In situ recording of Mars soundscape.
Before the Perseverance rover landing, the acoustic environment of Mars was unknown. Models predicted that: (1) atmospheric turbulence changes at centimetre scales or smaller at the point where molecular viscosity converts kinetic energy into heat1, (2) the speed of sound varies at the surface with frequency2,3 and (3) high-frequency waves are strongly attenuated with distance in CO2 (refs. 2-4). However, theoretical models were uncertain because of a lack of experimental data at low pressure and the difficulty to characterize turbulence or attenuation in a closed environment. Here, using Perseverance microphone recordings, we present the first characterization of the acoustic environment on Mars and pressure fluctuations in the audible range and beyond, from 20 Hz to 50 kHz. We find that atmospheric sounds extend measurements of pressure variations down to 1,000 times smaller scales than ever observed before, showing a dissipative regime extending over five orders of magnitude in energy. Using point sources of sound (Ingenuity rotorcraft, laser-induced sparks), we highlight two distinct values for the speed of sound that are about 10 m s-1 apart below and above 240 Hz, a unique characteristic of low-pressure CO2-dominated atmosphere. We also provide the acoustic attenuation with distance above 2 kHz, allowing us to explain the large contribution of the CO2 vibrational relaxation in the audible range. These results establish a ground truth for the modelling of acoustic processes, which is critical for studies in atmospheres such as those of Mars and Venus.


Management of radial head fracture.
A fracture involves not only bone, but also surrounding soft tissues. Attention to soft tissue injury may help prevent long-term complications such as contractures, weakness, instability and loss of proprioception. Appropriate treatment is directed at three phases of healing: inflammation, repair and remodeling. The two- to seven-day inflammatory phase is controlled with rest, ice, elevation, immobilization and medications to reduce the pain and swelling. Immobilization during the two- to eight-week repair phase promotes bone healing but may lead to contractures and loss of strength if continued for too long. Physical therapy during the several-month remodeling phase helps restore strength, range of motion and proprioception. Although six to eight weeks is a usual estimate for fracture healing, the actual time can be affected by the type of fracture and the person's age, nutritional and health status, and medication use. This review of the diagnosis and treatment of radial head fractures illustrates the importance of directing the treatment toward the three phases of healing.


A new extinct species of Ataenius Harold from Baltic amber (Coleoptera: Scarabaeidae: Aphodiinae).
Fossil records of Scarabaeidae in Eocene amber deposits are scarce. Previously, only three species were known from Baltic amber. Based on well-preserved specimens, an additional extinct species of Eupariini (Coleoptera: Scarabaeidae: Aphodiinae), Ataenius damzeni Bukejs Alekseev, new species is described and illustrated from this Lagerstätte. A key to the species of Scarabaeidae that have been described from European Eocene amber is provided.


Smoking cessation during pregnancy: a population-based study.
To measure the prevalence of smoking cessation during pregnancy and to identify factors associated with its occurrence. The present survey included all puerperal women living in the municipality of Rio Grande, RS, whose birth occurred between January 1 and December 31, 2013. A single standardized questionnaire was applied, in the hospital, within 48 hours of delivery. Multivariate analysis was performed using Poisson regression with robust variance. The prevalence of smoking cessation among the 598 parturients studied was 24.9% (95%CI 21.5-28.6). After adjusting for confounding factors, mothers aged 13 to 19 years (PR = 1.76; 95%CI 1.13-2.74), who had higher family income (PR = 1.83; 95%CI, 1.23-2.72), higher educational level (PR = 2.79; 95%CI 1.27-6.15), higher number of prenatal appointments (PR = 1.84; 95%CI 1.11-3.05), and who did not smoke in the previous pregnancy (PR = 2.93; 95% CI, 1.95-4.41) presented a higher prevalence ratio of smoking cessation. Although pregnancy is a window of opportunity for smoking cessation, the rate of cessation was low. The prevalence of cessation was higher among mothers with lower risk of complications, suggesting the need for interventions prioritizing pregnant women of lower socioeconomic levels.


Features in Vibrational Spectra Induced by Ar-Tagging for H3O(+)Arm, m = 0-3.
Understanding the spectral features for solvated hydronium has been hindered due to the strong and complex vibrational couplings that lead to broad bands in the aqueous phase. In this work, utilizing ab initio vibrational calculations, we determine how the vibrational couplings induced by the Ar microsolvation in H3O(+)Arm m = 0-3 affect the observed spectra. With theoretical peak intensities and peak positions, we assign the experimental spectra. We also show that an increase in the number of Ar atoms results in an anticooperative blue shifting in the Ar-tagged OH stretching bands. This change in peak position of the OH stretching fundamental modulates the Fermi resonance with the bending overtone. This is observed as a distinct doublet feature at 3200 cm(-1) with varying intensities for H3O(+)Ar2 and H3O(+)Ar3. The coupling between the in-plane rotation of the hydronium and the bending modes of H3O(+) leads to the existence of a strong association bands around 1900 cm(-1).


An evaluation of data quality in Canada's Continuing Care Reporting System (CCRS): secondary analyses of Ontario data submitted between 1996 and 2011.
Evidence informed decision making in health policy development and clinical practice depends on the availability of valid and reliable data. The introduction of interRAI assessment systems in many countries has provided valuable new information that can be used to support case mix based payment systems, quality monitoring, outcome measurement and care planning. The Continuing Care Reporting System (CCRS) managed by the Canadian Institute for Health Information has served as a data repository supporting national implementation of the Resident Assessment Instrument (RAI 2.0) in Canada for more than 15 years. The present paper aims to evaluate data quality for the CCRS using an approach that may be generalizable to comparable data holdings internationally. Data from the RAI 2.0 implementation in Complex Continuing Care (CCC) hospitals/units and Long Term Care (LTC) homes in Ontario were analyzed using various statistical techniques that provide evidence for trends in validity, reliability, and population attributes. Time series comparisons included evaluations of scale reliability, patterns of associations between items and scales that provide evidence about convergent validity, and measures of changes in population characteristics over time. Data quality with respect to reliability, validity, completeness and freedom from logical coding errors was consistently high for the CCRS in both CCC and LTC settings. The addition of logic checks further improved data quality in both settings. The only notable change of concern was a substantial inflation in the percentage of long term care home residents qualifying for the Special Rehabilitation level of the Resource Utilization Groups (RUG-III) case mix system after the adoption of that system as part of the payment system for LTC. The CCRS provides a robust, high quality data source that may be used to inform policy, clinical practice and service delivery in Ontario. Only one area of concern was noted, and the statistical techniques employed here may be readily used to target organizations with data quality problems in that (or any other) area. There was also evidence that data quality was good in both CCC and LTC settings from the outset of implementation, meaning data may be used from the entire time series. The methods employed here may continue to be used to monitor data quality in this province over time and they provide a benchmark for comparisons with other jurisdictions implementing the RAI 2.0 in similar populations.


Comparison of cell response to chromatin and DNA damage.
DNA-targeting drugs are widely used for anti-cancer treatment. Many of these drugs cause different types of DNA damage, i.e. alterations in the chemical structure of DNA molecule. However, molecules binding to DNA may also interfere with DNA packing into chromatin. Interestingly, some molecules do not cause any changes in DNA chemical structure but interfere with DNA binding to histones and nucleosome wrapping. This results in histone loss from chromatin and destabilization of nucleosomes, a phenomenon that we call chromatin damage. Although the cellular response to DNA damage is well-studied, the consequences of chromatin damage are not. Moreover, many drugs used to study DNA damage also cause chromatin damage, therefore there is no clarity on which effects are caused by DNA or chromatin damage. In this study, we aimed to clarify this issue. We treated normal and tumor cells with bleomycin, nuclease mimicking drug which cut predominantly nucleosome-free DNA and therefore causes DNA damage in the form of DNA breaks, and CBL0137, which causes chromatin damage without direct DNA damage. We describe similarities and differences between the consequences of DNA and chromatin damage. Both agents were more toxic for tumor than normal cells, but while DNA damage causes senescence in both normal and tumor cells, chromatin damage does not. Both agents activated p53, but chromatin damage leads to the accumulation of higher levels of unmodified p53, which transcriptional activity was similar to or lower than that of p53 activated by DNA damage. Most importantly, we found that while transcriptional changes caused by DNA damage are limited by p53-dependent activation of a small number of p53 targets, chromatin damage activated many folds more genes in p53 independent manner.


Levansucrase from Bacillus amyloliquefaciens KK9 and Its Y237S Variant Producing the High Bioactive Levan-Type Fructooligosaccharides.
Levan-typed fructooligosaccharide (LFOS), a β-2,6 linked oligofructose, displays the potential application as a prebiotic and therapeutic dietary supplement. In the present study, LFOS was synthesized using levansucrase from Bacillus amyloliquefaciens KK9 (LsKK9). The wild-type LsKK9 was cloned and expressed in E. coli, and purified by cation exchanger chromatography. Additionally, Y237S variant of LsKK9 was constructed based on sequence alignment and structural analysis to enhance the LFOS production. High-performance anion-exchange chromatography coupled with pulsed amperometric detection (HPAEC-PAD) analysis indicated that Y237S variant efficiently produced a higher amount of short-chain LFOS than wild type. Also, the concentration of enzyme and sucrose in the reactions was optimized. Finally, prebiotic activity assay demonstrated that LFOS produced by Y237S variant had higher prebiotic activity than that of the wild-type enzyme, making the variant enzyme attractive for food biotechnology.


Pathogenic Vibrio species in dutch shellfish destined for direct human consumption.
Vibrio parahaemolyticus is a common cause of shellfish-related gastroenteritis all over the world. V. parahaemolyticus and Vibrio alginolyticus have previously been detected in water samples from the Oosterschelde, a large inlet on the North Sea, which is used for both recreational purposes and shellfish production. In 2006, oysters (Crassostrea gigas) from a noncommercial oyster bed in the Oosterschelde and oysters bought in Dutch fish shops were tested for the presence of pathogenic Vibrio species; in 2007 and 2008, oysters (C. gigas) and mussels (Mytilus edulis) from Oosterschelde production areas were examined. Total Vibrio numbers were related to water temperatures to study joint patterns. Vibrio was found in oysters and mussels from the production areas, and levels ranged from 6 to 622 most probable number (MPN) per g in oysters and 6 to 62 MPN/g in mussels. Vibrio levels in oysters from fish shops were 231 to >333 MPN/g, whereas levels in noncommercial oysters ranged from 231 to >2,398 MPN/g. About 80% of the isolated strains were V. alginolyticus, and approximately 10% were identified as V. parahaemolyticus. Vibrio counts in shellfish samples increased with increasing water temperature and declined when water temperatures dropped; Vibrio was not detected when water temperatures declined to <13.5 degrees C. Based on the obtained results and the known high V. parahaemolyticus dose (>10(4) cells per serving of oysters) required for infection, it is concluded that the risk of gastrointestinal infections with V. parahaemolyticus through consumption of shellfish from the Oosterschelde production sites is presumably low.


The association between hemoglobin concentration and clinical outcomes after aneurysmal subarachnoid hemorrhage: Insights from the LongTEAM registry.
The aim of this study is to explore whether preoperative hemoglobin levels could serve as a prospective biomarker for early brain injury in patients with aneurysmal subarachnoid hemorrhage (aSAH). This investigation seeks to discern its association with postoperative complications and unfavorable clinical outcomes. We conducted a comprehensive analysis of data derived from the LongTeam registry, including patients with aSAH diagnosed between January 2015 and September 2021. These patients were stratified into three distinct groups based on their hemoglobin levels: anemic, standard, and elevated HGB. We employed logistic models featuring spline transformations to assess the relationship between HGB levels and in-hospital complications. Furthermore, a multivariate Cox proportional hazard model was employed to estimate the impact of elevated hemoglobin levels on the hazard function, which was elucidated through Kaplan-Meier curves. Our study comprised a total of 988 patients, among whom 115 (11.6%) presented preoperative anemia, and 63 (6.4%) exhibited elevated preoperative HGB levels. Following adjustments for potential confounding factors, no significant disparity in risk was evident between anemic patients and those with standard HGB levels. However, individuals with elevated HGB levels displayed a heightened incidence and an increased risk of developing deep vein thrombosis (DVT, odds ratio [OR] = 2.39, 95% confidence interval [CI] = 1.16-4.91, p = 0.018; hazard ratio [HR] = 2.05, 95% CI 1.08-3.92, p = 0.015). Aberrant HGB concentrations did not demonstrate an association with other clinical outcomes. Our findings emphasize that abnormal HGB levels show no association with adverse outcomes at the 90 days mark after accounting for clinical confounding factors in patients with aSAH. Simultaneously, the study illuminates the potential of HGB as an early indicator for identifying patients at a heightened risk of developing DVT.


Lower Extremity Strength and Recovery Time in Youth Baseball Pitchers: A Pilot Study.
Livingston, JL and Tavoukjian, NM. Lower extremity strength and recovery time in youth baseball pitchers: a pilot study. J Strength Cond Res 34(7): 1990-1998, 2020-The purpose of this study was to investigate the Little League pitching regulations by measuring the change in lower extremity force production after a pitching performance and the subsequent days of rest required for youth baseball pitchers to recover. Bilateral manual muscle testing of the gluteus maximus, hamstrings, gluteus medius, triceps surae, and quadriceps was conducted using a handheld dynamometer. Fifteen healthy, youth baseball pitchers (9.80 ± 1.08 years) threw a submaximal number of pitches and were tested before, immediately after, and for the next 4 consecutive days. Time in days required per muscle group to return to baseline force production levels were compared with Little League rest guidelines for pitchers. Results indicated that Little League rest requirements did not allow for sufficient recovery of lower extremity strength (p = 0.017). Results suggest that current Little League pitching guidelines provide an inadequate recovery period for youth pitchers, even when pitching a submaximal volume. Little League pitch count regulations and associated rest days may require revisions to avoid having youth athletes pitch while fatigued.


Use of FM System in cochlear implant.
To verify the use of the Frequency Modulation System (FM) and its benefit for cochlear implant users. Analysis of medical records of 113 users of Cochlear Implants (CI) adapted with FM System kits between September 2013 and September 2015 after publication of the Administrative Rule 1.274 of 6/25/2013, regarding the results of the speech perception tests (SPT) and the Listening Inventory For Education - Revised (LIFE-R) and Classroom Participation Questionnaire (CPQ). The use of the FM System in the classroom was effective for 47.15% of the patients, while 21.42% did not use it. There was no correlation between the use of the FM System and the age group of patients. The results of the SPT regarding noise were statistically better with the use of FM System. Regarding the questionnaires, the score obtained in the LIFE-R in the situation "after use of the FM System" was statistically better for the item "listening situations in the classroom" and in the CPQ, for the items "teacher understanding" and "positive aspects", when compared to the situation "without using the FM System". Patients benefitting from the concession of the FM System made use of the device in the classroom and improvement in both speech perception in noisy environments and subjective impression of the understanding of teachers' speech in the classroom was observed after the use of the FM System.


Two-site monoclonal antibody assays for human heart- and brain-type creatine kinase.
Monoclonal antibodies have been raised against human heart- and brain-type creatine kinase (CK-MB and CK-BB). We used a low-affinity monoclonal antibody to develop a simple two-step immunoaffinity purification procedure for native CK-MB. Antibodies of higher affinity were used to construct specific two-site immunoradiometric assays for CK-MB and CK-BB. In the assay for CK-MB we used an 125I-labeled B subunit-specific antibody with an immobilized anti-M subunit antibody--adding either simultaneously, for a 1-h assay in which between 5 and 1000 ng of CK-MB per milliliter could be measured with an intra-assay CV of 4% to 20%, or sequentially, for a 2-h magnetic separation assay in which between 0.5 and 1000 ng/mL could be measured with an intra-assay CV of 14 to 19%. In both versions CK-BB up to 100 ng/mL and CK-MM up to 5000 ng/mL did not interfere. In the assay for CK-BB we used an 125I-labeled, reduced, and alkylated monoclonal antibody specific for the B subunit of CK-BB, and removed bound isoenzyme with a second immobilized monoclonal antibody specific for a different epitope on the B subunit. Total incubation time for this assay was 5 h. Intra-assay CV was 7.5 to 20% between 0.1 and 1000 ng/mL. CK-MB up to 1000 ng/mL and CK-MM up to 100 000 ng/mL did not interfere. Inter-assay CVs in all three assays varied from 9 to 21%.


Development and validity of methods for the estimation of temporal gait parameters from heel-attached inertial sensors in younger and older adults.
The heel is likely a suitable location to which inertial sensors are attached for the detection of gait events. However, there are few studies to detect gait events and determine temporal gait parameters using sensors attached to the heels. We developed two methods to determine temporal gait parameters: detecting heel-contact using acceleration and detecting toe-off using angular velocity data (acceleration-angular velocity method; A-V method), and detecting both heel-contact and toe-off using angular velocity data (angular velocity-angular velocity method; V-V method). The aim of this study was to examine the concurrent validity of the A-V and V-V methods against the standard method, and to compare their accuracy. Temporal gait parameters were measured in 10 younger and 10 older adults. The intra-class correlation coefficients were excellent in both methods compared with the standard method (0.80 to 1.00). The root mean square errors of stance and swing time in the A-V method were smaller than the V-V method in older adults, although there were no significant discrepancies in the other comparisons. Our study suggests that inertial sensors attached to the heels, using the A-V method in particular, provide a valid measurement of temporal gait parameters.


[Pruritus--a side effect of hydroxyethyl starch? First report].
It is generally assumed that a disturbance of microcirculation is the common pathogenic pathway of various cochleovestibular disorders. Several studies have demonstrated that hydroxyethyl starch (HES) has better rheological effects than dextran 40, and fewer side-effects. Therefore, we changed from dextran 40 to hydroxyethyl starch in 1987 for the treatment of several otoneurological disorders. However, some patients complained of general pruritus after 1 or 2 weeks of therapy with HES. Therefore, a retrospective study was performed using a questionnaire of 491 patients treated for various cochleovestibular disorders. We received answers from 94 (20%): 25 of 59 (42.4%) patients treated with HES complained of pruritus compared with only 4 of 35 (11.4%) patients treated with dextran 40. The difference was significant (P less than 0.01). Critical points are the retrospective study design and the small number of patients, so that no conclusions can be drawn about the incidence of pruritus after therapy with HES. However, we would like to focus attention on this side-effect, which has been neglected in the literature but is extremely uncomfortable and socially embarrassing for some patients.


T cell hybrids with arsonate specificity. I. Initial characterization of antigen-specific T cell products that bear a cross-reactive idiotype and determinants encoded by the murine major histocompatibility complex.
T cell hybrids have been constructed between the BW5147 thymoma cell line and A/J splenocytes from mice suppressed with the p-azophenylarsonte hapten. Three independently derived cloned lines have been chracterized. Each secretes or sheds a 62,000-dalton antigen-specific product bound by rabbit antisera directed against the arsonate cross-reactive idiotype. In addition, each of the antien-specific molecules contains determinants encoded within the I region of the murine major histocompatibility complex. Peptide mapping analysis indictes that, whereas these molecules are remarkably similar, each is individually distinct in primary structure. The availability of cloned T cell lines that produce antigen-specific idiotype-positive I region-containing products should facilitate a more thorough dissection of the interrelationships of T-B interctions in the arsonate idiotypic system.


Regional cerebral blood flow and metabolism in patients with transient global amnesia: a positron emission tomography study.
In four patients who experienced transient global amnesia (TGA), clinical features and neuroradiological findings including positron emission tomography (PET) were studied within three months of the episodes, and compared with those in seven cases with cerebral transient ischaemic attacks (TIA). None of TGA patients had a previous history or significant risk factors for the cerebrovascular diseases. Their electroencephalogram, brain CT and angiogram for the head and neck were almost normal. PET study showed better preserved cerebral blood flow and oxygen metabolism in each area of the brain in patients with TGA compared with those with TIA in whom focal reductions of flow and metabolism were evident. These observations suggest that TGA is caused by reversible circulatory and/or metabolic disturbance, of which mechanism might be different from that in TIA.


Aesthetic correction of double tooth: simplified technique.
The aim of this study is to report aesthetic conservative treatment of double tooth anomaly. Case report: A 7.5-year-old patient presents an anomaly of the maxillary right upper central incisor with a bifid crown and an increased mesio-distal width and a central incisal notch, probably amenable to a gemination. Single tooth anesthesia and conservative enameloplasty procedure was performed, with universal adhesive and a single shade universal composite restorative material. Adhesive aesthetic restorations allow to resolve dental anomalies quickly, cheaply and asily for pediatric dentistry.


The Utilization of the Surviving Sepsis Campaign Care Bundles in the Treatment of Pediatric Patients with Severe Sepsis or Septic Shock in a Resource-Limited Environment: A Prospective Multicenter Trial.
Sepsis is a common condition affecting the lives of infants and children worldwide. Although implementation of the surviving sepsis campaign (SSC) care bundles was once believed to be effective in reducing sepsis mortality rates, the approach has recently been questioned. The study was a prospective, interventional, multicenter trial. Infants and children aged 1 month to 15 years in seven different large academic centers in Thailand who had been diagnosed with severe sepsis or septic shock. They were given treatment based on the SSC care bundles. A total of 519 children with severe sepsis or septic shock were enrolled in the study. Among these, 188 were assigned to the intervention group and 331 were recruited to the historical case-control group. There were no significant differences in the baseline clinical characteristics. The intervention group was administered a significantly higher fluid bolus than was the control group (28.3 ± 17.2 cc/kg vs. 17.7 ± 10.6 cc/kg; P = 0.02) with early vasopressor used (1.5 ± 0.7 h) compared to control group (7.4 ± 2.4 h, P < 0.05). More importantly, our sepsis mortality reduced significantly from 37% ± 20.7% during the preintervention period to 19.4% ± 14.3% during the postintervention period (P < 0.001). Our study demonstrated a significant reduction in sepsis mortality after the implementation of the SSC care bundles. Early diagnosis of the disease, optimum hemodynamic resuscitation, and timely antibiotic administration are the key elements of sepsis management.


Fluorescence-Based Evaluation of Bacterial Load in Perilesional Skin: A Comparison Between Short Stretch Bandage and Zinc Oxide Bandage.
Bacterial proliferation plays a well-known role in delayed tissue healing. To date, the presence of microorganisms on the wound bed can be detected by skin swabs or skin biopsies. A novel noninvasive fluorescence imaging device has recently allowed real-time detection of bacteria in different types of wounds through endogenous autofluorescence. The fluorescence signals detected by the device provide health workers with a visual indication of the presence, load, and distribution of bacteria. The aim of our study was to evaluate the level of bacterial colonization in perilesional skin of patients affected by venous leg ulcers treated with 2 different types of bandages: short stretch bandage and zinc oxide bandage. We conducted a monocentric prospective study, enrolling 30 patients with venous leg ulcers, divided into 2 groups: group A was treated with short stretch bandage and group B with zinc oxide bandage. A complete patient's assessment was performed once a week for 3 weeks. Levels of potentially harmful bacteria in perilesional skin were detected using a fluorescent device by 2 experienced operators on the frames taken at individual injuries, while pain was evaluated with the Numerical Rating Scale. After 3 weeks, we observed a reduction in the bacterial colonization levels of the perilesional skin by 68.67% for group A and 85.54% for group B. All the patients had a statistically significant reduction in bacterial load (P < .001), and a statistically significant difference was identified between the 2 groups (P = .043). No statistically significant differences were found between the 2 groups in terms of pain relief (P = .114). Our study demonstrated that the application of zinc oxide bandage provides a higher reduction in bacterial load perilesional skin. On the other hand, we found no difference between the 2 bandages in terms of pain symptom reduction.


Association of Titanium Mesh and Bovine Pericardium Membrane in the Treatment of Severe Enophthalmos.
The blowout fractures may be classified as pure or impure depending on the associated structures. There are 2 main theories attempting to describe the mechanism of injury, the hydraulic, and blocking mechanism. The complications of this type of fracture may involve diplopia, enophthalmos, and ocular movement restriction. Several materials are available for the reconstruction of orbital floor, including the titanium mesh, which present great properties, such as easy modeling and stabilization, small thickness, and shape maintenance. There, however, are disadvantages such as the possibility of adherence formation. The aim of this report is to describe the case of a patient with an 8-month blowout fracture sequel, presenting extensive enophthalmos and treated by affixing a titanium mesh associated with bovine pericardium membrane in the orbital floor. Therefore, based on a 2-year follow-up, it was possible to observe how effective the association between these 2 materials in solving the case was.


Diagnosis of the Lelystad strain of Porcine reproductive and respiratory syndrome virus infection in individually housed pigs: comparison between serum and oral fluid samples for viral nucleic acid and antibody detection.
There has been a developing interest in the use of oral fluid for the diagnosis of different pathogens such as Porcine reproductive and respiratory syndrome virus (PRRSV). PRRSV and PRRSV-specific antibodies have been shown to be present in oral fluid samples, but the correlation between diagnostic results in oral fluid and serum samples has been insufficiently addressed. Studies investigating this correlation focused on boars older than 6 months and type 2 strains, but it is known that the outcome of a PRRSV infection is age and strain dependent. To address this gap, the current study reports on the detection of PRRSV and PRRSV-specific antibodies in serum and oral fluid samples collected over a 6-week period after an experimental infection of 8-week-old individually housed pigs with Lelystad virus, the type 1 prototype strain. Quantitative reverse transcription polymerase chain reaction analysis showed that significantly more serum samples were PRRSV RNA-positive than oral fluid until 5 days postinfection (dpi). Between 7 and 21 dpi, PRRSV RNA detection was similar in both samples but higher detection rates in oral fluid were found from 28 dpi. Compared with existing literature, this highlights that detection rates at particular time points postinfection might vary in function of strain virulence and animal age and provides useful information for the interpretation of pen-based oral fluid results. An excellent agreement between the oral fluid and serum enzyme-linked immunosorbent assay results was observed at every time point, further supporting the usefulness of oral fluid as a diagnostic sample for antibody detection.


Cognitive function of idiopathic childhood epilepsy.
Most children with epilepsy are of normal intelligence. However, a significant subset will have temporary or permanent cognitive impairment. Factors that affect cognitive function are myriad and include the underlying neuropathology of the epilepsy, seizures, epileptiform discharges, psychosocial problems, age at seizure onset, duration of epilepsy, and side effects associated with antiepileptic drugs. This review article discusses cognitive function in children with idiopathic epilepsy and the effects of antiepileptic drugs on cognitive function in children.


Gambling behavior of student-athletes and a student cohort: what are the odds?
This study investigated the prevalence of gambling, gambling related NCAA violations, and disordered gambling in student-athletes (n = 736) with a comparison cohort of students (n = 1,071) at four universities. Student-athletes reported similar rates of gambling frequency, use of a bookmaker, and disordered gambling as students. After accounting for demographic differences, student-athletes were less likely to engage in sports wagering than students. Several risk factors for disordered gambling were identified, including being male and reporting at least one parent with a history of gambling problems. These findings suggest that problems associated with gambling are a university-wide issue with student-athletes meriting additional attention because of implications for the integrity of intercollegiate sports. Improved prevention and intervention efforts for collegiate gambling are recommended.


[Cardiocirculatory effects of halothane and isoflurane in respiratory distress caused by oleic acid].
When lungs are damaged or affected by edema they behave differently from healthy lungs in the presence of drugs that can modify vascular reactivity. To determine the effects of halothane and isoflurane on pulmonary edema induced by oleic acid in dogs. Eighteen dogs were anesthetized with sodium pentothal. Hemodynamic and lung parameters as well as end-tidal gases were monitored. Pulmonary edema was induced with an injection of oleic acid (0.1 ml/kg). Five periods were studied: 1) before injection of oleic acid; 2) 90 min after injection; 3) 20 min after ventilation with 1 MAC halothane or isoflurane; 4) 20 min after 2 MAC ventilation with the assigned anesthetic, and 5) 20 min after withdrawal of anesthetic. With halothane, cardiac output and arterial blood pressure decreased significantly. With isoflurane, arterial pressure decreased by way of changes in vascular resistance. Neither anesthetic affected hypoxic pulmonary vasoconstriction. Neither anesthetic worsens arterial oxygenation in a model of pulmonary edema that is similar to adult respiratory distress.


Survival Outcomes of Primary Intraocular Lymphoma: A Single-institution Experience.
We report the clinical outcomes of 22 patients with primary intraocular lymphoma (PIOL) treated over a 15-year period. Patients with confirmed PIOL by central pathology review treated from 1994 to 2010 with isolated ocular (N=13) or central nervous system (CNS) plus ocular involvement (N=9) were included. Intraocular and CNS failure-free survival, relapse-free survival, and overall survival outcomes were analyzed. Median follow-up was 29.0 (range, 10.2 to 96.4) months. Sixteen patients (9 with isolated ocular, 7 with ocular and CNS disease) received combined modality therapy (CMT) consisting of systemic chemotherapy (usually high-dose methotrexate based) and orbital +/- whole-brain radiation. Two patients were treated with chemotherapy and 4 with local ocular therapy alone. Among patients with isolated ocular versus CNS involvement, CNS failure-free survival was 79% versus 57%, and intraocular failures were 62% versus 78% at 24 months. Median relapse-free survival was 34.0 versus 21.3 months (P=0.368), and overall survival 43.4 versus 30.3 months (P=0.744), respectively. Three patients treated with CMT (2 with isolated ocular and 1 with CNS involvement) with >1-year follow-up alive at the time of analysis never relapsed, and one remains disease-free >4.5 years after treatment. In this series of patients with PIOL+/- CNS disease, CNS and intraocular relapse were common. A trend toward better survival was seen among patients with isolated ocular presentation, and a limited number of long-term disease-free survivors seen after CMT.


Embolization of unruptured wide-necked aneurysms at the MCA bifurcation using the Neuroform atlas stent-assisted coiling: a two-center retrospective study.
The management of middle cerebral artery (MCA) aneurysms remains a controversial topic, and MCA aneurysms have traditionally been treated primarily by surgical clipping. The Neuroform Atlas Stent™ (NAS, available from Stryker Neurovascular, Fremont, California) represents the latest generation of intracranial stents with improved stent delivery system capabilities. This study aims to investigate the safety, feasibility and efficacy exhibited by NAS in treating unruptured aneurysms at the MCA bifurcation. This was a two-center retrospective study involving 42 patients with unruptured wide-necked aneurysms (WNAs) of the MCA treated with the NAS from October 2020 to July 2022. The stent was used to treat 42 cases of unruptured WNA at the MCA bifurcation. Endovascular treatment techniques had a 100% success rate. Immediate postoperative angiography found complete aneurysm occlusion in 34 patients (80.9%) (mRRC 1), neck remnant in 7 patients (16.7%) (mRRC 2), and residual aneurysm in 1 patient (2.4%) (mRRC 3). The thromboembolic complication rate was 2.4% (1/42). The follow-up period was 8.7 months on average (3-16 months). The last angiographic follow-up results revealed complete aneurysm occlusion in 39 patients (92.9%) (mRRC 1), neck remnant in 3 (7.1%) patients (mRRC 2), no aneurysm recanalization or recurrence, and no cases of stent intimal hyperplasia. During the latest clinical follow-up, all patients had an mRS score of 0. Our study demonstrates that the NAS can be applied to treat unruptured WNAs at the MCA bifurcation with favorable safety, feasibility, and efficacy.


High-Flow Extracranial-Intracranial Bypass for Giant Cavernous Carotid Aneurysm.
Giant intracranial aneurysms have always been remain the most difficult cerebrovascular lesions to treat, especially for giant cavernous carotid aneurysm (CCA). The treatment of giant CCA is a greatest challenge for neurosurgeons. Surgical clipping morbidity and mortality rates are relatively high, and endovascular embolization also have a high complication. The authors reported a special 74-year-old female patient who presented with blurred vision and double vision for 3 years, a giant CCA was found by digital subtraction angiography and computed tomography angiography. In the end, the CCA was treated using high-flow external carotid artery to middle cerebral artery bypass and clipping distal of the aneurysm. This technique and treatment was successful and without ischemia and neurologic sequelae. Also, their long-term follow-up demonstrated that brain tissue perfusion was better than before. Based on the literature reviewing, this technique might be an alternative strategy for intracranial giant unruptured aneurysms, especially for not suitable for direct clipping or with a high risk for endovascular embolization.


Mono-, di- and triglycerides in serum of spontaneously hypertensive and normotensive rats in relation to age.
Serum triglycerides appeared significantly lower in spontaneously hypertensive as compared to normotensive rats except in 8-week-old animals. Tri-, di and monoglycerides decreased continuously with age in the former but revealed only a transient fall in the latter. The remarkably high portion of partial glycerides (about 30% of total glycerides) in serum should be considered in all studies on lipolysis in rats.


[Experience of patients and their families with a palliative care interdisciplinary team].
This study aims at describing the experience of the patients and their family when they are faced with an interdisciplinary team in palliative care. Are the patients and their family aware of the interdisciplinarity within the team and does this organization meet their expectations? We also went deeper into some themes, i.e. pain treatment, notion of safety and the position of the patients and of his relatives as object or subject of the care. We chose the qualitative approach to answer this question. We interviewed 25 patients and 18 family referents following the method of non directive interview. The method for data processing was double: on the one hand, the constant comparative analysis of GLASER and STRAUSS enabling the emergence of significant categories from the speech of the patients and referents. on the other hand, the structural analysis method of BOURGOIS and NIZET enabling the emergence of meaning structures in the speech, their positive or negative valuation and the definition of quest plans to underline the working strategies of the actors. What could be stressed as a specific reflection subject is the perception of the team and its interdisiplinarity: the latter implies a common project around the patient and his family; it seems that if the will of the teams is indeed an interdisciplinary organization, in the praxis, it is not yet achieved. The pluridisciplinary team organization is taken for granted in most teams, but it is not perceived as such by the patients and the families. The involvement of the patients and of the families is still weak, and they are still sometimes the objects of the care. What we therefore found striking is that the patients and the relatives have a tendency to "justify" their dissatisfactions by invoking constraints to which the team members are subjected, in the hospital as well as at home. At home, the interdisciplinarity is not yet perceived by the subjects and it is striking to see the relatives who wish to "take a break" in their accompaniment of the sick person, even if they feel very guilty and are not very well considered by the care takers. We also noted all what was expressed around the death and the death accompaniment, which raises questions on the role of the team, the limits of this accompaniment and the training of the care takers for this accompaniment. To conclude, this study allowed us to describe an experience rather precisely; we could thus stress the perception by the patients and the families of a team, what, we think, can help the latter in their daily practice but also in a deepened reflection on the interdisciplinarity conditions and the implementation of real team projects, involving the patient and his family.


A Detailed Spatial Expression Analysis of Wing Phenotypes Reveals Novel Patterns of Odorant Binding Proteins in the Soybean Aphid, Aphis glycines.
The wide range of insect niches has led to a rapid expansion of chemosensory gene families as well as their relatively independent evolution and a high variation. Previous studies have revealed some functions for odorant-binding proteins (OBPs) in processes beyond olfaction, such as gustation and reproduction. In this study, a comparative transcriptomic analysis strategy was applied for the soybean aphid, Aphis glycines, focusing on various functional tissues and organs of winged aphids, including the antenna, head, leg, wing, thorax, cauda, and cornicle. Detailed spatial OBP expression patterns in winged and wingless parthenogenetic aphids were detected by RT-qPCR. Twelve OBPs were identified, and three new OBPs in A. glycines are first reported. All OBPs showed comparatively higher expression in sensory organs and tissues, such as the antenna, head, or leg. Additionally, we found some novel expression patterns for aphid OBPs (Beckendorf et al., 2008). Five OBPs exhibited high-expression levels in the cauda and four in the cornicle (Biasio et al., 2015). Three genes (OBP2/3/15) were highly expressed in the wing (Calvello et al., 2003). Two (OBP3/15) were significantly more highly expressed in the wingless thorax than in the winged thorax with the wings removed, and these transcripts were significantly enriched in the removed wings. More details regarding OBP spatial expression were revealed under our strategy. These findings supported the existence of carrier transport functions other than for foreign chemicals and therefore broader ligand ranges of aphid OBPs. It is important for understanding how insect OBPs function in chemical perception as well as their other potential physiological functions.


Measuring change in students' critical thinking ability: implications for health care education.
The purpose of this study was to determine the change in critical thinking (CT) dispositions and skills among physical therapy students over academic and clinical portions of a year and to determine correlates of change in CT abilities. Twenty-eight middle-year physical therapy students participated (26 women and 2 men; mean age, 22 years). Participants completed a descriptive survey at the beginning of the study. They also completed the California Critical Thinking Disposition Inventory (CCTDI) and the California Critical Thinking Skills Test (CCTST) before the academic year, after the academic year, and after their clinical placements. A one-way repeated measures analysis of variance was conducted on the subscales and total scores of the CCTDI and CCTST. Multiple regression was used to determine the correlations between the descriptive variables and change in total CCTDI and CCTST scores. Statistically significant improvements in all subscales and both total scores were obtained over the year. Greatest improvements on the CCTDI were observed for truth-seeking (p < 0.001) and CT self-confidence (p < 0.001). Greatest improvement on the CCTST was noted for deduction (p < 0.001). Changes in skills were more modest than changes in dispositions. None of the descriptive variables were correlated with change in total score on the CCTDI. Age was negatively associated with change on the CCTST. Although both instruments detected change over the year, more change was detected by the CCTDI; it also took less time to complete. The CCTDI can be used to monitor individual change and to evaluate the effectiveness of a program in enhancing CT ability. Although this study was conducted with physical therapy students, it should be of interest to educators in other health care disciplines because CT ability is a fundamental component of clinical reasoning.


Conjugated Polyelectrolyte-Induced Self-Assembly of Alkynylplatinum(II) 2,6-Bis(benzimidazol-2'-yl)pyridine Complexes.
Water-soluble cationic alkynylplatinum(II) 2,6-bis(benzimidazol-2'-yl)pyridine (bzimpy) complexes have been demonstrated to undergo supramolecular assembly with anionic polyelectrolytes in aqueous buffer solution. Metal-metal-to-ligand charge transfer (MMLCT) absorptions and triplet MMLCT ((3) MMLCT) emissions have been found in UV/Vis absorption and emission spectra of the electrostatic assembly of the complexes with non-conjugated polyelectrolytes, driven by Pt⋅⋅⋅Pt and π-π interactions among the complex molecules. Interestingly, the two-component ensemble formed by [Pt(bzimpy-Et){CCC6 H4 (CH2 NMe3 -4)}]Cl2 (1) with para-linked conjugated polyelectrolyte (CPE), PPE-SO3 (-) , shows significantly different photophysical properties from that of the ensemble formed by 1 with meta-linked CPE, mPPE-Ala. The helical conformation of mPPE-Ala allows the formation of strong mPPE-Ala-1 aggregates with Pt⋅⋅⋅Pt, electrostatic, and π-π interactions, as revealed by the large Stern-Volmer constant at low concentrations of 1. Together with the reasonably large Förster radius, large HOMO-LUMO gap and high triplet state energy of mPPE-Ala to minimize both photo-induced charge transfer (PCT) and Dexter triplet energy back-transfer (TEBT) quenching of the emission of 1, efficient Förster resonance energy transfer (FRET) from mPPE-Ala to aggregated 1 molecules and strong (3) MMLCT emission have been found, while the less strong PPE-SO3 (-) -1 aggregates and probably more efficient PCT and Dexter TEBT quenching would account for the lack of (3) MMLCT emission in the PPE-SO3 (-) -1 ensemble.


Accessory cell function of dendritic cells from lymph nodes containing Mycobacterium leprae induced granulomas.
Dendritic cells were enriched from guinea pig auricular lymph nodes containing Mycobacterium leprae induced granulomas by immunomagnetic depletion of other cells. These cells were strongly positive for major histocompatibility complex class II antigens and labelled with an antidendritic cell monoclonal antibody, but not with an antimacrophage antibody. Interdigitating dendritic cells were identified in the granulomatous lymph node by staining with the antidendritic cell antibody and by transmission electron microscopy. When cultured in vitro with purified T lymphocytes, these cells acted as accessory cells for both purified protein derivative and concanavalin A induced proliferation. Although previous studies have shown that macrophages from these lymph nodes do not act as accessory cells, the present results indicate that dendritic cells from M. leprae granuloma containing lymph nodes may act as antigen-presenting cells.


Effect of consecutively applied fluorescein eye drops on corneal and aqueous concentrations of fluorescein.
The main objective of this study was to determine the intraocular concentration of fluorescein after applying five eye drops with only 1-min intervals in human eyes. The concentration of fluorescein in corea and aqueous was studied with fluorophotometry in 11 healthy volunteers. Five 10-microliter drops of 2% fluorescein solution were administered with 1-min intervals, and the intraocular concentrations that were achieved were compared with those obtained with just one eye drop. Five consecutive fluorescein drops caused a 2.6- to 3.1-fold increase in fluorescein concentrations of the anterior chamber 1-8 h after application compared with a single eye drop (p < 0.05). Corresponding values for the cornea were 2.1-2.8. As a conclusion, administration of five eye drops applied consecutively significantly increases intraocular drug concentration during 8 h in humans.


[Minimally invasive video-assisted thyroidectomy (MIVAT)].
Minimally invasive video-assisted thyroidectomy (MIVAT) was published in 1998. In this paper authors describe their initial experiences with this new technique, which is the first publication in their country on this topic based on authors knowledge. Ten patients were selected for MIVAT. Selection criteria were nodule size less than 30 mm, thyroid lobe volume less than 20 ml, no thyroiditis, no previous neck surgery or irradiation. The procedure was carried out through a 20-25 mm central incision above the sternal notch. Dissection was performed under endoscopic vision, using endoscopic, some special and conventional instruments. Authors performed 1 total thyroidectomy, 6 lobectomies, 2 lobectomies with subtotal resection on the opposite side, and 1 resection of thyroid isthmus. Mean operative time was 77 minutes. No conversion to open procedure was performed. No recurrent laryngeal nerve palsy or postoperative hypocalcemia were observed postoperatively. The mean hospital stay was 2 days. The cosmetic result and the postoperative distress were considered very good by the patients. The authors conclude that MIVAT is a safe and feasible procedure. The indications are limited, but in this small group of patients offer excellent cosmetic results with less postoperative distress.


The general surgery model: a more appealing and sustainable alternative for the care of trauma patients.
The contemporary model of trauma care where dedicated trauma/critical care surgeons exclusively manage trauma patients has become progressively unsustainable. Little objective data, however, is available documenting that a better model exists. From September 2002 through August 2003, the trauma model at a 735-bed level I trauma teaching hospital was changed from the contemporary model to a new one where selected general surgeons with Advanced Trauma Life Support (ATLS) certification covered in-house trauma and emergency surgery call on a rotational basis. As well, each pursued elective practices, admitting all inpatients (trauma, emergent, elective) to a single teaching service (formerly the trauma service). Critical care was managed by a separate group of intensivists. The purpose of this study was to objectively compare the two models. Quantitative, financial, and qualitative data were derived from August 2001 to January 2002 (trauma/critical care model) and compared to August 2003 to January 2004 (general surgery model). During the two periods (trauma/critical care vs general surgery), the mean Revised Trauma Score (7.1 vs 7.2; P = 0.029), the mean Injury Severity Score (ISS) (10.9 vs 10.8; P = 0.84), and the percentage of penetrating trauma (12.5% vs 13.2%; P = 0.79) were similar. Differences (trauma/critical care vs general surgery, % increase/P value) included average daily census (24 vs 54, 225%), cases/attending (262 vs 543, 207%), cases/resident (54 vs 262, 485%), charges/attending (353,811 dollars vs 471,725 dollars, 133%), collections/attending (106,143 dollars vs 165,103 dollars, 156%), number of trauma patients (643 vs 748, 116%), trauma mortality (7.3% vs 4.0%; P = 0.007), trauma mortality with ISS >15 (21.7% vs 12.0%; P = 0.035), trauma complications (33.1% vs 17%; P < 0.001), and ICU morbidity (66.8% vs 43.9%; P < .001). The new general surgery model produced superior financial results and better quantitative surgical experience while exceeding trauma and ICU quality outcomes compared to the former trauma/critical care model. These data objectively support a model such as ours--one that is financially sustainable and more professionally attractive.


Differential Effects of Resveratrol on the Expression of Brain-Derived Neurotrophic Factor Transcripts and Protein in the Hippocampus of Rat Brain.
The induction of brain-derived neurotrophic factor (BDNF) expression in the hippocampus has shown to play a role in the beneficial effects of resveratrol (RSV) on the learning and memory. The BDNF gene has a complicated structure with eight 5' noncoding exons (I-IXa), each of which can splice to a common coding exon (IX) to form a functional transcript. Estrogens increase levels of BDNF transcripts in the hippocampus of rats. The aim of this study was to evaluate the effects of the phytoestrogen, RSV, on the splicing pattern of BDNF transcripts and on the pro-BDNF protein in the hippocampi of mother rats and their embryos. RSV (60 or 120 mg/kg BW/day) was administered orally to pregnant rats from days 1 to 20 of gestation. Hippocampi of adults and embryos were dissected 24 h after the last administration of RSV. Extracts from hippocampi were subject to quantitative (q) RT-PCR and Western blotting to assess splicing pattern of the BDNF transcripts and levels of pro-BDNF protein, respectively. RSV (120 mg/kg BW/day) caused a statistically significant increase in the expression levels of BDNF exons III, IV and IX, but not the exon I in the hippocampi of adult rats (P≤0.05). Levels of pro-BDNF protein remained unchanged in the hippocampal tissues from both adult and embryonic rats treated by RSV (60 or 120 mg/kg BW/day). Our results showed that RSV differentially activates promoters of the BDNF gene in the hippocampus of pregnant rats, but fails to affect the pro-BDNF level neither in adult nor in the embryonic hippocampal tissues.


Chemical features of the photosensitizers new methylene blue N and S137 influence their subcellular localization and photoinactivation efficiency in Candida albicans.
Antimicrobial photodynamic treatment (APDT) has emerged as an effective therapy against pathogenic fungi with both acquired and intrinsic resistance to commonly used antifungal agents. Success of APDT depends on the availability of effective photosensitizers capable of acting on different fungal structures and species. Among the phenothiazinium dyes tested as photoantifungals, new methylene blue N (NMBN) and the novel pentacyclic compound S137 are the most efficient. In the present study we compared the effects of APDT with NMBN and S137 on the survival of Candida albicans and employed a set of fluorescent probes (propidium iodide, FUN-1, JC-1, DHR-123 and DHE) together with confocal microscopy and flow cytometry to evaluate the effects of these two chemically diverse photosensitizers on cell membrane permeability, metabolism and redox status, and mitochondrial activity. Taken together, our results indicate that, due to chemical features resulting in different lipophilicity, NMBN and S137 localize to distinct subcellular structures and hence inactivate C. albicans cells via different mechanisms. S137 localizes mostly to the cell membrane and, upon light exposure, photo-oxidizes membrane lipids. NMBN readily localizes to mitochondria and exerts its photodynamic effects there, which was observed to be a less effective way to achieve cell death at lower light fluences.


Ectopic localization of Carabelli's tubercle. Review of the literature and description of two clinical cases.
The aim of this study is to describe 2 ectopic localizations of Carabelli's tubercle. Carabelli's tubercle or cusp is present, in a fair number of cases, in the vestibular walls of both first upper molars. Its size may vary. It is named after the Italian scientist Antonio Carabelli who first had described it in the first half of the 19(th) century. Carabelli's cusp has been often detected and studied in not hybridized ethnical groups, especially Eastern and Central Ameri-can groups, in which the evaluation of heritability and sex distribution is easier. It has been found that this cusp is not clinically important, it may only sometimes interfere with orthodontic treatments. It is seldom present in the second upper molars and almost never in the vestibular walls of either side of the second upper or lower molars. After a review of the literature showing that this cusp is more rarely present in Caucasian peoples, the authors describe 2 case reports with ectopic localization. This has never been found in recent literature and therefore it is to be considered absolutely rare.


Relevance of anaerobic bacteremia in adult patients: A never-ending story?
Obligate anaerobic bacteria are considered important constituents of the microbiota of humans; in addition, they are also important etiological agents in some focal or invasive infections and bacteremia with a high level of mortality. Conflicting data have accumulated over the last decades regarding the extent in which these pathogens play an intrinsic role in bloodstream infections. Clinical characteristics of anaerobic bloodstream infections do not differ from bacteremia caused by other pathogens, but due to their longer generation time and rigorous growth requirements, it usually takes longer to establish the etiological diagnosis. The introduction of matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) has represented a technological revolution in microbiological diagnostics, which has allowed for the fast, accurate and reliable identification of anaerobic bacteria at a low sample cost. The purpose of this review article is to summarize the currently available literature data on the prevalence of anaerobic bacteremia in adults for physicians and clinical microbiologists and to shed some light on the complexity of this topic nowadays.


Membrane Tension Acts Through PLD2 and mTORC2 to Limit Actin Network Assembly During Neutrophil Migration.
For efficient polarity and migration, cells need to regulate the magnitude and spatial distribution of actin assembly. This process is coordinated by reciprocal interactions between the actin cytoskeleton and mechanical forces. Actin polymerization-based protrusion increases tension in the plasma membrane, which in turn acts as a long-range inhibitor of actin assembly. These interactions form a negative feedback circuit that limits the magnitude of membrane tension in neutrophils and prevents expansion of the existing front and the formation of secondary fronts. It has been suggested that the plasma membrane directly inhibits actin assembly by serving as a physical barrier that opposes protrusion. Here we show that efficient control of actin polymerization-based protrusion requires an additional mechanosensory feedback cascade that indirectly links membrane tension with actin assembly. Specifically, elevated membrane tension acts through phospholipase D2 (PLD2) and the mammalian target of rapamycin complex 2 (mTORC2) to limit actin nucleation. In the absence of this pathway, neutrophils exhibit larger leading edges, higher membrane tension, and profoundly defective chemotaxis. Mathematical modeling suggests roles for both the direct (mechanical) and indirect (biochemical via PLD2 and mTORC2) feedback loops in organizing cell polarity and motility-the indirect loop is better suited to enable competition between fronts, whereas the direct loop helps spatially organize actin nucleation for efficient leading edge formation and cell movement. This circuit is essential for polarity, motility, and the control of membrane tension.


Ethanol does not significantly affect the bioavailability of almotriptan: an open, randomized, crossover, single-dose, phase I clinical trial in healthy volunteers.
A number of clinical reports have revealed a link between the use of alcohol and the onset or exacerbation of migraine headaches. This open, randomized, crossover, single-dose, phase I clinical trial evaluated the possible pharmacokinetic interactions between a single oral dose of almotriptan 12.5 mg, a 5-HT(1B/1D receptor agonist for the acute treatment of migraine, and ethanol in 16 healthy male volunteers. Tolerability and safety of this combined treatment were also assessed. Subjects received a crossed oral dose of almotriptan (12.5 mg) with and without concomitant alcohol intake (target plasma concentration 0.8 g/kg) in two different treatment periods. Almotriptan was administered alone, while ethanol was diluted with orange juice, which was also given to the control group. There was a washout period of 7 days between treatments. Plasma levels of almotriptan were analyzed using a sensitive and specific liquid chromatographic-tandem mass spectrometry method. The 90% non-parametric confidence interval for the median t(max) of almotriptan plus ethanol compared to almotriptan alone (0.61/2.72) was outside the acceptable range (0.70 - 1.30), demonstrating that concomitant ethanol administration slightly increases the variability of absorption of almotriptan 12.5 mg. In contrast, the main bioavailability criteria parameters, C(max) and AUC, which show the rate and extent of systemic absorption, were not affected by alcohol ingestion. Therefore, it is unlikely that concomitant ethanol intake would produce clinically relevant differences in the therapeutic effect of almotriptan at the dose studied here. Tolerability of treatments was good throughout the entire study period. Almotriptan 12.5 mg, with or without concomitant alcohol ingestion, showed similar plasma concentrations after a single dose in healthy volunteers with no clinically relevant drug-to-drug interactions.


Confronting Racism in Medicine: Stories of Resistance.
The national (even global) discussion about racism in medicine has evolved significantly in the past few years. Important efforts are underway in many areas of health care; efforts that center on previously marginalized voices. Yet is it clear that there is a wide range in our collective levels of understanding and awareness of the fundamental and ongoing presence of racism and white supremacy in our society, in general, and in health care, in particular. The stories in this symposium offer a valuable perspective, highlighting the lived experience of medical students and physicians as they navigate their lives and careers through systems that tolerate and often build upon racism.


The impact of educational interventions on enhancing perceptions of patient safety culture among Jordanian senior nurses.
The worldwide rate of medical errors and the subsequent patient harm triggered the healthcare organizations to find solutions to transform their punitive culture to safety culture. The purpose of this study was to examine the impact of patient safety educational interventions among senior nurses on their perceptions of safety culture, and the rate of reported adverse events, pressure ulcers, and patients' falls. The design of the study was a quasi-experimental without control group. Fifty-seven senior nurses received the educational program. The Hospital Survey on Patient Safety Culture (HSPSC) was administered pre and 4 months post the educational program, and the rate of reported adverse events, pressure ulcers, and patients' falls were collected 4 months pre and 4 months post the educational program. There were significant improvements of senior nurses' positive scores of two composites, "Frequency of event reporting" and "Non-punitive response to errors," and significant decline of the rate of adverse events. The findings of the study suggested that patient safety educational interventions could be used by nursing administrators to enhance subcultures of patient safety such as "reporting" and "blame free," and to decrease the rate of adverse events.


The molecularly controlled semiconductor resistor: how does it work?
We examine the current response of molecularly controlled semiconductor devices to the presence of weakly interacting analytes. We evaluate the response of two types of devices, a silicon oxide coated silicon device and a GaAs/AlGaAs device, both coated with aliphatic chains and exposed to the same set of analytes. By comparing the device electrical response with contact potential difference and surface photovoltage measurements, we show that there are two mechanisms that may affect the underlying substrate, namely, formation of layers with a net dipolar moment and molecular interaction with surface states. We find that whereas the Si device response is mostly correlated to the analyte dipole, the GaAs device response is mostly correlated to interactions with surface states. Existence of a silicon oxide layer, whether native on the Si or deliberately grown on the GaAs, eliminates analyte interaction with the surface states.


The low-lying electronic states and ultrafast relaxation dynamics of the monomers and J-aggregates of meso-tetrakis (4-sulfonatophenyl)-porphyrins.
The electronic and vibrational spectra of the meso-tetrakis(4-sulfonatophenyl)-porphyrins (TSPP) have been studied computationally using the PFD-3B functional with time-dependent density functional theory for the excited states. The calculated UV-vis absorption and emission spectra in aqueous solution are in excellent agreement with the experimental measurements of both H2TSPP-4 (monomer) at high pH and H4TSPP-2 (forming J-aggregate) at low pH. Moreover, our calculations reveal an infrared absorption at 1900 cm-1 in the singlet and triplet excited states that is absent in the ground state, which is chosen as a probe for transient IR absorption spectroscopy to investigate the vibrational dynamics of the excited state. Specifically, the S2 to S1 excited state internal conversion process time, the S1 state vibrational relaxation time, and the lifetime of the S1 excited electronic state are all quantitatively deduced.


Dichloroacetonitrile induces cytotoxicity through oxidative stress-mediated and p53-dependent apoptosis pathway in LO2 cells.
Dichloroacetonitrile (DCAN), one of the disinfection byproducts of water chlorination, induces cell proliferation and apoptosis; however, the detailed mechanism remains unclear. Oxidative stress participates in various biological processes, including DNA damage and cytotoxicity. To explore whether oxidative stress mediated DCAN-induced cell proliferation and apoptosis, we assessed the effect of redox imbalance and apoptosis in LO2 cells. We observed increase of reactive oxygen species and malondialdehyde and increased apoptosis by 13.6% in 500 μM DCAN compared with the control group. We also observed a decrease of antioxidant ability damage including glutathione, superoxide dismutase, and total antioxidant capacity depletion. Furthermore, DCAN might activate oxidative stress-mediated apoptosis pathway via up-regulation of p53 expression and caspase-3 activity. Therefore, we conclude that DCAN may activate apoptotic signals via p53 up-regulation and oxidative stress-mediated apoptosis in LO2 cells.


Solvent effects in tandem mass spectrometry: mechanistic studies indicating how a change in solvent conditions and pH can dramatically alter CID spectra.
Dramatically different CID (collision-induced dissociation) spectra are obtained when the complex [Zn(dien-glucose)](+) is electrosprayed from acidic and basic solutions. To understand this peculiar phenomenon, an in-depth mechanistic study was performed on one of the product ions that is present when the initial complex is diluted in basic solution but absent when the complex is diluted with acidic solution. On the basis of the results of this study, the differences in the CID spectra can be rationalized by the fact that the complex electrosprayed from basic solution was kinetically trapped, with the deprotonation site distal from the metal center. Under acidic conditions, the deprotonation site is at a hydroxyl group coordinated to the metal ion. A variety of experiments support this hypothesis. The studies herein underscore the importance of using identical solvent conditions when comparing sets of CID spectra. The data also highlight a very interesting phenomenon involving deprotonation of a hydroxyl group, which was several atoms away from the Zn(II) metal center.


[Is preoperative evaluation of the internal mammary artery for suitability in coronary bypass surgery possible?].
The internal mammary artery (IMA) is the preferred conduit for coronary artery surgery due to its high patency rate. In order to determine the role of preoperative duplex investigation of the IMA, preoperative noninvasive measurements of IMA diameter, blood velocity and blood flow were performed bilaterally in 30 patients eligible for coronary surgery. The diameter of the left and right IMA was 2.1(+) -0.2 mm and 2.2(+) -0.2 mm at the third intercostal space, respectively. Preoperative mean flow was 51 ml/min in the left and 54 ml/min in the right IMA. Due to the close proximity of the IMA to the sternal border (8 mm), care must be taken not to injure the IMA during routine sternal closure. In conclusion, noninvasive assessment of the patency of the IMA is possible prior to coronary artery surgery.


Numerical method for integrodifferential generalized Langevin and master equations.
We show that the integrodifferential generalized Langevin and non-Markovian master equations can be transformed into larger sets of ordinary-differential equations. On the basis of this transformation we develop a numerical method for solving such integrodifferential equations. Physically motivated example calculations are performed to demonstrate the accuracy and convergence of the method.


Dementia and the Death Penalty.
As death row prisoners age, a new set of issues arises regarding their competence to be executed. Can a prisoner with dementia who no longer remembers the crime be put to death? What if the dementia has progressed to the point that the prisoner no longer understands that he or she faces execution, or why? These issues were considered by the U.S. Supreme Court in its recent decision in Madison v. Alabama. Implicitly rejecting the cruelty of executing a highly impaired prisoner, the court clarified the conditions that could preclude execution and the degree of impairment that must be present.


[Oral theophylline therapy for dyspnea].
With regard to special situations in severe dyspnea 10 patients with reversible airway obstruction were studied to verify the effect of oral and systemic application of 193,2 mg Theophyllinmonohydrat and 46,8 mg Aethylendiamin as customary in the trade injection fluid (Euphyllin) on blood levels. In comparison both medications are bioaquivalent . The oral application yields with duration serum concentrations of theophylline higher than 5 mg/l but less than the postulated therapeutic levels from 10--20 mg/l.


Function of microtubules under inadequate protein diet.
Microtubules from pancreas have been isolated and estimated. It was found that rats fed with lysine and threonine deficient diet have profoundly lowered levels of microtubules as compared to rats fed either with lysine and threonine supplemented diet or a casein diet at 20% protein level, implicating the role of dietary protein in microtubule assembly. Levels of microtubules in turn may influence the turnover of phosphatidyl inositol as well as release of insulin from pancreas.


Isolation of two distinct cytochromes P-45011 beta with aldosterone synthase activity from bovine adrenocortical mitochondria.
Two distinct forms of cytochrome P-45011 beta, with apparent molecular weights of 48,500 (48.5K) and 49,500 (49.5K), have been isolated from bovine adrenocortical mitochondria. Their amino acid sequences up to the 19th position from the N-terminus were only different at the 6th position (Val and Ala for the 48.5K and 49.5K enzymes, respectively). Each sequence was assignable to a distinct cDNA clone for cytochrome P-450(11) beta (Kirita, S., et al. [1988] J. Biochem. 104, 683-686), indicating that the two proteins originate from different genes in bovine adrenocortical cells. Both forms of cytochrome P-450(11) beta were capable of catalyzing aldosterone synthesis as well as the 11 beta- and 18-hydroxylation of 11-deoxycorticosterone. Thus, at least two distinct cytochrome P-450(11) beta species exist in the adrenal cortex and participate in steroidogenesis.


Interaction between ganglioside-containing liposome and rat T-lymphocyte: confocal fluorescence microscopic study.
Interaction between rat T-lymphocytes and a ganglioside (GM3, GD3, GT1b, or GQ1b)-containing liposome was investigated in vitro. The direct stimulation of T cell by a ganglioside-containing liposome was followed by monitoring an increase in the intracellular calcium signal using a confocal laser fluorescence microscopic method. The GT1b- or GQ1b-containing liposome strongly stimulated the cell, while the GM3- or GD3-containing liposome showed much less effect. Free gangliosides did not stimulate the cell at all under the same condition. The extent of the stimulation depended on the surface density of GT1b on the liposome accompanied by a clear threshold concentration. The efficiency of this direct T cell stimulation with the ganglioside-containing liposome was closely related to the efficiency of the tumor growth suppression reported previously by ourselves.


Endogenous suppression of WNT signalling in human embryonic stem cells leads to low differentiation propensity towards definitive endoderm.
Low differentiation propensity towards a targeted lineage can significantly hamper the utility of individual human pluripotent stem cell (hPSC) lines in biomedical applications. Here, we use monolayer and micropatterned cell cultures, as well as transcriptomic profiling, to investigate how variability in signalling pathway activity between human embryonic stem cell lines affects their differentiation efficiency towards definitive endoderm (DE). We show that endogenous suppression of WNT signalling in hPSCs at the onset of differentiation prevents the switch from self-renewal to DE specification. Gene expression profiling reveals that this inefficient switch is reflected in NANOG expression dynamics. Importantly, we demonstrate that higher WNT stimulation or inhibition of the PI3K/AKT signalling can overcome the DE commitment blockage. Our findings highlight that redirection of the activity of Activin/NODAL pathway by WNT signalling towards mediating DE fate specification is a vulnerable spot, as disruption of this process can result in poor hPSC specification towards DE.


Self-powered enzyme-linked microneedle patch for scar-prevention healing of diabetic wounds.
Diabetic wounds with complex pathological features and a difficult-to-heal nature remain a formidable challenge. To address this challenge, we design and fabricate a self-powered enzyme-linked microneedle (MN) patch composed of anode and cathode MN arrays, which respectively contain glucose oxidase (GOx) and horseradish peroxidase (HRP) encapsulated in ZIF-8 nanoparticles. The enzymatic cascade reaction in the MN patch can effectively reduce local hyperglycemia in diabetic wounds while generating stable microcurrents to promote rapid healing of diabetic wounds. Therefore, the diabetic wounds treated with this MN patch exhibit rapid, complete, and scar-preventative healing, which can be attributed to the synergistic actions of hypoglycemic, antibacterial, anti-inflammatory, and bioelectrical stimulation. In brief, the self-powered MN patch is an effective method to rapidly promote diabetic wound healing and prevent scar formation.


Hierarchical classification of protein folds using a novel ensemble classifier.
The analysis of biological information from protein sequences is important for the study of cellular functions and interactions, and protein fold recognition plays a key role in the prediction of protein structures. Unfortunately, the prediction of protein fold patterns is challenging due to the existence of compound protein structures. Here, we processed the latest release of the Structural Classification of Proteins (SCOP, version 1.75) database and exploited novel techniques to impressively increase the accuracy of protein fold classification. The techniques proposed in this paper include ensemble classifying and a hierarchical framework, in the first layer of which similar or redundant sequences were deleted in two manners; a set of base classifiers, fused by various selection strategies, divides the input into seven classes; in the second layer of which, an analogous ensemble method is adopted to predict all protein folds. To our knowledge, it is the first time all protein folds can be intelligently detected hierarchically. Compared with prior studies, our experimental results demonstrated the efficiency and effectiveness of our proposed method, which achieved a success rate of 74.21%, which is much higher than results obtained with previous methods (ranging from 45.6% to 70.5%). When applied to the second layer of classification, the prediction accuracy was in the range between 23.13% and 46.05%. This value, which may not be remarkably high, is scientifically admirable and encouraging as compared to the relatively low counts of proteins from most fold recognition programs. The web server Hierarchical Protein Fold Prediction (HPFP) is available at http://datamining.xmu.edu.cn/software/hpfp.


RAF may induce cell proliferation through hypermethylation of tumor suppressor gene promoter in gastric epithelial cells.
The extracellular signal-regulated kinase/mitogen-activated protein kinase (ERK-MAPK) is critical in human malignancies. It remained to be established whether DNA methyltransferases (Dnmt) and proliferating cell nuclear antigen (PCNA) involved in DNA methylation during RAF-transformed cell proliferation. The plasmid of constitutively active RAF was used to transfect gastric cell GES-1 and cancer cell AGS. RAF promoted cell proliferation, growth in soft agar and induced cell cycle progress faster than empty plasmid by accelerating G1/S transition in both cell lines, a massive induction of cyclin D1 and PCNA expression was observed, along with reduced expression of p16INK4A, p21WAF1 and p27KIP1. Methylation-specific polymerase chain reaction and bisulfite sequencing showed that the promoter of p16INK4A was methylated in RAF-transformed cells, treatment with 5-aza-dC or PD98059 restored the expression of p16INK4A, increased p21WAF1 and p27KIP1 partially, associated with upregulation of the activity of Dnmt in RAF-transformed cell GES-1, and also decreased the hypermethylation status of p16INK4A, but not all CpG islands of p21WAF1 and p27KIP1. These data suggest that RAF may induce cell proliferation through hypermethylation of tumor suppressor gene p16INK4A, while the epigenetic inactivation of p21WAF1 and p27KIP1 may be not a key factor in RAF-transformed cells.


Collective cell migration of the cephalic neural crest: the art of integrating information.
The cephalic neural crest (NC) cells delaminate from the neuroepithelium in large numbers and undergo collective cell migration under the influence of multiple factors including positive and negative taxis, cell-cell interactions mediating cell sorting, cell cooperation, and Contact-Inhibition of Locomotion. The migration has to be tightly regulated to allow NC cells to reach precise locations in order to contribute to various craniofacial structures such as the skeletal and peripheral nervous systems. Several birth defects, syndromes, and malformations are due to improper cephalic NC (CNC) migration, and NC cell migration bears important similarities to cancer cell invasion and metastasis dissemination. Therefore, understanding how CNC cells interpret multiple inputs to achieve directional collective cell migration will shed light on pathological situations where cell migration is involved.


Marketing physical activity: lessons learned from a statewide media campaign.
Steps taken to create, implement, and initially assess a statewide physical activity social marketing campaign targeted to 18-to 30-year-olds are presented. Included is a summary demonstration of the application of the associative group analysis in formative market research and message development. Initial postcampaign questionnaire (n = 363) results indicated that 39.1% of respondents had seen the television ad, of which 31.2% indicated they intended to be more active, and 62.5% of respondents had been exposed to either the television or outdoor media ads. Lessons learned through the social marketing process including media channel effectiveness, message development and assessment, and marketing firm relationships are provided.


Modifications to the nutrition for sport knowledge questionnaire (NSQK) and abridged nutrition for sport knowledge questionnaire (ANSKQ).
New evidence and feedback from colleagues have led to modifications to the Nutrition for Sport Knowledge Questionnaire (NSKQ) and Abridged Nutrition for Sport Knowledge Questionnaire (ANSKQ). The changes predominately affect questions regarding the nutrient content of foods, protein recommendations and the legality of supplements. Some English language edits have also been made.


Circuit parties: sexual behaviors and HIV disclosure practices among men who have sex with men at the White Party, Palm Springs, California, 2003.
The syphilis epidemic among men who have sex with men (MSM) in major US cities and concomitant increases in high-risk sexual behavior, have raised concerns of increased HIV transmission in this population. Therefore, to provide information for health promotion and disease awareness efforts, we investigated sexual behaviors, partner selection preferences and HIV serostatus disclosure practices of MSM at the White Party in Palm Springs, California. Circuit party attendees reported engaging in unprotected anal sex, however, a high proportion reported disclosing their HIV status. These findings suggest that some gay men are serosorting as a risk reduction strategy or implementing sexual risk reduction strategies to protect themselves and their partners. In our study, HIV-negative men were nine times more likely to report a preference for a seroconcordant sexual partner. The self-protecting attitudes of HIV-negative men in our sample outweighed the partner-protecting attitudes of HIV-positive men. This suggests that prevention interventions focusing on HIV-positive persons are warranted.


Synthesis and antiplasmodial evaluation of novel mefloquine-based fumardiamides.
The paper is focused on the synthesis and screening of the antiplasmodial activity of novel fumardiamides 5-10 with the mefloquine pharmacophore and a Michael acceptor motif. Multi-step reactions leading to the title compounds included two amide bond formations. The first amide bond was achieved by the reaction of (E)-ethyl 4-chloro-4-oxobut-2-enoate (1) and N1-(2,8-bis(trifluoromethyl)quinolin-4-yl) butane-1,4-diamine (2). The obtained ester 3 was hydrolyzed and gave acid 4, which then reacted with the selected halogenanilines in the presence of HATU/DIEA and formed products 5-10. Title compounds showed marked, dose dependent activity in vitro against hepatic stages of Plasmodium berghei. IC50 values of the most active compounds 5, 7 and 9 bearing 3-fluoro, 3-chloro and 3-trifluoromethyl substituents were 3.04-4.16 µmol L-1, respectively. On the other hand, the compounds exerted only weak activity against the erythrocytic stages of two P. falciparum strains (Pf3D7 and PfDd2) in vitro, with the exception of compound 5 (IC50 = 2.9 µmol L-1).


Bariatric-metabolic surgery: A guide for the primary care physician.
Bariatric-metabolic surgery has emerged as an attractive option that offers significant and durable weight loss in the treatment of clinically severe obesity. Given the high prevalence of obesity, and growing numbers of bariatric-metabolic surgeries performed, primary care physicians increasingly encounter patients who have had, or are considering, bariatric-metabolic surgery. The aim of this article is to provide guidance on common issues pertaining to bariatric-metabolic surgery that general practitioners (GPs) face, including patient selection, preoperative work-up, acute and long-term complications following the surgery, and long-term lifestyle and nutritional support. In properly selected patients with clinically severe obesity, there is clear net benefit in terms of improved health outcomes and reduced mortality following bariatric-metabolic surgery. Similarly to other chronic conditions, GPs play a crucial role in the management of obesity, and in the multidisciplinary, long-term postoperative support and monitoring that is important for optimal outcomes after surgery.


Effect of extracorporeal shock wave treatment on deep partial-thickness burn injury in rats: a pilot study.
Extracorporeal shock wave therapy (ESWT) enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N = 15), but not to group 2 (N = 15). On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P < 0.05). The reepithelialization rate was improved significantly on day 15 (P < 0.05). The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.


Intravitreal triamcinolone compared with macular laser grid photocoagulation for the treatment of cystoid macular edema.
To evaluate the outcome of cystoid macular edema (CME) treated with intravitreal injections of triamcinolone acetonide (TA), macular laser grid photocoagulation (MLG), or both (TA+MLG). Prospective, randomized, interventional, parallel, three-arm clinical trial. Institutional clinical study. Fifty-six patients (63 eyes) affected by diabetic or retinal vein occlusion CME. Twenty-two eyes received intravitreal injections of 4 mg TA; 21 eyes underwent MLG; and 20 eyes received intravitreal injection of 4 mg TA, and after 3 months, MLG. Best-corrected visual acuity (VA), central macular thickness (CMT) (by optical coherence tomography), and postoperative complications. Mean follow-up was 9 +/- 2 months (range 6 to 12 months). Baseline VA (logarithm of minimal angle of resolution [logMAR]) and CMT were, respectively, 0.82 +/- 0.19 and 556 +/- 139 microm microns for the TA group, 0.84 +/- 0.15 and 601 +/- 102 microm microns for the MLG group, and 0.83 +/- 0.22 and 573 +/- 106 microm microns for the TA+MLG group (no statistically significant difference among the groups). After the treatment, at 45 days, 3, 6, and 9 months in the TA group, VA had improved (P = .004) by 0.26, 0.25, 0.22, and 0.23 logMAR and CMT had decreased by 37%, 33%, 29%, and 31% (P = < .001). In the MLG group, VA was unchanged although CMT had decreased by 5%, 13%, 14%, and 16% (P = .021). In the TA+MLG group, VA had improved (P = .003) by 0.26, 0.24, 0.19, and 0.20 logMAR, and CMT had decreased by 36%, 34%, 28%, and 29% (P = < .001). The groups receiving triamcinolone had better VA and lower CMT values at all time points (P < .05). A reinjection was performed in eight eyes; intraocular pressure increased in nine eyes (treated with medical therapy), and cataract progressed in one eye. No injection-related complications occurred. TA intravitreal injection improves VA and reduces CMT more than MLG, which in triamcinolone-treated eyes does not offer further advantages. Intravitreal TA injection could be used as primary treatment in patients with CME.


Combined analysis of the glia secretome and the CSF proteome: neuroinflammation and novel biomarkers.
Glial cells in the CNS are likely to communicate with other glial cells and neurons through secreted proteins. Glia-derived proteins also participate in neuroinflammation, which is a major component of neurodegenerative disease. Cerebrospinal fluid (CSF) is the biological fluid that best reflects the physiological or pathological conditions of the CNS. Proteins secreted from glial cells are often detected in the CSF. One of the major cellular sources of the highly abundant CSF proteins is glia. Combined analysis of secreted proteins of glial cells and CSF proteins of patients with inflammatory CNS disorders can provide new knowledge to the field of glia biology and neuron-glia interaction. The comparative analysis of the glia secretome and the CSF proteome would also facilitate the targeted proteomics-based discovery of new biomarkers for brain disease. Omics and systems biology approaches to glia and neuroinflammation will be a focus of future investigation and will enable an integrative understanding of inflammatory CNS disorders, such as neurodegenerative disease.


Chronic myelogenous leukemia.
Chronic myelogenous leukemia (CML) represents about 14% of all leukemias and occurs with a frequency of about 1 in 100,000. It is rare in children. Symptoms include fatigue, weight loss, sweating, and abdominal discomfort from an enlarged spleen. The white blood cell count can range from 100-600 ul. CML has three phases: the chronic phase, accelerated phase, and blast phase. Most patients are diagnosed during the chronic phase. Ionizing radiation has been implicated in some cases of CML, but in most individuals no cause is known. The Philadelphia chromosome, an acquired genetic mutation represented by a translocation of chromosome 22 and chromosome 9, drives the leukemic changes in CML. Imatinib mesylate, a tyrosine kinase inhibitor, was approved in 2002 for the treatment of all phases of CML. Because of its effectiveness, imatinib has become the treatment of choice for most patients with CML. Stem cell transplantation also is an option for eligible patients. It is the only curative treatment for CML. Two drugs under study for patients who cannot tolerate or who become resistant to imatinib are BMS-354825 and AMN107. Oncology nurses who are knowledgeable about new therapies for CML can be effective resources for their patients.


Bidirectional long-term motor cortical plasticity and metaplasticity induced by quadripulse transcranial magnetic stimulation.
Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising tool to induce plastic changes that are thought in some cases to reflect N-methyl-d-aspartate-sensitive changes in synaptic efficacy. As in animal experiments, there is some evidence that the sign of rTMS-induced plasticity depends on the prior history of cortical activity, conforming to the Bienenstock-Cooper-Munro (BCM) theory. However, experiments exploring these plastic changes have only examined priming-induced effects on a limited number of rTMS protocols, often using designs in which the priming alone had a larger effect than the principle conditioning protocol. The aim of this study was to introduce a new rTMS protocol that gives a broad range of after-effects from suppression to facilitation and then test how each of these is affected by a priming protocol that on its own has no effect on motor cortical excitability, as indexed by motor-evoked potential (MEP). Repeated trains of four monophasic TMS pulses (quadripulse stimulation: QPS) separated by interstimulus intervals of 1.5-1250 ms produced a range of after-effects that were compatible with changes in synaptic plasticity. Thus, QPS at short intervals facilitated MEPs for more than 75 min, whereas QPS at long intervals suppressed MEPs for more than 75 min. Paired-pulse TMS experiments exploring intracortical inhibition and facilitation after QPS revealed effects on excitatory but not inhibitory circuits of the primary motor cortex. Finally, the effect of priming protocols on QPS-induced plasticity was consistent with a BCM-like model of priming that shifts the crossover point at which synaptic plasticity reverses from depression to potentiation. The broad range of after-effects produced by the new rTMS protocol opens up new possibilities for detailed examination of theories of metaplasticity in humans.


Non-Atherosclerotic Obliteration Of Bilateral Supraclinoid Internal Carotid Arteries; A Classic Case Of Moyamoya Disease.
Moyamoya disease is an idiopathic progressive vasculopathy of distal internal carotid artery and circle of Willis which leads to the development of characteristic smoky appearance of the vascular collateral network on angiography. With the highest reported incidence among Japanese population, it has been under recognized as a cause of cerebrovascular accidents in Western countries. Here we report a case of a young 20-year-old Caucasian woman who presented to the emergency department with expressive aphasia, right arm weakness and numbness for three days. Imaging modalities confirmed Moyamoya disease.


Monoclonal antibodies in cancer immunotherapy.
Nowadays, in cancer treatments, immunotherapy which can be classified as a cancer type specific therapy is more popular than non-specific therapy methods such as surgery, radiotherapy and chemotherapy. The main aim of immunotherapy is to enable patients' immune system to target cancer cells and destroy them. The mainly used treatment methods in cancer immunotherapy are cancer vaccines, adoptive cell therapy, cytokines and monoclonal antibodies. In this review, we discuss the immunotherapy approaches, especially monoclonal antibodies which are mostly used in cancer immunotherapy in clinical applications.


Portal vein embolization before major hepatectomy.
To discuss the rationale, techniques and the unsolved issues regarding preoperative portal vein embolization (PVE) before major hepatectomy. After a systematic search of Pubmed, we reviewed and retrieved literature related to PVE. Preoperative PVE is an approach that is gaining increasing acceptance in the preoperative treatment of selected patients prior to major hepatic resection. Induction of selective hypertrophy of the nondiseased portion of the liver with PVE in patients with either primary or secondary hepatobiliary, malignancy with small estimated future liver remnants (FLR) may result in fewer complications and shorter hospital stays following resection. Additionally, PVE performed in patients initially considered unsuitable for resection due to lack of sufficient remaining normal parenchyma may add to the pool of candidates for surgical treatment. The results suggest that PVE is recommendable in treating the cirrhotic patients before major liver resection.


[Castleman's disease. X-ray computed tomographic aspect. Apropos of 2 mediastinal forms and a multicentric form].
A multicentric form of Castleman's disease is described, this being a rare affection for which CT image characteristics have not, to our knowledge, been reported. Two cases of localized and one case of multicentric Castleman's disease are reported, and differential characters of these two forms with common histology: angio-follicular lymphoid hyperplasia, outlined. The localized form is found mainly in the mediastinum in young patients and follows a favorable course with recovery after exeresis. The diffuse form develops in later life and presents with severe systemic signs and a marked biological inflammatory syndrome Glands and viscera are affected and its course is grave, with mostly fatal relapses. Angiography suggests diagnosis when images show hypervascular lesions in lymph glands. CT scan imaging with contrast is very suggestive when glandular lesions are present that take up contrast strongly. This appearance should always raise the possibility of Castleman's disease.


[Air pollution and the occurrence of recurrent respiratory tract diseases in children in the first years of life. II].
In 200 3-7-year-old children in two localities of Bratislava-city with different concentrations of NO2, SO2, dustiness with different bioclimatic factors and a different epidemiological position the authors investigated their effect on the frequency, incidence and types of relapsing respiratory diseases during different months in 1991. The different concentrations of the above substances in the atmosphere of the two localities did not affect the number of respiratory diseases nor their annual or monthly incidence. In the place with the increased NO2 concentration a significantly higher number of serious forms of respiratory diseases was found in the investigated group. In the locality with a more favourable oecological and epidemiological situation the adverse effect of monthly NO2 concentrations was manifested when it was potentiated by the SO2 concentration and combined with dustiness and dust fall-out. The authors found a significant correlation between the incidence of relapsing respiratory diseases and the atmospheric temperature and its relative humidity in the course of different months of the year.