Total polyphenols and bioactivity of seeds and sprouts in several legumes.
Seeds and sprouts from legume crop plants have received attention as functional foods, because of their nutritive values including amino acid, fiber, trace elements, vitamins, flavonoids, and phenolic acids. Consumption of seeds and sprouts has become increasingly popular among people interested in improving and maintaining their health status by changing dietary habits. The seeds and sprouts are excellent examples of functional food defined as lowering the risk of various diseases and/or exerting health promoting effects in addition to its nutritive value. Phenolic compounds are considered as secondary metabolites that are synthesized by plants during normal development and in response to stress conditions, and the compounds occur ubiquitously in plants as the diversified group of phytochemicals derived from phenylalanine and tyrosine. Plant phenolics include simple phenols, phenolic acids, coumarins, flavonoids, stilbenes, hydrolyzable and condensed tannins, lignans, and lignins. In plant, phenolics may act as phytoalexins, antifeedants, attractants for pollinators, contributors to the plant pigmentation, antioxidants, and protective agents against UV light, among others. In food, phenolics may contribute to the bitterness, astringency, color, flavor, odor, and oxidative stability of products. In addition, health-protecting capacity of some and antinutritional properties of other plant phenolics are of great importance to producers, processors and consumers. Several researches were conducted to compare the content of phenolics and flavonoids, antioxidant activity and antioxidant enzyme activity from seeds and sprouts of legume plants. Total phenolics (TP) content and total flavonoids (TF) level were highest in soybean sprout extracts, followed by cowpea and mungbean sprout extracts (p < 0.05). DPPH (1, 1-diphenyl-2-picryl hydrazyl radical) free radical scavenging activity was higher in cowpea or mungbean sprouts than in soybean sprouts. Among antioxidant enzymes, ascorbate peroxidase (APX) and peroxidase (POX) activities were highest in cowpea sprouts and catalase (CAT) and superoxide dismutase (SOD) activities in soybean sprouts. During sprouting in mungbean, TP and TF levels significantly increased and improved free radical scavenging, tyrosinase inhibition, anticancer, and ADH (alcohol dehydrogenase) activities, showing higher contents and activities in sprouts than in seeds. Sprouting of seeds is known to increase the nutritive value such as phenolics and flavonoids and the health qualities of foods in a natural way. Phasic bioactive responses from dry seeds to 7-day-old seedlings of cowpea showed differential growth, contents of TP and TF, antioxidant activity and antioxidant enzyme activity. Plant length and weight of cowpea sprouts were significantly increased until 7 days after seeding. TP content, however, was highest in dry seed (DS) extracts of cowpea (63.9 mg kg(1)), followed by imbibed seed (IS) (56.8 mg kg(1)) and 1-day-old sprout (1DOS) (46.4 mg kg(1)) extracts, and significantly reduced with increase of sprout age (p < 0.05). DPPH free radical scavenging activity was higher in DS or IS than in cowpea sprouts. APX, POX, and POX activities were highest in 7DOS and lowest in DS. SOD activity was lowest in DS and much higher in additional sprouting days.


Globin genes transcriptional switching, chromatin structure and linked lessons to epigenetics in cancer: a comparative overview.
At the present time research situates differential regulation of gene expression in an increasingly complex scenario based on interplay between genetic and epigenetic information networks, which need to be highly coordinated. Here we describe in a comparative way relevant concepts and models derived from studies on the chicken alpha- and beta-globin group of genes. We discuss models for globin switching and mechanisms for coordinated transcriptional activation. A comparative overview of globin genes chromatin structure, based on their genomic domain organization and epigenetic components is presented. We argue that the results of those studies and their integrative interpretation may contribute to our understanding of epigenetic abnormalities, from beta-thalassemias to human cancer. Finally we discuss the interdependency of genetic-epigenetic components and the need of their mutual consideration in order to visualize the regulation of gene expression in a more natural context and consequently better understand cell differentiation, development and cancer.


Revitalizing General Practice: The Critical Role of Medical Schools in Addressing the Primary Care Physician Shortage.
The shortage of primary care physicians is a growing crisis that threatens the stability and effectiveness of healthcare systems. This paper explores a multi-pronged approach to addressing this issue by focusing on the modernization of medical curricula, the establishment of new medical schools, fostering collaboration between institutions, and implementing policy innovations. The cases of South Tyrol, Italy, and Tyrol, Austria, are examined to highlight the challenges faced in establishing new medical schools. This paper proposes that a comprehensive strategy, including the incorporation of general practice content and experience in medical education, is crucial for preparing future physicians for careers in primary care. Furthermore, intensifying efforts to establish new medical schools, particularly in regions such as South Tyrol, which lack native-language medical university education, can provide additional benefits in addressing regional needs and augmenting the number of graduates. Collaboration between existing and new medical schools, regional partnerships, and policy innovations are essential to support the establishment of institutions with a particular focus on general practice and the modernization of curricula at existing universities. By embracing this approach, stakeholders can collectively shape the medical education landscape and address the growing crisis of physician shortages in primary care.


Accelerometer-measured stepping cadence patterns in Korean adults: an analysis of data from the 2014-2015 Korea National Health and Nutrition Examination Survey.
The aim of this study was to identify the stepping cadence patterns in Korean adults by using objectively measured accelerometer data to analyze the time spent in each cadence category by sex and age. During the 2014-2015 Korean National Health and Nutrition Examination Survey, 1,703 males and females aged 19-64 years provided at least 1 valid day of data (wearing an accelerometer ≥ 10 hr/d). The mean cumulative time and percentage per day in 8 cadence categories (0, 1-19, 20-29, 30-59, 60-79, 80-99, 100-119, and ≥ 120 steps/min) by sex and age group were calculated. Cumulative time and percentage per day decreased across the incremental cadence categories. Participants spent 360.08± 2.56 min/d in the non-movement cadence category and 361.50± 2.28 min/d in the incidental movement cadence category. However, they spent only about 18.1 min/d (2.1%) at ≥ 100 steps/min. Males spent significantly more time in the cadence categories of sporadic movement, purposeful steps, slow walking, and medium walking, but the other categories, except for brisk walking, had higher values in females (p< 0.001). The older age group spent less time in non-movement cadence categories, and the youngest and oldest groups spent more time at a higher cadence (≥ 100 steps/min) than the other age groups. Similar patterns were found in a subgroup analysis by sex. Korean adults spent most of their time at a low cadence and only a few minutes at a high cadence (≥100 steps/min); this trend was consistent across sex and age groups.


[Prognosis and therapy of carotid stenoses--a review of results of current studies].
Carotid stenoses as either a source of artery-to-artery emboli or a hemodynamic process of reduced brain perfusion can lead to transient ischemic attacks and brain infarcts. Although the prognosis of both symptomatic and asymptomatic patients correlates with the degree of the lumen narrowing and the progression of the atherosclerotic vessel process, the risk of a new cerebral ischemia is 5 to 15 times greater in symptomatic patients than in those whose vessel process has remained silent. Correspondingly, multicenter studies have shown that surgical treatment of high degree carotid stenosis under certain conditions as secondary prevention is warranted while until now no indication for carotid endarterectomy in the asymptomatic stage can be verified. An exact analysis of the studies' protocols and the results of multicenter examinations show that detailed patient selection is a prerequisite for both conservative and surgical treatment of a patient at risk.


[Studies of Yersinia pestis in wild animals captured in Ankara, Konya and Nevsehir].
No Yersinia pestis could be isolated, by culturing and by inoculations to 1212 guinea-pigs and 150 mice; from 623 citellus, 41 Mus musculus, 55 Microtus, 442 Meriones, 70 Rattus rattus, 56 turtle, 89 hare, 1 hamster, 1 hedgehog, 1 sea snake, altogether 790 dead, 589 alive, i.e. 1379. wild animals captured in Ankara, Konya (Karapinar), Urfa (Akçakale) and in Nevşehir. In 141 sera taken from citellus captured alive, and in 174 sera taken from guinea-pigs inoculated with spleen, liver and kidney suspensions of wild animals, 1/20 - 1/80 agglutination titers (one of the sera from a guinea-pig inoculated with hare organ suspension) were obtained. These findings, probably were due to Yersinia pseudotuberculosis, because this organism was isolated from citellus captured in Ankara and Konya.


Instantaneous Pulsed-Light Cross-Linking of a Polymer Gate Dielectric for Flexible Organic Thin-Film Transistors.
We report the instantaneous pulsed-light cross-linking of polymer gate dielectrics on a flexible substrate by using intensely pulsed white light (IPWL) irradiation. Irradiation with IPWL for only 1.8 s of a poly(4-vinylphenol) (PVP) thin film with the cross-linking agent poly(melamine-co-formaldehyde) (PMF) deposited on a plastic substrate was found to yield fully cross-linked PVP films. It was confirmed that the IPWL-cross-linked PVP films have smooth pinhole-free surfaces and exhibit a low leakage current density, organic solvent resistance, and good compatibility with organic semiconductor, and that they can be used as replacements for typical PVP dielectrics that are cross-linked with time and energy intensive thermal heating processes. The synchronization of the IPWL irradiation with substrate transfer was found to enable the preparation of cross-linked PVP films on large area substrates with a highly uniform capacitance. Flexible OTFT based on IPWL-cross-linked PVP dielectrics were found to exhibit good electrical performance that is comparable to that of devices with thermally cross-linked PVP dielectric, as well as excellent deformation stability even at a bending radius of 3 mm.


[Expression of HSF1 and XAF1 in gastro-intestinal cancer].
X-linked inhibitor of apoptosis protein (XIAP) To gastrointestinal (GI) investigate the expression of XAF1 and heat-shock transcription factors 1 èHSF1éand their relationship in human gastrointestinal cancers. Immunoblotting was used to analyze the expression of HSF1 and XAF1 in either gastric or colon cancer tissue and GI cancer cell line. Transient expression of the HSF1-containing vector in GI cell lines and RNA interference were used to up/down-regulae the expression of the HSF1, and the subsequent expression of XAF1 was measured. The expression of HSF1 was higher in GI cancers than in normal tissues. The expression of XAF1 and HSF1 was negatively correlated in GI cancer cell lines. Stress stimuli up-regulated the expression of HSF1 while the alteration of XAF1 expression was negatively correlated with HSF1 expression. The high expression of HSF1 in GI cancers is associated with suppressed expression of XAF1, which can be one of the mechanisms for low-expression of XAF1 and insufficient apoptosis in GI cancers.


Cyclic depsipeptides as potential cancer therapeutics.
Cyclic depsipeptides are polypeptides in which one or more amino acid is replaced by a hydroxy acid, resulting in the formation of at least one ester bond in the core ring structure. Many natural cyclic depsipeptides possessing intriguing structural and biological properties, including antitumor, antifungal, antiviral, antibacterial, anthelmintic, and anti-inflammatory activities, have been identified from fungi, plants, and marine organisms. In particular, the potent effects of cyclic depsipeptides on tumor cells have led to a number of clinical trials evaluating their potential as chemotherapeutic agents. Although many of the trials have not achieved the desired results, romidepsin (FK228), a bicyclic depsipeptide that inhibits histone deacetylase, has been shown to have clinical efficacy in patients with refractory cutaneous T-cell lymphoma and has received Food and Drug Administration approval for use in treatment. In this review, we discuss antitumor cyclic depsipeptides that have undergone clinical trials and focus on their structural features, mechanisms, potential applications in chemotherapy, and pharmacokinetic and toxicity data. The results of this study indicate that cyclic depsipeptides could be a rich source of new cancer therapeutics.


Early and final preferences for pediatrics as a specialty: a study of U.S. medical school graduates in 1983.
The early and final specialty preferences for pediatrics made by 10,321 U.S. medical school graduates in 1983 were obtained from the students' responses to the Premedical Student Questionnaire, which accompanied their Medical College Admissions Test, and to the Medical Student Graduation Questionnaire, filled out not long before they graduated from medical school. A total of 11.5% of the women and 5.9% of the men expressed a preference for pediatrics on the earlier questionnaire, when they were premedical students; 13.5% of the women and 4.8% of the men actually chose pediatrics when they were senior medical students, as reflected on the later questionnaire. On both questionnaires, 31.3% of the women's preferences and 14.6% of the men's preferences for pediatrics did not change. More than 70% of all the graduating students choosing pediatrics had expressed a premedical preference for a primary care specialty. Fifty-one percent of the women and 42% of the men who abandoned their early preferences for pediatrics chose another specialty within primary care. More students of both genders shifted from a premedical preference for family practice into pediatrics than kept their early preference for pediatrics. If the direction of change noted in this study and others continues, pediatrics will increasingly become a specialty chosen by women.


Dendrodendritic gap junctions: a developmental approach.
Dendrodendritic gap junctions have been identified in the periaqueductal gray substance of adult rabbits and in the visual cortex of sheep fetuses. The introduction of Alcian blue as a marker substance facilitated the positive identification of gap junctions. Dendrodendritic contacts in the human fetal neocortex have been examined in freeze-cleaved specimens. The contacts are identified as gap junctions by their freeze-fracture appearance. Features of the developing dendrodendritic gap junctions are described. The possible significance of these contacts is discussed, and it is suggested that they provide electrotonic coupling of neurons belonging to the same columnar organization. In addition it is suggested that the dendrodendritic gap junctions of fetal neocortex participate in cell differentiation and morphogenesis of the cerebral wall.


Proportion of life lived with dystonia inversely correlates with response to pallidal deep brain stimulation in both primary and secondary childhood dystonia.
The aim of this study was to examine the impact of dystonia aetiology and duration, contracture, and age at deep brain stimulation (DBS) surgery on outcome in a cohort of children with medically refractory, disabling primary, secondary-static, or secondary-progressive dystonias, including neurodegeneration with brain iron accumulation (NBIA). Dystonia severity was assessed using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) motor score at baseline and 6 and 12 months postoperatively in a cohort of 70 consecutive children undergoing DBS between June 2005 and July 2011. Two children (3%) received unilateral DBS for hemidystonia and were excluded and five (7%) developed infections requiring part-DBS removal within 6 months, leaving 63 children (90%) undergoing bilateral DBS for follow-up (34 males, 29 females; mean age at surgery for the whole group 10y 4mo, SD 4y 2mo, range 1-14y). Seventeen children were classified with primary dystonia: mean age 12 years 11 months, SD 4 years 6 months range 4 years 6 months to 17 years 3 months; 28 as having secondary-static dystonia: mean age 10 years 2 months, SD 4 years 9 months (range 3y 3mo-20y); five as having secondary-progressive dystonia: mean age 8 years 11 months, SD 3 years 9 months (range 5y 5mo-13y 1mo); and 13 as having NBIA dystonia: mean age 10 years 2 months, SD 3 years 11 months (range 1-14y). Children with primary dystonias demonstrated greater improvements in BFMDRS motor score than those in the other aetiological categories (Kruskal-Wallis test, p<0.001), which correlated negatively with dystonia duration and more strongly still against the ratio of dystonia duration normalized to age at surgery (DD/AS ratio) at 1 year (Spearman's rank correlation coefficient 0.4752 and -0.599 respectively). A similar significant negative correlation was found in the secondary-static dystonia group between outcome at 1 year and DD/AS ratio (-0.461). Poorer outcome in secondary dystonia coincided with the absence of a period of normal motor development in comparison with the primary dystonia group. A significant improvement in BFMDRS motor score was seen in the NBIA group at 6, but not 12 months (Wilcoxon signed rank test p=0.028, p=0.85 respectively). No reduction in efficacy was seen in children with a musculoskeletal deformity at the time of surgery. Response to pallidal DBS in the treatment of dystonia declines with the proportion of life lived with dystonia in primary and secondary dystonia. Other intrinsic factors reduce the median magnitude of reduction in secondary dystonia after DBS. DBS should be offered early, preferably within 5 years of onset, to maximize benefits and reduce the childhood experience of dystonia, including musculoskeletal deformity. Other multidimensional assessments are required to understand how DBS improves the lives of children with dystonia.


The effect of vibration training on delayed muscle soreness: A meta-analysis.
Delayed onset muscle soreness (DOMS) is caused by unaccustomed exercise, especially eccentric exercise, and is highly likely to cause skeletal muscle injury. It mainly manifests as ultrastructural changes in skeletal muscle, as well as decreased muscle strength, muscle soreness, swelling, and elevated levels of creatine kinase (CK). Vibration training (VT) has been attracting increasing attention as a new type of rehabilitation therapy. It can effectively minimize the occurrence and relieve the symptoms of DOMS, reduce muscle stiffness and soreness, and reduce serum concentrations of CK and lactate dehydrogenase (LDH). This article systematically assessed the impact of VT on the mitigation of DOMS through a meta-analysis to provide updated evidence-based information. Electronic databases such as China Knowledge Network, VIP Electronics, PubMed, EBSCO, and Web of Science were searched to identify randomized controlled trials of VT on DOMS. Searches were performed from database creation to November 2021. The quality of the literature was assessed using the Cochrane Manual for the Systematic Review of Interventions, and meta-analyses were performed using RevMan 5.4 software. VT intervention in DOMS was shown to effectively reduce subjective pain, improve pain tolerance, and accelerate the reduction of serum CK and LDH concentrations. Subgroup analysis of different test time periods showed that subjective pain decreased more significantly after 48 hours than after the other 2 time periods, and pain tolerance increased more significantly after 72 hours than the other 2 time periods; serum CK was significantly increased after 24 and 48 hours of intervention, but showed no significant change compared with the control group after 72 hours. Serum LDH decreased significantly after 24 hours of intervention, but there was no significant difference compared with the control group after 48 hours or 72 hours. VT effectively reduced the subjective pain sensation after DOMS, increased the pain threshold, reduced serum LDH and CK concentrations, and accelerated muscle damage repair compared with control interventions. However, the effect of improving the range of motion of the joints is not clear and should be studied further. number: INPLASY2021120115.


Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI.
The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease. One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard. The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone. Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis.


First Report of Bacterial Blight on arugula (Eruca vesicaria subsp. sativa) caused by Pseudomonas cannabina pv. alisalensis in New York.
Bacterial blight of arugula (Eruca vesicaria subsp. sativa cv. Standard) was observed in a commercial crop being grown in a high tunnel under overhead irrigation in Argyle, NY in January 2021. Approximately 80-100% of the plants were affected. Symptoms started as small, angular, water-soaked lesions visible on both sides of the leaves, then expanded, coalesced and later dried and turned tan. Fluorescent pseudomonads from five different plants were isolated on King's medium B agar amended with boric acid, chloramphenicol, and cycloheximide (Schaad et al. 2001) from surface disinfested symptomatic leaf tissues macerated in phosphate buffer (10mM, pH 7.0). Five representative isolates from each of the five plants produced levan and were negative for arginine dihydrolase and oxidase. They did not rot potatoes but were able to induce a hypersensitive reaction on tobacco (Nicotiana tabacum L. cv Glurk) within 24 h, thus demonstrating that the isolates belonged to LOPAT group 1 (Lelliott et al. 1966). DNA fragment banding patterns of these isolates generated by repetitive extragenic palindromic sequence PCR (repPCR) with BOXA1R primers were compared to the pathotype strains of Pseudomonas cannabina pv. alisalensis and Pseudomonas syringae pv. maculicola, known fluorescent pathogens of the Brassicaceae. The repPCR banding pattern of all isolates matched the pattern of Pseudomonas cannabina pv. alisalensis. Bacterial inoculum for pathogenicity experiments was prepared from 48 h KBBC agar cultures suspended in phosphate buffer (10mM, pH 7.0) and adjusted to 0.6 optical density at 600nm yielding approximately 108 CFU/ml. Five-week-old arugula plants were sprayed until run-off with one of the three isolates from arugula, a negative control (sterile buffer), or a positive control (P. cannabina pv. alisalensis) that is pathogenic to crucifers and also reported to cause disease on arugula in California (Bull et al. 2004). Experiments consisted of three replications of each treatment and two independent experiments were conducted. Small water-soaked spots resembling the original symptoms developed on all plants inoculated with the three representative isolates and P. cannabina pv. alisalensis. Moreover, reisolates from the symptomatic tissues were fluorescent on KBBC and had identical repPCR banding pattern as inoculated strains, demonstrating Koch's postulates. To our knowledge, this is the first report of bacterial blight on arugula caused by Pseudomonas cannabina pv. alisalensis in the Northeastern US. It was previously reported in California, Nevada, and Minnesota (Bull and du Toit 2009; Bull et al. 2004). This report may have significance for all brassica leafy green growers in the Northeast as P. cannabina pv. alisalensis has a broad host range including members of the Brassicaceae and oats which are commonly used as cover crops in mixed vegetable production.


A factor analytic investigation of the Mercy Evaluation of Multiple Sclerosis.
Neurocognitive deficits commonly are an accompanying feature of Multiple Sclerosis (MS). A brief, yet comprehensive neuropsychological battery is desirable for assessing the extent of these deficits. Therefore, the present study examined the validity of the Mercy Evaluation of Multiple Sclerosis (MEMS) for use with the MS population. Archival data from individuals diagnosed with MS (N = 378) by independent neurologists was examined. Cognitive domains assessed included processing speed and attention, learning, and memory, visuospatial, language, and executive functioning. A mean battery index was calculated to provide a general indicator of cognitive impairment within the current sample. Overall performance across participants was found to be in the lower limits of the average range. Results of factor analytic statistical procedures yielded a four-factor solution, accounting for 67% of total variance within the MEMS. Four neurocognitive measures exhibited the highest sensitivity in detecting cognitive impairment, constituting a psychometrically established brief cognitive screening battery, which accounted for 83% of total variance within the mean battery index score. Overall, the results of the current study suggest appropriate construct validity of the MEMS for use with individuals with MS, as well as provide support for previously established cognitive batteries.


Aesthetic refinements in body contouring in the massive weight loss patient: trunk.
Aesthetic refinements in body contouring surgery after massive weight loss are evolving in an effort to improve patient appearance. This is a personal clinical review for the trunk. There are 10 essential elements to performing body contouring surgery after massive weight loss. Based on this generally accepted baseline, the author presents 16 outstanding aesthetic refinements. These reliable and safe adaptations to improve outcomes were assembled from a personal case review of the past 12 years of over 500 cases. The refinements are the result of lectures attended, literature read, and innovations tried. Gender enhancement is emphasized. Plastic surgeons improve female shape through artful management of adipose deposits. Surgeons enhance male muscularity through an abdominoplasty and a series of large opposing ellipses for skin tightening across the entire torso. These 16 refinements have been applied to the trunk. Four representative cases with preoperative markings and late postoperative results demonstrate the value of these aesthetic refinements. The accompanying video that demonstrates drawing the boomerang pattern correction of gynecomastia with J torsoplasty reveals many of these refinements. These aesthetic refinements are previously published anecdotal evidence that are presented together as part of the author's routine clinical experience. They await confirmatory experience or, better yet, rigorous scientific study. Until then, these are practical adaptations routinely used by the author on the trunk that merit the reader's consideration.


Analysis of the distribution and expression of claudin-1 tight junction protein in the oral cavity.
Claudins are the main sealing proteins of the intercellular tight junctions and play an important role in cancer cell progression and dissemination. The authors have previously shown that overexpression of claudin-1 is associated with angiolymphatic and perineural invasion, consistent with aggressive tumor behavior and with advanced stage disease in oral squamous cell carcinomas (OSCCs). Our goal in this study was to examine claudin-1 expression in a tissue microarray of OSCCs taken from multiple sites within the oral cavity. This study examined and compared the expression of claudin-1 by immunohistochemistry in 60 tissue samples (49 OSCCs and 10 cases of non-neoplastic tissue, single core per case) were analyzed for claudin-1 expression by immunohistochemistry. The tumors included SCCs from the tongue (n=28), the cheek (n=9), gingival (n=4), lip (n=3), and oral cavity (n=5). Nonmalignant normal oral mucosa from the tongue (unmatched cases, n=2). Cancer adjacent tissue samples were taken from the tongue (n=6), gingival (n=2), and palate (n=1). This study demonstrates the expression of claudin-1 protein across a sample of OSCCs originating from multiple locations in the oral cavity. The highest expression of claudin-1 was observed in well-differentiated OSCCs, whereas poorly differentiated OSCCs exhibited mostly negative staining for claudin-1. In addition, we hereby report differential pattern of expression among tumors of different sites within the oral cavity, and between benign and cancerous samples. Our understanding of the exact function and role of claudin-1 in tumorigenesis is expanding exponentially.


Tipifarnib (Janssen Pharmaceutica).
Janssen is developing tipifarnib (formerly known as R-1 15777), an inhibitor of RAS farnesylation, for the potential treatment of neoplasia [287030], [289610]. Janssen commenced clinical trials in the US, in conjunction with the National Cancer Institute, in April 1997 [287030], [289610], and by May 1999, phase II trials in patients with advanced non-small cell lung cancer were being planned [325960]. By February 2001, phase III trials for the potential treatment of pancreatic cancer and leukemia had been initiated [399065], and by June 2001, it was in phase II trials for RAS-dependent solid tumors [412618]. In November 2001, Credit Lyonnais Securities predicted NDAfilings in 2002 and 2003 for pancreatic cancer and other cancers, respectively, and projected US introductions for these indications in 2004 and 2005, respectively [436939].


Characterization of a Prenyltransferase for Iso-A82775C Biosynthesis and Generation of New Congeners of Chloropestolides.
Chloropupukeananin and chloropestolides are novel metabolites of the plant endophyte Pestalotiopsis fici, showing antimicrobial, antitumor, and anti-HIV activities. Their highly complex and unique skeletons were generated from the coisolated pestheic acid (1) and iso-A82775C (10) based on our previous studies. Here, we identified the biosynthetic gene cluster iac of 10 and characterized an iacE encoded prenyltransferase. Deletion of iacE abolished iso-A82775C production, accumulated the prenyl group-lacking siccayne (2), and generated four new chloropestolides (3-6). Compounds 5 and 6 showed antibacterial effects against Staphylococcus aureus and Bacillus subtilis, and 5 was also cytotoxic to human tumor cell lines HeLa, MCF-7, and SW480. These results provided the first genetic and biochemical insights into the biosynthesis of natural prenylepoxycyclohexanes and demonstrated the feasibility for generation of diversified congeners by manipulating the biosynthetic genes of 10.


Challenges for Developing Palliative Care Services in Resource- Limited Settings of Kazakhstan.
Background: Approximately 40 million people in need of palliative care worldwide, while 80% of them live in low- and middle-income countries. Kazakhstan, a low-to middle-income country with a reforming healthcare system, is committed to improving quality and accessibility of care for its 100,000 terminal patients in need of palliative care. Policy Options and Recommendations: To join the group of countries where palliative care is available, accessible, and affordable, Kazakhstan must integrate palliative services into the mainstream healthcare system at all levels, from primary healthcare to hospices, and from major cities to remote villages. Based on the evidence thoroughly collected directly from the Ministry of Health, authors propose a feasible set of recommendations regarding palliative policy, pain relief, infrastructure, workforce, and education, which could be implemented in LMICs beyond Kazakhstan. Conclusion: This study presents an analysis of challenges, recent developments, and needs of palliative care in Kazakhstan, including funding, policy, workforce, education, and infrastructure, providing an evidence base and recommendations for future development of palliative care in Kazakhstan and in other LMICs.


Percutaneous radiofrequency ablation versus surgical radiofrequency ablation for malignant liver tumours: the long-term results.
Radiofrequency ablation (RFA) has been used to treat hepatocellular carcinoma (HCC) and liver metastases for more than 10 years with promising early outcomes. Preliminary results comparing percutaneous and surgical approaches have shown no difference in short-term outcomes. In this study, the longer-term outcomes were presented. Patients with liver malignancies treated by RFA were prospectively studied from 2003 to 2011. Post-ablation assessment by computed tomography (CT) scan and serum biochemistry was performed at regular intervals. Recurrence rates and long-term survival were analysed. A total of 233 patients with liver malignancies (75.5% HCC and 24.5% liver metastases) were analysed. Three RFA approaches were used (percutaneous 58.4%, laparoscopic 9.4% and open 32.2%). The median follow-up time was 29 months. Complete ablation was achieved in 83.7%, with no difference between the two approaches. More wound and chest complications were observed in the surgical group. Intra-hepatic recurrences were observed in 69.5%; extra-hepatic recurrences were detected in 22.3%, with no difference between the two groups. There was no statistical difference between the two approaches in overall 1-, 3- and 5-year survival. An extended period of follow-up in patients with liver malignancies showed that RFA is an effective treatment. No difference was demonstrated between the percutaneous and surgical approach, in terms of recurrence and survival.


Long-term and homogeneous regulation of the Escherichia coli araBAD promoter by use of a lactose transporter of relaxed specificity.
Expression systems based on the Escherichia coli arabinose operon P(BAD) promoter exhibit the all-or-nothing (autocatalytic) induction of expression that was first documented in the lac operon. Under conditions of subsaturating levels of inducer, some of the cells of the population are fully induced, whereas other cells remain uninduced. Recently, a new AraE transporter system was reported to have circumvented the problem of autocatalytic expression in the pBAD expression vectors and to provide graded and homogeneous cell-to-cell expression in the presence of variable inducer concentrations [Khlebnikov, A., Risa, O., Skaug, T., Carrier, T. A. & Keasling, J. D. (2000) J. Bacteriol. 182, 7029-7034]. However, we report that nonuniform gene expression in the AraE system was readily detectable by the use of mutant green fluorescent proteins that are rapidly degraded in E. coli. We report an approach to avoid all-or-nothing induction of the pBAD promoter; the use of a mutant LacY transporter in a strain deficient in both arabinose transport (araE araFGH) and degradation (araBAD). This mutant LacY protein performs facilitated diffusion of arabinose resulting in homogeneous expression of an unstable GFP that is maintained over extended incubation times at subsaturating levels of inducer. This approach is readily adapted to other sugar-regulated expression systems.


Genetic dissection of stem WSC accumulation and remobilization in wheat (Triticum aestivum L.) under terminal drought stress.
The accumulation and remobilization of stem water soluble carbohydrates (WSC) are determinant physiological traits highly influencing yield potential in wheat against drought stress. However, knowledge gains of the genetic control are still limited. A hexaploid wheat population of 120 recombinant inbred lines were developed to identify quantitative trait loci (QTLs) and to dissect the genetic basis underlying eight traits related to stem WSC under drought stress (DS) and well-watered (WW) conditions across three environments. Analysis of variance (ANOVA) revealed larger environmental and genotypic effects on stem WSC-related traits, indicating moderate heritabilities of 0.51-0.72. A total of 95 additive and 88 pairs of epistatic QTLs were identified with significant additive and epistatic effects, as well as QTL× water environmental interaction (QEI) effects. Most of additive QTLs and additive QEIs associated with drought-stressed environments functioned genetic effects promoting pre-anthesis WSC levels and stem WSC remobilization to developing grains. Compared to other genetic components, both genetic effects were performed exclusive contributions to phenotypic variations in stem WSC-related traits. Nineteen QTL clusters were identified on chromosomes 1B, 2A, 2B, 2D, 3B, 4B, 5A, 6A, 6B and 7A, suggestive of the genetic linkage or pleiotropy. Thirteen additive QTLs were detectable repeatedly across two of the three water environments, indicating features of stable expressions. Some loci were consistent with those reported early and were further discussed. Stem WSC-related traits were inherited predominantly by additive and QEI effects with a moderate heritability. QTL cluster regions were suggestive of tight linkage or pleiotropy in the inheritance of these traits. Some stable and common loci, as well as closely linked molecular markers, had great potential in marker-assisted selection to improve stem WSC-related traits in wheat, especially under drought-stressed environments.


Specific delivery of therapeutic RNAs to cancer cells via the dimerization mechanism of phi29 motor pRNA.
The application of small RNA in therapy has been hindered by the lack of an efficient and safe delivery system to target specific cells. Packaging RNA (pRNA), part of the DNA-packaging motor of bacteriophage phi29(Phi29), was manipulated by RNA nanotechnology to make chimeric RNAs that form dimers via interlocking right- and left-hand loops. Fusing pRNA with receptor-binding RNA aptamer, folate, small interfering RNA (siRNA), ribozyme, or another chemical group did not disturb dimer formation or interfere with the function of the inserted moieties. Incubation of cancer cells with the pRNA dimer, one subunit of which harbored the receptor-binding moiety and the other harboring the gene-silencing molecule, resulted in their binding and entry into the cells, and subsequent silencing of anti/proapoptotic genes. The chimeric pRNA complex was found to be processed into functional double-stranded siRNA by Dicer (RNA-specific endonuclease). Animal trials confirmed the suppression of tumorigenicity of cancer cells by ex vivo delivery. It has been reported [Shu, D., Moll, W.-D., Deng, Z., Mao, C., and Guo, P. (2004). Nano Lett. 4:1717-1724] that RNA can be used as a building block for bottom-up assembly in nanotechnology. The assembly of protein-free 25-nm RNA nanoparticles reported here will allow for repeated long-term administration and avoid the problems of short retention time of small molecules and the difficulties in the delivery of particles larger than 100 nm.


[Colorectal carcinogenesis, frequency and significance of genetic alterations: deletion of the short arm of chromosome 1, and initiating event].
Cytogenetic anomalies described in colo-rectal tumors are numerous. Despite the complexity and the number of the anomalies observed, a combined study of their frequency and of the stage of prognosis of the tumors suggests that the evolution from colonic adenoma to carcinoma often follows a sequence of events comprising a 5q15-22 deletion (DCC), and a 17p deletion (P53). It even seems likely that in many cases, these events are not constant and that others might lead to the same phenotypic transformation. Chromosome 1 involvement in structural rearrangements has been demonstrated in numerous forms of cancers, malignant blood disorders and in solid tumors. In colorectal adenocarcinoma anomalies have been described on short and/or long arms. In a case of adenoma with mild dysplasia a deletion of the distal part of the short arm of chromosome 1 was observed as an isolated cytogenetic anomaly, suggesting it would be an early, perhaps triggering, event for the tumour development. A cytogenetic study in a series of colo-rectal tumours, researches on loss of heterozygosity and microsatellite instability lead to consider deletions at chromosome 1p as an early event in human colorectal tumourigenesis.


Accumulation of DNA, RNA, and protein by cultured rat embryos following maternal administration of a teratogenic dose of trypan blue.
The effect of trypan blue on the rates of DNA, RNA, and protein accumulation in rat embryos was investigated using a system of whole embryo culture. Embryos were isolated on the 10th gestational day (sperm day = Day 0) either 4 or 24 hr after maternal injection. The cultivation period was for 24 or 42 hr. The rate of DNA and RNA accumulation in the embryo following either a 4- or 24-hr previous maternal treatment was significantly decreased at at both 24 and 42 hr of cultivation. Protein values were significantly reduced after a 4-hr maternal exposure, but only slightly reduced after a 24-hr maternal exposure. No significant differences in DNA, RNA, or protein content were observed at the beginning of cultivation, following either a 4- or 24-hr previous maternal treatment. The percentage of embryos establishing a visceral yolk sac circulation was greatly reduced, and this supports the conclusion that trypan blue interferes with yolk sac function. The most obvious teratogenic insults include failure of neuropore closure, retention of a dorsiflexed position, and cranial edema.


LATERAL ORGAN BOUNDARIES defines a new family of DNA-binding transcription factors and can interact with specific bHLH proteins.
Conserved in a variety of evolutionarily divergent plant species, LOB DOMAIN (LBD) genes define a large, plant-specific family of largely unknown function. LBD genes have been implicated in a variety of developmental processes in plants, although to date, relatively few members have been assigned functions. LBD proteins have previously been predicted to be transcription factors, however supporting evidence has only been circumstantial. To address the biochemical function of LBD proteins, we identified a 6-bp consensus motif recognized by a wide cross-section of LBD proteins, and showed that LATERAL ORGAN BOUNDARIES (LOB), the founding member of the family, is a transcriptional activator in yeast. Thus, the LBD genes encode a novel class of DNA-binding transcription factors. Post-translational regulation of transcription factors is often crucial for control of gene expression. In our study, we demonstrate that members of the basic helix-loop-helix (bHLH) family of transcription factors are capable of interacting with LOB. The expression patterns of bHLH048 and LOB overlap at lateral organ boundaries. Interestingly, the interaction of bHLH048 with LOB results in reduced affinity of LOB for the consensus DNA motif. Thus, our studies suggest that bHLH048 post-translationally regulates the function of LOB at lateral organ boundaries.


Secular trends in caesarean section rates over 20 years in a regional obstetric unit in Hong Kong.
Although caesarean section rates have been increasing over the years in both public and private sectors in Hong Kong, there has been a paucity of formal surveys on local trends in such rates. This study aimed to examine the trends in caesarean section rates over a 20-year period at a public regional obstetric unit in Hong Kong using the Robson's Ten-group Classification System. All deliveries in a single obstetric unit during a 20-year period (1995-2014) were classified into 10 subgroups according to the Robson's classification. The annual caesarean section rate for each subgroup was calculated and then stratified into 5-year intervals to analyse any significant trends. The caesarean section rates in a total of 86 262 births with complete data were analysed. The overall caesarean section rate increased modestly from 15.4% to 24.6% during the study period. There was an obvious increasing trend for caesarean section in those with previous caesarean section (Robson's category 5), breech presentation at delivery (category 6 and 7), multiple pregnancy (category 8), and preterm labour (category 10). A gradual fall in caesarean section rate from 14.4% to 10.8% was seen in primiparous women with term spontaneous labour (category 1). Statistically significant differences (P<0.001) in these trends were confirmed when the data were stratified into 5-year intervals for comparison. The rising caesarean section rate may be associated with clinical management policies that allow women with relative risk factors (such as breech, previous caesarean section, or multiple pregnancy) to opt for caesarean section. This rise was counterbalanced by a decrease in primary caesarean section rate in primiparous women with spontaneous labour. The trend for caesarean section was more in line with patient expectations rather than evidence-based practice.


Effects of caerulein on the apical cytoskeleton of the pancreatic acinar cell.
In this study experiments were performed to correlate the rate of digestive enzyme secretion to morphologic observations of the apical cytoskeleton using dispersed rat pancreatic acini with various concentrations of caerulein. Caerulein at concentrations of 10 pM to 0.1 nM stimulated increasing rates of secretion of amylase, a digestive enzyme. Greater concentrations of caerulein caused progressively less amylase secretion. Transmission electron microscopy demonstrated several characteristics of the apical cytoskeleton in untreated acini that were altered with the "inhibitory" concentrations of caerulein. In control acini and acini stimulated with concentrations of caerulein up to 0.1 nM, the micrographs reveal an apical actin network extending into microvilli, an intermediate filament band, and electron-dense structures contained in both the actin filament network and the intermediate filament band. With concentrations of caerulein greater than 0.1 nM, these structures were progressively ablated. The findings with respect to the actin filament network were confirmed with light microscopic observations of dispersed acini stained with rhodamine-phalloidin. These results indicate that caerulein has marked morphologic effects on the pancreatic acinar cell cytoskeleton and that the cytoskeletal changes may modulate the secretory response.


Late-stage progressive corneal astigmatism after penetrating keratoplasty for keratoconus.
Progressive corneal astigmatism occurring at least 10 years after penetrating keratoplasty for keratoconus is a late-phase complication of surgery. This report characterizes this condition in a series of patients from three corneal referral centers in the United States. Charts were retrospectively reviewed which met the following criteria: penetrating keratoplasty performed for keratoconus at least 10 years ago, keratometry or simulated keratometry from topography as well as manifest refraction recorded at least 6 months after the last suture removal ("baseline"), and an increase in corneal astigmatism of at least three D over baseline recorded at least 5 years later. Patients who had any other corneal or intraocular surgery performed were excluded. Data from 15 patients (11 males and 4 females) who had penetrating keratoplasties performed by 8 different surgeons are included in this descriptive series. Postoperative follow-up averaged 17.27 years (range 11-24 years). The average donor button size was 7.83 mm (range 7.25-8.5 mm). Baseline corneal astigmatism was obtained an average of 5.2 years after penetrating keratoplasty (range 1.5-16 years) and was on average 3.57 +/- 1.8 D (10 with-the-rule [WTR], 3 against-the-rule [ATR], 2 oblique). Corneal astigmatism significantly increased to an average of 11.23 +/- 3.56 D (range 8.00-19.37 D, P < 0.0001) and most astigmatism was regular and WTR (9 WTR, 3 ATR, 3 oblique) 15.3 years (range 10-22 years) after surgery. Inferior steepening on topography was often noted, even those with oblique and ATR axes. High, late-stage, regular astigmatism after penetrating keratoplasty for keratoconus is described in a series of patients occurring at least 10 years after surgery. Possible mechanisms of this progressive astigmatism are recurrence of keratoconus in the graft, progressive corneal thinning of the host cornea, or progressive misalignment of the graft-host interface over time.


Psychological abuse and posttraumatic stress symptoms in college students.
Research suggests that among college students, physical and sexual abuse in intimate relationships are associated with posttraumatic stress. Psychological abuse occurs in intimate relationships among college students, and though there is evidence that such abuse has a negative emotional impact, posttraumatic stress has not been extensively researched as an outcome in this population. The purpose of this study is to determine the associations of past-year psychological abuse with posttraumatic stress symptoms while controlling for other types of past-year relationship abuse and lifetime trauma history. The sample consists of 191 college men and women (81.7% women and 89.5% White). Linear regression analyses demonstrate that trauma history, but not past year relationship violence, is a significant predictor of PTSD symptom severity for women, and neither set of variables significantly predicts PTSD symptom severity for men. Implications for future research are discussed.


Sarcoidosis and multiple sclerosis: systemic toxicity associated with the use of interferon-beta therapy.
Sarcoidosis is a multi-systemic inflammatory disease of unknown origin characterized by the presence of noncaseating epitheloid cell granulomas in multiple organs. Diagnosis is made on the basis of a compatible clinical-radiological scenario and the histological demonstration of the typical granulomas in the affected tissues. Interferons are immuno-modulators that have been used in a wide range of diseases, including hepatitis C virus infection, multiple sclerosis, and multiple myeloma and other types of tumours, including leukemia, lymphomas, Kaposi's sarcoma, and melanoma. Interferon-alpha-induced sarcoidosis has been reported repeatedly and there are two reports in the literature of cases of pulmonary sarcoidosis treated with interferon-1b therapy: one for advanced renal cell carcinoma and the other for multiple myeloma. A 35-year-old man on chronic immune-modulant Interferon-1b-based therapy for multiple sclerosis presented to the Neurology Unit with mild dyspnoea, dry cough, and transient pain to right upper abdomen. Lungs, spleen, liver, and almost all lymphnode stations of abdomen and mediastinum were clearly involved on ultrasound examination, chest X-ray, and computed tomography. A transbronchial biopsy showed non-caseating granuloma on histopathologic evaluation of the lungs. To the best of our knowledge, this is the first report of a chronic multisystemic sarcoidosis that was associated with interferon-beta treatment.


Working as simulated patient has effects on real patient life - Preliminary insights from a qualitative study.
Persons who simulate patients during medical education understand the routines and the underlying script of medical consultations better. We aimed to explore how simulated patients (SPs) integrated this new understanding into their daily life, how this work affected their private life as patients, and what we can learn from these changes for concepts of empowerment. A qualitative interview study. All SPs of Göttingen medical school who had been working longer than three semesters (n=14) were invited and agreed to take part in an open interview about their daily experience with real doctors. Documentary method was used to identify the main issues. Several cases were chosen according to maximum contrast and analysed by in-depth analysis to provide vivid examples of how simulations may affect the real life of the SPs as patients. Our analysis revealed three main changes in the behaviour of SPs as real patients. They were more attentive, had a better understanding of the circumstances under which doctors work, and acted more self-confidently. From the selected cases it became apparent that working as a SP may lead to a constant and significant decrease of fear of hospitals and medical procedures or, in other cases, may enable the SPs to develop new abilities for giving feedback, questioning procedures, and explanations for real doctors. working as a simulated patient seems to be well-suited to understand own progression of diseases, to increase self-responsibility and to a confident attitude as patient.


Drug interaction studies during drug development: which, when, how?
Drug-drug interaction studies have become an important aspect of the development process of new drugs. Since formal studies of all possible interactions are neither practicable nor suggestive, a careful selection of a limited number of drug combinations to be investigated during the development phase is indicated. Priorities should be based on the likelihood of certain combinations to occur in clinical practice as well as on risks associated with them. In the main, clinical drug interaction studies are performed during late phase II and phase III of clinical drug development. In some exceptional cases clinical interaction studies are necessary at an earlier stage of development. This counts especially for drugs with a small therapeutic range and a steep course of the dose-response curve and especially for drug interactions which may effect vital processes. For all other drugs often administered together an initial screen for pharmacokinetic and/or pharmacodynamic interactions with plasma level measurements and examinations of a possible concentration-effect relationship might be sufficient. Taking these criteria into account an interaction program for new drugs under development with different indications like cardiovascular diseases, respiratory diseases, diseases of the central nervous system as well as rheumatic diseases, metabolic diseases and infectious diseases was developed.


Early versus late introduction of continuous negative pressure in the management of the idiopathic respiratory distress syndrome.
To evaluate the effectiveness of the early application of continuous negative pressure about the thorax, 23 infants with the idiopathic respiratory distress syndrome who had adequate alveolar ventilation were assigned to early or late application of CNP. There were 11 infants in the early CNP and 12 in the late CNP group. There were no differences between the two groups with respect to birth weight, gestational age, age at admission to the study, initial FIO2 requirements, or initial PaO2, PaCo2, and AaPO2. None of the ENCP patients required mechanical ventilation, whereas four of the LCNP group did so. The FIO2 requirements were significantly less for the ECNP infants when compared to the LCNP ones. The mean duration of FIO2 requirements greater than 0.6 was 28.3 hours for those receiving ECNP and 60.7 hours for those in LCNP (P LESS THAN 0.05). This study suggests that the course of RDS may be modified by the early application of CNP.


Drug discovery in Africa tackles zoonotic and related infections.
Zoonotic and related infections pose an enormous health threat to the world's second-most populous continent. Despite the challenges faced by drug discovery scientists in Africa, recent progress toward identifying potential medicines across diverse disease areas is a cause for optimism and an indicator of progress in African-led scientific initiatives.


Two-loop Bethe-logarithm correction in hydrogenlike atoms.
We calculate the two-loop Bethe logarithm correction to atomic energy levels in hydrogenlike systems. The two-loop Bethe logarithm is a low-energy quantum electrodynamic (QED) effect involving multiple summations over virtual excited atomic states. Although much smaller in absolute magnitude than the well-known one-loop Bethe logarithm, the two-loop analog is quite significant when compared to the current experimental accuracy of the 1S-2S transition: It contributes -8.19 and -0.84 kHz for the 1S and the 2S state, respectively. The two-loop Bethe logarithm has been the largest unknown correction to the hydrogen Lamb shift to date. Together with the ongoing measurement of the proton charge radius at the Paul Scherrer Institute, its calculation will bring theoretical and experimental accuracy for the Lamb shift in atomic hydrogen to the level of 10(-7).


Actinotignum schaalii Caught for the Second Time in Fournier's Gangrene!
Actinotignum schaalii, a Gram-positive rod residing in the urinary tract, is responsible for urinary tract infections and their complications including but not limited to bacteremia and sepsis. A. schaalii is increasingly being detected in body fluid specimens owing to advancements in PCR techniques. This report describes an interesting case of an adult diabetic patient managed for Fournier's gangrene. A. schaalii was detected in the PCR of his wound cultures. To the best of our knowledge, this is the second case of A. schaalii as the causative agent for Fournier's gangrene.


Late sequelae of percutaneous nephrostomy. Work in progress.
Renal scans of 36 patients were obtained with and without the use of contrast material, and a dynamic CT study was performed at least three years after percutaneous nephrostomy (PNS) to evaluate the late effects of that procedure on kidney morphology and function. Only one kidney showed a cortical scar (1 X 1 X 1 cm in size) at the puncture site, and there were no signs of a loss of renal function or of alterations of the collecting system. Eight kidneys demonstrated slight capsular fibrosis at the puncture site, three were displaced posteriorly, and ten had some slight perirenal scarring around the lower pole. Overall, the morphological alterations were minimal and considerably less than those associated with open surgery. Coupled with the minimal complication rate associated with the initial PNS procedure, these findings indicate that PNS may be considered safe.


Secreted adenosine triphosphate from Aggregatibacter actinomycetemcomitans triggers chemokine response.
Extracellular ATP (eATP) is an important intercellular signaling molecule secreted by activated immune cells or released by damaged cells. In mammalian cells, a rapid increase of ATP concentration in the extracellular space sends a danger signal, which alerts the immune system of an impending danger, resulting in recruitment and priming of phagocytes. Recent studies show that bacteria also release ATP into the extracellular milieu, suggesting a potential role for eATP in host-microbe interactions. It is currently unknown if any oral bacteria release eATP. As eATP triggers and amplifies innate immunity and inflammation, we hypothesized that eATP secreted from periodontal bacteria may contribute to inflammation in periodontitis. The aims of this study were to determine if periodontal bacteria secrete ATP, and to determine the function of bacterially derived eATP as an inducer of inflammation. Our results showed that Aggregatibacter actinomycetemcomitans, but not Porphyromonas gingivalis, Prevotella intermedia, or Fusobacterium nucleatum, secreted ATP into the culture supernatant. Exposure of periodontal fibroblasts to filter sterilized culture supernatant of A. actinomycetemcomitans induced chemokine expression in an eATP-dependent manner. This occurred independently of cyclic adenosine monophosphate and phospholipase C, suggesting that ionotrophic P2X receptor is involved in sensing of bacterial eATP. Silencing of P2X7 receptor in periodontal fibroblasts led to a significant reduction in bacterial eATP-induced chemokine response. Furthermore, bacterial eATP served as a potent chemoattractant for neutrophils and monocytes. Collectively, our findings provide evidence for secreted ATP of A. actinomycetemcomitans as a novel virulence factor contributing to inflammation during periodontal disease.


The multiple endocrine neoplasia type 1 gene product, menin, inhibits insulin production in rat insulinoma cells.
A mutant gene isolated from a patient with multiple endocrine neoplasia type 1, MEN1 encodes a protein, menin. Features of MEN1 include multiple endocrine tumors of the parathyroid glands, anterior pituitary and pancreatic islets. Insulinoma, arising from the pancreas is the most common MEN1-related tumor. Menin is a nuclear protein and interacts with the transcription factor, Jun D, but whether menin has a role in the pathogenesis of MEN1-related endocrine tumors including insulinoma remains unknown. In this study, we examined the effects of menin on production of human insulin. Insulinoma cells, INS-1 were co-transfected with a vector that expressed menin and a reporter template containing 235 bp of the rat insulin gene 5'-flanking region fused to the luciferase gene to yield pINS-LUC. Promoter activity of the insulin gene was significantly decreased in co-transfected cells as compared to mock-transfected controls. INS-1 cells stably transfected with a vector that expressed menin were used to examine the insulin secretion. In cells with a high level of menin expression, both insulin secretion and thymidine incorporation into DNA were inhibited when compared to mock-transfected cells. Additionally, the rate of apoptosis of menin-transfected cells was increased compared to mock-transfected cells. These observations suggest that menin inhibits insulin promoter activity and secretion, and also cell proliferation, raising the possibility that menin may play an important role in the pathogenesis of insulinoma.


Tall cell variant of papillary thyroid carcinoma. A cytohistologic correlation.
To identify the cytologic characteristics of the tall cell variant of papillary thyroid carcinoma in fine needle aspiration biopsies and make a cytohistologic correlation. The study group consisted of six patients subjected to fine needle aspiration biopsy of the thyroid prior to surgical resection of the tumor. Nineteen cases of the tall cell variant were identified in 229 cases of papillary thyroid carcinoma (8.5%) from 1957 to 1993. Six cases had aspirates with tall cells. The patients were females with a median age of 43 years, and all had aggressive neoplastic diseases. The tumors had > 30% tall cells. The fine needle aspiration biopsy findings included nuclear grooves and abundant oxyphilic cytoplasm (100%), pseudonuclear inclusions (83.3%) and ground glass chromatin (67%). The majority of neoplastic cells had a nuclear/cytoplasmic ratio of 1:2. A tadpole shape was observed in noncohesive cells, and a respiratory epithelium-like arrangement was seen in cohesive cells. Fine needle aspiration biopsy is the best method of identifying tall cells preoperatively. Nuclear and cytoplasmic changes should be added to make a firm diagnosis of the tall cell variant and to rule out columnar cell carcinoma or squamous metaplasia in goiter or usual thyroid papillary carcinoma.


Comparison of in vivo nephrotoxicity in the rabbit by a pyrrolidinyl-thio Carbapenem CW-270031.
CW-270031 is a novel synthesized carbapenem antibiotic with a broad antimicrobial activity. Carbapenem antibiotics are well known for their nephrotoxicity. In this study, we evaluated the nephrotoxicity potential of this compound in rabbits, which are known for being more sensitive than other animals to renal insult. CW-270031 was administered to NZW male rabbits via an ear vein (200 mg/kg, single injection). Blood samples were collected on 2, 3, and 4 days after treatment. Urea nitrogen and creatinine in plasma were quantified. Four days after the treatment, all animals were autopsied and histopathological examinations were performed on their kidneys, revealing that cephaloridine and imipenem were highly nephrotoxic, and cefazolin had mild renal toxicity, whereas CW-270031 as well as meropenem and tienam had no toxicity to the kidney. The present findings suggest that CW-270031 is a potential carbapenem antibiotic with no nephrotoxicity.


Recruitment and Feasibility of Hair Cortisol Collection in a Sample of Ethnically and Sexually Diverse, Low-Income Adults: A Qualitative Community-Partnered Participatory Research Study.
The current study describes how a community-partnered participatory research (CPPR) model was used to enhance hair cortisol research engagement among low-income adults of diverse ethnicities and sexual and gender identities. Participants' reported motivations and concerns surrounding providing a hair sample are also described. Participants from a larger longitudinal study were invited to provide a hair sample and/or complete acceptability interviews. Results indicated that 71% of all persons (N=133) contacted participated in the current study, of whom 82% provided hair samples. Several themes emerged from the interviews indicating that participants were motivated to provide a hair sample due to internal and external factors; however, concerns about mistrust of research remained. Thus, collecting biospecimens in research with underserved groups requires careful consideration of benefits and risks to the individual and their communities. Our results provide guidelines for engaging low-income racially/ethnically and sexually diverse community members in biospecimen research to understand stress-health relationships.


Diagnostic reference levels for common computed tomography (CT) examinations: results from the first Nigerian nationwide dose survey.
To explore doses from common adult computed tomography (CT) examinations and propose national diagnostic reference levels (nDRLs) for Nigeria. This retrospective study was approved by the Nnamdi Azikiwe University and University Teaching Hospital Institutional Review Boards (IRB: NAUTH/CS/66/Vol8/84) and involved dose surveys of adult CT examinations across the six geographical regions of Nigeria and Abuja from January 2016 to August 2017. Dose data of adult head, chest and abdomen/pelvis CT examinations were extracted from patient folders. The median, 75th and 25th percentile CT dose index volume (CTDIvol) and dose-length-product (DLP) were computed for each of these procedures. Effective doses (E) for these examinations were estimated using the k conversion factor as described in the ICRP publication 103 (EDLP = k × DLP). The proposed 75th percentile CTDIvol for head, chest, and abdomen/pelvis are 61 mGy, 17 mGy, and 20 mGy, respectively. The corresponding DLPs are 1310 mGy.cm, 735 mGy.cm, and 1486 mGy.cm respectively. The effective doses were 2.75 mSv (head), 10.29 mSv (chest), and 22.29 mSv (abdomen/pelvis). Findings demonstrate wide dose variations within and across centres in Nigeria. The results also show CTDIvol comparable to international standards, but considerably higher DLP and effective doses.


Microwave drying remediation of petroleum-contaminated drill cuttings.
The oil reservoir drilling phase generates contaminated cuttings with oil formation itself. These cuttings must be subjected to a decontamination process before being disposed of in the environment. Several technologies are cited in literature for the remediation of soil contaminated with oil or diesel, but none have been reported to remedy drill cuttings contaminated with oil from reservoir. The reservoir drill cuttings are a problem because its discharge is not allowed. The drying technology using microwave has shown promise in the decontamination of cuttings with non-aqueous base drilling fluid, conciliating good robustness and high removal efficiency. Considering the aspects mentioned previously, the application of heating and drying technology using microwave in the remediation of oil contaminated cuttings from well drill was studied. The influence of temperature, specific energy and initial content of water in the drying operation of the reservoir cuttings and of the drilling cuttings artificially contaminated with oil were analyzed. The results showed an influence of temperature in the drying of the cuttings, being necessary to reach the boiling temperature of heavier hydrocarbons to reach an efficient removal in the operation. The specific energy has a strong influence, reaching a total decontamination using 2.67 kWh/kg. The initial water content was effective in removing oil, reducing the residual level of oil with the increase of initial content of water. It also modifies the temperature profiles of the kinetic-warming of the contaminated cuttings. Both the technology and the equipment used proved effective for obtaining total decontamination of oil from the cuttings.


Nutritional standards needed for ready meals to avoid micronutrient deficiencies.
Micronutrient deficiencies contribute to many age-related disorders, although initial effects may be mild and easily missed. For example, B vitamin deficiency may result in mild cognitive decline, thiamine deficiency can contribute to development of type 2 diabetes and lack of vitamin D changes immune function.


A study of the feeding habits and nutrition of children in Anguganak area of West Sepik.
During November/December 1976 we surveyed 255 children of known age 5 years and under, and we questioned their parents about the foods given to them. We compared our results with previous survey results from this area. Despite the much earlier introduction of solid foods, there was no significant change in the mean weights of infants in this area since 1967. Sixty-four percent of the children were below 80% of the standard weight for age, and 57% of the children over one year of age had a mid upper-arm circumference of less than 14 cm. Health education needs to be supplemented by the use of high density weaning foods and the control of infection to overcome the very high prevalence of malnutrition.


Does omitting the accent mark in a word affect sentence reading? Evidence from Spanish.
Lexical stress in multisyllabic words is consistent in some languages (e.g., first syllable in Finnish), but it is variable in others (e.g., Spanish, English). To help lexical processing in a transparent language like Spanish, scholars have proposed a set of rules specifying which words require an accent mark indicating lexical stress in writing. However, recent word recognition using that lexical decision showed that word identification times were not affected by the omission of a word's accent mark in Spanish. To examine this question in a paradigm with greater ecological validity, we tested whether omitting the accent mark in a Spanish word had a deleterious effect during silent sentence reading. A target word was embedded in a sentence with its accent mark or not. Results showed no reading cost of omitting the word's accent mark in first-pass eye fixation durations, but we found a cost in the total reading time spent on the target word (i.e., including re-reading). Thus, the omission of an accent mark delays late, but not early, lexical processing in Spanish. These findings help constrain the locus of accent mark information in models of visual word recognition and reading. Furthermore, these findings offer some clues on how to simplify the Spanish rules of accentuation.


Magnetic coupling in discrete cyano-bridged Mn(III)-Fe(III) motifs: synthesis, crystal structure, magnetic properties and theoretical study.
The preparation, crystal structures and magnetic properties of the heterobimetallic complexes of formula [Mn(III)(n-MeOsalen)(H(2)O)(mu-CN)Fe(III)(bpym)(CN)(3)]·mH(2)O with n = m = 3 (1) and n = 4 and m = 2 (2) [n-MeOsalen(2-) = N,N'-ethylenebis(n-methoxysalicylideneiminate) dianion and bpym = 2,2'-bipyrimidine] are reported. 1 and 2 are dinuclear neutral species where the cyano-bearing low-spin unit [Fe(III)(bpym)(CN)(4)](-) acts as a monodentate ligand towards the [Mn(III)(SB)(solv)(x)](+) entity (SB = tetradentate Schiff-base) through one of its four cyano groups. Adjacent heterobimetallic units are interlinked through hydrogen bonds involving the coordinated water molecule of one dinuclear unit and the phenolate oxygen atoms of the neighbouring one to afford pairs of dimers with values of the interdimer Mn···Mn distance of 4.925(20) (1) and 5.0508(25) Å (2). The analysis of the magnetic data of 1 and 2 in the temperature range 1.9-300 K shows the coexistence of weak ferro- [J = +2.95 (1) and +3.88 cm(-1) (2)] and antiferromagnetic interactions [j = -1.91 (1) and -0.70 cm(-1) (2)] through the single cyano bridge and hydrogen bonds, respectively (the Hamiltonian being of the type Ĥ = J[Ŝ(Fe)·Ŝ(Mn) + Ŝ(Fe')·Ŝ(Mn')] -jŜ(Mn)·Ŝ(Mn')). Theoretical calculations using methods based on density functional theory (DFT) have been used to substantiate the nature and magnitude of the magnetic coupling observed in 1 and 2 and also to analyze the dependence of the magnetic coupling on the structural parameters for the Fe-C-N-Mn skeleton. An extension of the calculations to selected examples of heterobimetallic Fe(III)-C-N-Mn(III) compounds with a different number of cyano groups on the low-spin iron(III) precursor has been carried out allowing us to illustrate the influence of the symmetry of the magnetic orbital of the iron center on the magnetic coupling in this heterobimetallic unit.


Role for the mammalian female reproductive tract microbiome in pregnancy outcomes.
Since the discovery of the microbiome in humans, it has been studied in many mammalian species. Different microbiological communities with variable richness and diversity have been found among these species in distinct areas of the reproductive tract. Human studies have shown that the composition of the microbiome is dependent on body site and several host-related factors. Furthermore, specific phyla have been identified among the different species and within distinct areas of the female reproductive tract, but a "core" microbiome of the female reproductive tract has not been defined in any species. Moreover, the function of the microbiome in the reproductive tract is not yet fully understood. However, it has been suggested that a change in diversity of the microbiome and the presence or absence of specific microbial species might be useful indicators of pregnancy outcomes. Increased comprehensive knowledge of the microbiological communities in the female reproductive tract is needed since adverse outcomes represent a significant problem to many species, including livestock, exotic or endangered species, and humans. To the authors' knowledge, a review combining current female reproductive tract microbiome data among different mammalian species has not been published yet. Herein is a comprehensive review of what is known in the field of the female reproductive microbiome and how it correlates with reproductive success or failure in mammals. Further studies may lead to optimization of therapies in the treatment of reproductive tract infections and pregnancy failure, and may create opportunities for novel approaches for improving reproductive efficiency in animals and people.


[Absorption of flavonoids from Abelmoschus manihot extract by in situ intestinal perfusion].
To explore the mechanism of the absorption of flavonoids from Abelmoschus manihot flowers, in situ intestinal recirculation was performed to study the effect of the absorption at different concentrations and different intestinal regions. To evaluate the conditions of the absorption of six flavonoids from Abelmoschus manihot flowers, the concentrations of Abelmoschus manihot in the perfusion solution were determined by HPLC at predesigned time. And we have investigated the inhibitory effect of six flavonoids from Abelmoschus manihot flowers on P-glycoprotein (P-gp) drug efflux pump. The results demonstrated that the absorption rates of flavonoids from Abelmoschus manihot flowers are not significantly different (P > 0.05) at various drug concentrations, the absorption of flavonoids from Abelmoschus manihot flowers is a first-order process with the passive diffusion mechanism. The absorption rates of each of flavonoids are significantly different. The absorption rate of flavonoid glycoside was lower than that of aglycone; the flavonoids from Abelmoschus manihot flowers could be absorbed in all of the intestinal segments. The best parts of intestine to absorb hyperoside and myricetin are jejunum and duodenum, separately. Verapamil could enhance the absorption of isoquercitrin, hyperoside, myricetin and quercetin-3'-O-glucoside by inhibiting P-glycoprotein (P-gp) drug efflux pump.


Multidisciplinary team working in urological cancer: one CNS's role.
The 'cancer journey' for a patient with urological cancer can be complicated, with many different specialists involved and many treatment options. The uro-oncology clinical nurse specialist's role in one multidisciplinary team is to provide support, information and a link between all the staff involved in the patient's care.


Rett syndrome: revised diagnostic criteria and nomenclature.
Rett syndrome (RTT) is a severe neurodevelopmental disease that affects approximately 1 in 10,000 live female births and is often caused by mutations in Methyl-CpG-binding protein 2 (MECP2). Despite distinct clinical features, the accumulation of clinical and molecular information in recent years has generated considerable confusion regarding the diagnosis of RTT. The purpose of this work was to revise and clarify 2002 consensus criteria for the diagnosis of RTT in anticipation of treatment trials. RettSearch members, representing the majority of the international clinical RTT specialists, participated in an iterative process to come to a consensus on a revised and simplified clinical diagnostic criteria for RTT. The clinical criteria required for the diagnosis of classic and atypical RTT were clarified and simplified. Guidelines for the diagnosis and molecular evaluation of specific variant forms of RTT were developed. These revised criteria provide clarity regarding the key features required for the diagnosis of RTT and reinforce the concept that RTT is a clinical diagnosis based on distinct clinical criteria, independent of molecular findings. We recommend that these criteria and guidelines be utilized in any proposed clinical research.


Effective behavioral interventions for decreasing dementia-related challenging behavior in nursing homes.
This paper provides a selective review of behavioral intervention research aimed at successfully decreasing dementia-related challenging behaviors in nursing homes. The authors include separate discussions of behavioral excesses (disruptive vocalization, wandering, physical and verbal aggression) and deficits (excess dependency, therapeutic activities, social interaction/communication). Descriptions of interventions used to address each behavior problem are followed by methodological evaluations of the research. Discussions are augmented by inclusion of the authors' ongoing intervention research. The paper concludes with a description of a comprehensive program for teaching behavior management skills to nurse aides and a motivational system for maintaining the performance of these skills over the long term.


Superficial spreading malignant melanoma with neurosarcomatous metastasis.
Metastatic malignant melanoma often poses a difficult light and ultrastructural diagnostic challenge. A superficial spreading malignant melanoma without desmoplasia displayed neurosarcomatous light and electron microscopic features in metastatic sites. The ultrastructure displayed some Schwann cell features and strong-S-100 immunostaining. Metastatic melanoma with Schwannian differentiation in metastatic sites without lesional desmoplasia is rare and must be included in the differential diagnosis of spindled neoplasms involving lymph nodes. The evolution of this lesion illustrates the spectrum of melanocytic differentiation, i.e., pigment synthesis, adaptive fibroplasia and Schwannian differentiation.


Molecular physiology of amylin.
Amylin is a 37-amino acid peptide first isolated, purified, and characterized from the amyloid deposits in the pancrease of type 2 diabetics. It is synthesized and secreted primarily from pancreatic beta cells along with insulin. The ability of amylin to potently reduce insulin-stimulated incorporation of glucose into glycogen in skeletal muscle requires both an intact 2Cys-7Cys disulfide bond and a COOH-terminal amide. Amylin has structural and functional relationships to two other messenger proteins, calcitonin and CGRP. Amylin has relatively potent calcitonin-like activity on bone metabolism and weaker CGRP-like activity on the vasculature. CGRP is a slightly weaker agonist than amylin for metabolic responses. Although rat calcitonins are weak, teleost fish calcitonins are very potent agonists for amylin's metabolic effects. This group of peptides appears to act on a family of related G protein-coupled receptors; several variant calcitonin receptors have recently been cloned and expressed. These receptors appear to be coupled to adenylyl cyclase in many instances; recent evidence supports the view that amylin's effects on skeletal muscle occur, at least in large part, through activation of the cAMP pathway.


Examination of the protective efficacy of two avian influenza H5 vaccines against clade 188.8.131.52b H5N8 highly pathogenic avian influenza virus in commercial broilers.
The highly pathogenic avian influenza (HPAI) H5N8 virus of clade 18.104.22.168 was detected in 2017 in Egypt, which is one of the few countries using vaccination as a control strategy in poultry farms. This study was conducted to evaluate the efficacy of the commercial recombinant turkey herpes virus-H5 (rHVT-H5) vaccine (clade 2.2), alone or in combination with commercial inactivated reverse genetically engineered H5N1 vaccine (rgH5N1) (clade 2.2), in preventing the genetically distinct HPAI H5N8 virus of clade 188.8.131.52b in commercial broiler chickens. Four experimental groups of chickens were used as follows: G1, non-vaccinated and non-challenged; G2, non-vaccinated and challenged; G3, vaccinated with rHVT-H5; and G4, prime-boost vaccinated with rHVT-H5/rgH5N1. For challenge with the Egyptian HPAI H5N8 (184.108.40.206b) virus, the groups were divided into two subgroups (A and B); chickens in subgroups A were challenged at the age of 28 days, whereas those in subgroups B were challenged at the age of 35 days. Results showed that a protective efficacy (survival rate) of 40%-50% was obtained in the vaccinated subgroups A. By delaying challenge for 1 week (subgroups B), a single rHVT-H5 vaccination provided 80% protection, whereas prime-boost vaccination induced full protection and reduced viral shedding very efficiently (1/10 birds and only detected on the 3rd day post challenge) against HPAI H5N8 virus (184.108.40.206b). Moreover, body weight loss improved from 31.39% and 43.65% in G3A and G4A, respectively, to 16.34% and 7.7% in G3B and G4B, respectively. The HI titers obtained in G3A and G4A on the challenge day (28th d) using H5N8 antigen were 3 and 3.75 log2 (p > 0.05), respectively, whereas those in G3B and G4B on the challenge day (35th d) were 6.25 and 6 log2 (p > 0.05), respectively, which increased post-challenge in all vaccinated subgroups. Therefore, the dual use of vectored rHVT-H5 and inactivated rgH5N1 vaccines in the vaccination schedule in poultry farms is the most efficient tool for preventing the disease (mortality and viral shedding) caused by the genetically distinct virus (clade 18.104.22.168b HPAI H5N8) in combination with strict biosecurity and sanitary measures.


Nanofluidic diodes based on asymmetric bio-inspired surface coatings in straight glass nanochannels.
In this study, we present nanofluidic diodes fabricated from straight glass nanochannels and functionalized using bio-inspired polydopamine (PDA) and poly-L-lysine (PLL) coatings. The resulting PDA coatings are shown to be asymmetric due to a combination of transport considerations which can be leveraged to provide a measure of control over the effective channel geometry. By subsequently introducing a layer of amine-bearing PLL chains covalently bound to the PDA, we enhance heterogeneities in the charge and ion distributions within the channel and enable significant current rectification between forward-bias and reverse-bias modes; our PDA-PLL-coated channels yielded a rectification ratio greater than 1000 in a 100 nm channel filled with 0.01× phosphate-buffered saline solution (PBS). We further demonstrated that at higher ionic strength conditions, reducing the solution pH increased the number of protonated amines within the PLL layer, amplifying the charge disparities along the channel and leading to greater rectification. As nanofluidic diodes with bipolar surface charge distributions tend to provide superior performance compared to those with a single wall charge polarity, we imposed a more bipolar charge distribution in our devices by partially coating our PDA-PLL-coated channels with negatively charged polyacrylic acid (PAA). These enhanced bipolar channels exhibited greater current rectification than the PDA-PLL-coated channels, reaching rectification ratios in excess of 100 even in more physiologically-relevant 1× PBS solutions. Our fabrication approach and the results herein provide a promising platform from which the scientific community can build upon in the relentless endeavor for improved sensitivity in biosensors and other analytical devices.


Juvenile rheumatoid arthritis in two siblings: co-existence with polyarteritis nodosa in one parent.
Two siblings with identical HLA profiles developed the clinical picture of Juvenile Rheumatoid Arthritis of the pauciarticular variety with iritis. One parent had Polyarteritis Nodosa while both parents and siblings demonstrated the B15 DR5 antigens.


Interaction between the fluoroquinolones and the bronchodilator theophylline.
This review summarizes the available data on the influence of ofloxacin on the metabolic clearance of the bronchodilator theophylline. At the moment, several new fluoroquinolone derivatives, such as ofloxacin, ciprofloxacin, pefloxacin, and enoxacin are being clinically tested in respiratory tract infections. Enoxacin causes a strong and clinically important decrease (60%) of the total body clearance of theophylline. Ciprofloxacin and pefloxacin show the same effect, though to a smaller degree (30%). During treatment with these three agents clinical signs and symptoms of theophylline toxicity have been reported. However, no signs of increased plasma theophylline concentrations have been observed during concomitant treatment with ofloxacin and theophylline. Further research into the mechanism of this interaction has demonstrated that quinolones compete with cytochrome P450 related isoenzymes, resulting in a decreased demethylation of theophylline. Whereas a slight influence on these enzymes could be demonstrated for ofloxacin when the drug was administered in very high concentrations to rats, no significant influence on theophylline metabolic pathways in man has been measured, when ofloxacin was administered in doses up to 800 mg daily.


Management of Early Postoperative Bleeding After OAGB: A Single-center Experience.
One anastomosis gastric bypass (OAGB) has gained popularity among bariatric surgeons due to the shorter operative time, fewer sites for anastomotic leaks and internal herniation, shorter learning curve, ease of reversibility and revision with equivalent results to Roux en Y gastric bypass in terms of weight loss and co-morbidity resolution. We present our experience in managing early postoperative bleeding after OAGB. Patients who underwent OAGB in Bariatric Surgery Unit, Ain Shams University Hospitals between January 2016 and January 2023 were followed up for 30 days for early postoperative complications. Patients were 210 females (70%) and 90 males, with a mean age of 41.3±7.1 years, and mean preoperative body mass index of 45.2±6.1 kg/m². The incidence of early postoperative bleeding, the sites of the bleeding and management strategy were reported. Fourteen of 300 patients (4.67%) developed early postoperative bleeding after OAGB. Intraluminal bleeding occurred in 4 patients, 3 of which were controlled by endoscopy and one by laparoscopic suturing. Intra-abdominal bleeding occurred in 10 patients, 7 of which were successfully managed conservatively, and 3 required laparoscopic management. Two cases had both intra-abdominal bleeding and intraluminal bleeding in the distal stomach, confirmed by intraoperative endoscopy, and controlled by laparoscopic suturing. Early postoperative bleeding after OAGB is a rare complication (4.67%). Conservative treatment is more successful in controlling intra-abdominal bleeding. In case of failed conservative treatment, laparoscopy is the method of choice. Most cases of intra-luminal bleeding need early endoscopic intervention.


Acoustic Comfort in Virtual Inner Yards with Various Building Facades.
Housing complex residents in urban areas are not only confronted with typical noise sources, but also everyday life sounds, e.g., in the yards. Therefore, they might benefit from the increasing interest in soundscape design and acoustic comfort improvement. Three laboratory experiments (with repeated-measures complete block designs) are reported here, in which effects of several variables on short-term acoustic comfort were investigated. A virtual reference inner yard in the ODEON software environment was systematically modified by absorbers on building facades, whereby single-channel recordings were spatialized for a 2D playback in laboratory. Facade absorption was found, generally, to increase acoustic comfort. Too much absorption, however, was not found to be helpful. In the absence of any absorbers on the facade, absorbing balcony ceilings tended to improve acoustic comfort, however, non-significantly. Pleasant and unpleasant sounds were associated with comfort and discomfort, accordingly. This should encourage architects and acousticians to create comfortable inner yard sound environments, where pleasant and unpleasant sound occurrence probabilities are designed to be high and low, respectively. Furthermore, significant differences were observed between acoustic comfort at distinct observer positions, which could be exploited when designing inner yards.


Reasons for attending dental-care services in Ouagadougou, Burkina Faso.
To determine why patients attend dental-care facilities in Ouagadougou, Burkina Faso and to improve understanding of the capacity of oral health-care services in urban west Africa. We studied a randomly selected sample of patients attending 15 dental-care facilities in Ouagadougou over a 1-year period in 2004. Data were collected using a simple daily record form. From a total of 44,975 patients, the final sample was established at 14,591 patients, of whom 55.4% were new patients and 44.6% were "booking patients". Most patients seeking care (71.9%) were aged 15-44 years. Nongovernmental not-for-profit dental services were used by 41.5% of all patients, 36% attended private dental-care services, and 22.5% of patients visited public services. The most common complaint causing the patient to seek dental-care services was caries with pulpal involvement (52.4%), and 60% of all complaints were associated with pain. The patients' dental-care requirements were found to differ significantly according to sex, health insurance coverage and occupation. Urban district health authorities should ensure provision of primary health-care services, at the patients' first point of contact, which are directed towards the relief of pain. In addition to the strengthening of outreach emergency care, health centres should also contribute to the implementation of community-based programmes for the prevention of oral disease and the promotion of oral health. Exchange of experiences from alternative oral health-care systems relevant to developing countries is urgently needed for tackling the growing burden of oral disease.


Characterization of a naturally occurring infection of a Mycoplasma gallisepticum house finch-like strain in turkey breeders.
An outbreak of Mycoplasma gallisepticum (MG) in commercial turkeys involving very mild clinical signs was difficult to confirm by routine methods. In the first part of this study (trial A), we conducted a bioassay to increase the likelihood of detecting MG. Susceptible turkeys were inoculated with sinus exudates from four different affected commercial turkey flocks. Turkeys were evaluated for clinical signs, as well as by serology and culture of tracheal swabs, at 21 and 42 days postchallenge. An MG isolate from one of the sinus exudates used for inoculation, designated K5054, was very similar to isolates from house finches when characterized by random amplified polymorphic DNA analysis as well as DNA sequence analysis of portions of the phase-variable putative adhesin protein (pvpA) gene, a lipoprotein gene, and the cytadhesin gapA/mgc1 gene. The turkeys inoculated with the K5054 sinus exudate seroconverted in the absence of severe clinical signs. There was a single reisolation of K5054 from these turkeys 42 days postchallenge. Susceptible contact turkeys were commingled with the K5054-inoculated turkeys at 49 days postchallenge. We found no evidence of transmission of MG to the contacts by culture or serology at 7, 21, or 35 days after commingling. In the second part of this study (trial B), we challenged the contacts and K5054 sinus exudate-inoculated turkeys from trial A with virulent R strain 88 days after the K5054 sinus exudate inoculation. On necropsy 10 days postchallenge, the evaluation of gross and microscopic lesions, serology, and culture showed that the turkeys previously inoculated with K5054 sinus exudate were protected against disease and reinfection.


Effect of Vitamin D Supplementation on Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Dysmenorrhea causes pain and inconvenience during menstruation. In addition to medication, natural compounds are widely used to relieve various types of pain. In this study, we aimed to assess the effects of vitamin D (vit. D) supplementation in relieving the symptoms of primary dysmenorrhea. A comprehensive systematic database search of randomized controlled trials (RCTs) was performed. Oral forms of vit. D supplementation were included and compared with a placebo or standard care. The degree of dysmenorrhea pain was measured with a visual analogue scale or numerical rating scale. Outcomes were compared using the standardized mean difference (SMD) and 95% confidence intervals (CIs) in a meta-analysis. RCTs were assessed using the Cochrane risk-of-bias v2 (RoB 2) tool. The meta-analysis included 8 randomized controlled trials involving 695 participants. The results of the quantitative analysis showed a significantly lower degree of pain in the vit. D versus placebo in those with dysmenorrhea (SMD: -1.404, 95% CI: -2.078 to -0.731). The results of subgroup analysis revealed that pain lessened when the average weekly dose of vit. D was over 50,000 IU, in which dysmenorrhea was relieved regardless of whether vit. D was administered for more or less than 70 days and in any dose interval. The results revealed that vit. D treatment substantially reduced the pain level in the primary dysmenorrhea population. We concluded that vit. D supplementation is an alternative treatment for relieving the pain symptoms of dysmenorrhea.


Ceruletide resembles antipsychotics in rats and schizophrenic patients. Preliminary report.
Peptides related to the C-terminal part of cholecystokinin, including ceruletide, were found to be active in a number of behavioral test procedures in rats, predicting antipsychotic action. In a subsequent clinical trial ceruletide was administered intramuscularly in a dose of 40 micrograms twice for 2 consecutive weeks to 6 neuroleptic-treated schizophrenic patients following a single-blind design. In 3 patients, a pronounced long-lasting antipsychotic effect was observed, while in the other 3 the response was less marked. It is suggested that ceruletide may be a potential antipsychotic peptide.