endosperm to embryo.


Drawing inferences from clinical studies with missing values using genetic algorithm.
Missing data problem degrades the statistical power of any analysis made in clinical studies. To infer valid results from such studies, suitable method is required to replace the missing values. There is no method which can be universally applicable for handling missing values and the main objective of this paper is to introduce a common method applicable in all cases of missing data. In this paper, Bayesian Genetic Algorithm (BGA) is proposed to effectively impute both missing continuous and discrete values using heuristic search algorithm called genetic algorithm and Bayesian rule. BGA is applied to impute missing values in a real cancer dataset under Missing At Random (MAR) and Missing Completely At Random (MCAR) conditions. For both discrete and continuous attributes, the results show better classification accuracy and RMSE% than many existing methods.


Impact of Transitioning a Senior Seminar Capstone Course to an Intensive Hybrid Course.
Objective. To compare outcomes (grades, resources, and perceptions) from a weekly in-person seminar capstone course (pre-revision group) to an intensive hybrid course design that included a two-day, in-person conference (10- and 25-minute student presentations) and asynchronous seminar skills sessions (post-revision group).Methods. Students' scores on seminar presentation rubrics were compared before and after the course revision. Between the groups, we compared resources, such as number of faculty and hours of involvement, and student time away from advanced pharmacy practice experiences (APPEs). We also assessed student and faculty satisfaction and perception. Comparisons between groups were made using statistical tests, and descriptive statistics were used to summarize student performance and survey responses.Results. The study included 370 students, 205 in the pre-revision group and 165 in the post-revision group. No significant difference was found in mean overall scores for the 25-minute presentation between groups; however, the post-revision group had significantly lower subscores for objectives and slides and significantly higher subscores for critical analysis. The survey was completed by 82% of faculty and 43% of students from the class of 2018. Most students (80%) found all of the asynchronous sessions helpful, and 70.6% preferred the intensive hybrid course format. Compared to the weekly format, all faculty reported student presentations were similar or better in quality and workload was similar or decreased with the intensive hybrid format.Conclusion. Changing the senior seminar capstone course to an intensive hybrid design reduced faculty workload and decreased student time away from APPEs while maintaining similar presentation grades and quality.


Poly[μ(2)-aqua-aqua-μ(5)-naphthalene-2,7-disulfonato-strontium].
In the crystal structure of the polymeric title compound, [Sr(C(10)H(6)O(6)S(2))(H(2)O)(2)](n), the naphthalene-2,7-disulfonate dianion uses one -SO(3) unit to bind to two Sr(II) cations and the other -SO(3) unit to bind to three Sr(II) cations; of the two coordinated water mol-ecules, one is monodentate to one Sr(II) cation, whereas the other bridges two Sr(II) cations. The μ(5)-bridging mode of the dianon and the μ(2)-bridging mode of the water mol-ecule generate a polymeric three-dimensional network which is consolidated by O-H⋯O hydrogen bonds. The Sr(II) cation exists in an undefined eight-coordinate environment.


During muscle ageing the activation of the mitogenic signalling is not sufficient to guarantee cellular duplication.
Satellite cells are quiescent cells that can be induced to proliferate by a variety of stimuli such as injury and exercise, providing in this way a source of new myoblasts that repopulate the damaged muscle. It is well known that, as senescence progresses, the muscle regenerative potential progressively diminishes, but the molecular mechanisms underlying this process are not yet completely defined. Many growth factors, including Platelet Derived Growth Factor (PDGF-BB)*, have been associated to satellite cells activation, acting as potent mitogenic agents for these cells. The aim of this study is to explore if the diminished response of senescent myoblasts to growth stimuli could be due to the inability to receive and transduce hormonal signals. Herein, we demonstrate that that although PDGF-r expression is down-regulated during senescence, the receptor is fully able to be phosphorylated and to transmit the signal. Although senescent myoblasts display increased level of phosphotyrosine phosphatases (PTPs), neither the PDGF receptor (PDGF-r) phosphorylation level nor the citosolic signal transduction machinery is affected. Indeed, we demonstrated that senescent human myoblasts are able to initiate a proper mitogenic signalling cascade, since the activation of mitogen-activated protein kinases (MAPK) and phosphatydil inositole 3 kinase (PI-3K) pathways is similar in young and senescent cells. Our data underline that, despite a conserved capability to activate PDGF-r after agonist stimulation and a functional signal transduction machinery, the mitogenic signal initiated by growth factors in senescent cells does not lead to cell division, being unable to overcome the cell cycle block, likely caused by the accumulation of the inhibitor p21WAF1.


Lactate and glucose in cerebrospinal fluid heavily contaminated with blood.
To simulate a traumatic lumbar puncture, blood was added to 33 normal cerebrospinal fluid (CSF) specimens. A hypothesis was tested if the CSF glucose and CSF lactate were unchanged after contamination with blood. Lactate and glucose here measured in both normal and blood-stained CSF. The estimated contamination of the normal CSF with red cells ranged from 84000 to 676500 cells per cubic millimeter. CSF lactate was unchanged by the addition of blood (P = 0.8), whereas CSF glucose was significantly higher in the blood-stained CSF (P = 0.0005). Therefore, the determination of lactate levels in the CSF heavily contaminated with blood could be useful in differentiating viral from bacterial meningitis.


Mitigation effects of selenium on accumulation of cadmium and morpho-physiological properties in rice varieties.
Selenium (Se) is a beneficial element, but only when present within its permissible range. Its hyper-accumulation in edible plant parts can cause Se toxicity. This study aimed to develop an agronomic plan for biofortification of rice with Se and reclamation of cadmium (Cd)-contaminated soil, utilizing sodium selenite (Na2SeO3) and cadmium chloride (CdCl2) as soil treatments. Biofortification was performed on two target rice varieties: genotypes 5097A/R2035 and GangYou725, in field trials by applying Cd at a concentration of 0-8 mg kg soil-1 and Se at 0-1 mg kg soil-1. Since these rice varieties have different metabolic specificity, the degree of elemental accumulation, deviations in chlorophyll concentration, activity of photosynthetic apparatus and grain yield were assessed. It was found that application of 1 mg kg-1 Se2O3 decrease Cd content and increased chlorophyll content and photosynthetic activity while grain yield was unaffected by application of the metallic trace-elements. Comparing effects at different stages, we found that the 50% heading stage was most sensitive to metal application. In sum, Se mitigates Cd toxicity, but hyperaccumulation of Se (4 mg kg-1) in polished rice was observed with Cd at 4 and 8 mg kg-1. The elevated level of Cd stress in pot experiments resulted in over-accumulation of Se in the germ and endosperm that poses serious health concerns.


Bronchial thermoplasty failure in severe persistent asthma: a case report.
Bronchial thermoplasty (BT) is an emerging therapy for patients with severe persistent asthma who remain poorly controlled despite standard maximal medical therapy. Thermoplasty elicits asthma control over time by applying thermal radiofrequency energy to airways to ablate underlying smooth muscle. While this therapy is suggested to eliminate such smooth muscle permanently, no human studies have examined the possibility of treatment failure. We present a 62-year-old female with severe, refractory asthma symptoms who underwent BT without apparent complications. However, severe symptoms including multiple clinical exacerbations persisted despite BT treatment. Repeat endobronchial biopsy done six months after BT treatment demonstrated persistent smooth muscle hyperplasia in multiple airways that previously had been treated. The patient continued to have uncontrolled, refractory asthma despite multiple therapies. This case is the first to describe a failure of BT to reduce or eliminate airway smooth muscle in a patient with severe persistent asthma. It suggests the potential for treatment failure in the management of these patients after BT and highlights the need for further study of potential BT-refractory patients.


Fax technology for collecting outcomes data in a computer database.
In this era of cost containment, outcomes research is becoming more prevalent. Therefore, various technologies allowing for flexibility in study design and the capture of specific clinical information need to be examined and used. These technologies include fax data systems, pocket scanners, automated telephone equipment, and hand-held computer devices. Fax data systems convert a fax machine into an automated data-entry system. Data-filled forms are faxed to a computer, the fax is converted, and the data are entered into preset fields in a database. Applications for fax systems include acute care-based and ambulatory care-based drug-use evaluations, drug recall systems, and patient-completed surveys of health status. Pocket scanners are hand-held instruments for rapid data entry and transport. Applications for pocket scanning include patient interview responses, procedure and disease analysis, and procedure coding. Options for automated telephone equipment include surveys with interactive voice-mail responses or keypad data entry, pharmacist-monitored drug information and survey services, fax-back and mail-out services, and patient-generated disease intervention programs. Hand-held computer technology is a source of information on multiple protocols and care pathways. All these technologies improve data collection with respect to accuracy and speed, facilitate data analysis, and promote cost-efficient information sharing. The purpose of this study was to evaluate the use of fax technology in data collection for a prospective, multicenter study of the outcomes and cost-effectiveness of two drugs used in the treatment of cancer. Details for the pharmacoeconomic study can be found elsewhere. Fax technology was selected because of the ease with which those responsible for managing the data collection could be trained to use it, the affordability and efficiency of the technology, the ease with which data could be analyzed, and the accuracy of data collection.


Characterization of human insulin-like growth factor-binding proteins by two-dimensional polyacrylamide gel electrophoresis and Western ligand blot analysis.
The insulin-like growth factor (IGF)-binding proteins (IGFBPs) from adult human serum, amniotic fluid, and cerebrospinal fluid were analyzed by a modified two-dimensional gel electrophoresis followed by Western ligand blotting. The samples were subjected to immobilized pH gradient isoelectric focusing in the first dimension, followed by nondenaturing SDS-PAGE in the second dimension and autoradiography after ligand blotting with [125I]IGF-I or [125I]IGF-II. The identity of the binding proteins was confirmed by immunoblotting and immunoprecipitation with specific antibodies. Using this method, all six human high affinity IGFBPs could be clearly separated from each other according to their molecular mass and isoelectric points (pI). All IGFBPs exhibited a variety of specific pI isoforms, which presumably represent posttranslational modifications. In adult human serum, glycosylated IGFBP-3 is found as a broad band of spots with molecular masses of 41 and 45 kDa and a pI in the range of 4.8-8.2. The two IGFBP-3 bands could be reduced to a single 36-kDa band after deglycosylation (pI 6-9). Furthermore, the specific spots for IGFBP-2 (33 kDa; pI 6.2-7.1) and deglycosylated IGFBP-4 (24 kDa; pI 6.3, 6.5, and 6.8) were found with their expected molecular masses. Additionally, the diffuse bands around 30 kDa, found in one-dimensional Western ligand blotting, could be clearly separated into distinct groups of specific spots representing IGFBP-1 (30 kDa; pI 4.0-4.8), IGFBP-6 (30 kDa; pI 4.8-5.8), glycosylated IGFBP-4 (29 kDa; pI 6.1 and 6.3), and IGFBP-5 (30/31 kDa; pI 6.4-8). As expected, IGFBP-6 was visible only when IGF-II was used as radioligand. In conclusion, two-dimensional gel electrophoresis followed by Western ligand blotting allows identification of all six high affinity IGFBPs with their isoforms on the basis of their characteristic molecular masses and pI, especially in the range of 30 kDa. This technique can be rapidly performed with small amounts of complex biological fluids and is a powerful tool for the detection and analysis of posttranslational modifications of IGFBPs.


An improved method for tyrosine hydroxylase immunolabeling of catecholamine cells in whole mounted rat retina.
We developed a rapid and efficient method to achieve good penetration of anti-tyrosine hydroxylase (TH) antiserum into whole mounted rat retinas. The retinas were defatted before incubation in the primary antibody. This operation was thought to increase membrane permeability, facilitating penetration of antibodies. As a result, all TH-positive cells in the entire retina were labeled. Thus, it becomes possible to study the morphology, the distribution, and the counting of TH immunoreactive cells in whole retinas.


[Cement-free revision arthroplasty of the acetabulum--intermediate term outcome with trabecular-oriented acetabulum implant].
In the case of hip revision arthroplasty, cementless implants combined with bone grafts are increasingly used to reconstruct the acetabular bone stock. The study on hand reports about the results with the trabecular orientated cup implant of CopflHolz after 10 years of application. A total of 256 hip revision arthroplasties were prospectively recorded with a mean follow-up period of 5.6 years. For the osseous augmentation of the acetabulum, autogenous bone was used in 227 cases, allogenic spongy bone in 15 cases and mixed bony materials in 8 cases. The clinical and radiological follow-ups were done after 3, 6, 12 months and then in 2-years intervals. Within the 10 years follow-up 3 rerevisions must be done because of deep infection, 6 rerevisions because of aseptic loosening or primary instable fixation. The specific failure rate of the used cup implant amounts to 96.2% five years after revision arthroplasty, and 86.8% ten years after revision arthroplasty. Revealed from a radiological point of view, the transplanted spongiosa showed in 83.5% a complete osseous integration one year after the operation. Worse incorporation was conspicuous especially when allografts or mixed bone grafts were used. Clinically, a permanent improvement of motion, pain and walking ability was seen postoperatively. 91% of all follow-up patients were satisfied with the result of the revision arthroplasty. The trabecular orientated cup implant has proven itself worthy for cementless cup revision arthroplasty and will be an alternative to the cups and rings used up to now for the reconstruction of great acetabular bone deficiencies.


Icariin, an Anti-atherosclerotic Drug from Chinese Medicinal Herb Horny Goat Weed.
Icariin is a major bioactive pharmaceutical constituent isolated from Chinese medicine Horny Goat Weed (Ying Yang Huo) with potent cardiovascular protective functions. Emerging evidence in the past decade has shown that Icariin possesses multiple atheroprotective functions, through multiple mechanisms, including attenuating DNA damage, correcting endothelial dysfunction, inhibiting the proliferation and migration of smooth muscle cells, repressing macrophage-derived foam cell formation and inflammatory responses, as well as preventing platelet activation. All of these protective effects, combined with its lipid-modulatory effects, contribute to the broad atheroprotective effects of Icariin. In this review, we will summarize the anti-atherosclerotic properties of Icariin and highlight future perspectives in developing Icariin as a promising anti-atherosclerotic drug.


[Surgical strategy in paranasal sinus mucoceles].
The aim of this retrospective study is to describe the surgical management of paranasal sinus mucoceles. In the period from 1981 through 2000, 45 patients were treated for symptomatic mucoceles. The mucoceles were most frequently found in the anterior ethmoidofrontal system. 13 patients were operated via a bicoronal transfrontal extradural approach. A complete marsupialization under endonasal endoscopic control was performed in 21 cases. Eleven patients were operated via a trans-facial approach. The follow up period was 4.7 years (2 to 15 years) on average for endonasal approaches and 11 years on average (2 to 20 years) for the other approaches. All patients were free of complaints immediately after the operation. Nine cases were lost to follow-up. Cysts recurred in 5 patients. We recommend an endoscopic approach to the treatment of mucoceles as the surgical procedure of choice. In high and lateral extended frontal mucoceles, a trans-frontal extradural approach is still recommended. Long term follow-up is necessary to obtain an accurate assessment of the results.


The effect of neo-adjuvant chemotherapy on the improvement of oral cancer patients and the predictive value of miR-182 on its efficacy.
This study aimed to observe the effect of neo-adjuvant chemotherapy on the improvement of oral cancer patients and investigate the predictive value of miR-182 on its efficacy. A total of 143 patients with advanced oral cancer admitted to Yidu Central Hospital of Weifang from September 2015 to July 2017 formed the study group. Among them, there were 62 cases in the control group (surgery+postoperative radiotherapy) and 81 cases in the study group (preoperative neo-adjuvant chemotherapy+surgery+postoperative radiotherapy). The treatment effect and adverse reactions of patients were compared between the two groups. RT-PCR was used to detect the expression levels of serum miR-182 of patients before and after treatment. The 1-year survival of patients in the two groups was recorded and compared by follow-up. The total effective rate of patients in the study group was significantly higher than that of patients in the control group (p<0.05). The incidence of adverse reactions of patients in the study group was significantly higher than in the control group (p<0.05). There was no significant difference in the prognostic 1-year survival rate between the two groups. After treatment, the expression of miR-182 was lower than before treatment and in the study group it was significantly lower than the control group (p<0.05). ROC curve analysis showed that the area under the curve of miR-182 in the predictive value of oral cancer was 0.756. When the cut-off value was less than 1.823, the optimal specificity was 70.18% and the sensitivity was 75.86%. Neo-adjuvant chemotherapy can significantly improve the therapeutic effect, but the incidence of adverse reactions increases. miR-182 may be involved in the occurrence and deterioration of oral cancer and is a good indicator for predicting the treatment efficacy of patients with oral cancer.


Hermansky-Pudlak syndrome pulmonary fibrosis: a rare inherited interstitial lung disease.
Pulmonary fibrosis is a progressive interstitial lung disease of unknown aetiology with a poor prognosis. Studying genetic diseases associated with pulmonary fibrosis provides insights into the pathogenesis of the disease. Hermansky-Pudlak syndrome (HPS), a rare autosomal recessive disorder characterised by abnormal biogenesis of lysosome-related organelles, manifests with oculocutaneous albinism and excessive bleeding of variable severity. Pulmonary fibrosis is highly prevalent in three out of 10 genetic types of HPS (HPS-1, HPS-2 and HPS-4). Thus, genotyping of individuals with HPS is clinically relevant. HPS-1 tends to affect Puerto Rican individuals due to a genetic founder effect. HPS pulmonary fibrosis shares some clinical features with idiopathic pulmonary fibrosis (IPF), including dyspnoea, cough, restrictive lung physiology and computed tomography (CT) findings of fibrosis. In contrast to IPF, HPS pulmonary fibrosis generally affects children (HPS-2) or middle-aged adults (HPS-1 or HPS-4) and may be associated with ground-glass opacification in CT scans. Histopathology of HPS pulmonary fibrosis, and not IPF, shows vacuolated hyperplastic type II cells with enlarged lamellar bodies and alveolar macrophages with lipofuscin-like deposits. Antifibrotic drugs approved as treatment for IPF are not approved for HPS pulmonary fibrosis. However, lung transplantation has been performed in patients with severe HPS pulmonary fibrosis. HPS pulmonary fibrosis serves as a model for studying fibrotic lung disease and fibrosis in general.


The Interactions between Polyphenols and Microorganisms, Especially Gut Microbiota.
This review presents the comprehensive knowledge about the bidirectional relationship between polyphenols and the gut microbiome. The first part is related to polyphenols' impacts on various microorganisms, especially bacteria, and their influence on intestinal pathogens. The research data on the mechanisms of polyphenol action were collected together and organized. The impact of various polyphenols groups on intestinal bacteria both on the whole "microbiota" and on particular species, including probiotics, are presented. Moreover, the impact of polyphenols present in food (bound to the matrix) was compared with the purified polyphenols (such as in dietary supplements) as well as polyphenols in the form of derivatives (such as glycosides) with those in the form of aglycones. The second part of the paper discusses in detail the mechanisms (pathways) and the role of bacterial biotransformation of the most important groups of polyphenols, including the production of bioactive metabolites with a significant impact on the human organism (both positive and negative).


Quantitative liquid-phase infrared spectra of several simple organic compounds.
Many simple compounds exhibit pronounced changes in absorptivity between the vapor and liquid phases, particularly at longer wavelengths in the infrared. Therefore liquid-phase spectral data cannot be computed from available quantitative vapor spectra. Quantitative liquid spectra are presented for methanol, ethanol, formic acid, acetic acid, acetone, and diethyl ether in the region 2.5-13 microm. While phase-transition changes in absorptivity of these compounds do not approach those of water, they can be significant, and troublesome if not appreciated.


Angiogenesis, angiogenic factor expression and hematological malignancies.
Solid tumor growth consists of an avascular and a subsequent vascular phase. Several studies have now shown that, as in solid tumors, angiogenesis also plays a critical role in the progression of hematological malignancies. Monoclonal gammopathy of undetermined significance (MGUS) and non-active to active multiple myeloma (MM) progress when plasma cells induce angiogenesis and this in turn promotes progression. The increased bone marrow neovascularization, increased angiogenic and proteolytic potential of plasma cells may explain the frequent occurrence of extramedullary localization in MM. As observed in active MM, enhanced bone marrow neovascularization is apparent in acute untreated lymphoblastic leukemia. In B-cell non-Hodgkin's lymphomas, angiogenesis is significantly enhanced in relation to progression. Angiostatic molecules, such as thalidomide, could also be considered for the clinical management of hematological tumors.


Blood conservation techniques and platelet function in cardiac surgery.
Postoperative alterations in platelet function induced by cardiopulmonary bypass (CPB) are of importance. The effect on platelet aggregation of three different techniques for reducing blood consumption was studied in 30 patients undergoing elective aortocoronary bypass grafting from the beginning of anesthesia until the 1st postoperative day. The patients were randomly divided into three groups, in which 1) a cell separator was used during and after CPB; 2) a hemofiltration device was used; and 3) high-dose aprotinin was used in order to reduce the need of homologous blood. A fourth group undergoing neurosurgery procedures served as a control. Platelet aggregation induced by adenosine diphosphate (concentration 0.25, 0.50, 1.0, and 2.0 microM), collagen (4 microliters/ml), and epinephrine (25 microM) was determined by the turbidimetric method. Platelet aggregation was not significantly changed in the control group, indicating that the operation itself did not impair platelet function. At the end of the operation (after retransfusion of the salvaged pump blood), the maximum aggregation and maximum gradient of aggregation induced by all three inductors were most reduced (significantly) in the cell-separator patients. On the 1st postoperative day, platelet aggregation in the hemofiltration patients and the patients treated with aprotinin had normalized. Aggregation of patients pretreated with high-dose aprotinin was not different from that of the hemofiltration patients throughout the investigation. Blood loss was significantly highest in the cell-separator group (770 +/- 400 ml on the 1st postoperative day) but was not different between the hemofiltration (390 +/- 230 ml) and the aprotinin-treated patients (260 +/- 160 ml).(ABSTRACT TRUNCATED AT 250 WORDS)


Current distribution measurements inside an electromagnetic plasma gun operated in a gas-puff mode.
Measurements are presented of the time-dependent current distribution inside a coaxial electromagnetic plasma gun. The measurements are carried out using an array of six axially distributed dual-Rogowski coils in a balanced circuit configuration. The radial current distributions indicate that operation in the gas-puff mode, i.e., the mode in which the electrode voltage is applied before injection of the gas, results in a stationary ionization front consistent with the presence of a plasma deflagration. The effects of varying the bank capacitance, transmission line inductance, and applied electrode voltage were studied over the range from 14 to 112 μF, 50 to 200 nH, and 1 to 3 kV, respectively.


The flavonoid apigenin from Croton betulaster Mull inhibits proliferation, induces differentiation and regulates the inflammatory profile of glioma cells.
This study aimed to investigate the antitumor and immunomodulatory properties of the flavonoid apigenin (5,7,4'-trihydroxyflavone), which was extracted from Croton betulaster Mull, in glioma cell culture using the high-proliferative rat C6 glioma cell line as a model. Apigenin was found to have the ability to reduce the viability and proliferation of C6 cells in a time-dependent and dose-dependent manner, with an IC50 of 22.8 µmol/l, 40 times lower than that of temozolomide (1000 µmol/l), after 72 h of apigenin treatment. Even after C6 cells were treated with apigenin for 48 h, high proportions of C6 cells entered apoptosis (39.56%) and autophagy (22%) as shown by flow cytometry using annexin V/propidium iodide and acridine orange staining, respectively. In addition, the flavonoid apigenin induced cell accumulation in the G0/G1 phase of the cell cycle and inhibited glioma cell migration efficiently. Moreover, apigenin induced astroglial differentiation and morphological changes in C6 cells, characterized by increased expression of glial fibrillary acidic protein and decreased expression of nestin protein, a typical marker of neuronal precursors. The immunomodulating effects of apigenin were also characterized by a change in the inflammatory profile as evidenced by a significant decrease in interleukin-10 and tumor necrosis factor production and increased nitric oxide levels. Because apigenin can induce differentiation, apoptosis, and autophagy, can alter the profile of cytokines involved in regulating the immune response, and can reduce the survival, growth, proliferation, and migration of C6 cells, this flavonoid may be considered a potential antitumor drug for the adjuvant treatment of malignant gliomas.


Rapid acquisition in concurrent chains: evidence for a decision model.
Pigeons' choice in concurrent chains can adapt to rapidly changing contingencies. Grace, Bragason, and McLean (2003) found that relative initial-link response rate was sensitive to the immediacy ratio in the current session when one of the terminal-link fixed-interval schedules was changed daily according to a pseudorandom binary sequence (e.g., Schofield & Davison, 1997). The present experiment tested whether the degree of variation in delays across sessions had any effect on acquisition rate in Grace et al.'s (2003) rapid-acquisition procedure. In one condition ("minimal variation"), the left terminal link was always fixed-interval 8 s and the right terminal link was either fixed-interval 4 s or fixed-interval 16 s. In the other condition ("maximal variation"), a unique pair of fixed-interval values was used in each session. Responding was sensitive to the current-session immediacy ratio in both conditions, but across subjects there was no systematic difference in sensitivity. These results challenge the view that initial-link responding in the rapid-acquisition procedure is determined by changes in the learned value of the terminal-link stimuli, and suggests instead that a process resembling categorical discrimination may control performance. A decision model based on the assumption that delays are categorized as short or long relative to the history of delays provided a good account of the data and shows promise in being able to explain other choice phenomena.


Stimulation of nonspecific immunity to reduce the risk of recurrent infections in children attending day-care centers. The Epicrèche Research Group.
A randomized, double blind, placebo-controlled clinical trial was performed in 423 children attending day-care centers to assess whether stimulating nonspecific immunity would reduce the incidence of recurrent infections. The drug used for the trial (Imocur) is an extract obtained from eight different species of bacteria. At the end of the total follow-up period (3 months with treatment and 4.5 months without), the risk for > or = 4 episodes of upper respiratory infections was not significantly lower in the treated group than in the placebo group (26.7% vs. 33.8%, relative risk, 0.79; 95% confidence interval, 0.59 to 1.06). In an exploratory analysis limited to the 3-month treatment period, however, we observed a 48% reduction in the risk of presenting > or = 3 episodes of upper respiratory infections: 9.5% vs. 18.3%, respectively, in the treatment group and the placebo group (relative risk, 0.52; 95% confidence interval, 0.31 to 0.86). Similar results were found for the risk of > or = 1 episode of gastroenteritis. We also observed a strong correlation between the drug efficacy and age; this observation is coherent with the underlying pathophysiologic model in which the immune system matures with age.


[The immunomodulating action of the surface antigens of the influenza A virus in experimental staphylococcal infection].
The results of the study of influenza A virus surface antigens, hemagglutinin and neuraminidase, in the induction of nonspecific immunomodulation and protection from acute pulmonary staphylococcal infection have been studied. Protective effect, the cell composition of bronchoalveolar lavage fluid depend on the serological subtypes of surface antigens used for intranasal immunization and the infective dose of staphylococci.


Adaptability of expert visual anticipation in baseball batting.
By manipulating stimulus variation in terms of opponent pitcher actions, this study investigated the capability of expert (n = 30) and near-expert (n = 95) professional baseball batters to adapt anticipation skill when using the video simulation temporal occlusion paradigm. Participants watched in-game footage of two pitchers, one after the other, that was temporally occluded at ball release and various points during ball flight. They were required to make a written prediction of pitch types and locations. Per cent accuracy was calculated for pitch type, for pitch location, and for type and location combined. Results indicated that experts and near-experts could adapt their anticipation to predict above guessing level across both pitchers, but adaptation to the left-handed pitcher was poorer than the right-handed pitcher. Small-to-moderate effect sizes were found in terms of superior adaptation by experts over near-experts at the ball release and early ball flight occlusion conditions. The findings of this study extend theoretical and applied knowledge of expertise in striking sports. Practical application of the instruments and findings are discussed in terms of applied researchers, practitioners and high-performance staff in professional sporting organisations.


Behcet's Syndrome.
A patient with classical features of Behcet's Syndrome is presented. The case which initially had ophthalmological manifestations posed great difficulty in diagnosis until the genital and oral ulcerations appeared. Systemic manifestations in the form of arthritis and hepatomegaly appeared still later. Neurological involvement set in as a terminal event.


Excited state properties of mixed phosphine 2-(2'-pyridyl)quinoline complexes of ruthenium(II).
Mixed ligand complexes of the type Ru(pq)(2)(PP)(2+) (pq = 2,2'-pyridylquinoline and PP = one bidentate or two monodentate phosphine ligands) have been prepared from the appropriate phosphine and Ru(pq)(2)Cl(2). The room temperature absorption spectra and low temperature (77 K) emission spectra, emission lifetimes, and quantum yields have been measured for the series of complexes and compared with those of Ru(pq)(3)(2+) and analogous Ru(bpy)(2)(PP)(2+) complexes (bpy = 2,2'-bipyridine) where possible. Emission spectra have been fit using a single mode Franck-Condon analysis. The visible absorption bands and emission bands are assigned to MLCT transitions that are blue shifted relative to Ru(pq)(3)(2+), while the emission lifetimes and quantum yields are increased. The trends in the nonradiative rate constants, k(nr), are described in terms of the energy gap, E(0), and the Huang-Rhys factor, S(M), which were obtained from the spectral fittings, and are correlated with the phosphine ligand structures.


[Detection of serum neopterin in patients with hemophagocytic lymphohistiocytosis and its significance].
This study was aimed to detect the peripheral blood serum neopterin (Npt) level in the patients with hemophagocytic lymphohistiocytosis (HLH) and to explore its significance in HLH. The enzyme-linked immunosorbent assay (ELISA) was applied to detect the serum Npt level and sCD25 level in 20 HLH patients before and after treatment and 15 healthy controls. The results indicated that the serum Npt and sCD25 levels in HLH patients were significantly higher than those in healthy controls (P < 0.0001). The serum Npt and sCD25 levels in the HLH group decreased significantly after treatment, respectively (P < 0.0001). The correlation analysis of Npt with sCD25 before and after treatment showed that they had significant correlation (r = 0.81, P < 0.05 before treatment; r = 0.65, P < 0.05 after treatment). Meanwhile, the level of serum Npt and ferritin had a significant correlation in newly diagnosed HLH patients (r = 0.55, P < 0.05). It is concluded that the serum Npt may play an important role in the HLH pathogenesis, the enhancement of Npt levels has an important significance for diagnosis and evaluation for HLH.


Effect of Donor Building Blocks on the Charge-Transfer Characteristics of Diketopyrrolopyrrole-Based Donor-Acceptor-Type Semiconducting Copolymers.
We investigate the effect of donor (D) building blocks on the charge transportation characteristics of donor (D)-acceptor (A)-type semiconducting copolymers with alternating electron-donating and electron-accepting units to provide a basis for the rational design of high-performance semiconducting polymers. For this purpose, we studied three different diketopyrrolopyrrole (DPP)-based semiconducting copolymers comprising a common dithienyl-DPP [3,6-dithienyl-2,5-diketopyrrolo(3,4-c)pyrrole] and variable donor moieties: phenylene (P)-PDPPTPT, thiophene (T)-PDPP3T, and thienothiophene (TT)-PDPP2T-TT. Structural analysis using grazing incidence X-ray diffraction indicates that all three DPP-based copolymer films have edge-on phases but poor crystallinity of the films, except the PDPP2T-TT copolymer with branched alkyl side chains that are relatively long. The electrical measurements show that the DPP-based copolymer with a TT donor unit has the highest field-effect mobility value of 0.30 cm2/V s. To understand the role of the donor units in DPP-based D-A copolymers, further insight into the charge transportation behavior is realized by analyzing the temperature-dependent transfer curves of the DPP semiconducting copolymer-based field-effect transistors using the Gaussian disorder model. Compared to the DPP-based D-A-type semiconducting copolymer with a P-moiety and shorter-branched alkyl side chains that exhibit a broad distribution in the density of localized states (DOS) and a higher thermal-activated energy for charge hopping, the DPP copolymers with a TT-moiety and longer branched side chains have the narrowest DOS, the lowest activation energy, and thus the highest hole mobility. These results suggest that the higher mobilities obtained from PDPP2T-TT with a TT donor unit can be attributed to the suppressed DOS distribution near the transport level, which mainly originates from the narrowest energy band gap tuned with the orbital couplings of the DPP acceptor and TT donor units.


Prevalence of behavioral changes associated with age-related cognitive impairment in dogs.
To determine the prevalence of age-related behavioral changes, namely impairment, in a randomly chosen population of dogs. Age-stratified cohort study. 97 spayed female and 83 castrated male dogs that were 11 to 16 years old. Data on possible impairment in 4 behavioral categories (ie, orientation in the home and yard, social interaction, house training, and sleep-wake cycle) linked to cognitive dysfunction were obtained from dog owners, using a structured telephone interview. Hospital records of dogs had been screened to exclude dogs with dysfunction in organ systems that may cause behavioral changes. Dogs with behavioral impairment were those with > or = 2 signs of dysfunction within a category. Dogs with impairment in 1 category were considered mildly impaired and those with impairment in > or =2 categories were considered severely impaired. Age by sex interactions for dogs with impairment in any category were not significant, and, therefore, data on castrated males and spayed females were pooled for analyses across ages. The prevalence of age-related progressive impairment was significant in all categories. The percentage of 11- to 12-year-old dogs with impairment in > or = 1 category was 28% (22/80), of which 10% (8/80) had impairment in > or = 2 behavioral categories. Of 15- to 16-year-old dogs, 68% (23/34) had impairment in > or =1 category, of which 35% (12/34) had impairments in > or = 2 categories. There were no significant effects of body weight on the prevalence of signs of dysfunction in the behavioral categories. Data collected provide estimates of the prevalence of various degrees of age-related behavioral changes associated with cognitive dysfunction in dogs. Age-related behavioral changes may be useful indicators for medical intervention for dogs with signs of cognitive impairment.


Retropharyngeal space infections in a community hospital.
The emergency physician often has to deal with infectious disease emergencies. The authors have seen four cases of retropharyngeal infection of potentially life-threatening severity in less than 1 year, all were admitted through the emergency department (ED). Reporting these cases is important to increase awareness among emergency physicians of this classic disease entity. The characteristics of the patients are discussed including initial diagnostic approaches and the use of computed tomography (CT) scanning of the neck and mediastinum. One case of retropharyngeal space infection caused by Neisseria meningitidis serotype W-135 is described. This is the first such reported case. The recommendations are that, in the absence of overt focal infection, a non-surgical approach to the treatment of these patients is indicated. This should include suitable neck roentgenograms, CT scanning, and high-dose, intravenous, beta-lactamase-resistant antibiotics.


Pediatric prehospital care in urban and rural areas.
There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10,493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P less than .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.


Tunable phase detection sensitivity of transmitted-type guided-mode resonance sensor in a heterodyne interferometer.
A transmitted-type guided-mode resonance (GMR) sensor is presented for using an electro-optic heterodyne interferometer to tune phase detection sensitivity. The GMR grating waveguide structure is fabricated using a low-cost nanoimprinting SiO(2) sol-gel process and sputtering TiO(2) film. The phase properties of the GMR sensor are numerically investigated to verify its phase detection capability in a heterodyne interferometer. The phase curves for both transmitted- and reflected-type GMR sensors are experimentally obtained and compared. We conclude that the transmitted-type GMR sensor is more feasible for tuning phase detection sensitivity by rotating the analyzer in the electro-optic heterodyne interferometer. In our experiment, we achieved the GMR sensor phase detection sensitivity as high as 1.8 × 10(-7) RIU.


Sex-dependent pharmacokinetics and in vitro reductive metabolism of acetohexamide in Wistar-Imamichi rats.
A significant sex-related difference was observed for the pharmacokinetics of acetohexamide in Wistar-Imamichi (Wistar-IM) rats. However, there was no sex difference of the in vitro reductive metabolism of acetohexamide in the liver or kidney of these rats. Testectomy was found to decrease the plasma clearance (CLp) of acetohexamide in male rats, whereas ovariectomy had no effect on the CLp of acetohexamide in female animals, suggesting that androgens regulate the pharmacokinetics of acetohexamide. The co-administration of sulfamethazine, which is known to be metabolized by a male-specific cytochrome P450 (CYP) isoform (CYP2C11), significantly decreased the CLp of acetohexamide in male Wistar-IM rats. Based on these results, it is reasonable to assume that the sex-dependent pharmacokinetics of acetohexamide observed in Wistar-IM rats is associated with the male-specific hydroxylation catalyzed by CYP2C11.


Relapse of duodenal ulceration after healing with omeprazole.
The subsequent recurrence rate after duodenal ulcers were healed with omeprazole, 10 mg or 30 mg a day, was documented during a 12-month period in 55 patients. Endoscopy was performed if patients developed symptomatic recurrence; those patients who remained symptom-free at 12 months were also requested to undergo endoscopy to assess the incidence of asymptomatic recurrence. The proportion with symptomatic recurrence during the year was 56%. The median times (life-table analysis) to relapse were 50 and 39 weeks in the group that was treated initially with 30 mg and 10 mg of omeprazole, respectively, although this trend to slower relapse in the higher-dose group was not statistically significant. Five asymptomatic ulcers were detected in 11 asymptomatic subjects who agreed to a final endoscopy. The over-all recurrence rate was similar to previously-reported recurrence rates after the cessation of histamine H2-receptor antagonist drugs.


Studies on the euglycemic and hypolipidemic potentials of the novel indole analogue of thiazolidinedione, DRF 2189.
Euglycemic and hypolipidemic activities of a novel indole analogue of thiazolidinedione, DRF 2189 (CAS 172647-53-9), have been evaluated in different animal models. Compared to troglitazone (CAS 97322-87-7), DRF 2189 exhibited interesting plasma glucose and triglyceride lowering activity in genetically diabetic and obese db/db mice. It also produced a significant reduction in plasma glucose, triglyceride, total cholesterol levels and improvement in oral glucose tolerance in another genetic mouse model, the ob/ob mice. In high-fat diet fed Sprague-Dawley rats, DRF 2189 treatment showed improvement in plasma lipid parameters. Like other thiazolidinediones, this compound also possesses peroxisome proliferator activated receptor gamma (PPAR gamma) transactivation potential. In anaesthetized rat experiment, DRF 2189 produced a transient fall in blood pressure without any change in the ECG pattern. It showed non-specific smooth muscle relaxant activity against acetylcholine, histamine and potassium chloride induced contractions in isolated guinea pig ileum. A twenty-eight-day toxicity study in Wistar rats did not show any signs of treatment related adverse effects. The overall antidiabetic and hypolipidemic activities of DRF 2189 are comparable with rosiglitazone (CAS 155141-29-0) and superior to troglitazone. In conclusion, results from these preclinical studies indicate that DRF 2189, a novel thiazolidinedione, has a marked potential for the management of type-2 diabetes.


Grit predicts less severe hoarding symptoms among patients seeking treatment at an anxiety disorders clinic.
Grit is associated with positive outcomes in nonclinical samples. However, no studies have examined grit in relation to psychopathology in patients with clinical mood or anxiety disorders. Research and clinical experience suggest that individuals who hoard struggle with characteristics associated with grit, such as task persistence, impulsivity, and self-control. The authors tested the hypothesis that hoarding symptoms are associated with less grit in a sample of individuals (N = 72) presenting for treatment to an anxiety disorders clinic. After covarying symptoms of the four mood and anxiety disorders most commonly comorbid with hoarding disorder (viz. depression, generalized anxiety, social anxiety, and obsessive-compulsive disorder), the authors found that hoarding symptoms were associated with less grit, and the effects were medium-to-large. These results indicate that grit is worthy of investigation in individuals with hoarding disorder using methodologies that permit inferences about causality, and with attention to clinical implications for prevention or treatment.


Home is where the medical device is.
For a number of reasons, consumers are becoming less willing to rely solely on physicians and other health professionals for medical care. As these consumers swell the ranks of the self-care movement, they provide a growing market for a wide variety of home-use medical devices--everything from blood pressure monitors to cancer screening kits. These products can be valuable tools in self-care, but their use by laymen is not without limits.


Synthesis of beta-O-4-type artificial lignin polymers and their analysis by NMR spectroscopy.
We describe the synthesis and NMR spectroscopic analysis of three artificial lignin polymers containing only the beta-O-4 substructure: syringyl-type homopolymer, p-hydroxyphenyl-type homopolymer and guaiacyl/syringyl-type heteropolymer. Using gel permeation chromatography, the weight-average degree of polymerization (DP(w)) of the three polymers was determined as 19.2, 38.6, and 13.9, respectively. The polymers were prepared based on the synthetic methodology of guaiacyl-type homopolymer, and were fully characterized using (1)H-, (13)C-, and (1)H-(13)C NMR spectroscopy of the acetylated and non-acetylated forms. The spectra of guaiacyl/syringyl-type heteropolymers were in good agreement with those of the beta-O-4 substructure of milled wood lignin obtained from the hardwood of Japanese white birch.


Ultrasensitive aptamer-based multiplexed electrochemical detection by coupling distinguishable signal tags with catalytic recycling of DNase I.
This work reports an aptamer-based, disposable, and multiplexed sensing platform for simultaneous electrochemical determination of small molecules, employing adenosine triphosphate (ATP) and cocaine as the model target analytes. The multiplexed sensing strategy is based on target-induced release of distinguishable redox tag-conjugated aptamers from a magnetic graphene platform. The electronic signal of the aptasensors could be further amplified by coupling DNase I with catalytic recycling of self-produced reactants. The assay was based on the change in the current at the various peak potentials in the presence of the corresponding signal tags. Experimental results revealed that the multiplexed electrochemical aptasensor enabled the simultaneous monitoring of ATP and cocaine in a single run with wide working ranges and low detection limits (LODs: 0.1 pM for ATP and 1.5 pM for cocaine). This concept offers promise for rapid, simple, and cost-effective analysis of biological samples.


Hepatocyte growth factor increases in injured organs and functions as an organotrophic factor in rats with experimental acute pancreatitis.
We previously reported that serum hepatocyte growth factor (HGF) levels are elevated in patients with acute pancreatitis and that pancreatitis-associated ascitic fluid (PAAF) contains cytotoxic factor(s) inducing apoptosis on Madin-Darby canine kidney (MDCK) cells. In this study, plasma HGF levels and HGF tissue distribution were investigated in rats with experimental acute pancreatitis, and the effects of HGF on the cytotoxic activity and apoptosis-inducing activity of PAAF also were examined. Plasma HGF levels were elevated in rats with two experimental pancreatitis models of different grades of severity. The degree of its elevation was correlated with the severity and the organ dysfunctions. In rats with severe pancreatitis, HGF protein and messenger RNA (mRNA) levels significantly increased in liver, kidney, and lung, which were injured organs. When anti-HGF neutralizing antibody was administered in severe pancreatitis, liver dysfunction worsened, and apoptotic cells increased in kidney. Recombinant HGF inhibited the cytocidal activity of PAAF on MDCK cells in a dose-dependent manner. Moreover, recombinant HGF prevented the apoptotic cell death (DNA fragmentation, nuclear fragmentation, and caspase-3 activation) induced by PAAF. These results suggest that HGF is produced in injured organs and may function as an organotrophic and antiapoptotic factor against the organ injuries in acute pancreatitis.


Relation between location of a motor unit in the human biceps brachii and its critical firing levels for different tasks.
Critical firing levels (CFLs) of single motor units (MUs) in the long head of the human biceps brachii muscle were determined in combinations of two isometric tasks: flexion of the elbow, supination of the lower arm, and exorotation of the humerus, as well as the corresponding antagonistic tasks. The MU activity was recorded by 25-micron bipolar wire electrodes. Four main patterns of MU recruitment, related to the recording location in the muscle, were found: (i) MUs active only when flexing the elbow were located mostly laterally. (ii) MUs active only when supinating were all located medially. (iii) MUs whose CFL depended on a linear combination of flexion and supination forces were all located medially. Some of these MUs could not be recruited during pronation. (iv) Nonlinearly behaving MUs, located centrally. The relative weights of flexion and supination input were constant for all units, whose CFL depended on a linear sum of flexion and supination forces, as well as for the nonlinearly behaving units. Supination and exorotation showed equivalent CFL changes when they were combined with the flexion task. Extension did not change the CFL for supination- or exorotation tasks. No clear difference was found between the ratios of the peak twitch forces in flexion and supination direction for laterally and medially located small muscle areas or single MUs. A simple model of the motoneuron pool organization is proposed to explain our findings.


[Cutaneous infection due to Mycobacterium chelonae in a hemodialysed patient].
We report a case of a hemodialysed patient who developed a cutaneous Mycobacterium chelonae infection. This infection was only localised on the left upper limb, downstream from the arteriovenous fistula. M. chelonae is an unusual human pathogen, which is present in soil, dust, and stagnant water. Various factors, especially immunosuppression can favour this sort of infection in humans. Because of the ubiquity of the mycobacterium, the source of the inoculation sometimes remains unknown. However, a great number of cases are related to nosocomial infections. The preferential localizations are cutaneous, ocular, and pulmonary. Some cases of cutaneous infections due to M. chelonae, or caused by other atypical mycobacterium, are described in renal transplantation, peritoneal dialysis and hemodialysis. In the case we describe here, the source of contamination was not identified. The outcome was favourable with clarithromycin. This treatment is still continued because of a reappearance of the lesions when treatment was discontinued.


Phenomenology and management of cognitive and behavioral disorders in Parkinson's disease. Rise and logic of dementia in Parkinson's disease.
An overview of studies on the issue of dementia in Parkinson's disease shows that, over time, there has been an evolution in the perception of the magnitude of the problem and of its nature. Dementia seems today to be part of the disease. This change in the understanding of the disease can be accounted for by various methodological problems and by difficulties, on one hand, in the definition of dementia and its differentiation from other conditions, and, on the other hand, in the diagnosis of the disease itself in individual cases. Optimal therapeutic strategies are also examined, either based on cholinesterase inhibitors or antiparkinsonian drugs and symptomatic measures.


Interpretation of cardiac pathophysiology from pressure waveform analysis: pacemaker hemodynamics.
The abnormal sequence of A-V contraction produces alteration of right and left heart hemodynamics reflecting the inappropriate timing of atrial contraction to ventricular filling. Some symptomatic patients may require A-V sequential pacing to improve cardiac output. The clinical effects of the atrial contribution to left ventricular function can be demonstrated by careful review of hemodynamic tracings in these individuals.


Measurements of plasma potential in high-pressure microwave plasmas.
Plasma potential of a high-pressure ( approximately 1 Torr) microwave-generated argon plasma is measured using a Langmuir probe and a cold emissive probe. The operation of a hot emissive probe in a high-pressure plasma has been very difficult due to frequent burn-outs and significantly reduced lifetime of the probe filament, which, in turn, limits the possibility of collecting a wide range of data. The I-V characteristics from both Langmuir and emissive probes are interpreted using the collisionless probe theory since the collision correction factor is not very significant. The plasma potential determined from both Langmuir and cold emissive probe characteristics agrees well with one another and is observed to be dependent on the operating gas pressure but relatively unchanged as a function of the microwave power. An average plasma potential determined over the operating range of microwave powers varies nonlinearly with the gas pressure.


Complexity loss in physiological time series of patients in a vegetative state.
Consciousness has not yet been satisfactorily defined because of its puzzling nature which involve the perception of the environment (perceptual awareness) and of the self (self-awareness). Current available methods fail in establishing prognosis in patients with vegetative state (VS): to our mind, this failure stems from the heterogeneous localization of brain damages causing VS and from available approaches tending to investigate self-awareness separately from perceptual awareness, whereas consciousness should be explored as a single and indivisible whole. Moving from the assumption that consciousness depends on the normal activity of wide neural networks, that may be regarded as complex systems whose outputs show a nonlinear behaviour, we propose a nonlinear approach applied to electroencephalographic (EEG) signal, aimed at exploring residual neural networks complexity in patients with VS. For this objective the EEG recording of 10 patients previously admitted to our department were retrospectively analyzed and compared with those of ten matched healthy control subjects. Approximate Entropy (ApEn) was calculated from the average values of time series with fixed input variables. Mean ApEn values were lower in patients than in controls (t18 18 = 12.3, p < 0.001). ApEn is able to discriminate patients from controls thus supporting the hypothesis about a decreased neural networks complexity in VS.


The effect of sunitinib on immune subsets in metastatic clear cell renal cancer.
Sunitinib is standard first-line therapy for metastatic clear cell renal cancer (MCRC). It is associated with leucopenia; however, its effects on specific immune cell subsets are unclear. Alterations in immune cell subsets may contribute to tumour progression. Lymphocyte subsets (CD3, 4, 8, 19 and 56) were measured in 43 untreated MCRC patients who received sunitinib. The protocol included a structured treatment interruption of 5 weeks. Cell populations were measured at specific time points during sunitinib treatment and the treatment break. Sunitinib was associated with significant declines in total leucocyte (-48%), neutrophil (-62%), CD3 total T cell (-31%) and CD4 counts (32%; p < 0.05). There was no significant change in CD19 B lymphocyte, CD8 or CD56 natural killer cells. During the sunitinib-free interval, all parameters recovered to baseline. No patients developed opportunistic infections or neutropenic sepsis. The level of specific immune subsets at presentation or occurrence of a fall in specific counts had an effect on progression-free survival (p > 0.05). Sunitinib is associated with reversible inhibition of specific lymphocyte subsets which has implications for the immunological control of MCRC and its use in combination with other agents. Despite suppressive effects, there was no evidence of predisposition to immune suppressive-related infection.


Antineutrophil cytoplasm autoantibodies and vasculitis.
Antineutrophil cytoplasm autoantibodies are useful diagnostic serologic markers for a variety of well-known primary vasculitic syndromes, including Wegener's granulomatosis, microscopic polyangiitis, and idiopathic necrotizing and crescentic glomerulo-nephritis. More recently antineutrophil cytoplasm autoantibodies have been found in other vasculitic syndromes, such as Churg-Strauss syndrome, Henoch-Schönlein purpura, and some nonvasculitic diseases such as rheumatoid arthritis, inflammatory bowel disease, and autoimmune hepatobiliary diseases. There is now evidence to suggest that infection might be an important etiologic factor in the development of antineutrophil cytoplasm autoantibody-associated vasculitides. This link has been strengthened by in vitro data that suggest that antineutrophil cytoplasm autoantibodies are directly involved in the pathogenesis of antineutrophil cytoplasm autoantibody-associated vasculitides.


Comparing effects of low- and high-volume moderate-intensity exercise on sexual function and testosterone in obese men.
Obesity and inactivity are associated with erectile dysfunction and hypogonadism. To compare the effects of low volume (LV) and high volume (HV) of moderate-intensity exercise on sexual function, testosterone, lower urinary tract symptoms (LUTS), endothelial function, and quality of life (QoL) in obese men. Weight, waist circumference (WC), body composition, International Index of Erectile Function 5-item (IIEF-5), International Prostate Symptom Scale (IPSS) (for LUTS), and 36-item Short Form Survey version 2 Instrument (SF-36) (for QoL) scores, plasma testosterone, sex-hormone binding globulin, glucose, insulin and lipids, and endothelial function (by Reactive Hyperaemia Index [RHI] using finger plethysmography) were measured at baseline and 24 weeks. Ninety abdominally obese (body mass index > 27.5 kg/m(2), WC > 90 cm), sedentary (exercise ≈ 80 minutes/week) Asian men (mean age 43.6 years, range 30-60) were prescribed a diet to reduce daily intake by ≈ 400 kcal below calculated requirement and randomized to perform moderate-intensity exercise of LV (<150 minutes/week) or HV (200-300 minutes/week) (n = 45 each) for 24 weeks. Seventy-five men (83.3%) completed the study. Weekly exercise volume was significantly greater in the HV (236 ± 9 minutes) than the LV (105 ± 9 minutes) group. The HV group had significantly greater increases in IIEF-5 score (2.6 ± 0.5 points) and testosterone (2.06 ± 0.46 nmol/L) and reductions in weight (-5.9 ± 0.7 kg, -6.2%), WC (-4.9 ± 0.8 cm, -4.9%), and fat mass (-4.7 ± 1.0 kg, -14.5%) than the LV group (-2.9 ± 0.7 kg, -3.0%; -2.7 ± 0.7 cm, -2.5%; -1.1 ± 0.8 kg, -3.2%; 0.79 ± 0.46 nmol/L; and 1.8 ± 0.5 points). Improvements in IPSS and SF-36 scores, and RHI, were similar. Moderate-intensity HV aerobic exercise > 200 minutes/week produces greater improvements in sexual function, testosterone, weight, WC, and fat mass than smaller exercise volume.


Measuring Electrolyte Impedance and Noise Simultaneously by Triangular Waveform Voltage and Principal Component Analysis.
In order to measure the impedance variation process in electrolyte solutions, a method of triangular waveform voltage excitation is investigated together with principal component analysis (PCA). Using triangular waveform voltage as the excitation signal, the response current during one duty cycle is sampled to construct a measurement vector. The measurement matrix is then constructed by the measurement vectors obtained from different measurements. After being processed by PCA, the changing information of solution impedance is contained in the loading vectors while the response current and noise information is contained in the score vectors. The measurement results of impedance variation by the proposed signal processing method are independent of the equivalent impedance model. The noise-induced problems encountered during equivalent impedance calculation are therefore avoided, and the real-time variation information of noise in the electrode-electrolyte interface can be extracted at the same time. Planar-interdigitated electrodes are experimentally tested for monitoring the KCl concentration variation process. Experimental results indicate that the measured impedance variation curve reflects the changing process of solution conductivity, and the amplitude distribution of the noise during one duty cycle can be utilized to analyze the contact conditions of the electrode and electrolyte interface.


Proximity Labeling Techniques: A Multi-Omics Toolbox.
Proximity labeling techniques are emerging high-throughput methods for studying protein-protein, protein-RNA, and protein-DNA interactions with temporal and spatial precision. Proximity labeling methods take advantage of enzymes that can covalently label biomolecules with reactive substrates. These labeled biomolecules can be identified using mass spectrometry or next-generation sequencing. The main advantage of these methods is their ability to capture weak or transient interactions between biomolecules. Proximity labeling is indispensable for studying organelle interactomes. Additionally, it can be used to resolve spatial composition of macromolecular complexes. Many of these methods have only recently been introduced; nonetheless, they have already provided new and deep insights into the biological processes at the cellular, organ, and organism levels. In this paper, we review a broad range of proximity labeling techniques, their development, drawbacks and advantages, and implementations in recent studies.


Susceptibility of bacterial isolates to cefepime in comparison to other broad spectrum antimicrobial agents at a tertiary care center in Lebanon.
Newly introduced antimicrobial agents have to be evaluated to establish their current activity and susceptibility data base against microorganisms for future comparison. Cefepime is a fourth generation cephalosporin that was recently introduced in Lebanon but no background susceptibility data is available for it in this country. We prospectively analyzed the antimicrobial susceptibility pattern of the bacterial isolates from the American University of Beirut Medical Center to a number of broad spectrum antimicrobial agents and compared it to the susceptibility of cefepime. Consecutive clinical bacterial isolates, representing 665 gram-negative and 387 gram-positive were tested: 82 to 100% of the gram-negative isolates were susceptible to cefepime, including most of the extended spectrum beta-lactamase producing Enterobacteriaceae. All the oxacillin susceptible staphylococcus isolates, and the penicillin susceptible Streptococcus spp. as well as 92% of the S. pneumoniae isolates were susceptible. The data shows that currently, cefepime provides a very broad spectrum of activity against gram-positive as well as gram-negative bacterial isolates recovered from clinical specimens.


Associations with Prehospital Antibiotic Receipt among Combat Casualties with Open Wounds: A Department of Defense Trauma Registry Study.
Current Tactical Combat Casualty Care (TCCC) guidelines recommend antibiotic administration for all open wounds to prevent infection. We identified associations between demographics, procedures, and medicines with the receipt of prehospital antibiotics among combat casualties. We used a series of emergency department procedure codes to identify adult subjects within the Department of Defense Trauma Registry from January 2007 to August 2016 who sustained open wounds. We compared demographics, procedures, and medicines administered among casualties receiving prehospital wound prophylaxis versus casualties not receiving antibiotic prophylaxis. We controlled for confounders with multivariable logistical regression. We identified 18,366 encounters meeting inclusion criteria. Antibiotic recipients (n = 2384) were comparable to nonrecipients (n = 15,982) with regard to age and sex. Antibiotic recipients were more likely to sustain injuries from firearms and undergo all procedures examined related to hemorrhage control, airway management, pneumothorax treatment, and volume replacement except for intraosseous access. Antibiotic recipients were less likely to sustain injuries from explosives. Antibiotic recipients had a modestly higher survival than nonrecipients (97.4% versus 96.0%). Associations with prehospital antibiotic receipt in multivariable logistic regression included non-North Atlantic Treaty Organization military force affiliation (odds ratio (OR) 4.65, 95% CI, 1.0-20.8), tachycardia (OR 3.4, 95% CI, 1.1-10.5), intubation (OR 2.0, 95% CI, 1.1-3.8), and administration of tranexamic acid (OR 5.6, 95% CI, 1.2-26.5). The proportion of combat casualties with open wounds receiving prehospital antibiotics was low despite published recommendations for early antibiotics in patients with open wounds. These findings highlight the ongoing need for additional educational and quality assurance initiatives to continue improving adherence to TCCC guidelines with regard to prehospital antibiotic administration. Future studies are necessary to determine reasons for suboptimal TCCC guideline compliance.


Dermoscopy and Reflectance Confocal Microscopy in Actinic Keratosis, Intraepithelial Carcinoma, and Invasive Squamous Cell Carcinoma.
Patients with multiple actinic keratosis (AK), have pre-neosplastic abnormalities, constituting the sites of new tumors, this region is called the cancerization field. Due to the risk of malignant transformation, rigorous evaluation, follow-up, and treatment of the cancerization field is proposed. Recently, non-invasive diagnostic technologies such as confocal reflectance microscopy (RCM), detect AK, intraepithelial carcinomas (IEC), and SCC, without the need of repeated biopsies. There are few reports of the progression of AK assessed by dermatoscopy and RCM concomitantly. Define morphological patterns and clinical applicability of dermatoscopy and MCR examinations of the AK lesions and their degrees of progression to IEC and SCC. A retrospective cross-sectional study of dermatoscopy and RCM examinations was performed in 30 patients with histopathological diagnosis of AK (20), IEC (6), and SCC (4). In the comparative analysis of the dermatoscopic features, erythema was present in 100% of the lesions, the red pseudo-network in 75% of the AK (P=0.007), and linear and irregular vessels in 90% of the lesions of IEC/SCC. In the RCM of AK, the most striking finding was the presence of atypical honeycomb in the spinous layer, but typical in the granular layer. While the IEC/SCC group presented irregular epidermal architecture and atypical honeycomb in all epider-mal layers, it also showed a higher prevalence of individual corneocytes and nucleated cells, cellular pleomorphism, and nuclear atypia in the dermal papillae, irregular vessels within papilla, and cells with bright edges and dark central nuclei in the dermis. Dermoscopy and RCM may be considered as auxiliary methods for assessing lesions resulting from ke-ratinocyte atypia. The results of this study are consistent with published studies and it was possible to propose, with literature support, a model of progression of AK to IEC and SCC. J Drugs Dermatol. 2022;21(3):259-268. doi:10.36849/JDD.5086.


Callous-unemotional traits and empathy deficits: Mediating effects of affective perspective-taking and facial emotion recognition.
Although empathy deficits are thought to be associated with callous-unemotional (CU) traits, findings remain equivocal and little is known about what specific abilities may underlie these purported deficits. Affective perspective-taking (APT) and facial emotion recognition may be implicated, given their independent associations with both empathy and CU traits. The current study examined how CU traits relate to cognitive and affective empathy and whether APT and facial emotion recognition mediate these relations. Participants were 103 adolescents (70 males) aged 16-18 attending a residential programme. CU traits were negatively associated with cognitive and affective empathy to a similar degree. The association between CU traits and affective empathy was partially mediated by APT. Results suggest that assessing mechanisms that may underlie empathic deficits, such as perspective-taking, may be important for youth with CU traits and may inform targets of intervention.


Breakdown of the gut barrier in patients with multiple organ dysfunction syndrome is attenuated by continuous blood purification: effects on tight junction structural proteins.
Breakdown of the gut barrier increases intestinal permeability and allows movement of intraluminal contents across the mucosa, which can lead to distant organ injury and multiple organ dysfunction syndrome (MODS). Intestinal permeability is associated with alterations in cellular tight junctions involving the structural proteins occludin and zonula occludens-1 (ZO-1). The aim of this study was to investigate the effect of continuous blood purification (CBP) on gut barrier function in patients with MODS. Serum diamine oxidase (DAO) and endotoxin, epithelial monolayer permeability, and transepithelial electrical resistance (TER) were used as markers for the assessment of gut barrier function in 22 patients with MODS who underwent continuous venovenous hemofiltration (CWH) for 24 hours. Blood samples were taken from patients at 0, 6, 12, and 24 hours during CWH therapy. Serum DAO and endotoxin were determined by spectrophotography. Permeability and TER were assessed using Caco-2 cell monolayers. Occludin and ZO-1 protein levels were analyzed by immunoblotting and immunofluorescence staining. And inducible nitric oxide synthase (iNOS) mRNA levels and nitric oxide (NO) production were determined by real-time PCR and spectrophotography, respectively. Gut barrier dysfunction was evident in patients with MODS compared with normal controls. Serum DAO, endotoxin levels, and epithelial permeability were elevated, while TER was decreased in patients with MODS, and this change was more pronounced in nonsurvivors. Breakdown and reorganization of occludin and ZO-1 away from tight junctions was found in all MODS patients. After CBP treatment, APACHE II and MODS scores improved significantly. Serum DAO and endotoxin levels and epithelial permeability also diminished, while TER increased in all patients; CBP significantly attenuated breakdown and reorganization of tight junction proteins, and also attenuated the inflammation-induced increase in iNOS mRNA expression and NO production. Breakdown of gut barrier function is present in patients with MODS and may be correlated with poor outcomes in the disease. CBP can not only improve the general conditions, as measured by the APACHE II score, but also improve gut barrier dysfunction by attenuating the breakdown and reorganization of occludin and ZO-1. This beneficial effect of CBP on gut barrier dysfunction is associated with down-regulation of iNOS.


The Diversification of Zika Virus: Are There Two Distinct Lineages?
Zika virus (ZIKV) has caused explosive epidemics in the Pacific and the Americas, posing a serious threat to public health. Conventional opinion advocates that ZIKV evolved into two distinct lineages, namely, African and Asian. Descendants of this latter lineage dispersed globally causing major epidemics. However, based on shared amino acid replacements and phylogenetic analyses, it was recently contentiously proposed that the Asian lineage was a direct descendant of the African lineage. To address this contentious issue, we reconstructed a phylogenetic tree of ZIKV using the method based on shared amino acid replacements and found that ZIKV evolved into two distinct lineages. This supports the conventional phylogenetic divergence pattern of ZIKV. Evidence of recombination and sequencing errors was identified among the large collection of ZIKV. As such problematic sequences could confound the phylogenetic analyses, they were removed. Bayesian phylogenetic analyses using the improved sequence data enabled estimates for the divergence time in the past of the African and Asian lineages of ∼180 years ago. Moreover, we found that the Asian lineage viruses did not evolve at an elevated rate. Our findings provide additional support for the conventional opinion that the Asian lineage of ZIKV diverged from the African lineage.


The effect of routine steam autoclaving on orthodontic pliers.
Five commonly used types of orthodontic plier of similar design, but different manufacture were evaluated for wear and corrosion following a 6-month regime of routine use in a hospital department together with steam autoclaving in a centralized unit. Three different types of manufacture (metal finish) were evaluated: (1) a stainless steel plier; (2) a chrome plated plier; and (3) a cheaper chrome plated plier. Four identical kits for changing archwires were assembled for each of the three manufacture types. A sixth 'plier', always of chrome plated manufacture (group 2) was added to every kit and acted as an additional control. In all, 72 pliers were evaluated by three observers immediately before and after the trial. Visual analogue and rank scales were used to assess corrosion, damage, the efficiency of the plier, etc. Generally, all of the pliers stood up well to a combination of routine clinical use and steam autoclaving; however, the stainless steel pliers appeared to perform the best. It is likely that the most important factor, when setting up this type of sterilizing method for orthodontic instruments, is to establish a careful and meticulous routine for cleaning, lubricating, and steam autoclaving pliers.


Advances in paediatric strength assessment: changing our perspective on strength development.
Our knowledge of the age and sex associated changes in strength during childhood and adolescence is relatively limited compared to other physiological parameters. However, those studies available on the age and sex associated change in strength are relatively consistent, especially for the lower limbs. Caution must be taken when transferring this knowledge to other muscle joints as the development in strength appears to be both muscle action and joint specific. Strength appears to increase in both boys and girls until about the age of 14 y where it begins to plateau in girls and a spurt is evident in boys. By 18 y there are few overlaps in strength between boys and girls. The exact age in which sex differences become apparent appears to be both muscle group and muscle action specific and there is a suggestion that sex differences in upper body strength occur earlier than lower body strength. What is less clear is the complex factors that contribute to the production of strength during childhood and adolescence. There are few well controlled longitudinal studies that have concurrently examined the influence of known variables using appropriate statistical techniques. Most studies have shown that maturation does not exert an independent effect when other factors, such as stature and body mass are accounted for. Also, the assumption that muscle cross-sectional area is the most important parameter in strength production does not hold when examined with other known variables. Consistently, stature appears to play a key role in strength development and this may be attributed to the strength spurt that has been linked to peak height velocity, and the muscle moment arm. Advances in technology have provided us with more accurate techniques to examine these explanatory variables but the complex interaction of neural, mechanical and muscular remains to be clearly identified from well controlled longitudinal studies. Key pointsThe age associated development in strength is attributable to changes in growth and maturation. Sex differences appear at around 14y and very few girls out perform boys in strength tests at 18y.Stature and mass appear to be important explanatory variables in the development of muscle strength. PHV is a particularly important time for maximal gains in strength during childhood.The muscle moment arm is possibly the most important factor in the development of muscle strength with age but further longitudinal studies using MRI are needed.


1,4-disubstituted anthracene antitumor agents.
Three different types of 1,4-disubstituted anthracenes were synthesized, and their cytotoxicity in a panel of tumor cells was compared with that of the corresponding 9,10-disubstituted anthracenes. The panel contained human myeloma, melanoma, colon, and lung cancer cells and sensitive and multidrug-resistant murine L1210 leukemia cells. These compounds had [[(dimethylamino)ethyl]amino]methyl, N-[(dimethylamino)ethyl]carbamoyl, and carboxaldehyde (4,5-dihydro-1H-imidazol-2-yl)hydrazone side chains. The 1,4-diamide was more potent across the tumor panel than the corresponding 9,10-isomer, but the 1,4-diamine and the 1,4-hydrazone were less potent than their 9,10-isomers. Although the 1,4-hydrazone was active against P388 leukemia in mice, it was inactive against L1210 leukemia. Within each pair of compounds, the one with greater average potency against tumor cells gave a greater increase in the transition melt temperature of DNA.


In vitro isolation of equine piroplasms derived from Cape Mountain zebra (Equus zebra zebra) in South Africa.
Twenty blood samples of zebras (Equus zebra zebra) from the Karoo National Park and the Bontebok National Park in South Africa, all seropositive for Theileria equi, were subjected to in vitro culture to identify carrier animals and to isolate the parasites. Sixteen animals had a detectable parasitaemia in Giemsa-stained blood smears examined before culture initiation, the remaining four animals were identified as T. equi carriers by in vitro culture. Cultures were initiated either in an oxygen-reduced gas mixture or in a 5% CO2-in-air atmosphere. Out of the 20 blood samples, 12 cultures of T. equi and two cultures of T. equi mixed with Babesia caballi were established. None of the four animals seropositive for B. caballi could be identified as carrier animals, whereas two seronegative samples became culture-positive for B. caballi.


Economic Burden of Chronic Obstructive Pulmonary Disease and Lung Cancer Between 2000 and 2015 in Saskatchewan: Study Protocol.
Chronic obstructive pulmonary disease (COPD) and lung cancer are both detrimental diseases that present great burdens on society. Years of life lost (YLL), premature years of life lost (PYLL), working years lost (WYL), and productivity loss are all effective measures in identifying economic burden of disease. We propose a population-based study to analyze comprehensive provincial cohorts of Saskatchewan residents with COPD, lung cancer, and combined COPD and lung cancer in order to identify the burden these diseases present. Saskatchewan residents over the age of 35 years who had COPD, lung cancer, or both, between January 1, 2000, and December 31, 2015, will be identified and used in this study. Data for analysis including age, gender, and date of death, alongside Statistics Canada income estimates, will be used to estimate productivity loss and WYL. Statistics Canada life tables will be used to calculate YLL and PYLL by subtracting the patients' ages at death by their life expectancies, adjusted using sex and age at death. We will link the Saskatchewan cancer registry with Saskatchewan health administrative databases to create three cohorts: (1) COPD; (2) lung cancer; and (3) COPD and lung cancer. Individuals with lung cancer will be identified using ICDO-T (International Classification of Diseases for Oncology-Topography) codes, and those with COPD will be defined and identified as individuals who had at least 1 visit to a physician with a diagnosis of COPD or 1 hospital separation with a diagnosis of COPD. Those without a valid health care coverage for a consecutive 12 months prior to the first diagnostic code will be excluded from the study. Those with a combined diagnosis of COPD and lung cancer will be identified as individuals who were diagnosed with COPD in the 12 months following their lung cancer diagnosis or anytime preceding their lung cancer diagnosis. As of April 2021, we have had access to all relevant data for this study, have received funding (January 2020), and have begun the preliminary analysis of our data set. It is well documented that COPD and lung cancer are both destructive diseases in terms of YLL, PYLL, WYL, and productivity loss; however, no studies have been conducted to analyze a cohort with combined COPD and lung cancer. Understanding the economic burden associated with each of our 3 cohorts is necessary in understanding and thus reducing the societal impact of COPD and lung cancer. RR1-10.2196/31350.


[The university network of education and technical support of treatment of fungal diseases for dermatologists].
In July 2007, information on the current status of mycological examinations in Japanese university clinics and requests for a university network system was gathered by a questionnaire completed by 98 of 112 professors or directors of those clinics. A summary of the findings follows: only 9% of the hospitals performed fungal culture studies for all or most cases, indicating a drop of 7% from 2000 (16% in 2000, reported by Kasai) . Also, just 55% of relevant departments maintained the ability to identify most or all clinical isolates in-house, which down 27% from 2000 (83% in 2000, reported by Kasai). These findings indicate that mycological diagnoses by many departments have been rapidly decreasing. Eighty-nine percent of respondents indicated a desire for some help from the university network including: basic training in medical mycology of young doctors (senior residents in university hospitals); aid in diagnosing rare fungal infections; and support in obtaining knowledge and new technologies. The basic training of senior residents in each department is not possible in the network system so each department is required to take responsibility for training their own. However, a project of an advanced course at the leader level, which educates the person in charge of each department, may be possible in the network system. Employing this would make it realistic for the educated leaders to train the senior residents in their departments.