Density and stability of soil organic carbon beneath impervious surfaces in urban areas.
Installation of impervious surfaces in urban areas has attracted increasing attention due to its potential hazard to urban ecosystems. Urban soils are suggested to have robust carbon (C) sequestration capacity; however, the C stocks and dynamics in the soils covered by impervious surfaces that dominate urban areas are still not well characterized. We compared soil organic C (SOC) densities and their stabilities under impervious surface, determined by a 28-d incubation experiment, with those in open areas in Yixing City, China. The SOC density (0-20 cm) under impervious surfaces was, on average, 68% lower than that in open areas. Furthermore, there was a significantly (P<0.05) positive correlation between the densities of SOC and total nitrogen (N) in the open soils, whereas the correlation was not apparent for the impervious-covered soils, suggesting that the artificial soil sealing in urban areas decoupled the cycle of C and N. Cumulative CO2-C evolved during the 28-d incubation was lower from the impervious-covered soils than from the open soils, and agreed well with a first-order decay model (Ct = C1+C0(1-e-kt)). The model results indicated that the SOC underlying capped surfaces had weaker decomposability and lower turnover rate. Our results confirm the unique character of urban SOC, especially that beneath impervious surface, and suggest that scientific and management views on regional SOC assessment may need to consider the role of urban carbon stocks.


How does Reelin signaling regulate the neuronal cytoskeleton during migration?
Neuronal migration is an essential step in the formation of laminated brain structures. In the developing cerebral cortex, pyramidal neurons migrate toward the Reelin-containing marginal zone. Reelin is an extracellular matrix protein synthesized by Cajal-Retzius cells. In this review, we summarize our recent results and hypotheses on how Reelin might regulate neuronal migration by acting on the actin and microtubule cytoskeleton. By binding to ApoER2 receptors on the migrating neurons, Reelin induces stabilization of the leading processes extending toward the marginal zone, which involves Dab1 phosphorylation, adhesion molecule expression, cofilin phosphorylation and inhibition of tau phosphorylation. By binding to VLDLR and integrin receptors, Reelin interacts with Lis1 and induces nuclear translocation, accompanied by the ubiquitination of phosphorylated Dab1. Eventually Reelin induces clustering of its receptors resulting in the endocytosis of a Reelin/receptor complex (particularly VLDLR). The resulting decrease in Reelin contributes to neuronal arrest at the marginal zone.


The Prevalence and Role of Hemoglobin Variants in Biometric Screening of a Multiethnic Population: One Large Health System's Experience.
To characterize and quantitate hemoglobin (Hb) variants discovered during biometric hemoglobin A1c (HbA1c) analyses in a large multiethnic population with a focus on the effect of variants on testing method and results. In total, 13,913 individuals had their HbA1c measured via ion-exchange high-performance liquid chromatography. Samples that had a variant Hb detected or HbF fraction more than 25% underwent variant Hb characterization and confirmation by gel electrophoresis. RBC indices were also evaluated for possible concomitant thalassemia. Of the 13,913 individuals evaluated, 524 (3.77%) had an Hb variant. The prevalence of each variant was as follows: HbS trait (n = 396, 2.85%), HbSS disease (n = 4, 0.03%), HbC trait (n = 85, 0.61%), HbCC disease (n = 2, 0.01%), HbSC disease (n = 5, 0.04%), HbE trait (n = 18, 0.13%), HbD or G trait (n = 9, 0.06%), HbS β-thalassemia + disease (n = 1, 0.01%), hereditary persistence of HbF (n = 2, 0.01%), and HbMontgomery trait (n = 1, 0.01%). Concomitant α-thalassemia was detected in 20 (3.82%) of the 524 individuals with an Hb variant. This study represents one of the largest epidemiologic investigations into the prevalence of Hb variants in a North American metropolitan, multiethnic workforce and their dependents and reinforces the importance of method selection in populations with Hb variants.


Heterogeneity of the factor IX locus in nine hemophilia B inhibitor patients.
DNA from nine hemophilia B patients who produce anti-factor IX inhibitors (antibodies), including two brothers, was analyzed by the Southern blotting method and hybridization with factor IX cDNA, intragenomic, and 3'-flanking probes. Two inhibitor patients were shown to have total deletions of the factor IX gene. Two other inhibitor patients, the brothers, were shown to have a presumably identical complex rearrangement of the factor IX gene involving two separate deletions. The first deletion is of approximately 5.0 kb and removes exon e. The second deletion is between 9 and 29 kb and removes exons g and h but leaves exon f intact. An abnormal Taq I fragment at one end of the deletion junctions acted as a marker for the inheritance of hemophilia B in the patients' family. Five other inhibitor patients have a structurally intact factor IX gene as detected by this method. Our studies indicate that whereas large structural factor IX gene defects predispose hemophilia B patients to developing an anti-factor IX inhibitor, the development of an inhibitor can be associated with other defects of the factor IX gene.


The protective effect of fish n-3 fatty acids on cerebral ischemia in rat hippocampus.
Reactive oxygen species (ROS) have been implicated in the pathogenesis of cerebral injury after ischemia-reperfusion (I/R). Fish n-3 essential fatty acids (EFA), contain eicosapentaenoic acids (EPA) and docosahexoenoic acids (DHA), exhibit antioxidant properties. DHA is an important component of brain membrane phospholipids and is necessary for the continuity of neuronal functions. EPA prevents platelet aggregation and inhibits the conversion of arachidonic acid into thromboxane A(2) and prostaglandins. They have been suggested to be protective agents against neurological and neuropsychiatric disorders. In this study, the neuroprotective effects of fish n-3 EFA on oxidant-antioxidant systems and number of apoptotic neurons of the hippocampal formation (HF) subjected to cerebral I/R injury was investigated in Sprague-Dawley rats. Six rats were used as control (Group I). Cerebral ischemia was produced by occlusion of both the common carotid arteries combined with hypotension for 45 min, followed by reperfusion for 30 min, in rats either on a standard diet (Group II) or a standard diet plus fish n-3 EFA (Marincap((R)), 0.4 g/kg/day, by gavage) for 14 days (Group III). At the end of procedures, the rats were sacrificed and their brains were removed immediately. The levels of malonedialdehyde (MDA) and nitric oxide (NO) and activities of superoxide dismutase (SOD) and catalase (CAT) were measured in left HF. In addition, the number of apoptotic neurons was counted by terminal transferase dUTP nick end labelling (TUNEL) assay in histological samples of the right HF. We found that SOD activities and MDA levels increased in Group III rats compared with Group II rats. On the other hand, CAT activities and NO levels were found to be decreased in Group III rats compared with Group II rats. Additionally, the number of apoptotic neurons was lower in Group III in comparison with Group II rats. The present findings suggest that fish n-3 EFA could decrease the oxidative status and apoptotic changes in ischemic rat hippocampal formation. Dietary supplementation of n-3 EFA may be beneficial to preserve or ameliorate ischemic cerebral vascular disease.


The proliferative behavior of the human Fallopian tube epithelium.
Using autoradiography after in vitro administration of tritiated thymidine a low grade of DNA synthesis had been found to take place in the epithelium of the human Fallopian tube in reproductive and postmenopausal age. No synchronization was found to take place in the menstrual cycle. There seems to be no relationship between tubal renewal and the endogenous hormones of the reproductive system in the human.


Dimethylsulphoxide stimulation of dome formation in cultured rat prostate epithelial cells.
Primary cultures of normal rat prostate produce cells with epithelial characteristics that may be useful in the study of cell differentiation and prostate physiology. These epithelial cells, grown in DME plus 10% FCS, 10% HS, and 50 ng/ml each of hydrocortisone and insulin, can be induced to differentiate into dome ( hemicyst ) forming cells by 250 mM DMSO, a molecule that acts as a differentiation inducer in Friend erythroleukemia cells, Madin-Darby canine kidney cells, and in mouse and rat mammary epithelial cells. Dome formation in cell culture is the consequence of transepithelial transport of water and ions, resulting in fluid accumulation between the culture dish and the cell layer. Dome formation in prostate epithelial cells, besides representing an example of induction of differentiation in a cell culture system, suggests that prostate (ductal?) epithelial cells have fluid reabsorption capabilities.


Putting evidence into practice: evidence-based interventions for sleep-wake disturbances.
Symptom management is a vital aspect of the practice of oncology nursing. The Oncology Nursing Society has identified outcomes sensitive to nursing intervention, known as nursing-sensitive patient outcomes. This article presents information about sleep-wake disturbances that occur in patients with cancer and makes recommendations for evidence-based interventions to improve sleep for patients. Sleep-wake disturbances occur in 30%-75% of people with cancer and have a negative impact on other symptoms and quality of life. Despite the frequency and severity of sleep-wake disturbances, limited research has tested interventions to improve sleep-wake outcomes. Although no interventions currently receive the highest recommendations for implementation into practice, several nonpharmacologic interventions show initial positive findings in promoting high-quality sleep and daytime functioning. Oncology nurses can screen for sleep-wake disturbances and suggest tailored interventions. Four categories of promising interventions are cognitive-behavioral therapy, complementary therapies, psychoeducation and information, and exercise. Clinicians can use the Putting Evidence Into Practice (PEP) card and PEP resources at www.ons.org/outcomes to improve sleep-wake outcomes.


MIX2: A Novel Natural Multi-Component Modulator of Multidrug-Resistance and Hallmarks of Cancer Cells.
Multidrug resistance is one of the key barriers suppressing the effectiveness of drug therapies of malignant tumors. Here, we report a study on the effect of a mix of natural extracts (MIX2) prepared from fresh fruits of Prunus spinosa, Crataegus monogyna, Sorbus aucuparia, and Euonymus europaeus on the classic hallmarks of cancer cells and the expression of multidrug resistance proteins. In the studies, HeLa and T98G cell lines, and classic methods of molecular biology, including RT-qPCR, Western blot, flow cytometry, and confocal imaging, were used. Additionally, migration, adhesion, and proliferation assays were performed. The obtained results indicate that the MIX2 cocktail presents strong anti-cancer properties. MIX2 is not toxic, but at the same time significantly alters the migration, proliferation, and adhesion of tumor cells. Furthermore, it was found that cells exposed to the mixture presented a significantly reduced expression level of genes associated with MDR, including ABCB1, which encodes for glycoprotein P. In vitro data showed that MIX2 effectively sensitizes tumor cells to doxorubicin. We postulate that modulation of the multidrug resistance phenotype of tumors with the use of MIX2 may be considered as a safe and applicable tool in sustaining drug delivery therapies of malignancies.


Safety and tolerability of first-line bevacizumab in metastatic colorectal cancer.
To determine the clinical features of bevacizumab-associated toxicities in metastatic colorectal cancer (MCRC) patients. The medical records of 60 patients with MCRC who were treated with chemotherapy including bevacizumab in the first-line setting were retrospectively evaluated. Bevacizumab was administered along with irinotecan plus 5-fluorouracil7sol;leucovorin (5-FU/LV) to 44 patients, 57horbar;FU7sol;LV+oxaliplatin to 8 patients, capecitabine+oxaliplatin to 6 patients and 5-FU/LV to 2 patients. The total number of the cycles received was 381 (median 6, range 17horbar;13). The most common bevacizumab-related toxicity was grade 1-2 bleeding (28%) followed by hypertension (17%). Grade 1-2 proteinuria was seen in 8% of the patients (no grade 3-4 proteinuria). Arterial thromboembolic events (ATE) were not observed, however 3 patients (5%) had experienced grade 3-4 venous thromboembolic events. In 3 patients (5%) grade 1-2 wound complications were seen (delayed wound healing in the place of the venous access device in 2, and wound infection in 1). In addition, gastrointestinal perforation (GIP) was seen in 3 (5%) patients. Two of the patients were treated by surgical intervention and one patient died of sepsis. Bevacizumab is well tolerated when combined with various chemotherapy regimens. As bevacizumab is becoming widely used in the routine oncology practice, further studies which investigate the mechanism of bevacizumab-associated toxicities are warranted to develop effective management strategies for these adverse events.


Distribution of alleles, genotypes and haplotypes of the CYP2B6 (rs3745274; rs2279343) and CYP3A4 (rs2740574) genes in the Malian population: Implication for pharmacogenetics.
Cytochrome P450 enzymes play a central role in the phase I biotransformation process of a wide range of compounds, including xenobiotics, drugs, hormones and vitamins. It is noteworthy that these enzymes are highly polymorphic and, depending on the genetic makeup, an individual may have impaired enzymatic activity. Therefore, the identification of genetic variants in these genes could facilitate the implementation of pharmacogenetic studies and genetic predisposition to multifactorial diseases. We have established the frequencies of CYP2B6 (rs3745274; rs2279343) and CYP3A4 (rs2740574) alleles and genotypes in 209 healthy Malian subjects using TaqMan drug metabolism genotyping assays for allelic discrimination. Allele frequencies were 37% for CYP2B6 rs3745274; 38% for CYP2B6 rs2279343; and 75% for CYP3A4 rs2740574 respectively. Overall, the frequencies observed in Mali are statistically comparable to those reported across Africa except North Africa. The major haplotypes in CYP2B6 rs3745274 and CYP2B6 rs2279343 were represented by GA (60.24%) followed by TG (35.36%). We noted a strong linkage disequilibrium between CYP2B6 rs3745274 and CYP2B6 rs2279343 with D' = 0.91 and r2 = 0.9. The frequencies of the genotypic combinations were 43.5% (GT/AG), 37.3% (GG/AA) and 11.5% (TT/GG) in the combination of CYP2B6-rs3745274 and CYP2B6-rs2279343; 26.8% (GT/CC), 25.4%, (GT/CT), 17.2% and GG/CT in the combination CYP2B6-rs3745274-CYP3A4-rs2740574; 26.8% (AG/CC), 23.9% (AA/CC), 19.1% (AG/CT), and 11% (AA/CT) in the combination CYP2B6-rs2279343-CYP3A4-rs2740574, respectively. The most common triple genotype was GT/AG/CC with 24.9%, followed by GG/AA/CC with 23.9%, GT/AG/CT with 16.7%, and GG/AA/CT with 10%. Our results provide new insights into the distribution of these pharmacogenetically relevant genes in the Malian population. Moreover, these data will be useful for studies of individual genetic variability to drugs and genetic predisposition to diseases.


Evaluation of Eye Protection Filters Used with Broad-Spectrum and Conventional LED Curing Lights.
The high irradiance and the different emission spectra from contemporary light curing units (LCU) may cause ocular damage. This study evaluated the ability of 15 eye protection filters: 2 glasses, 1 paddle design, and 12 dedicated filters to block out harmful light from a monowave (HP-3M ESPE) and a broad-spectrum (Valo, Ultradent) LED LCU. Using the anterior sensor in the MARC-Patient Simulator (BlueLight Analytics) the irradiance that was delivered through different eye protection filters was measured three times. The LCUs delivered a similar irradiance to the top of the filter. The mean values of the light that passed through the filters as percent of the original irradiance were analyzed using two-way ANOVA followed by Tukey test (a= 0.05). The emission spectra from the LCUs and through the filters were also obtained. Two-way ANOVA showed that the interaction between protective filters and LCUs significantly influenced the amount of light transmitted (p< 0.001). Tukey test showed that the amount of light transmitted through the protective filters when using the HP-3M-ESPE was significantly greater compared to when using the Valo, irrespective of the protective filter tested. When using the HP-3M-ESPE, the Glasses filter allowed significantly more light through, followed by XL 3000, ORTUS, Google Professional, Gnatus filters. The Valo filter was the most effective at blocking out the harmful light. Some protective filters were less effective at blocking the lower wavelengths of light (<420 nm). However, even in the worst scenario, the filters were able to block at least 97% of the irradiance.


Electroretinographic Findings in Melanoma-Associated Retinopathy Treated by Intravitreal Dexamethasone Implant.
A 63-year-old male with a history of bladder cancer in remission presented with progressive vision loss during a period of 2 years. Slit-lamp and funduscopic examination were unremarkable. Electroretinogram (ERG) revealed an unrecordable scotopic response and a moderately decreased photopic response. Computed tomography of the chest, abdomen, and pelvis showed a new duodenal mass. Subsequent biopsy disclosed malignant melanoma, and a diagnosis of melanoma-associated retinopathy (MAR) was made. The patient was then treated with a dexamethasone intravitreal implant 0.7 mg in his left eye. Two months after the implant, the patient reported a mild symptomatic improvement in his left eye, and ERG testing performed after the implant insertion revealed partial improvement in several scotopic and photopic ERG parameters. Repeat spectral-domain optical coherence tomography disclosed an improvement in retinal thickening. To the best of the authors' knowledge, this is the first report illustrating potential subjective visual improvement, improvement in retinal thickening, and ERG changes following treatment by intravitreal dexamethasone implant for MAR. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:454-456.].


Malignant lymphomas in road transport workers.
The relative risks of malignant lymphomas among road transport workers were investigated using the National Cancer Registry in England and Wales. Drivers of buses and coaches (OCC unit 120) had increased risks for both Hodgkin's and non-Hodgkin's lymphomas and the drivers of other road passenger vehicles (OCC unit 121) for Hodgkin's lymphomas only. Although the increased risks did not show statistical significance, they corresponded to and reinforced previously described findings based on occupational mortality.


Toward effective regional trauma networks: management auditing initiatives in Ontario.
Trauma is a significant multidimensional health problem in North America. An important organizational response to this problem has been the creation of regional trauma care systems. This article focuses on the need to assess the effectiveness of such systems from a regional management perspective.


Dry eye among computer operators at a tertiary care centre in India.
There is global digitalization. With the increased use of computers in the workplace, refraction and dry eye related health concerns are developing. This study is conducted to evaluate the effects of long-term computer use on tear production and evaporation. Thisis a cross-sectional study among 97 computer operators in a Tertiary care centre. Dry eye disease was assessed subjectively with the Ocular Surface Disease Index (OSDI) questionnaire and objectively by performing Schirmer's test and Tear Break-up Time (TBUT). Majority of participants (59.2%) were male's age group between 36- 40 years. The prevalence of dry eye among the computer Operators was found to be 51%. Mean TBUT and mean Schirmer's Test value for those with dry eye was 12.65s and 10.3mm respectively. This study showed that a positive relation between dry eye and computer usage. Computer users are predisposed to developing dry eye diseases. It is therefore necessary for them to go for regular ophthalmic examination to prevent dry eye symptoms and disease.


Predictors of Early Continence after Robot-assisted Radical Prostatectomy.
Our objective was to investigate predictors of early continence outcome after robot-assisted radical prostatectomy (RARP). Clinical records were prospectively collected in 272 patients who underwent RARP. Clinical parameters, continence rates, and time to achieve continence were investigated and analyzed. Recovery of continence was defined as achieving complete continence (pad-free). In the univariate analysis, young age (≤67 years) and low pT stage (≤pT2) were significantly associated with continence achieved within 2 weeks after RARP (P = 0.0343 and P = 0.0406, respectively). Low prostate weight was the only factor associated with recovery of continence within 1 month (P = 0.0461). Multivariate analysis revealed that young age (≤67 years) and low pT stage (≤pT2) were statistically significant predictors of continence within 2 weeks after RARP (P = 0.040 and P = 0.015, respectively). Young age and low pT stage were independent predictors of early continence.


Characterizing affective instability in borderline personality disorder.
This study sought to understand affective instability among patients with borderline personality disorder by examining the degree of instability in six affective domains. The authors also examined the subjective intensity with which moods are experienced and the association between instability and intensity of affect. In a group of 152 patients with personality disorders, subjective affective intensity and six dimensions of affective instability were measured. The mean scores for lability and intensity for each affective domain for patients with borderline personality disorder were compared with those of patients with other personality disorders through analyses that controlled for other axis I affective disorders, age, and sex. Greater lability in terms of anger and anxiety and oscillation between depression and anxiety, but not in terms of oscillation between depression and elation, was associated with borderline personality disorder. Contrary to expectation, the experience of an increase in subjective affective intensity was not more prominent in patients with borderline personality disorder than in those with other personality disorders. By applying a finer-grained perspective on affective instability than those of previous personality disorder studies, this study points to patterns of affective experience characteristic of patients with borderline personality disorder.


ACCURACY OF SELF-REPORTED FOOT STRIKE PATTERN IN INTERCOLLEGIATE AND RECREATIONAL RUNNERS DURING SHOD RUNNING.
Clinicians are interested in the foot strike pattern (FSP) in runners because of the suggested relationship between the strike pattern and lower extremity injury. The purpose of this study was to assess the ability of collegiate cross-country runners and recreational runners to self-report their foot strike pattern during running. Cross-sectional Study. Twenty-three collegiate cross-country and 23 recreational runners voluntarily consented to participate. Inclusion criteria included running at least 18 miles per week, experience running on a treadmill, no history of lower extremity congenital or traumatic deformity, or acute injury three months prior to the start of the study. All participants completed a pre-test survey to indicate their typical foot strike pattern during a training run (FSPSurvey). Prior to running, reflective markers were placed on the posterior midsole and the vamp of the running shoe. A high-speed camera was used to film each runner in standing and while running at his or her preferred speed on a treadmill. The angle between the vector formed by the two reflective markers and the superior surface of the treadmill was used to calculate the foot strike angle (FSA). To determine the foot strike pattern from the video data (FSPVideo), the static standing angle was subtracted from the FSA at initial contact of the shoe on the treadmill. In addition to descriptive statistics, percent agreement and Chi square analysis was used to determine distribution differences between the video analysis results and the survey. The results of the chi-square analysis on the distribution of the FSPSurvey in comparison to the FSPVideo were significantly different for both the XCRunners (p < .01; Chi-square = 8.77) and the REC Runners (p < .0002; Chi-square = 16.70). The cross-country and recreational runners could correctly self-identified their foot strike pattern 56.5% and 43.5% of the time, respectively. The findings of this study suggest that the clinician cannot depend on an experienced runner to correctly self-identify their FSP. Clinicians interested in knowing the FSP of a runner should consider performing the two-dimensional video analysis described in this paper. 3.


Fibulin-1 Regulates Initiation of Successional Dental Lamina.
In humans, teeth are replaced only once, and the successional dental lamina (SDL) of the permanent tooth is maintained in a quiescent state until adolescence. Recently, we showed that biomechanical stress generated by the rapid growth of the deciduous tooth inhibits SDL development via integrin β1-RUNX2 signaling at embryonic day 60 (E60) in miniature pigs. However, the mechanism by which RUNX2 regulates SDL initiation within the SDL stem cell niche remains unclear. In the current study, we transcriptionally profiled single cells from SDL and surrounding mesenchyme at E60 and identified the landscape of cellular heterogeneity. We then identified a specific fibroblast subtype in the dental follicle mesenchyme between the deciduous tooth and the SDL of the permanent tooth (DFDP), which constitutes the inner part of the niche (deciduous tooth side). Compared with traditional dental follicle cells, the specific expression profile of DFDP was identified and found to be related to biomechanical stress. Subsequently, we found that RUNX2 could bind to the enhancer regions of Fbln1 (gene of fibulin-1), one of the marker genes for DFDP. Through gain- and loss-of-function experiments, we proved that the biomechanical stress-mediated RUNX2-fibulin-1 axis inhibits the initiation of SDL by maintaining SDL niche homeostasis.


Scanning electron microscopy combined with image processing technique: Analysis of microstructure, texture and tenderness in Semitendinous and Gluteus Medius bovine muscles.
In this study the effect of freeze drying on the microstructure, texture, and tenderness of Semitendinous and Gluteus Medius bovine muscles were analyzed applying Scanning Electron Microscopy combined with image analysis. Samples were analyzed by Scanning Electron Microscopy at different magnifications (250, 500, and 1,000×). Texture parameters were analyzed by Texture analyzer and by image analysis. Tenderness by Warner-Bratzler shear force. Significant differences (p < 0.05) were obtained for image and instrumental texture features. A linear trend with a linear correlation was applied for instrumental and image features. Image texture features calculated from Gray Level Co-occurrence Matrix (homogeneity, contrast, entropy, correlation and energy) at 1,000× in both muscles had high correlations with instrumental features (chewiness, hardness, cohesiveness, and springiness). Tenderness showed a positive correlation in both muscles with image features (energy and homogeneity). Combing Scanning Electron Microscopy with image analysis can be a useful tool to analyze quality parameters in meat.Summary SCANNING 38:727-734, 2016. © 2016 Wiley Periodicals, Inc.


Haemophilia A: database of nucleotide substitutions, deletions, insertions and rearrangements of the factor VIII gene, second edition.
A large number of different mutations in the factor VIII (F8) gene have been identified as a cause of haemophilia A. This compilation lists known single base-pair substitutions, deletions and insertions in the F8 gene and reviews the status of the inversional events which account for a substantial proportion of mutations causing severe haemophilia A.


The Morning Report Practice and Its Contribution to Education of Internal Medicine Residents: A Multicenter Cross-Sectional Survey in the Eastern Province, Saudi Arabia.
Morning Report (MR) is a ubiquitous traditional educational activity in internal medicine residency training. It is under-researched; hence, this study was conducted. It aimed to examine the practice of MR by internal medicine residents, their motivation to engage with it, and their perception of its contribution to education. This was a multi-center cross-sectional study. The data was collected using an online self-administered 12-item questionnaire that covered MR practice, respondents' motivation for participation, MR contribution to education, and its impact on the practice of evidence-based medicine and quality improvement and patient safety. One hundred seventy residents returned the online questionnaire (54.7%). The respondents' gender and year of training were balanced (P > 0.05). The most common MR frequency and duration were five days per week (85.4%) and 45-60 minutes (47.1%), respectively. The most common format was handover combined with an emergency long case presentation (55.8%), and consultants were the most common facilitators (79.7%). The respondents' motivation to engage with MR was predominantly intermediate. The top reasons for attending and not attending MR were mandatory attendance and embarrassing questions, respectively. The perceived MR contribution to residents' different roles development was predominantly intermediate; however, it was predominantly very low/low (42%) for overall education. The perceived MR impact on the practice of EBM and QIPS were both predominantly intermediate. MR was found to be a commonly practiced educational activity in internal medicine residency training programs in the eastern province of Saudi Arabia. The case discussion was the core format for education. The respondents' motivation to participate in MR and their perception of its contribution to education was predominantly intermediate. To our best knowledge, this is the first study in Saudi Arabia that examined MR. We hope its findings will be taken for further MR studies and actions for improvement.


Cholesterol in serum lipoprotein fractions after spaceflight.
Cholesterol, triglycerides, very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were measured in blood samples from 125 crewmembers on the first 24 space shuttle flights. Samples were obtained before, immediately after, and 3-23 days after spaceflight. On landing day, only HDL-C was significantly changed from its preflight level; it had decreased 12.8%. Later in the postflight period, total cholesterol and LDL-C as well as HDL-C decreased significantly. Possible causes of these decreases in estimated cholesterol content of lipoprotein fractions include increased levels of thyroxine during flight and reduced physical activity. The postflight decrease in HDL-C is not considered to have clinical significance for shuttle astronauts, but lipoproteins and apolipoproteins should be measured in blood drawn during longer missions.


Distinct skeletal muscle molecular responses to pulmonary rehabilitation in chronic obstructive pulmonary disease: a cluster analysis.
Pulmonary rehabilitation (PR) is a cornerstone in the management of chronic obstructive pulmonary disease (COPD), targeting skeletal muscle to improve functional performance. However, there is substantial inter-individual variability in the effect of PR on functional performance, which cannot be fully accounted for by generic phenotypic factors. We performed an unbiased integrative analysis of the skeletal muscle molecular responses to PR in COPD patients and comprehensively characterized their baseline pulmonary and physical function, body composition, blood profile, comorbidities, and medication use. Musculus vastus lateralis biopsies were obtained from 51 COPD patients (age 64 ± 1 years, sex 73% men, FEV1 , 34 (26-41) %pred.) before and after 4 weeks high-intensity supervised in-patient PR. Muscle molecular markers were grouped by network-constrained clustering, and their relative changes in expression values-assessed by qPCR and western blot-were reduced to process scores by principal component analysis. Patients were subsequently clustered based on these process scores. Pre-PR and post-PR functional performance was assessed by incremental cycle ergometry and 6 min walking test (6MWT). Eight molecular processes were discerned by network-constrained hierarchical clustering of the skeletal muscle molecular rehabilitation responses. Based on the resulting process scores, four clusters of patients were identified by hierarchical cluster analysis. Two major patient clusters differed in PR-induced autophagy (P < 0.001), myogenesis (P = 0.014), glucocorticoid signalling (P < 0.001), and oxidative metabolism regulation (P < 0.001), with Cluster 1 (C1; n = 29) overall displaying a more pronounced change in marker expression than Cluster 2 (C2; n = 16). General baseline characteristics did not differ between clusters. Following PR, both 6 min walking distance (+26.5 ± 8.3 m, P = 0.003) and peak load on the cycle ergometer test (+9.7 ± 1.9 W, P < 0.001) were improved. However, the functional improvement was more pronounced in C1, as a higher percentage of patients exceeded the minimal clinically important difference in peak workload (61 vs. 21%, P = 0.022) and both peak workload and 6 min walking test (52 vs. 8%, P = 0.008) upon PR. We identified patient groups with distinct skeletal muscle molecular responses to rehabilitation, associated with differences in functional improvements upon PR.


Direct comparison of four implicit memory tests.
Four verbal implicit memory tests, word identification, word stem completion, word fragment completion, and anagram solution, were directly compared in one experiment and were contrasted with free recall. On all implicit tests, priming was greatest from prior visual presentation of words, less (but significant) from auditory presentation, and least from pictorial presentations. Typefont did not affect priming. In free recall, pictures were recalled better than words. The four implicit tests all largely index perceptual (lexical) operations in recognizing words, or visual word form representations.


Pain and sensitization after total knee replacement or nonsurgical treatment in patients with knee osteoarthritis: Identifying potential predictors of outcome at 12 months.
This study is a secondary analysis of 12-month follow-ups from two parallel, randomized controlled trials (RCT) in painful knee osteoarthritis patients. RCT1: Total knee replacement (TKR) followed by nonsurgical treatment compared with nonsurgical treatment. RCT2: Nonsurgical treatment compared with usual care. The aims were to investigate (1) possible predictors of treatment outcome after TKR and nonsurgical interventions at 12 months, (2) associations between pain intensity and pressure pain thresholds (PPTs) (pain sensitization) at baseline and after 12 months and (3) possible gender differences. Each RCT included 100 patients. Pain intensities, PPTs and number of painful sites were assessed at baseline and after 12 months. In all groups, pain improved and pain sensitization decreased. In RCT1, the TKR group had the greatest improvements in pain. In RCT2 the nonsurgical group had the greatest improvement, with no between-group differences in PPTs. Lower PPTs at baseline predicted higher pain after TKR. Baseline pain intensity and PPT levels were associated with the number of painful sites. Subjects with the highest pain and lowest PPTs at baseline showed the largest relative improvement in pain and sensitization but were still experiencing highest absolute pain and lowest PPTs after 12 months (combined cohorts). Low PPTs at baseline predicted worse pain outcome after TKR, but did not predict outcome after nonsurgical interventions. The number of painful sites was weakly associated with pain and PPTs, and the higher pain/lower PPTs, the higher pain/lower PPTs at 12 months with females showing the lowest PPT values. Human experimental pain assessment was used to assess the degree of pain sensitization in patients with painful knee osteoarthritis. High sensitization before TKR predicted worse outcome. Outcome after nonsurgical interventions could not be predicted.


A clinical evaluation of the DSM-5 criteria for Internet Gaming Disorder and a pilot study on their applicability to further Internet-related disorders.
Internet Gaming Disorder (IGD) and other Internet-related disorders (IRDs) have become growing health concerns in our today's lives. Based on defined diagnostic criteria, IGD has been recognized as a condition for further research in the DSM-5; however, other IRDs have been excluded. Since the release of the DSM-5, representativeness and appropriateness of the nine diagnostic criteria have been debated. Although some first evidence has been published to evaluate these criteria, our knowledge is still limited. Thus, the purpose of this study was to provide data on the clinical validity of the DSM-5 criteria for IGD and other types of IRD. We were also interested in examining the additional diagnostic validity of craving that is currently not being considered in the DSM-5. Analyses on a sample of n = 166 treatment seekers for IRDs were performed. The clinician's diagnosis was used as a main reference for determining the DSM criteria's diagnostic performance. Secondary criteria (depression and anxiety) were defined as indicators for the construct validity. The overall diagnostic accuracy ranged between 76.6% for deceiving and 92% for loss of control and craving. Considerable differences occurred in the degree of sensitivity and specificity between the single criteria. No particular differences were found for the applicability of the criteria to other forms of IRDs. Our results confirm the validity of the DSM criteria. However, the diagnostic utility of the criterion escaping aversive moods is critically discussed. Considering craving as an additional diagnostic indicator might be recommendable.


How to Explore Fetal Sacral Agenesis Without Open Dysraphism: Key Prenatal Imaging and Clinical Implications.
The estimated prevalence of fetal caudal dysgenesis is 1 per 100,000 births. The functional prognosis of sacral agenesis is dominated by the large spectrum of associated caudal malformations. Except for cases associated with hydrocephalus secondary to open spinal dysraphism or chromosomal anomalies, association with mental deficiency is rare. We propose a systematic prenatal approach to cases of fetal sacral agenesis based on 9 etiologic items: clinical context, type of sacral dysgenesis, associated spinal cord malformations, mobility of lower limbs, investigation of the presacral region, analysis of the gastrointestinal tract, analysis of the genitourinary tract, associated vertebral defects, and cytogenetic analysis.


Surgical Exposure Gained in an Extended Retrosigmoid Approach to the Cerebellopontine Angle Compared to the Traditional Retrosigmoid Approach.
Retrosigmoid approach to the posterior fossa has been a popular and dependable approach for accessing the cerebellopontine angle (CPA) and petroclival region. Although this approach is commonly used, it requires cerebellar retraction and has limitations when the lesion is located ventral to the brainstem. The aim was to quantify the angle of view provided by extended retrosigmoid approach in comparison to the traditional approach. A secondary objective was to identify a strategic initial burr hole site for craniotomy. Ten adult human cadaver heads (20 sides) were used. First, traditional retrosigmoid approach was performed and the angle of exposure was measured on cranial computerized tomography (CT). Following, extended retrosigmoid approach was performed with mastoid bone drilling and reflection of venous sinuses. Angle of exposure was measured on CT. Two measurements of both approaches were compared. Mean angle of view for the traditional retrosigmoid approach (31.4° ± 4.1°) was significantly smaller than that of the extended approach (46.0° ± 4.7°) (p < 0.001). Site of strategic burr hole was 5 mm below and 15 mm lateral to the asterion was defined. Extended retrosigmoid approach offers neurosurgeons approximately 50% larger angle of view and shorter working distance than the traditional approach provides. This modification permits better access to the CPA and ventral brain stem without cerebellar retraction.


Advances in genome editing: the technology of choice for precise and efficient β-thalassemia treatment.
Beta (β)-thalassemia is one of the most significant hemoglobinopathy worldwide. The high prevalence of the β-thalassemia carriers aggravates the disease burden for patients and national economies in the developing world. The survival of β-thalassemia patients solely relies on repeated transfusions, which eventually results into multi-organ damage. The fetal γ-globin genes are ordinarily silenced at birth and replaced by the adult β-globin genes. However, mutations that cause lifelong persistence of fetal γ-globin, ameliorate the debilitating effects of β-globin mutations. Therefore, therapeutically reactivating the fetal γ-globin gene is a prime focus of researchers. CRISPR/Cas9 is the most common approach to correct disease causative mutations or to enhance or disrupt the expression of proteins to mitigate the effects of the disease. CRISPR/cas9 and prime gene editing to correct mutations in hematopoietic stem cells of β-thalassemia patients has been considered a novel therapeutic approach for effective hemoglobin production. However, genome-editing technologies, along with all advantages, have shown some disadvantages due to either random insertions or deletions at the target site of edition or non-specific targeting in genome. Therefore, the focus of this review is to compare pros and cons of these editing technologies and to elaborate the retrospective scope of gene therapy for β-thalassemia patients.


[Changes of plasma uPA and TGF-beta1 in patients with preeclampsia].
To study the roles of uPA and TGF-beta1 in the etiology of preeclampsia (PE). The plasma uPA and TGF-beta 1 were determined with enzyme linked immunosorbent assay (ELISA) in 70 patients with PE, and compared with those with normal pregnancy (n = 40). 1) The patients with PE had lower levels of plasma uPA (436.39 +/- 29.57) pg/mL than those with normal pregnancy [(646.54 +/- 35.39) pg/mL, P < 0.01]. No significant difference was found in the levels of plasma uPA between the patients with severe PE (417.11 +/- 48.47) pg/mL and the patients with mild PE [(468.81 +/- 14.91) pg/mL, P > 0.05]. 2) The patients with PE had higher levels of plasma TGF-beta1 (14.32 +/- 4.37) ng/mL than those with normal pregnancy [(9.85 +/- 3.19) ng/mL, P < 0. 05]. No significant difference was found in the levels of plasma TGF-beta1 between the patients with severe PE (15.37 +/- 4.93) ng/mL and the patients with mild PE [(11.21 +/- 2.32) ng/mL, P > 0.05)]. 3) There was a negative correlation between plasma uPA and plasma TGF-beta1 in the patients with PE (r = -0.497, P < 0.01). The changes of uPA and TGF-beta1 are associated with the occurrence and development of PE.


Precoded and pre-equalized multi-band FBMC transmission enabled by radio-frequency DACs and the undersampling technique.
In this Letter, we use radio-frequency digital-to-analog converters (DACs) operating in different frequency response modes to generate a high spectral-efficiency multi-band (MB) filter bank multicarrier (FBMC) signal. In the receiver, the undersampling technique is employed to realize down-conversions. No electrical mixers are required. Besides, discrete Fourier transform and orthogonal circulant matrix transform precoding techniques combined with channel-independent digital pre-equalization are enabled to enhance transmission performance. Both numerical simulations and offline experiments are performed. The relevant results show that the MB-FBMC without a cyclic prefix (CP) is robust against inter-symbol interference induced by the band-pass filtering. By using precoding and pre-equalization techniques, the bit error rate can be improved by more than one order of magnitude. In contrast, an additional 12.5% CP overhead is required for the MB orthogonal frequency division multiplexing system to achieve such an improvement.


Intralesional treatment with meglumine antimoniate in three patients with New World cutaneous leishmaniasis and large periarticular lesions with comorbidities.
Although New World cutaneous leishmaniasis is not itself a life-threatening disease, its treatment with systemic antimonials can cause toxicity that can be dangerous to some patients. Intralesional meglumine antimoniate provides a viable, less toxic alternative. Herein, we describe an alternative treatment with subcutaneous intralesional injections of meglumine antimoniate into large periarticular lesions of three patients with cutaneous leishmaniasis and comorbidities. This treatment was safe, successful, and well tolerated. This case series suggests that intralesional meglumine antimoniate is an effective therapy for cutaneous leishmaniasis, even with periarticular lesions. This hypothesis should be tested in controlled clinical trials.


Solid-phase tandem radical addition-cyclization reaction: triethylborane-induced reaction of oxime ethers anchored to polymer support.
Tandem radical addition-cyclization of oxime ethers anchored to polymer support was studied. The reaction of oxime ethers with stannyl radical proceeded effectively by the use of triethylborane as a radical initiator. The alkyl radical addition-cyclization reactions of oxime ether connected with alpha,beta-unsaturated carbonyl group proceeded under iodine atom-transfer reaction conditions to give the functionalized azacycles via two carbon-carbon bonds-forming process.


Infusions of 3alpha,5alpha-THP to the VTA enhance exploratory, anti-anxiety, social, and sexual behavior and increase levels of 3alpha,5alpha-THP in midbrain, hippocampus, diencephalon, and cortex of female rats.
17beta-Estradiol (E2) and progesterone (P4) influence the onset and duration of sexual behavior and are also associated with changes in behaviors that may contribute to mating, such as exploration, anxiety, and social behaviors (socio-sexual behaviors). In the midbrain ventral tegmental area (VTA), the P4 metabolite, 5alpha-pregnan-3alpha-ol-20-one (3alpha,5alpha-THP), modulates lordosis of E2-primed rodents; 3alpha,5alpha-THP can also influence anxiety and social behaviors. To examine if 3alpha,5alpha-THP in the VTA mediates socio-sexual behaviors, we infused 3alpha,5alpha-THP to the VTA of diestrous and proestrous rats. As expected, proestrous, compared to diestrous, rats showed more exploratory (open field), anxiolytic (elevated plus maze), pro-social (partner preference, social interaction), and sexual (paced mating) behavior and had increased E2, P4, dihydroprogesterone (DHP), and 3alpha,5alpha-THP in serum, midbrain, hippocampus, diencephalon, and cortex. Infusions of 3alpha,5alpha-THP to the VTA, but not control sites, such as the substantia nigra (SN) or central grey (CG), of diestrous rats produced behavioral and endocrine effects akin to that of proestrous rats and increased DHP and 3alpha,5alpha-THP levels in midbrain, hippocampus, and diencephalon. Levels of DHP and 3alpha,5alpha-THP, but neither E2 nor P4 concentrations, in midbrain, hippocampus, diencephalon, and/or cortex were positively correlated with socio-sexual behaviors. Thus, 3alpha,5alpha-THP infusions to the VTA, but not SN or CG, can enhance socio-sexual behaviors and increase levels in midbrain, hippocampus, and diencephalon.


Distinct effect of stress on 11beta-hydroxysteroid dehydrogenase type 1 and corticosteroid receptors in dorsal and ventral hippocampus.
Multiple lines of evidence suggest the participation of the hippocampus in the feedback inhibition of the hypothalamus-pituitary-adrenal axis during stress response. This inhibition is mediated by glucocorticoid feedback due to the sensitivity of the hippocampus to these hormones. The sensitivity is determined by the expression of glucocorticoid (GR) and mineralocorticoid (MR) receptors and 11beta-hydroxysteroid dehydrogenase type 1 (11HSD1), an enzyme that regulates the conversion of glucocorticoids from inactive to active form. The goal of our study was to assess the effect of stress on the expression of 11HSD1, GR and MR in the ventral and dorsal region of the CA1 hippocampus in three different rat strains with diverse responses to stress: Fisher 344, Lewis and Wistar. Stress stimulated 11HSD1 in the ventral but not dorsal CA1 hippocampus of Fisher 344 but not Lewis or Wistar rats. In contrast, GR expression following stress was decreased in the dorsal but not ventral CA1 hippocampus of all three strains. MR expression was not changed in either the dorsal or ventral CA1 region. These results indicate that (1) depending on the strain, stress stimulates 11HSD1 in the ventral hippocampus, which is known to be involved in stress and emotion reactions whereas (2) independent of strain, stress inhibits GR in the dorsal hippocampus, which is predominantly involved in cognitive functions.


Olmesartan-Induced Enteropathy: A Case Report.
Patients with olmesartan-induced enteropathy, a rare illness, frequently endure prolonged diarrhea and weight loss with no apparent cause. Because this adverse event's clinical and histological characteristics mimic those of other small intestine illnesses, it can be challenging to recognize it in a timely manner. We report a case of olmesartan-induced enteropathy in a 58-year-old male who had been on olmesartan for several years. Recently, during his travel to Greece, he developed diarrhea lasting several weeks. This was accompanied by a significant weight loss of 35 lbs, acute kidney injury, and hypokalemia. Extensive negative workup, including esophagogastroduodenoscopy (EGD) with normal biopsy of esophagus, stomach, duodenum, and terminal ileum, and colonoscopy with biopsies, autoimmune serologies, and infectious disease workup, led to a diagnosis of olmesartan-induced enteropathy as a diagnosis of exclusion. Diarrhea improved/resolved within a few days after stopping olmesartan in our patient.


KSHV hijacks FoxO1 to promote cell proliferation and cellular transformation by antagonizing oxidative stress.
Reactive oxygen species (ROS) are a group of a highly short-lived molecules that control diverse behaviors of cells. Normal cells maintain ROS balance to ensure their functions. Because of oncogenic stress, cancer cells often have excessive ROS, also known as oxidative stress, which are often counteracted by enhanced antioxidant systems to maintain redox homeostasis. Kaposi's sarcoma-associated herpesvirus (KSHV) is an oncogenic virus associated with Kaposi's sarcoma (KS), which manifests hyper inflammation and oxidative stress as the hallmarks. We have previously shown that excessive ROS can disrupt KSHV latency by inducing viral lytic replication, leading to cell death. Paradoxically, most KS tumor cells are latently infected by KSHV in a highly inflammatory and oxidative stress tumor microenvironment, which is in part due to the activation of alternative complement and TLR4 pathways, indicating the existence of an enhanced antioxidant defense system in KS tumor cells. In this study, we show that KSHV upregulates antioxidant genes, including SOD2 and CAT by hijacking the forkhead box protein O1 (FoxO1), to maintain intracellular ROS level. Moreover, the fine-tuned balance of ROS level in KSHV-transformed cells is essential for cell survival. Consequently, KSHV-transformed cells are extremely sensitive to exogenous ROS insult such as treatment with a low level of hydrogen peroxide (H2 O2 ). Either chemical inhibition or knockdown of FoxO1 by short interfering RNAs decreases the expression of antioxidant genes and subsequently increases the intracellular ROS level in KSHV-transformed cells, resulting in the inhibition of cell proliferation and colony formation in soft agar. Mechanistically, KSHV-encoded microRNAs and vFLIP upregulate FoxO1 by activating the NF-κB pathway. These results reveal a novel mechanism by which an oncogenic virus counteracts oxidative stress by upregulating FoxO1, which is essential for KSHV-induced cell proliferation and cellular transformation. Therefore, FoxO1 might be a potential therapeutic target for KSHV-related malignancies.


[Ileosigmoid fistula due to an abscess of a periappendicular mass].
The paper debates the subject of the undiagnosed acute appendicitis. The formation of a complex ileosigmoid fistula due to an abscess of the periappendicular mass and the three steps peritonitis determined a particular approach in solving the case.


Safety of selegiline transdermal system in clinical practice: analysis of adverse events from postmarketing exposures.
The objective of this analysis is to present the safety profile of selegiline transdermal system (STS) in clinical practice after US Food and Drug Administration approval by analyzing reported postmarketing adverse events (AEs). Deidentified data were obtained on AEs, regardless of causality, as collected and compiled in the pharmaceutical company's adverse event collection systems/databases after the launch of STS in the United States. All reports of hypertensive crisis, suicide attempts, and STS overdoses were carefully examined to independently determine relation of the AE to STS. From April 2006 to October 2010, a total of 3,155 AEs in 1,516 patients were reported (5.2% of the total exposures; N = 29,141), regardless of causality. The most frequently reported categories of AEs were general disorders (no. of AEs = 1,037, 3.6%) and central nervous system (CNS) disorders (no. of AEs = 574, 2.0%). A total of 266 reports (0.9%) were classified as serious AEs; CNS disorders (no. of AEs = 71, 26.7%) and cardiac and vascular disorders (no. of AEs = 44, 16.5%) were most common. There were 13 self-reports of possible hypertensive events or hypertension, although objective clinical data were not submitted in any of these cases. Thirteen drug-drug interactions (0.04%) were reported, and 5 were classified as serious. The most commonly reported AEs were application site reactions and insomnia. Very few patients reported a hypertensive event, and there were no objectively confirmed reports of hypertensive crisis with food at any STS dose. Therapeutic doses of STS appear to have a safety profile in clinical practice that is consistent with that observed in clinical trials. However, given the relatively modest exposure numbers, continued safety monitoring is recommended.


[Strengthening scientific and technological support for health adaptation action to climate change under the 'double carbon' goal].
With the global climate change process is accelerating, China is facing great challenges. It is urgent to carry out scientific study, aiming at the major needs of health adaptation action to climate change under the 'double carbon' target. This special issue on Climate Change and Health highlights and reports on China's latest scientific findings in this field. The health risks of non-optimal temperature, drought, ultraviolet radiation and other meteorological factors and cold spells in China are clarified, and the research methods of health risk early warning of heat waves are summarized. Future researches need to further elucidate the scientific evidence of the impact of meteorological factors and extreme weather events on population health in China systematically. Focus on innovating and developing technical methods and tools such as health risk early warning models. Accelerate the transformation and application of relevant scientific and technological achievements in China. To provide scientific and technological support for the health adaptation action to climate change under the 'double carbon' goal.


Prognostic correlates of psychotherapy in psychiatric outpatients.
The authors examined the follow-up data for 113 psychiatric outpatients who had been treated for up to a year in an outpatient community mental health center. Correlations between therapist and patient ratings of improvement were generally low, and anlayses were done separately for therapist and patient ratings. The strongest confirmed hypothesis was the relationship between therapist and patient ratings of improvement and therapist and patient evaluations of each other as likable, physically attractive, and either a good patient for treatment or a competent therapist. The authors discuss the advantages and disadvantages of multivariate statistics for the analysis of psychotherapy data.


Management recommendations for body stuffers at emergency units.
Managing body packers and stuffers is a challenge to emergency physicians, stuffers in particular, as there is no systematic approach to their treatment. The aim of this study was therefore to review all available literature on body stuffing and propose a guide to manage these patients. We searched Medline/PubMed, Google Scholar, and Scopus for published work on body stuffers using key words "body stuffer", "body stuffing", "poisoning", "toxicity", and "treatment" without a time limit and retrieved 290 articles, of which 61 remained after exclusion of those on "body packers" and repetitive documents. This review article evaluates and summarises the information gathered from them. The main step in body stuffer management is observation to make sure that they have passed all the swallowed packages of drugs of abuse. In some cases, imaging can be quite useful. Diagnostic pitfalls may be avoided with abdominopelvic CT without contrast, which is probably the best diagnostic method to determine the presence and the number of packages in these patients. Treatment should be specific for each group of drugs, whether it is opioids, cocaine, or amphetamine. Surgical interventions are indicated for obstruction of the intestines or package rupture. Legal precautions should be taken because of the legal complexity of body stuffing cases.


Screening and Identification of a Phage Display Derived Peptide That Specifically Binds to the CD44 Protein Region Encoded by Variable Exons.
CD44, especially the isoforms with variable exons (CD44v), is a promising biomarker for the detection of cancer. To develop a CD44v-specific probe, we screened a 7-mer phage peptide library against the CD44v3-v10 protein using an improved subtractive method. The consensus sequences with the highest frequency (designated CV-1) emerged after four rounds of panning. The binding affinity and specificity of the CV-1 phage and the synthesized peptide for the region of CD44 encoded by the variable exons were confirmed using enzyme-linked immunosorbent assay and competitive inhibition assays. Furthermore, the binding of the CV-1 probe to gastric cancer cells and tissues was validated using immunofluorescence and immunohistochemistry assays. CV-1 sensitively and specifically bound to CD44v on cancer cells and tissues. Thus, CV-1 has the potential to serve as a promising probe for cancer molecular imaging and target therapy.


Hydroxyapatite nanoparticles promote mitochondrial-based pyroptosis via activating calcium homeostasis and redox imbalance in vascular smooth muscle cells.
Hydroxyapatite nanoparticles (HAP) have been widely used in various fields because of their natural biological origin and functional properties. The emerging evidence on their toxicities has attracted research interest. HAP-induced vascular smooth muscle cell (VSMC) damage is a key step in vascular calcification (VC), particularly in patients with chronic kidney disease. However, the injury effects and mechanism of action of HAP on VSMCs have not been extensively investigated. This study comprehensively characterized commercially available HAP and investigated its adverse biological effects in cultured A7R5 cells.In vitroexperiments revealed that internalized HAP was localized in lysosomes, followed by the release of Ca2+owing to the low pH microenvironment. Upon Ca2+homeostasis, Ca2+enters the mitochondria, leading to the simultaneous generation of reactive oxygen species (ROS). ROS subsequently attack mitochondrial transmembrane potentials, promote mitochondrial ROS production, and oxidize mitochondrial DNA (Ox-mtDNA). Mitochondrial permeability-transition pores open, followed by the release of more Ox-mtDNA from the mitochondria into the cytosol due to the redox imbalance. This activates NLRP3/caspase-1/gasdermin D-dependent pyroptosis and finally excretes inflammatory factors to induce VC; an antioxidant could rescue this process. It has been suggested that HAP could induce an imbalance in intracellular Ca2+homeostasis in A7R5 cells, followed by the promotion of mitochondrial dysfunction and cell pyroptosis, finally enhancing VC. To detect thein vivotoxicity of HAP, mice were treated with Cy7-labelled HAP NPs for 24 h.In vivoresults also demonstrated that HAP accumulated in the kidneys, accompined with increased Ca concentration, upregulated oxidative stress-related factor and kidney damage. Overall, our research elucidates the mechanism of calcium homeostasis and redox imbalance, providing insights into the prevention of HAP-induced cell death.


Selective and sensitive platform for function-based screening of potentially harmful furans.
Many furan-containing compounds have been reported to be toxic and/or carcinogenic. Furanoids have been found in a wide range of fruits, herbs, foods, and beverages. The risks for intake of toxic furans have been rising, due to the rapid growth of globe-wide consumption of natural products. The objective of the study was to develop an analytical platform to screen cis-enediones (cis-enedials or γ-ketoenals) resulting from metabolic activation of potentially harmful furans. 2,5-Dimethylfuran (DMF), a model furan compound, was incubated with rat liver microsomes supplemented with glutathione (GSH) and 4-bromobenzylamine (BBA) as trapping agents, to produce a GSH/BBA-derived pyrrole. The incubation mixture was monitored by acquiring neutral loss scan of 129 Da and precursor ion scans of m/z 272, 169, and 171 in polarity switch mode. Four individual chromatograms showed the respective peak with the same retention time. An additional six furan-containing compounds were tested by the same approach, and similar observation was obtained. The system also showed its extremely high sensitivity, and an estimate of the limit of detection for DMF bioactivated in rat liver microsomes was <100 fmol. We also applied inductively coupled plasma mass spectrometry (ICP-MS) to monitor the formation of the bromine-tagged pyrrole derivatives. Crude extracts obtained from traditional Chinese medicine Dioscorea bulbifera L., known to contain furanoditerpenoids, were analyzed by the approach. In conclusion, the platform has been proven selective, sensitive, effective, and reliable, and ICP MS allows us to estimate the resulting bromine-labeled pyrroles without authentic standards.


Combination of solid-phase affinity capture on magnetic beads and mass spectrometry to study non-covalent interactions: example of minor groove binding drugs.
A simple and novel approach was developed to detect non-covalent interactions. It is based on combination of solid-phase affinity capture with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS). One of the interacting molecules is bound to magnetic beads and is incubated with the target molecules in solution. The complex bound on the solid support is removed from the solution and transferred for MALDI analysis. Mass spectrometry is used only to detect the target compound, which is far more straightforward than detecting the intact non-covalent complex. To demonstrate the applicability of the method, an AT-rich oligonucleotide (5'-CCCCCAATTCCCCC-3') and its complementary biotinylated sequence (5'-biotin-GGGGGAATTGGGGG-3') were hybridized and immobilized to paramagnetic particles by streptavidin-biotin interaction. The immobilized duplex oligonucleotide was reacted with minor groove binding drugs, Netropsin, Distamycin A, Hoechst 33258 and 4',6-diamidino-2-phenylindole. The resulting DNA-drug complex bound to the particles was separated and analyzed by linear MALDI-TOFMS after washing. Drugs were selectively detected in the spectra. Relative binding strengths were also estimated using competitive complexation.


Semiempirical quantum chemical method and artificial neural networks applied for lambdamax computation of some azo dyes.
The maximum absorption wavelengths of 31 azo dyes have been calculated by two comprehensive methods using the semiempirical quantum chemical method, PM3, and the weight decay based artificial neural network (WD-ANN) or the early stopping based artificial neural network (ES-ANN). The average absolute errors of WD-ANN and that of ES-ANN are 10.07 nm and 12.40 nm, respectively. These results are much better than the results using ZINDO/S with the default value (0.585) only.


Prevalence of current school-level nutrition policies and practices of secondary schools in NSW, Australia.
Lowering the rates of adolescent overweight and obesity is a public health priority. The implementation of nutrition policies and practices in schools is recommended by various health organisations, but there is little information on the extent of their implementation. The aim of this study is to describe the prevalence of the implementation of recommended school-level nutrition policies and practices in secondary schools in New South Wales (NSW), Australia, and reported barriers and facilitators to the adoption of such policies and practices in school plans. A cross-sectional study was undertaken with school principals and canteen managers. All eligible secondary schools in NSW were approached to participate in a telephone survey (n = 440). Descriptive statistics were used to describe prevalence, and associations between school characteristics and implementation were examined using univariate statistics. A total of 137 school principals and 80 canteen managers completed the survey. The implementation of practices on drinking water during class, healthy food and beverage marketing and learning opportunities regarding healthy eating was high (>90% of participating schools). The implementation of practices regarding the restriction of unhealthy drinks in school canteens, healthy school fundraisers and staff training related to healthy eating was reported in under 25% of participating schools. There were no significant differences in implementation by school sector, socio-economic status and geographic location. The main barrier to inclusion of nutrition policies and practices in the school plan was having other priorities and commitments (28.5%), and the main facilitator was support from stakeholders, the staff, students and their parents (37.2%). There is opportunity to improve the implementation of nutrition policies and practices in NSW secondary schools. SO WHAT?: Strategies are needed for targeting barriers. These include: gaining support from school staff, students and parents, provision of resources and funding and staff training.


Six-dimensional vibrational analysis of coupled intermolecular vibrations in a binary cluster.
We report on full- (six-) dimensional calculations of the intermolecular vibrations of a binary aromatic-solvent cluster. An exact Hamiltonian for this kind of interaction is modified in a general manner in order to perform calculations of molecules without symmetry. The binary cluster phenol(H2O)1 is used as a test case since its intermolecular vibrations are anharmonic and highly coupled. The formulation of the Schrodinger equation leads to a complex-valued eigenvalue problem with a dimension larger than two million, which is solved by filter diagonalization to obtain both eigenvalues and eigenvectors. With the knowledge of the eigenvectors, an interpretation of all eigenvalues is possible by a characterization with pseudoquantum numbers that are related to the widely used nomenclature of intermolecular normal motions in aromatic(solvent) clusters.


Metabolic function of grafted liver in rats.
We studied the metabolic variations in grafted livers at different times after transplant by measuring the hepatic energy and redox states. Five groups of rats were studied: control ungrafted Wistar (RT1y) rats (group 1), ungrafted Wistar rats with ligature of the hepatic artery (group 2), isografted Wistar rats (group 3), allografted Wistar rats with livers from ACI (RT1a) donors (group 4, long-term surviving rat strain combination), and allografted Wistar rats with livers from BN (RT1n) rats (group 5, rejector rats). The metabolism of grafted livers was studied for 7 days in groups 2 and 3, for 2 months in group 4, and at the time of rejection in group 5. Adenine nucleotide levels (ATP, ADP, AMP) were significantly impaired at 24 hr and at 48 hr from grafting in isografted and in allografted livers, and the reestablishment of normal values began at the 7th day from grafting. Cytoplasmic NAD+/NADH ratios were lowered at 24 hr from grafting in isografted and in allografted livers. Mitochondrial NAD+/NADH ratios were lowered at 24 hr in isografted livers and at 24 hr and 48 hr from grafting in allografted livers. The metabolic studies performed for 2 months revealed a significant correlation between well-maintained metabolic functions and transplant survival. On the contrary, an important energy loss was evidenced in livers of group 5, at the time of rejection.


Five-Year Outcomes of Ultrathin Descemet Stripping Automated Endothelial Keratoplasty.
To report 5-year outcomes of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) with a central graft thickness intended to be <100 μm. This retrospective, consecutive, interventional case series included 354 eyes with endothelial decompensation due to various causes (Fuchs endothelial dystrophy, pseudophakic or aphakic bullous keratopathy, failed previous graft, herpetic endothelitis, or buphthalmos). Donor tissue was prepared using the microkeratome-assisted double-pass technique aiming at a graft thickness <100 μm. The Descemet membrane was stripped under air. The graft was delivered into the anterior chamber using the pull-through technique through a 3.2-mm clear corneal incision using a modified Busin glide. The best spectacle-corrected visual acuity (BSCVA), endothelial cell loss, graft survival rates, and immunologic rejection rates were evaluated. Follow-up data at 1, 2, 3, and 5 years after UT-DSAEK were collected from 214, 172, 147, and 105 eyes, respectively. After excluding eyes with comorbidities, BSCVA better than or equal to 20/20 was recorded in 36.3%, 37.4%, 46.4%, and 53.4% of eyes, respectively, whereas BSCVA better than or equal to 20/40 was documented in 95.5%, 95.3%, 96.0%, and 96.6% of eyes, respectively. The mean endothelial cell loss was 35.4%, 42.3%, 43.3%, and 52.3%; Kaplan-Meier graft survival probability was 99.1%, 96.2%, 94.2%, and 94.2%, and Kaplan-Meier cumulative probability of a rejection episode was 3.4%, 4.3%, 5%, and 6.9% at 1, 2, 3, and 5 years, respectively. UT-DSAEK grafts allow excellent 5-year outcomes, including BSCVA, endothelial cell density, and survival rates comparable with those recorded post-Descemet membrane endothelial keratoplasty, but with a higher immunologic rejection rate.


[Effect of recombinant human granulocyte colony-stimulating factor (rG-CSF) on chemotherapy-induced neutropenia in patients with lung cancer].
In an attempt to evaluate rG-CSF for preventing and reducing the period of chemotherapy-induced neutropenia, phase II studies of the agent, KRN 8601, have been conducted in patients receiving chemotherapy for lung cancer. In the cooperative study, 53 patients with lung cancer were fully evaluated. The chemotherapy regimen for the patients enrolled in the study was not specified, but an identical regimen with an identical dose and schedule was mandatory for the first cycle in which the patients did not receive the rG-CSF, and for the following cycles in which they received it after completion of chemotherapy for 14 days consecutively. Patients were allocated to receive the agents either at a dose of 100, 200 or 400 micrograms/m2 via intravenous drip infusion; or at as ub cutaneous dose of 25, 75, or 125 micrograms. In the author's study, all the 9 patients with non-small cell lung cancer received a 3-drug combination of vindesine, ifosfamide, and cisplatin(VIP) at an identical dose throughout the cycles. The rG-CSF was administered on the second and the following cycles at a dose of 100 micrograms/m2, subcutaneously, in the same manner as the above. Myelogram and neutrophil functions, i.e., superoxide anion production, chemotactic, and phagocytic activity, were serially determined in these patients. With intravenous dose of 100 micrograms/m2, the rG-CSF considerably elevated the nadir count of neutrophils and significantly reduced the duration of neutropenia. Subcutaneously administered rhG-CSF at 75 micrograms doses did as with intravenous infusion. The optimal dose of the agent in conventional chemotherapy was estimated to be 100 micrograms/m2 when infused intravenously, and 75-125 micrograms subcutaneously. Subcutaneously administered rG-CSF at a dose of 100 micrograms/m2 did not contribute to spare the nadir count of neutrophils, but contributed toward reducing the period of neutropenia induced by the 3-drug combination which was much more myelosuppressive than conventional regimens. Thus, the optimal dose of the agent should be determined according to the dose-intensity of chemotherapy. Peripheral neutrophils obtained after recovery from VIP-induced neutropenia showed a normal activity in superoxide anion production and mobility when combined with rG-CSF, although the activity showed a trend to remain subnormal in the recovered neutrophils without rG-CSF. In conclusion, rG-CSF considerably reduces the neutropenia and possibly reduces infections caused by intensive chemotherapy. Hereafter, clinical trials must determine whether rG-CSF improve the therapeutic outcomes of patients receiving chemotherapy in terms of response rate and patient survival.


Control of Partial Coalescence of Self-Assembled Metal Nano-Particles across Lyotropic Liquid Crystals Templates towards Long Range Meso-Porous Metal Frameworks Design.
The formation of purely metallic meso-porous metal thin films by partial interface coalescence of self-assembled metal nano-particles across aqueous solutions of Pluronics triblock lyotropic liquid crystals is demonstrated for the first time. Small angle X-ray scattering was used to study the influence of the thin film composition and processing conditions on the ordered structures. The structural characteristics of the meso-structures formed demonstrated to primarily rely on the lyotropic liquid crystal properties while the nature of the metal nano-particles used as well as the their diameters were found to affect the ordered structure formation. The impact of the annealing temperature on the nano-particle coalescence and efficiency at removing the templating lyotropic liquid crystals was also analysed. It is demonstrated that the lyotropic liquid crystal is rendered slightly less thermally stable, upon mixing with metal nano-particles and that low annealing temperatures are sufficient to form purely metallic frameworks with average pore size distributions smaller than 500 nm and porosity around 45% with potential application in sensing, catalysis, nanoscale heat exchange, and molecular separation.


Cooperation in the care for patients with home enteral tube feeding throughout the care trajectory: nurses' perspectives.
The aim of this study was to explore how the planning, daily care and follow-up procedures work in the care trajectory for patients treated with home enteral tube feeding, from the perspective of hospital and community care nurses. Discharge planning for patients in need of home enteral tube feeding is a complex process. Several studies have described routines for discharge and care of patients with home enteral tube feeding in the care trajectory, but few studies have investigated how this really works. A qualitative method with a phenomenographic approach was used. Interviews, with open-ended questions, with ten nurses from both hospitals and communities were performed. One main category, 'cooperation', emerged, which describes an hierarchical relationship to three description categories: 'nurses' knowledge', 'nurses' view of responsibility' and 'nurses' professional awareness and commitment'. Each of these contained two sub-categories showing a positive and a negative pole. Cooperation in the care of patients with home enteral tube feeding throughout the care trajectory was influenced by the nurses' knowledge about enteral tube feeding, the discharge-planning process, and whether their responsibility was clearly distributed. Whether nurses had a patient- or task-oriented attitude was also important. Inefficient cooperation was considered having negative effects on the quality of care regarding home enteral tube feeding. This study has stressed the need for improving cooperation and communication between nurses at hospitals and in communities, as well as for increasing nurses' level of knowledge, to make home enteral tube feeding work in a safe way. It also has illuminated the urgent need to clarify responsibility distribution at the workplace, which is a question for nurse managers. Discussions should be undertaken among nurses about guidelines for tube feeding care and discharge process, as this is the responsibility of all professional nurses.


Grain dormancy genes responsible for preventing pre-harvest sprouting in barley and wheat.
Pre-harvest sprouting (PHS) remains a long-standing problem for the production of barley (Hordeum vulgare) and wheat (Triticum aestivum) worldwide. Grain dormancy, a key trait for the prevention of PHS, controls the timing of germination. Discovery of the causal sequence polymorphisms (CSPs) that produce naturally occurring variation in dormancy will help improve PHS tolerance. The identification of CSPs for dormancy remains difficult, especially for barley and wheat, because they are the last major cereals to have their genomes sequenced. However, recent work has identified several important CSPs that play pivotal roles in fine-tuning the dormancy levels in barley and wheat cultivars. This review summarizes these recent advances, which can be directly applied in breeding programs to improve PHS tolerance. These recent findings indicate the possibility that barley and wheat cultivars grown in East Asia, where much rain falls during the harvest season, will be rich sources of alleles that confer strong dormancy, since these cultivars have been selected to cope with the regional climate. The newly discovered dormant alleles will be useful for improving PHS tolerance around the world, just as Reduced-height (Rht) alleles from Japanese wheat varieties contributed to yield increases for the Green Revolution.


Motion templates with eye velocity gain fields for transformation of retinal to head centric flow.
Heading perception from the optic flow is more difficult during eye rotations than when the eye is stationary, because the centre of the retinal motion identifies the fixation direction rather than the direction of heading. Eye movement signals helps when motion parallax is absent. This paper distinguishes two different possibilities for interactions between eye movement and visual motion signals to perceive heading with a rotating eye. A pre-motion template transformation changes local retinal velocity into head centric velocity. These velocities then feed head centric motion templates. A post-motion template model combines oculomotor signals with retinal motion templates to arrive at head centric flow templates. The latter scheme involves eye velocity gain fields similar to the eye position gain fields as found in area 7a. We propose that the parietal cortex transforms retinal to head centric direction and retinal to head centric flow on the same principle.


Blood cells from Friedreich ataxia patients harbor frataxin deficiency without a loss of mitochondrial function.
Friedreich ataxia (FRDA) is an autosomal recessive neurodegenerative disorder caused by GAA triplet expansions or point mutations in the FXN gene on chromosome 9q13. The gene product called frataxin, a mitochondrial protein that is severely reduced in FRDA patients, leads to mitochondrial iron accumulation, Fe-S cluster deficiency and oxidative damage. The tissue specificity of this mitochondrial disease is complex and poorly understood. While frataxin is ubiquitously expressed, the cellular phenotype is most severe in neurons and cardiomyocytes. Here, we conducted comprehensive proteomic, metabolic and functional studies to determine whether subclinical abnormalities exist in mitochondria of blood cells from FRDA patients. Frataxin protein levels were significantly decreased in platelets and peripheral blood mononuclear cells from FRDA patients. Furthermore, the most significant differences associated with frataxin deficiency in FRDA blood cell mitochondria were the decrease of two mitochondrial heat shock proteins. We did not observe profound changes in frataxin-targeted mitochondrial proteins or mitochondrial functions or an increase of apoptosis in peripheral blood cells, suggesting that functional defects in these mitochondria are not readily apparent under resting conditions in these cells.


[Possibility of local control of breast cancer by microwave tissue coagulator (MTC)].
The tissue injury caused by microwave tissue coagulator (MTC) was assessed clinically and pathologically in a case of advanced breast cancer with skin invasion. On condition that the output was 10 watts and radiation lasted for 90 seconds at one time, temperature on breast skin was measured after each radiation. The maximum temperature was over 60 degrees C at the needle electrode and over 42 degrees C at 10 mm from the electrode after 21 radiations. From assessment of the resected specimen after operation, the following results were obtained. The mechanism of tissue injury by MTC consists of direct heat injury and infarct by circulatory disturbance. The extent of injury from the needle electrode is approximately 10 mm in the former mechanism and 15 mm in the latter. In conclusion, MTC is useful for the therapy of local recurrence of the breast cancer because of effectiveness in control of tumor-oozing and occurrence of tumor necrosis.


Management of ureteroscopic ureteral injuries.
Ureteroscopy will continue to have a place in the management of renal stone disease and is invaluable to evaluate other types of ureteral lesions. Although ureteroscopy can be performed safely in most cases, it is invasive and there is a potential for ureteral injury. The well-trained urologic surgeon should be familiar with techniques to minimize the incidence of complications of ureteroscopy. However, faced with a ureteral complication, no matter the severity, the surgeon should have the ingenuity and expertise to restore anatomic integrity to the renal unit.


Selected Extracts of Chinese Herbal Medicines: Their Effect on NF-κB, PPARα and PPARγ and the Respective Bioactive Compounds.
Chinese herbal medicinal (CHM) extracts from fourteen plants were investigated in cell-based in vitro assays for their effect on nuclear factor κB (NF-κB), a key regulator of inflammation, as well as on peroxisome proliferator-activated receptors (PPARs) being key regulators of genes involved in lipid and glucose metabolism. 43% of the investigated CHMs showed NF-κB inhibitory and 50% PPARα and PPARγ activating effects. Apolar extracts from cortex and flos of Albizia julibrissin Durazz. and processed rhizomes of Arisaema sp. and Pinellia ternata (Thunb.) Breit. that effectively inhibited TNF-α-induced NF-κB activation and dose-dependently activated PPARα and PPARγ were further investigated. Bioassay-guided fractionation and analysis by GC-MS led to the identification of fatty acids as PPAR agonists, including linoleic and palmitic acid.


Treatment of insomnia in older adults: re-evaluating the benefits and risks of sedative hypnotic agents.
Insomnia and sleep complaints are common among older adults. Although once considered safer than benzodiazepine drugs, recent data on non-benzodiazepine drugs, such as zolpidem (Ambien(®)), have revealed similar negative effects. This issue, as well as others, has been included in the recent updated 2012 American Geriatrics Society Beers Criteria. This article describes the risks and benefits associated with sedative hypnotic agents in older adults and discusses the conundrum facing practitioners as well as patients.


Analyzing Dendritic Morphology in Columns and Layers.
In many regions of the central nervous systems, such as the fly optic lobes and the vertebrate cortex, synaptic circuits are organized in layers and columns to facilitate brain wiring during development and information processing in developed animals. Postsynaptic neurons elaborate dendrites in type-specific patterns in specific layers to synapse with appropriate presynaptic terminals. The fly medulla neuropil is composed of 10 layers and about 750 columns; each column is innervated by dendrites of over 38 types of medulla neurons, which match with the axonal terminals of some 7 types of afferents in a type-specific fashion. This report details the procedures to image and analyze dendrites of medulla neurons. The workflow includes three sections: (i) the dual-view imaging section combines two confocal image stacks collected at orthogonal orientations into a high-resolution 3D image of dendrites; (ii) the dendrite tracing and registration section traces dendritic arbors in 3D and registers dendritic traces to the reference column array; (iii) the dendritic analysis section analyzes dendritic patterns with respect to columns and layers, including layer-specific termination and planar projection direction of dendritic arbors, and derives estimates of dendritic branching and termination frequencies. The protocols utilize custom plugins built on the open-source MIPAV (Medical Imaging Processing, Analysis, and Visualization) platform and custom toolboxes in the matrix laboratory language. Together, these protocols provide a complete workflow to analyze the dendritic routing of Drosophila medulla neurons in layers and columns, to identify cell types, and to determine defects in mutants.


Effect of nifedipine versus telmisartan on prevention of atrial fibrillation recurrence in hypertensive patients.
It is controversial whether angiotensin II receptor blockers provide better protection than calcium antagonists against atrial fibrillation (AF) recurrence in hypertensive patients. This study was designed to compare the effect of nifedipine- and telmisartan-based antihypertensive treatments for preventing AF recurrence in hypertensive patients with paroxysmal AF. A total of 149 hypertensive patients with paroxysmal AF were randomized to nifedipine- or telmisartan-based antihypertensive treatment groups. The target blood pressure (BP) was <130/80 mm Hg. Clinic BP, ECG, Holter monitoring, and echocardiography were followed up for 2 years. The primary end point was the incidence of overall and persistent AF recurrence. During follow-up, there was no statistical difference in the rate of patients lowering to target BP between both groups, whereas nifedipine group had slightly better BP control but similar heart rate control at 24 months. The incidence of AF recurrence was similar in both groups (nifedipine versus telmisartan: 58.7% versus 55.4%; P=0.742), and Kaplan-Meier analysis showed no significant difference in the freedom from AF recurrence (log-rank test; P=0.48). However, the rate of developing persistent AF in telmisartan group was lower than that in nifedipine group (5.4% versus 16.0%; P=0.035). Patients in telmisartan group had lower values of left atrial diameter, left atrial volume index, and left ventricular mass index at the end of follow-up. The effects of telmisartan in preventing AF recurrences in hypertensive patients with paroxysmal AF after intensive lowering BP is similar to that of nifedipine, but telmisartan has more potent effects on preventing progression to persistent AF.


[Neuronal division or enucleation].
In this work,using the classical neurohistological Bielschowsky-Gros method, all the morphological phenomena were reproduced that were earlier interpreted by many authors as the signs of neuron division, budding and fission. It is suggested that these phenomena are associated with the effect of enucleation demonstrated in many cells of other tissue types exposed to different physical and chemical factors. The experiments were conducted in tissue culture, using the isolated neurons of the mollusk Lymnnaea stagnalis, in which the neural cells were treated with actin microfilament inhibitor cytochalasin B. Phase-contrast time-lapse video recording during 4-8 hours demonstrated the effects of nucleus displacement, ectopy and bulging up to almost complete fission of neuronal body. These effects reproduce the images obtained in static fixed preparations under "normal" and various experimental conditions. Sometimes, at the early experimental stages, the bulging of cytoplasm was also detected. Control experiments in which the neurons were treated with the culture medium containing cytochalasin B solvent dimethyl sulfoxide, showed no changes in neurons during 8-hour period. It is suggested that the images, interpreted earlier as neuron division or fission, could be explained by inhibition of actin microfilaments, which sometimes may develop spontaneously in cells experiencing individual metabolic changes compromising the cytoskeleton stability maintenance.


Library learning space--empirical research and perspective.
Navigate the Net columns offer navigation to Web sites of value to medical librarians. For this issue, the authors recognize that librarians are frequently challenged to justify the need for the physical space occupied by a library in the context of the wide availability of electronic resources, ubiquitous student laptops, and competition for space needed by other institutional priorities. While this trend started years ago, it continues to raise a number of important practical and philosophical questions for libraries and the institutions they serve. What is the library for? What is library space best used for? How does the concept of "Library as Place" support informed decisions for librarians and space planners? In this issue, Web-based resources are surveyed that address these questions for libraries generally and health sciences libraries more specifically.


Tumour induction by activated abl involves tyrosine phosphorylation of the product of the cbl oncogene.
v-cbl is the transforming gene of a murine retrovirus which induces pre-B cell lymphomas and myelogenous leukaemias. It encodes 40 kDa of a gag fusion protein which is localized in the cytoplasm and nucleus of infected cells. The c-cbl oncogene encodes a 120 kDa cytoplasmic protein and its overexpression is not associated with tumorigenesis. The c-cbl sequence has shown that v-cbl was generated by a truncation that removed 60% of the C-terminus. In this study, we carried out experiments to identify the position within cbl where the transition occurs between non-tumorigenic and tumorigenic forms. These experiments focused attention on a region of 17 amino acids which is deleted from cbl in the 70Z/3 pre-B lymphoma due to a splice acceptor site mutation. This mutation activates cbl's tumorigenic potential and induces its tyrosine phosphorylation. We also show that the expression of the v-abl and bcr-abl oncogenes results in the induction of cbl tyrosine phosphorylation, and that abl and cbl associate in vivo. These findings demonstrate that tyrosine-phosphorylated cbl promotes tumorigenesis and that cbl is a downstream target of the bcr-abl and v-abl kinases.


Approach for designing and developing high-precision integrative systems for strip flatness detection.
In this paper, we propose an approach for designing and developing high-precision integrative systems for strip flatness detection. Algorithms are developed for camera calibration, which are more accurate than the general method calculating all the camera parameters. On the basis of this method, a detection system is developed including an integrative device for easy calculation and repeated usage. On-site experiment results confirm that the proposed method works well under hostile environmental conditions in mills.


The Frontal Sinus Cavity Exhibits Sexual Dimorphism in 3D Cone-beam CT Images and can be Used for Sex Determination.
Few studies have assessed the use of the frontal sinus cavities for sex differentiation. In this study, a new methodology was used to assess the reliability of CBCT images of the frontal sinus cavity for determining sex based on the sexual dimorphism found in this anatomical structure. The survey sample consisted of 130 scans that were reconstructed three-dimensionally. 3D images of the cavity volume in the frontal, lateral, and basal views were exported in TIFF. The following variables were measured in a second program: area, perimeter, bounding rectangle, ellipse fit, circularity, aspect ratio, roundness, solidity, and Feret's diameter. The methodology demonstrated the existence of sexual dimorphism with an accuracy of 80.0% in the logistic regression model. The basal view had the greatest explanatory power in the final model. This methodology may be used as an alternative way of determining a reliable biological profile during the analysis of skeletal remains.


HMG-CoA reductase inhibitors, other lipid-lowering medication, antiplatelet therapy, and the risk of venous thrombosis.
Statins [3-hydroxymethyl-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors] and antiplatelet therapy reduce the risk of atherosclerotic disease. Besides a reduction of lipid levels, statins might also have antithrombotic and anti-inflammatory properties, and anti-platelet therapy reduces clot formation. We have studied the risk of venous thrombosis with use of statins, other lipid-lowering medication, and antiplatelet therapy. Patients with a first episode of deep vein thrombosis in the leg or pulmonary embolism between March 1999 and September 2004 were included in a large population-based case-control study (MEGA study). Control subjects were partners of patients (53%) or recruited via a random-digit-dialing method (47%). Participants reported different all-medication use in a questionnaire. Of 4538 patients, 154 used statins (3.3%), as did 354 of 5914 control subjects (5.7%). The use of statins [odds ratio (OR) 0.45; 95% confidence interval (CI) 0.36-0.56] but not other lipid-lowering medications (OR 1.22; 95% CI 0.62-2.43), was associated with a reduced venous thrombosis risk as compared with individuals who did not use any lipid-lowering medication, after adjustment for age, sex, body mass index, atherosclerotic disease, antiplatelet therapy and use of vitamin K antagonists. Different types and various durations of statin therapy were all associated with a decreased venous thrombosis risk. Antiplatelet therapy also reduced venous thrombosis risk (OR 0.56; 95% CI 0.42-0.74). However, sensitivity analyses suggested that this effect is most likely explained by a so-called 'healthy user effect'. Simultaneous use of medication most strongly reduced venous thrombosis risk. These results suggest that the use of various types of statins is associated with a reduced risk of venous thrombosis, whereas antiplatelet therapy and other lipid-lowering medications are not.


Natural Polyphenols in the Treatment of Alzheimer's Disease.
Neurodegenerative disease is an incurable disease which involves the degeneration or death of the nerve cells. Alzheimer's Disease (AD) is a neurodegenerative disease discovered in 1906 by Alois Alzheimer, a German clinical psychiatrist and neuroanatomist. The main pathological hallmarks of this disease are the formation of extracellular amyloid β (Aβ) plaques and intracellular neurofibrillary tangle (NFT). The accumulation of the amyloid protein aggregates in the brain of AD patients leads to oxidative stress and inflammation. Other postulated reasons for the development of this disease are cholinergic depletion and excessive glutamatergic neurotransmission. The current drugs approved and marketed for the treatment of AD are cholinesterase inhibitors (ChEIs) and N-methyl-Daspartate (NMDA) receptor antagonists. The function of ChEIs is to avoid cholinergic depletion; whereas the function of NMDA receptor antagonist is to block excessive glutamatergic neurotransmission. Unfortunately, the current drugs prescribed for AD show only modest improvement in terms of symptomatic relief and delay the progression of the disease. This review will discuss about several polyphenolic compounds as potential natural treatment options for AD. Three compounds are highlighted in this review - Curcumin (Cur), Resveratrol (Rsv) and Epigallocatechin-3- gallate (EGCG). These compounds have huge potential for AD treatment, especially due to their low frequency of adverse events. However, the current conventional pharmaceutical drugs remain as the mainstay of treatment for AD.