Cardiac arrhythmias and atrioventricular block in a cohort of asymptomatic individuals without heart disease.
To evaluate cardiac arrhythmias and rhythm disturbances on 24 h ambulatory electrocardiographic monitoring in a cohort of asymptomatic healthy individuals with normal clinical examination. 625 asymptomatic healthy individuals, in the age range 15-83 (mean 42, SD 11.9) years; 276 (44.2%) men and 349 (55.8%) women were submitted to 24-hour ambulatory electrocardiographic monitoring. Statistical analysis was performed with likelihood ratio test and automatic backward logistic regression. The frequency of atrial arrhythmias (p < 0.0001; OR 1.059; 95% CI 1.050-1068) and of ventricular arrhythmias (p < 0.0001; OR 1.023; 95% CI 1.017-1.029) increased for each age increase of 1 year; neither atrial nor ventricular arrhythmias demonstrated a statistically significant difference relative to gender. Transient second-degree atrioventricular block (Mobitz I) was observed in 14 (2.2%) individuals and was more frequent in individuals with resting heart rate <60 bpm (p = 0.006; OR 6.7, 95% CI 1.7-25.5). The frequency of atrial and ventricular arrhythmias increased with age and did not demonstrate a significant difference relative to gender. Transient atrioventricular block was more frequent in individuals with lower resting heart rate.


Evaluation of observed blast loading effects on NIF x-ray diagnostic collimators.
We present the "debris wind" models used to estimate the impulsive load to which x-ray diagnostics and other structures are subject during National Ignition Facility experiments. These models are used as part of the engineering design process. Isotropic models, based on simulations or simplified "expanding shell" models, are augmented by debris wind multipliers to account for directional anisotropy. We present improvements to these multipliers based on measurements of the permanent deflections of diagnostic components: 4× for the polar direction and 2× within the equatorial plane-the latter relaxing the previous heuristic debris wind multiplier.


Evolution of living donor liver transplantation in Egypt.
To date, cadaveric organ donation is illegal in Egypt. Therefore, Egypt recently introduced living donor liver transplantation (LDLT), aiming to save those who are suffering from end stage liver disease. Herein, we study the evolution of LDLT in Egypt. In Egypt, between August 2001 and February 2004, we approached all centers performing LDLT through personal communication and sent a questionnaire to each center asking for limited information regarding their LDLT experience. We identified and approached 7 LDLT centers, which collectively performed a total of 130 LDLT procedures, however, 3 major centers performed most of the cases (91%). Overseas surgical teams, mainly from Japan, France, Korea, and Germany, either performed or supervised almost all procedures. Out of those 7 LDLT centers, 5 centers agreed to provide complete data on their patients including a total of 73 LDLT procedures. Out of those 73 recipients, 50 (68.5%) survived after a median follow-up period of 305 days (range 15-826 days). They reported single donor mortality. Hepatitis C virus cirrhosis, whether alone or mixed with schistosomiasis, was the main indication for LDLT. Egypt recently introduced LDLT with reasonable outcomes; yet, it carries considerable risks to healthy donors, it lacks cadaveric back up, and is not feasible for all patients. We hope that the initial success in LDLT will not deter the efforts to legalize cadaveric organ donation in Egypt.


Taste acuity and zinc metabolism in captopril-treated hypertensive male patients.
Hypogeusia is a reported side effect of captopril. Linkage of hypogeusia to zinc deficiency has been suggested. We objectively assessed taste acuity using Henkin's three-drop stimulus technique and measured plasma zinc (PZn) level and urinary zinc excretion in 31 hypertensive patients. Of these, 11 were long-term, high-dose captopril recipients (more than 6 months, 266 +/- 34 mg/day), six were short-term captopril recipients (less than 6 months, 104 +/- 40 mg/daily dose), and the remaining 14 served as noncaptopril controls. Compared to controls, the long-term captopril group had significantly higher taste detection and recognition thresholds, lower PZn (91 +/- 3 vs. 100 +/- 3 micrograms/dl, P less than 0.05) and higher urinary zinc excretion (1017 +/- 89 vs. 609 +/- 76 micrograms/day, P less than 0.005). The short-term captopril group did not differ significantly from the noncaptopril group except for higher taste-recognition thresholds for NaCl and sucrose (P less than 0.05). Discontinuing captopril improved taste acuity and almost normalized zinc parameters in two patients on long-term captopril. These results suggest that abnormalities of taste are commonly associated with captopril therapy and may be related to changes in zinc metabolism. This is especially true in patients on long-term, high-dose captopril therapy.


The fractured rib in chest wall trauma.
Chest wall trauma and rib fractures are significant sources of morbidity and mortality in countries in which motor vehicle accidents are prevalent. Physicians who care for injured patients should realize that patients with thoracic trauma are at significant risk for mortality, deterioration, and associated injuries. Care must be taken to avoid underestimation of the effect of the injury on subsequent respiratory mechanics. Armed with an understanding of chest injury epidemiology, biomechanics, and pain control, physicians can better serve these high-risk patients.


Actinically degenerate elastic tissue: the prime antigen in the giant cell (temporal) arteritis syndrome? New data from the posterior ciliary arteries.
To search for evidence of actinic elastotic degeneration (actinic arteriopathy) and giant cell arteritis (GCA) in the posterior ciliary arteries of eyes from aged white Australians. Three hundred donor eyes were given to us by the Lions Eye Bank of New South Wales at Sydney Hospital. Of these, 146 formed the basis of this study. Portions of the posterior ciliary arteries located in relation to the optic nerve heads were processed in paraffin and were then stained by a sensitive haematoxylin and eosin stain that had been especially developed to display actinic elastotic degeneration of elastic tissue. Among 60 "aged" subjects (70-90 yrs.), a total of 41 (approximately 68%) showed definite changes of actinic elastotic degeneration in their laminae, a condition called actinic arteriopathy. One of these subjects revealed giant cells on degenerate lamina, giving a picture regarded as early (pre-clinical) GCA. A young "control" group of 60 subjects 17-59 years of age revealed only one subject with a similar degree of actinic arteriopathy. Actinic arteriopathy of the posterior ciliary arteries was more frequent and advanced in the "aged", over-70 group as compared with changes in the "young" group < 60 years of age. One aged subject without a history of eye disease showed giant cells associated with elastotically degenerate internal elastic lamina. Her fortuitous lesions are regarded as indicative of how GCA is likely to begin in the damaged arteries.


One-step synthesis of highly dispersed gold nanocrystals on silica spheres.
Highly dispersed gold nanocrystals decorating silica spheres were prepared from HAuCl4 and NaOH via a deposition-precipitation (DP) process, in which the isoelectric point (IEP) of the substrate was adjusted during sphere synthesis by interaction of the surface with ammonia molecules. Through the systematic variation of pH (4-8), reaction temperature (65-96 degrees C), and time (10-30 min), a superior product with small (2-5 nm), homogeneously distributed gold crystals was obtained at pH 7 and a reaction temperature of 96 degrees C. These materials will offer enhanced performance as catalysts and contrast enhancers in biomedical imaging.


Bioavailability of nifedipine: a comparison between two preparations.
In a random cross-over study, eight healthy volunteers received single 10 mg doses of either nifedipine capsule (Adalat, Bayer) or nifedipine tablets (Taro) after an overnight fast. The areas under the serum concentration time curves were not significantly different (AUC0----infinity 319.8 +/- 28.0 (SEM) ng ml-1 h-1 for capsules, 260.8 +/- 15.3 ng ml-1 h-1 for tablets). The peak serum levels and the time of their occurrence were 162.4 +/- 23.4 ng ml-1 at 30 min for capsules and 43.0 +/- 3.0 ng ml-1 at 1-2 h for tablets, indicating that the absorption of nifedipine from the capsule is faster than from the tablet form. Clinical symptoms of vasodilation corresponded with the nifedipine peak levels. We conclude that although the bioavailability in general of the two preparations is similar, the therapeutic equivalence may differ. Depending on the therapeutic indication each preparation may have its merits.


Multiplicity of genetic backgrounds among vancomycin-resistant Enterococcus faecium isolates recovered from an outbreak in a New York City hospital.
A total of 182 vancomycin-resistant Enterococcus faecium and 6 Enterococcus faecalis inpatient isolates recovered during a 2-year period (1990-1992) in a New York City hospital were analyzed by molecular fingerprinting techniques, pulsed-field gel electrophoresis (PFGE), of chromosomal SmaI digests combined with Southern hybridization using vanA and vanB2-specific DNA probes. Of the 180 isolates hybridizing with these probes, 153 carried the vanA and 27 the vanB gene. As many as 21 different PFGE types and a total of 54 subtypes were identified among the isolates, and the size of vanA and vanB-hybridizing DNA fragments also showed a wide range of sizes, from about 37 to over 280 kb (in vanA) or 140 kb (in vanB), suggesting extensive recombination, including chromosomal integration, of the resistance genes in the isolates. Close to one-third, 46, of the 148 isolates from 1992 belonged to two closely related PFGE subtype variants, each of which carried a 48 kb vanA hybridizing DNA fragment. Spread of this clone appears to be mainly responsible for the substantial increase in the prevalence of vancomycin-resistant E. faecium in early 1992.


Chemical Fingerprinting, Aorta Endothelium Relaxation Effect, and Enzymatic Inhibition of Canelo (Drimys winteri J. R. Forst. & G. Forst, (D.C) A. Gray, Family Winteraceae) Fruits.
Drimys winteri J.R. Forst. & G. Forst (D.C) G. Gray, var. chilensis (canelo) is an endemic tree from Chile. Since pre-Columbian times, it has produced a fruit known as the canelo pepper, (pimienta de canelo) or Foye pepper, which can be used as a spice. The chemical and biological analysis of canelo fruits is reported for the first time in this study, that is, its phenolic fingerprinting by UHPLC-PDA- Q-orbitrap MS, the antioxidant activity, the enzymatic inhibitory activity, and its relaxation effects on rat aorta. The proximal composition and the mineral content (Ca: 1.45 ± 0.03 mg/100 g; Mg: 7.72 ± 0.03 mg/100 g; Fe: 4.54 ± 0.21 mg/100 g; Zn: 2.99 ± 0.02 mg/100 g; Mn: 1.08 ± 0.03 mg/100 g; Cu: 0.82 ± 0.02 mg/100 g; K: 53.03 ± 0.20 mg/100 g; Na: 0.087 ± 0.00 mg/100 g) are also reported. The canelo fruits showed a total phenolic content of 57.33 ± 0.82 mg GAE/g dry weight. In addition, the total flavonoid content was 38.42 ± 1.32 mg equivalent of QE/g dry weight. The antioxidant activity was evaluated by employing DPPH and ABTS methods (IC50 of 6.65 ± 0.5 and 9.5 ± 0.05 μg/mL, respectively), ORAC (25.33 ± 1.2 μmol Trolox/g dry plant) and FRAP (45.56 ± 1.32 μmol Trolox/g dry plant). The enzymatic inhibition of acetylcholinesterase, butyrylcholinesterase, and tyrosinase (IC50: 1.94 ± 0.07, 2.73 ± 0.05, and 9.92 ± 0.05 µg extract/mL, respectively) is also reported. Canelo extract led to an 89% relaxation of rat aorta. Our results confirm that D. winteri fruits are a rich source of secondary metabolites and can inhibit enzymes associated with neurodegenerative diseases; the results also suggest that canelo may induce a potentially hypotensive effect in rat aorta. The study demonstrates the medicinal properties of canelo fruit and spice.


Functional significance of arytenoid adduction with the suture attaching to cricoid cartilage versus to thyroid cartilage for unilateral paralytic dysphonia.
In the treatment of unilateral paralytic dysphonia, traditional arytenoid adduction is designed to place suture through the muscular process of the arytenoid attaching anteriorly to the thyroid ala. In contrast with the suture direction of this technique, a new paramedian approach to arytenoid adduction anchors anteroinferiorly to the cricoid cartilage, mimicking the force action of the lateral cricoarytenoid muscle (the major adductor of the larynx). This study investigated the influence of these changes in suture direction on the vocal fold level as well as the vocal outcomes in these two techniques of arytenoid adduction. A prospective clinical series. Thirty patients with unilateral paralytic dysphonia underwent medialization laryngoplasty with arytenoid adduction and strap muscle transposition. Under local anesthesia, the thyroid lamina on the involved side was paramedially separated. The inner perichondrium was carefully elevated away from the overlying thyroid cartilage, carrying the dissection posteriorly to the level of the superior and inferior cornua. The lamina was retracted laterally, the inner perichondrium was opened near the midpoint, and the lateral cricoarytenoid muscle identified. Tracing the muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 Prolene suture was placed through the muscular process and temporarily tied to the anterolateral aspect of the thyroid ala (AA-thyroid suture). Intraoperative acoustic and perceptual assessments were performed. After releasing the tie, the suture was anchored to the cricoid cartilage at the origin of the lateral cricoarytenoid muscle (AA-cricoid suture). Voice assessments were repeated, and the outcomes of the two tests were compared. The choice of the type of arytenoid adduction suture was made intraoperatively according to which condition provided better vocal performance. After securing the suture, a bipedicled strap muscle flap was transposed into the space between the lamina and inner perichondrium and the thyroid cartilages sutured back into place. The intraoperative acoustic and perceptual assessments revealed the vocal performance was significantly better with AA-cricoid suture than the AA-thyroid suture in this series. No major complications occurred in the study. This study suggests that arytenoid adduction with suture attachment along the longitudinal axis of the lateral cricoarytenoid muscle to the cricoid cartilage is more physiologic and effective than that attaching the suture to the thyroid ala. A paramedian approach to arytenoid adduction with or without strap muscle transposition is a safe and effective method for treatment of unilateral paralytic dysphonia.


A systematic review of full endoscopic versus micro-endoscopic or open discectomy for lumbar disc herniation.
Aim: Endoscopic discectomies provide several advantages over other techniques such as traditional open lumbar discectomy (OLD) including possibly decreased complications, shorter hospital stay and an earlier return to work. Methods: An electronic database search including MEDLINE/PubMed, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Cochrane Controlled trials (CENTRAL) were reviewed for randomized controlled trials (RCTs) only. Results: A total of nine RCTs met inclusion criteria. Three showed benefit of endoscopic discectomy over the comparator with regards to pain relief, with the remaining six studies showing no difference in pain relief or function. Conclusion: Based on review of the nine included studies, we can conclude that endoscopic discectomy is as effective as other surgical techniques, and has additional benefits of lower complication rate and superior perioperative parameters.


Expression of homeodomain protein CDX2 in colorectal adenoma and adenocarcinoma.
CDX2 is a homeobox domain-containing transcription factor that is important in the development and differentiation of the intestine. In this study, we examined CDX2 expression in normal and neoplastic human colon using a newly isolated monoclonal antibody. When compared to the intensity observed in adjacent normal mucosal epithelial cells, strong nuclear staining for CDX2 was observed in 10 (100%) of 10 colonic adenomas, 30 (88.2%) of 34 colorectal adenocarcinomas, including 17(94.47%) of 18 well-or moderately differentiated tumors and 13(81.2%) of 16 high-grade tumors. The percentage of CDX2 immunopositive cells was generally lower in carcinomas than in adenomas (p<0.001) and lower in moderately or poorly differentiated tumors than in well-differentiated tumors (p<0.001). There was an inverse correlation between CDX2 expression and tumor grade, tumor stage and lymph node metastasis (respectively, p<0.001; p<0.05; p<0.001), but this was not associated with age, gender, or tumor location and size. These results indicate that loss of expression of CDX2 protein may play an important role in the tumorigenesis of colorectal cancers. Down-regulation of CDX2 may cause dedifferentiation of gastrointestinal epithelial cells.


Comparison of effects of antimicrobial interventions on multidrug-resistant Salmonella, susceptible Salmonella, and Escherichia coli O157:H7.
Several strains of Salmonella have been identified as resistant to multiple antibiotics. What is not known is whether strains possessing multidrug resistance properties also have the ability to resist the killing effects of the antimicrobial interventions used in beef processing. The research project described herein was designed to determine whether antimicrobial interventions currently in place in beef processing facilities are adequate for reducing the foodborne pathogen loads on beef carcass surfaces contaminated with multidrug-resistant (MDR) Salmonella. The data presented here indicate that MDR Salmonella is reduced at least as effectively as are Escherichia coli O157:H7 and susceptible Salmonella when treated with antimicrobial interventions currently in use at most U.S. beef processing plants. The E. coli O157:H7 strains used in this study were divided into two groups, strains that have a genetic polymorphism associated with human disease and strains not typically found to cause human disease. No differences were detected in the abilities of these two strain types to survive antimicrobial interventions. These results indicate that neither the drug resistance status of a particular Salmonella strain nor the likelihood that a particular E. coli O157:H7 strain will cause human illness influences the antimicrobial efficacy of the interventions utilized by the modern beef processing plants.


Riociguat for the treatment of chronic thromboembolic pulmonary hypertension.
Riociguat, a member of a new class of compounds (soluble guanylate cyclase stimulators), has been shown in previous clinical studies to be beneficial in the treatment of chronic thromboembolic pulmonary hypertension. In this phase 3, multicenter, randomized, double-blind, placebo-controlled study, we randomly assigned 261 patients with inoperable chronic thromboembolic pulmonary hypertension or persistent or recurrent pulmonary hypertension after pulmonary endarterectomy to receive placebo or riociguat. The primary end point was the change from baseline to the end of week 16 in the distance walked in 6 minutes. Secondary end points included changes from baseline in pulmonary vascular resistance, N-terminal pro-brain natriuretic peptide (NT-proBNP) level, World Health Organization (WHO) functional class, time to clinical worsening, Borg dyspnea score, quality-of-life variables, and safety. By week 16, the 6-minute walk distance had increased by a mean of 39 m in the riociguat group, as compared with a mean decrease of 6 m in the placebo group (least-squares mean difference, 46 m; 95% confidence interval [CI], 25 to 67; P<0.001). Pulmonary vascular resistance decreased by 226 dyn·sec·cm(-5) in the riociguat group and increased by 23 dyn·sec·cm(-5) in the placebo group (least-squares mean difference, -246 dyn·sec·cm(-5); 95% CI, -303 to -190; P<0.001). Riociguat was also associated with significant improvements in the NT-proBNP level (P<0.001) and WHO functional class (P=0.003). The most common serious adverse events were right ventricular failure (in 3% of patients in each group) and syncope (in 2% of the riociguat group and in 3% of the placebo group). Riociguat significantly improved exercise capacity and pulmonary vascular resistance in patients with chronic thromboembolic pulmonary hypertension. (Funded by Bayer HealthCare; CHEST-1 and CHEST-2 ClinicalTrials.gov numbers, NCT00855465 and NCT00910429, respectively.)


Patient values and preferences for end-of-life treatments: are values better predictors than a living will?
Advance care planning is widely considered important for good treatment decision making. Patient values have been proposed as superior to standard living wills as guides to end-of-life (EOL) care decisions on behalf of decisionally incapacitated patients. Little research has examined whether values outperform living wills as predictors of treatment preferences. The study aimed to test whether patient values are associated with treatment preferences, compare values and preferences to responses from a standard living will, and determine whether some values are better predictors than others. Community-dwelling elderly men and women (n=304) were interviewed in their homes by telephone. The interview consisted of an eight-item EOL values scale, a standard living will question, preferences for four life-prolonging treatments in each of six scenarios, and sociodemographic questions. Principal components analysis of the EOL values revealed two factors: (1) dignity, pain management, and reluctance to burden others; and (2) religiosity and desire for longevity and following family wishes. In regression analyses, stronger preferences for life-prolonging treatments were correlated with higher scores on factor 1 and lower scores on factor 2. But when living will responses were also entered into the regression model, only religiosity, longevity, and following family wishes predicted treatment preferences independently of the living will responses. Providing better guidance than a living will in determining a patient's EOL treatment preferences are (1) knowledge about a patient's religiosity, (2) patient's wishes for longevity, and (3) patient's wishes for following family preferences. Wishes for dignity and pain management and reluctance to burden others do not offer better guidance than a living will.


Influence of doxorubicin on apoptosis and oxidative stress in breast cancer cell lines.
Breast cancer is one of the leading causes of mortality among women worldwide due to aggressive behavior, early metastasis, resistance to existing chemotherapeutic agent and high mortality rate. Doxorubicin (Dox) is a powerful antitumoral drug. It is one of the most active agents for treatment of breast cancer. The aim of the present study was to evaluate the influence of Dox in apoptosis and oxidative stress in the breast cancer cell lines MCF-10F, MCF-7 and MDA-MB-231. These studies showed that Dox decreased anti-apoptotic Bcl-2 protein expression and affected oxidative stress by increasing hydrogen peroxide production and simultaneously decreasing NF-κB gene and protein expression in MCF-7, a tumorigenic triple-positive cell line. Results also indicated that Dox induced apoptosis by upregulating Bax, caspase-8 and caspase-3 and downregulation of Bcl-2 protein expression. On the contrary, ROS damage decreased by increasing SOD2 gene and protein expression and hydrogen peroxide production with parallel NF-κB protein expression decrease in MDA-MB-231, a tumorigenic triple-negative breast cancer cell line. It can be concluded that Dox activated apoptosis by inducing proteolytic processing of Bcl-2 family, caspases and simultaneously decreased oxidative stress by influencing ROS damage in MCF-7 and MDA-MB-231 cell lines.


Change in emotion regulation during the course of treatment predicts binge abstinence in guided self-help dialectical behavior therapy for binge eating disorder.
Dialectical behavior therapy (DBT), which appears to be an effective treatment for binge eating disorder (BED), focuses on teaching emotion regulation skills. However, the role of improved emotion regulation in predicting treatment outcome in BED is uncertain. This secondary analysis explored whether change in self-reported emotion regulation (as measured by the Difficulties in Emotion Regulation Scale) during treatment was associated with abstinence from binge eating at post-treatment and 4-, 5-, and 6-month follow-up in individuals who received a guided self-help adaptation of DBT for BED. Participants were 60 community-based men and women with BED who received a self-help manual and six 20-minute support phone calls. Greater improvement in self-reported emotion regulation between pre- and post-treatment predicted abstinence from binge eating at post-treatment, 4-, 5-, and 6-month follow-up. However, some follow-up results were no longer significant when imputed data was excluded, suggesting that the effect of emotion regulation on binge abstinence may be strongest at 4-month follow-up but decline across a longer duration of follow-up. This study provides preliminary support for the theoretical role played by improved emotion regulation in achieving binge eating abstinence. If this finding is replicated with larger samples, further research should identify specific techniques to help more individuals to effectively regulate their emotions over a longer duration.


Bowhead whale springtime song off West Greenland.
Three songs were recorded from bowhead whales (Balaena mysticetus) in Disko Bay, West Greenland, during 59 h of recordings via sonobuoys deployed on seven days between 5 and 14 April 2007. Song elements were defined by units following the protocol of previous description of bowhead whale song. The two most prominent songs were loud, complex, and repeated in long bouts on multiple recording days while the third song was much simpler and recorded on only one day. Bowhead whale simple calls and faint song elements were also recorded using digital audio tape recorders and a dipping hydrophone deployed from the sea ice approximately 100-150 km southwest of Disko Bay on three separate days suggesting that song is also produced in the central portion of Baffin Bay in winter. Songs recorded in Disko Bay are from an area where approximately 85% of the whales have been determined to be adult females. Although it is not known which sex was singing, we speculate that, as in humpback whales (Megaptera novaeangliae), male bowhead whales may sing to mediate sexual competition or mate selection behaviors. This is the first detailed description of springtime songs for bowhead whales in the eastern Arctic.


A qualitative study of perceptions of determinants of disease burden among young patients with type 1 diabetes and their parents in South India.
Diabetes is a leading threat to public health in India. A huge prevalence of type 1 diabetes among young patients is documented in literature; India is one of the countries with the highest number of new cases per year (10,900), of which 3-4 million face poverty along with diabetes. The aim of this study was to explore the perceptions of determinants of the disease burden among young patients with type 1 diabetes and their parents. In June 2014, perceptions were collected from eleven young patients and five available parents using the critical incident technique. Disease burdens associated with the management of type 1 diabetes can vary significantly according to the different social and economic determinants facing each household. Determinants associated with good practices in the management of childhood type 1 diabetes included socioeconomic status, unawareness of health complications, and beliefs about nutrition. Coping strategies applied via lifestyle changes included monitoring glycemia and regular checkups by diabetologists. A general lack of awareness about type 1 diabetes in Indian society, stigmatization, and limited access and systematic barriers to the delivery of optimal health care were all perceived to be factors hindering the successful management of chronic type 1 diabetes by young patients and their parents. Stigmatization, a lack of therapeutic adherence, and the financial strains placed on families, particularly on poor ones, are critical. More emphasis must be put on the prevention of acute and long-term complications and education.


Efficacy of topical calcineurin inhibitors in vitiligo.
Topical tacrolimus and pimecrolimus are indicated for the treatment of atopic dermatitis, but they have been studied in many off-label uses. We reviewed the English language literature to define their roles in treatment of vitiligo. Double-blind studies show that tacrolimus 0.1% ointment combined with excimer laser is superior to placebo, especially for UV resistant areas, such as bony prominences of the extremities. When used alone, tacrolimus 0.1% ointment is almost as effective as clobetasol propionate 0.05% ointment. Other studies suggest it can also be effective for facial lesions. Double blind studies show that pimecrolimus 1% cream combined with narrow band UVB is superior to placebo, especially for facial lesions. Additional studies would further clarify the role of topical calcineurin inhibitors in vitiligo.


Draft Genome Sequence of Salmonella enterica subsp. enterica Serovar Infantis Strain SPE101, Isolated from a Chronic Human Infection.
We report a 4.99-Mb draft genome sequence of Salmonella enterica subsp. enterica serovar Infantis strain SPE101, isolated from feces of a 5-month-old breast-fed female showing diarrhea associated with severe dehydration and malnutrition. The infection prolonged for 6 months despite antibiotic treatment.


HIV-2 encephalitis: case report and literature review.
We report the case of a 59-year-old man who moved from Cape Verde to Massachusetts at the age of 29. He had multiple sexual contacts with female partners in Cape Verde and with West African women in Massachusetts, as well as multiple past indeterminate HIV-1 antibody tests. He presented to our facility with 2-3 months of inappropriate behaviors, memory impairment, weight loss, and night sweats, at which time he was found to have an abnormal enhancing lesion of the corpus collosum on brain magnetic resonance imaging (MRI). Laboratory testing revealed a CD4 count of 63 cells/mm(3), positive HIV-2 Western blot, serum HIV-2 RNA polymerase chain reaction (PCR) of 1160 copies per milliliter and cerebrospinal fluid (CSF) HIV-2 RNA PCR of 2730 copies per milliliter. Brain biopsy demonstrated syncytial giant cells centered around small blood vessels and accompanied by microglia, which correlated with prior pathologic descriptions of HIV-2 encephalitis and with well-described findings of HIV-1 encephalitis. Based on genotype resistance assay results, treatment guidelines, and prior studies validating success with lopinavir-ritonavir, he was treated with tenofovir-emtricitabine and lopinavir-ritonavir, which has led to virologic suppression along with steady neurologic and radiologic improvement, although he continues to have deficits.


Artificial Intelligence in Surgery: Promises and Perils.
The aim of this review was to summarize major topics in artificial intelligence (AI), including their applications and limitations in surgery. This paper reviews the key capabilities of AI to help surgeons understand and critically evaluate new AI applications and to contribute to new developments. AI is composed of various subfields that each provide potential solutions to clinical problems. Each of the core subfields of AI reviewed in this piece has also been used in other industries such as the autonomous car, social networks, and deep learning computers. A review of AI papers across computer science, statistics, and medical sources was conducted to identify key concepts and techniques within AI that are driving innovation across industries, including surgery. Limitations and challenges of working with AI were also reviewed. Four main subfields of AI were defined: (1) machine learning, (2) artificial neural networks, (3) natural language processing, and (4) computer vision. Their current and future applications to surgical practice were introduced, including big data analytics and clinical decision support systems. The implications of AI for surgeons and the role of surgeons in advancing the technology to optimize clinical effectiveness were discussed. Surgeons are well positioned to help integrate AI into modern practice. Surgeons should partner with data scientists to capture data across phases of care and to provide clinical context, for AI has the potential to revolutionize the way surgery is taught and practiced with the promise of a future optimized for the highest quality patient care.


Methylothermus subterraneus sp. nov., a moderately thermophilic methanotroph isolated from a terrestrial subsurface hot aquifer.
A novel methane-oxidizing bacterium, strain HTM55(T), was isolated from subsurface hot aquifer water from a Japanese gold mine. Strain HTM55(T) was a Gram-negative, aerobic, motile, coccoid bacterium with a single polar flagellum and the distinctive intracytoplasmic membrane arrangement of a type I methanotroph. Strain HTM55(T) was a moderately thermophilic, obligate methanotroph that grew on methane and methanol at 37-65 °C (optimum 55-60 °C). The isolate grew at pH 5.2-7.5 (optimum 5.8-6.3) and with 0-1 % NaCl (optimum 0-0.3 %). The ribulose monophosphate pathway was operative for carbon assimilation. The DNA G+C content was 54.4 mol% and the major fatty acids were C(16 : 0) (52.0 %) and C(18 : 1)ω7c (34.8 %). Phylogenetic analysis of the 16S rRNA gene sequence indicated that strain HTM55(T) was closely related to Methylothermus thermalis MYHT(T) (99.2 % 16S rRNA gene sequence similarity), which is within the class Gammaproteobacteria. However, DNA-DNA relatedness between strain HTM55(T) and Methylothermus thermalis MYHT(T) was ≤ 39 %. On the basis of distinct phylogenetic, chemotaxonomic and physiological characteristics, strain HTM55(T) represents a novel species of the genus Methylothermus, for which the name Methylothermus subterraneus sp. nov. is proposed. The type strain is HTM55(T) ( = JCM 13664(T) = DSM 19750(T)).


Sustained hydrogen photoproduction by Chlamydomonas reinhardtii: Effects of culture parameters.
The green alga, Chlamydomonas reinhardtii, is capable of sustained H(2) photoproduction when grown under sulfur-deprived conditions. This phenomenon is a result of the partial deactivation of photosynthetic O(2)-evolution activity in response to sulfur deprivation. At these reduced rates of water-oxidation, oxidative respiration under continuous illumination can establish an anaerobic environment in the culture. After 10-15 hours of anaerobiosis, sulfur-deprived algal cells induce a reversible hydrogenase and start to evolve H(2) gas in the light. Using a computer-monitored photobioreactor system, we investigated the behavior of sulfur-deprived algae and found that: (1) the cultures transition through five consecutive phases: an aerobic phase, an O(2)-consumption phase, an anaerobic phase, a H(2)-production phase and a termination phase; (2) synchronization of cell division during pre-growth with 14:10 h light:dark cycles leads to earlier establishment of anaerobiosis in the cultures and to earlier onset of the H(2)-production phase; (3) re-addition of small quantities of sulfate (12.5-50 microM MgSO(4), final concentration) to either synchronized or unsynchronized cell suspensions results in an initial increase in culture density, a higher initial specific rate of H(2) production, an increase in the length of the H(2)-production phase, and an increase in the total amount of H(2) produced; and (4) increases in the culture optical density in the presence of 50 microM sulfate result in a decrease in the initial specific rates of H(2) production and in an earlier start of the H(2)-production phase with unsynchronized cells. We suggest that the effects of sulfur re-addition on H(2) production, up to an optimal concentration, are due to an increase in the residual water-oxidation activity of the algal cells. We also demonstrate that, in principle, cells synchronized by growth under light:dark cycles can be used in an outdoor H(2)-production system without loss of efficiency compared to cultures that up until now have been pre-grown under continuous light conditions.


Adverse Events Associated With Peroral Endoscopic Myotomy Affecting Extended Hospital Stay: A Multi-center Retrospective Study in South Korea.
To analyze various adverse events (AEs) related to the peroral endoscopic myotomy (POEM) procedure and to analyze whether these AEs are related to an extended hospital stay. Patients admitted for POEM for esophageal motility disorders from August 2012 to February 2020 at 5 centers were retrospectively collected. Length of hospital stay, AEs during or after the POEM procedure were analyzed. Of the 328 patients, 63.1% did not have any AEs, but 2.4% had major AEs, and 33.4% had minor AEs. Major AEs included mucosal injury, bleeding, and hemothorax, accounting for 1.5%, 0.6%, and 0.3%, respectively. Among the minor AEs, pneumoperitoneum was the most common gas-related AEs. Among non-gas-related minor AEs, pneumonia was the most common at 4.6%, followed by pain, fever, and pleural effusion. All major AEs had meaningful delayed discharge and significantly extended hospital stay compared to the no AEs group (median differences range 4.5-9.0 days). Among gas-related minor AEs, except for 4 cases of emphysema, the extended hospital stay was meaningless. All non-gas-related minor AEs was associated with a significant prolongation of hospital stay compared to that in the no AEs group (median differences range 2.0-4.0 days). In conclusion, most gas-related minor AEs do not significantly affect the patient's clinical course. However, subcutaneous emphysema and minor non-gas related AEs such as pneumonia, pain, fever, and pleural effusion can prolong the hospital stay, therefore careful observation is required. Efforts will be made to reduce major AEs that significantly prolong hospitalization.


Sublethal effects of organophosphorus insecticide phoxim on patch time allocation and oviposition behavior in a parasitoid wasp Meteorus pulchricornis.
Parasitoid wasps are key agents for controlling insect pests in integrated pest management programs. Although many studies have revealed that the behavior of parasitic wasps can be influenced by insecticides, the strategies of patch time allocation and oviposition have received less attention. In the present study, we forced the endoparasitoid Meteorus pulchricornis to phoxim exposure at the LC30 and tested the foraging behavior within patches with different densities of the host, the larvae of the tobacco cutworm Spodoptera litura. The results showed that phoxim treatment can significantly increase the patch-leaving tendency of female wasps, while host density had no impact. The number of oviposition and the number of previous patch visits also significantly influenced the patch time allocation decisions. The occurrence of oviposition behavior was negatively affected by phoxim exposure; however, progeny production was similar among patches with different host densities. Phoxim exposure shaped the offspring fitness correlates, including longer durations from cocoon to adult wasps, smaller body size, and shorter longevity. The findings of the present study highlight the sublethal effects that reduce the patch residence time and the fitness of parasitoid offspring, suggesting that the application of phoxim in association with M. pulchricornis should be carefully schemed in agroecosystems.


Time-of-flight electron spectrometer for a broad range of kinetic energies.
A newly constructed time-of-flight electron spectrometer of the magnetic bottle type is characterized for electron detection in a broad range of kinetic energies. The instrument is designed to measure the energy spectra of electrons generated from liquids excited by strong laser fields and photons in the range of extreme ultra violet and soft X-rays. Argon inner shell electrons were recorded to calibrate the spectrometer and investigate its characteristics, such as energy resolution and collection efficiency. Its energy resolution ΔE/E of 1.6% allows resolving the Ar 2p spin orbit structure at kinetic energies higher than 100 eV. The collection efficiency is determined and compared to that of the spectrometer in its field-free configuration.


Acceleration patterns in the lower and upper trunk during running.
The purpose of the present study was to relate 3D acceleration patterns of the lower and upper trunk during running to running gait cycle, assess the validity of stride duration estimated from acceleration patterns, investigate speed-dependent changes in acceleration, and examine the test-retest reliability of these parameters. Thirteen healthy young men performed two running trials each on a treadmill and on land at three speeds (slow, preferred, and fast). The 3D accelerations were measured at the L3 spinous process (lower trunk) and the ensiform process (upper trunk) and synchronised with digital video data. The amplitude and root mean square of acceleration and stride duration were calculated and then analysed by three-way analysis of variance to test effects of running conditions, device location, and running speed. Bland-Altman analysis was used to evaluate the test-retest reliability. Marked changes in acceleration were observed in relation to foot strike during running. Stride durations calculated from the vertical accelerations were nearly equal to those estimated from video data. There were significant speed effects on all parameters, and the low test-retest reliability was confirmed in the anterior-posterior acceleration during treadmill running and the anterior-posterior acceleration at slow speed during treadmill and overground running.


Factors influencing bone fractures in severely disabled persons.
Factors affecting bone fracture in severely disabled persons were evaluated. Bone mineral density was measured, and the ratio against the average values in healthy subjects was calculated. Seventy-three subjects were selected from among 113 inpatients with severe mental and physical handicaps. The subjects were classified into four levels of mobility. Multiple logistic regression analysis was conducted to determine the contribution of variables to the history of bone fracture. Age, medication of sodium valproate, and bone mineral density percentage were found to significantly affect bone fracture. Increase of bone mineral density is the protective or preventive factor in bone fracture.


Genes, emotions and gut microbiota: The next frontier for the gastroenterologist.
Most medical specialties including the field of gastroenterology are mainly aimed at treating diseases rather than preventing them. Genomic medicine studies the health/disease process based on the interaction of the human genes with the environment. The gastrointestinal (GI) system is an ideal model to analyze the interaction between our genes, emotions and the gut microbiota. Based on the current knowledge, this mini-review aims to provide an integrated synopsis of this interaction to achieve a better understanding of the GI disorders related to bad eating habits and stress-related disease. Since human beings are the result of an evolutionary process, many biological processes such as instincts, emotions and behavior are interconnected to guarantee survival. Nourishment is a physiological need triggered by the instinct of survival to satisfy the body's energy demands. The brain-gut axis comprises a tightly connected neural-neuroendocrine circuitry between the hunger-satiety center, the dopaminergic reward system involved in the pleasure of eating and the gut microbiota that regulates which food we eat and emotions. However, genetic variations and the consumption of high-sugar and high-fat diets have overridden this energy/pleasure neurocircuitry to the point of addiction of several foodstuffs. Consequently, a gut dysbiosis generates inflammation and a negative emotional state may lead to chronic diseases. Balancing this altered processes to regain health may involve personalized-medicine and genome-based strategies. Thus, an integrated approach based on the understanding of the gene-emotions-gut microbiota interaction is the next frontier that awaits the gastroenterologist to prevent and treat GI disorders associated with obesity and negative emotions.


Laparoscopic Revision of Failed Bariatric Procedures.
The main indications for revision of bariatric surgery are inadequate weight loss, weight regain, or complications. The objective of revision is to restore the restrictive component and/or add a malabsorptive component. To evaluate the effectiveness of revisional laparoscopic bariatric surgery for loss of weight and assess the risks and benefits associated with these technically demanding procedures. Revision cases performed between 2001 and 2013 were identified and grouped according to the primary procedure and type of revision. A retrospective analysis was carried out for weight loss as well as perioperative morbidity and mortality. The total of 271 patients underwent revisional laparoscopic surgery during the study period and were categorized into four groups. Group 1 (n = 67) had an adjustable gastric band converted to gastric bypass (GBP). Group 2 (n = 128) had a dilated gastric pouch after GBP and underwent pouch reduction. Group 3 (n = 57) had a GBP and underwent pouch reduction and elongation of the biliopancreatic limb. Group 4 (n = 19) had a vertical banded gastroplasty converted to a GBP. The mean total body weight loss for Groups 1 to 4 was 35.3%, 22.9%, 39.4%, and 33.2%, respectively. The average operative times were 185, 75, 142, and 205 minutes; and the average hospitalization was 1.5, 1.0, 2.0, and 2.5 days, respectively. All cases were completed laparoscopically. Concomitant procedures were liver biopsy, cholecystectomy, partial gastrectomy, hiatal, ventral, and internal hernia repairs. Complication rates were 2.9%, 0%, 3.5%, and 5.2% for each of the groups and there were no mortalities. Results of revisional bariatric surgery vary depending on the original procedure and the reasons for revision. In particular, if the main reason for reoperation is inadequate weight loss, then the burden is to demonstrate a surgically correctable deficiency. Revisional procedures incorporating malabsorption result in greater weight loss than gastric restriction alone.


Developmental trajectories of body mass index from childhood into late adolescence and subsequent late adolescence-young adulthood cardiometabolic risk markers.
Reports on body mass index (BMI) trajectories from childhood into late adolescence, their determinants, and subsequent cardiometabolic risk markers, particularly among European populations have been few. Moreover, sex-specific investigation is necessary considering the sex difference in BMI, and the sex-specific association between BMI and some cardiometabolic risk markers. Using a sample from the DOrtmund Nutritional and Anthropometric Longitudinally Designed study, we explored sex-specific trajectories of the BMI standard deviation score (SDS) from 4 to 18 years of age in 354 males and 335 females by latent (class) growth models. The determinants of trajectory were assessed by logistic regression. We identified cardiometabolic risk markers that were highly associated with BMI SDS trajectory by random forest regression, and finally we used generalized linear models to investigate differences in the identified cardiometabolic risk markers between pairs of trajectories. We observed four: 'low-normal weight', 'mid-normal weight', 'high-normal weight', and 'overweight', and three: ''low-normal weight', 'mid-normal weight', and 'high-normal weight' trajectories in males and females, respectively. Higher maternal prepregnancy BMI was associated with the 'overweight' trajectory, and with 'high-normal weight' trajectory in both sexes. In addition, employed mothers and first-born status were associated with 'high-normal weight' trajectory in females. BMI SDS trajectory was associated with high-density lipoprotein-cholesterol and interleukin-18 (IL-18) in males, and diastolic blood pressure and interleukin-6 (IL-6) in females. However, only males following the 'overweight' trajectory had significantly higher IL-18 when compared to their 'low-normal weight' counterpart. We identified sex-specific distinct trajectories of BMI SDS from childhood into late adolescence, higher maternal prepregnancy BMI as a common determinant of the 'high-normal weight' and 'overweight' trajectories, and 'overweight' trajectory being associated with elevated IL-18 in late adolescence-young adulthood. This study emphasizes the role of maternal prepregnancy BMI in overweight, and highlights IL-18 as a cardiometabolic signature of overweight across life.


Diagnostic accuracy, work-up, and outcomes of pregnancies with clubfoot detected by prenatal sonography.
To assess diagnostic accuracy, related findings, and outcomes of fetuses with clubfoot. Sonographic characteristics, pregnancy work-up, and postnatal outcomes were evaluated in 109 fetuses with clubfoot. Among 40 320 prenatal ultrasound anomaly scans, clubfoot was diagnosed in 150 (0.37%). Analysis included 108 pregnancies (72%) with 109 fetuses. Bilateral clubfoot was diagnosed in 51/109 (46.7%) fetuses and unilateral in 58/109 (53.2%). Clubfoot was diagnosed as an isolated anomaly in 76/109 (69.7%) and complex in 33/109 (30.2%). Amniocentesis or chorionic villus sampling in 48/109 (44%) yielded 6 (12.5%) with abnormalities (5.5% of the entire cohort). Diagnosis was confirmed in 65/91 (71.4%) liveborn infants. In singletons, 7/63 (11.1%) cases considered isolated on ultrasound had additional anomalies postpartum and 8/14 (57.1%) complex cases were verified after birth. Sonographic diagnosis of clubfoot was verified postpartum in more singletons than twins (p = 0.05). Bilateral clubfoot was verified postpartum more often than unilateral [29/33 (87.9%) vs. 29/44 (65.9%), respectively; p = 0.03]. Bilateral clubfoot resulted in additional prenatal testing without increased likelihood of finding additional anomalies and was associated with more surgical interventions postnatally. Prenatal ultrasound diagnosis of clubfoot is more accurate in singletons with bilateral findings. Bilateral findings do not increase the likelihood of additional anomalies. Karyotyping should be considered even with isolated clubfoot. © 2017 John Wiley & Sons, Ltd.


Psychiatric classification - a developmental perspective.
Current classification systems treat developmental and adult psychopathologies as separate. However, as risk factors for psychiatric disorders are identified it is increasingly clear that these can lead to multiple outcomes across different developmental stages. Research and classification schemes will therefore in the future need to adopt a lifespan approach to risk.


Parent Observations of the Health Status of Infants With Clefts of the Lip: Results From Qualitative Interviews.
To explore, using semistructured qualitative interviews, parent observations of their infant's health as they relate to having a cleft lip or cleft lip and cleft palate (CL±P) and/or associated treatments. Cross-sectional, qualitative study across 3 sites. Parents were recruited from 3 academic craniofacial centers. Most interviews were conducted over the telephone, audio-recorded, and transcribed. Forty-one parents (31 English-, 10 Spanish-speaking) were interviewed. Parents had a child ages 1 to 35 months diagnosed with CL±P. Twelve domains reflecting infant health and well-being, likely affected by a CL±P and/or associated treatments, were identified from clinical experience and literature review. Study investigators conducted semistructured interviews based on 12 identified domains. After transcripts of the interviews were reviewed, our multidisciplinary team selected illustrative quotes from each domain that reflected consistent observations made by parents. Parents' responses covered all 12 domains. Specifically, parents discussed the domain of feeding most frequently, followed by observations about sleep, development, comfort, breathing, and vocalization. We found that parents of infants with clefts provided caregiver-centered language useful in describing their daily observations. No additional domains of infant health were noted by parents. We will use these observations and language to develop and validate a parent-reported observation diary that can augment assessments of the impacts of interventions on infants who are receiving care for CL±P.


A Nanostructured SERS Switch Based on Molecular Beacon-Controlled Assembly of Gold Nanoparticles.
In this paper, highly purified and stable gold nanoparticle (AuNP) dimers connected at the two ends of DNA linkage were prepared by a versatile method. A nanostructured, surface-enhanced Raman scattering (SERS) switching sensor system was fabricated based on the controlled organization of gold nanoparticles (AuNPs) by a DNA nanomachine through the controlled formation/deformation of SERS "hotspots". This strategy not only opens opportunities in the precise engineering of gap distances in gold-gold nanostructures in a highly controllable and reproducible fashion, but also provides a unique ability to research the origin of SERS and sequence-specific DNA detection.


CD4 and p56lck can stably associate when co-expressed in NIH3T3 cells.
The CD4 T-cell surface antigen and the lymphocyte-specific tyrosine-protein kinase p56lck form a stable noncovalent complex in CD4+ T-lymphocytes. In this report, we demonstrate that these two gene products can also associate when co-expressed in NIH3T3 fibroblasts, therefore implying that other lymphoid specific components are not required for the CD4-lck interaction. These results also suggest that co-expression of CD4 and p56lck in non-lymphoid cells may prove to be a useful model system for the analysis of structural and possibly functional CD4-lck interactions.


Differential role of MAP kinase isoforms in malachite green transformed Syrian hamster embryo fibroblasts in culture.
Malachite green (MG) induces DNA damage and malignant transformation of Syrian hamster embryo (SHE) cells in primary culture. In the present study, we have studied the role of all the three isoforms of mitogen activated protein (MAP) kinases i.e. ERK (extracellular regulated kinase), JNK (JUN- N- terminal kinase) and p38 kinase during transformation of SHE cells by MG. The results showed that transformed cells were associated with a decreased expression of phosphoactive ERK and JNK and increased expression of p38 kinase as evident from the Western blot, immunofluorescence and flow cytometry studies. Also, a persistent nuclear localization of p38 kinase was observed in the transformed cells. The present study indicated that p38 kinase was present at higher levels and seemed to be associated with transformation, which suggested that inhibitors of p38 kinase could serve in general as potential agents for selective cancer therapy.


Non-technical skills of surgical trainees and experienced surgeons.
In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience.


The Foot and Ankle Kinematics of a Simulated Progressive Collapsing Foot Deformity During Stance Phase: A Cadaveric Study.
Progressive collapsing foot deformity (PCFD) is a complex pathology associated with tendon insufficiency, ligamentous failure, joint malalignment, and aberrant plantar force distribution. Existing knowledge of PCFD consists of static measurements, which provide information about structure but little about foot and ankle kinematics during gait. A model of PCFD was simulated in cadavers (sPCFD) to quantify the difference in joint kinematics and plantar pressure between the intact and sPCFD conditions during simulated stance phase of gait. In 12 cadaveric foot and ankle specimens, the sPCFD condition was created via sectioning of the spring ligament and the medial talonavicular joint capsule followed by cyclic axial compression. Specimens were then analyzed in intact and sPCFD conditions via a robotic gait simulator, using actuators to control the extrinsic tendons and a rotating force plate underneath the specimen to mimic the stance phase of walking. Force plate position and muscle forces were optimized using a fuzzy logic iterative process to converge and simulate in vivo ground reaction forces. An 8-camera motion capture system recorded the positions of markers fixed to bones, which were then used to calculate joint kinematics, and a plantar pressure mat collected pressure distribution data. Joint kinematics and plantar pressures were compared between intact and sPCFD conditions. The sPCFD condition increased subtalar eversion in early, mid-, and late stance (P < .05), increased talonavicular abduction in mid- and late stance (P < .05), and increased ankle plantarflexion (P < .05), adduction (P < .05), and inversion (P < .05). The center of plantar pressure was significantly (P < .01) medialized in this model of sPCFD and simulated stance phase of gait. Subtalar and talonavicular joint kinematics and plantar pressure distribution significantly changed with the sPCFD and in the directions expected from a PCFD foot. We also found that ankle joint kinematics changed with medial and plantar drift of the talar head, indicating abnormal talar rotation. Although comparison to an in vivo PCFD foot was not performed, this sPCFD model produced changes in foot kinematics and indicates that concomitant abnormal changes may occur at the ankle joint with PCFD. This study describes the dynamic kinematic and plantar pressure changes in a cadaveric model of simulated progressive collapsing foot deformity during simulated stance phase.


Argyrophil carcinoid tumors of the lung. Incidence, clinical study, and follow-up of 46 patients.
Forty-nine patients with lung tumors initially diagnosed as carcinoids from their cellular appearance and arrangement were originally included in the study. The tumors of 46 of these patients showed an argyrophil reaction with the Grimelius silver stain. The three nonargyrophil tumors were reclassified as noncarcinoid tumors at further examination. The use of the argyrophil technique in characterization of the lung carcinoid tumors is discussed. The incidence of lung carcinoid tumors in the County of Uppsala was 0.7 patients per 100,000 inhabitants per year. Eleven patients with detected disease were symptom-free. The doctor's delay in 9 patients was 3 to 13.8 years. Yet, the prognosis was good, with 5-year survival in 91 percent, 10-year survival in 91 percent, and 15-year survival in 86 percent of the 46 surgically-treated patients. It is concluded that the surgical treatment should at least comprise a lobectomy.


Effect of Receiving Dental Treatment on mortality among nursing facility residents.
To assess the association between receipt of different types of dental procedures and mortality among nursing home residents. Between June 2006 and March 2008, 535 nursing home residents received a health screening assessment and were offered comprehensive dental care. Death certificate data were obtained in September 2013 and multivariable regression models were generated to assess the effect of dental procedures delivered after the screening assessment on mortality, adjusting for demographic and health-related covariates. Residents had a mean age of 85.2 years at baseline and approximately 30% were edentulous. About two-thirds received at least one dental procedure, and about 88% had died, between the screening date and the end of follow-up. Among dentate residents, after adjustment for relevant covariates, for each one-unit increase in the number of intervals during which they received at least one preventive dental procedure there was a 13% decrease in mortality (HR = 0.87, 95% CI = 0.78-0.98) at any given time, while for prosthetic dental procedures there was a 16% decrease in mortality (HR = 0.84, 95% CI = 0.72-0.97). Among edentulous residents, only prosthetic procedures were analyzed, and they were not significantly associated with mortality. Among dentate institutionalized elderly, receipt of preventive or prosthetic dental procedures was associated with decreased mortality.


[Role of hepatic stellate cells in the angiogenesis of hepatoma].
Hepatic stellate cells (HSCs) in the hepatocellular carcinoma are responsible for tumor encapsulation as a host defense mechanism. Recently, it was suggested that HSCs might play an important role in hepatic angiogenesis. Thus, HSCs in the HCC may be involved in tumor angiogenesis and pathogenesis of hepatic carcinogenesis. The purpose of this study was to examine the involvement of activated HSCs in the angiogenesis of hepatoma. We investigated the effect of human HSC conditioned medium (CM) on the endothelial cell proliferation with or without stimulation of HepG2 CM, using [3H] thymidine incorporation assay. Additionally, we investigated the effect of HepG2 CM on HSCs proliferation and messenger RNA (mRNA) expression of various pro-angiogenic factors such as interleukin 8 (IL-8), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) in HSCs. HSC CM caused a significant increase in DNA synthesis in human umbilical vein endothelial cells (HUVEC). The endothelial proliferation effect of HSCs was augmented by HepG2 CM. HepG2 CM significantly increased HSCs proliferation and stimulated IL-8 and bFGF mRNA expression in HSCs. HSCs promote endothelial proliferation through various soluble factors. The soluble factors secreted in HepG2 stimulate HSC proliferation and up-regulate mRNA expression of proangiogenic factors. This result suggests that HSCs may play an important role in the angiogenesis of hepatoma.


Benefits of Cultural Activities on People with Cognitive Impairment: A Meta-Analysis.
Museums and cultural institutions are increasingly aware of both the interests and needs of society. Accordingly, these institutions are becoming allies in terms of health and well-being due to the importance of their social functions. Presently, many institutions create cultural activities aimed at cognitively impaired people, a group on the rise owing to the prevalence of dementia and the aging of society. Nevertheless, scientific evidence in this field remains scarce. As a result, the main objective of this research was to empirically evaluate and identify the benefits that cultural interventions can bring to cognitively impaired participants. A meta-analysis (MA) was performed following PRISMA guidelines. When inclusion and eligibility criteria had been established, articles were subsequently selected through a strategic search of Web of Science, SCOPUS, PubMed, and Medline. Twenty-six studies met the eligibility criteria, involving a total of 1201 participants with cognitive impairment. The results showed a statistically non-significant effect size when analyzing these cultural interventions for cognitively impaired people overall. However, when conducting partial meta-analyses (MA'), focusing on studies related to a specific disease, a particular type of treatment, or a specific type of evaluation, the results concurred with the conclusion of the previous systematic review (SR). Despite the high heterogeneity of the studies, benefits were identified in emotional well-being and social aspects but not in clinical ones such as the deterioration of cognitive or motor function, among others.


Return of function after intracranial suture of the trochlear nerve. Case report.
An excellent functional result was obtained after microsuture of a trochlear nerve which was inadvertently divided during the course of a craniotomy. Successful intracranial suture of this nerve has not previously been reported. Ophthalmoscopic detection of excyclotorsion of the eye on the side of the trochlear nerve palsy is discussed, along with its value in the differential diagnosis of acquired vertical diplopia.


RhBMP-2-Loaded PLGA/Titanium Nanotube Delivery System Synergistically Enhances Osseointegration.
Although Ti-based implants have been widely used, osseointegration failure can also be found between implants and the surrounding bone tissue, especially in aged patients or in patients with certain systemic diseases. Therefore, in this research, we establish a sustained rhBMP-2 delivery system on a titanium implant surface, an anodic oxidation TiO2 nanotube layer combined with the PLGA film, to enhance osseointegration. This designed system was characterized as follows: surface topography characterization by SEM and AFM; rhBMP-2 release; and the ability to influence MC3T3 cell adhesion, proliferation, and osteogenic differentiation in vitro. Additionally, we evaluated the ability of this system to generate new bone around implants in rabbit tibias by the histological assay and removal torque test. SEM and AFM showed that PLGA membranes were formed on the surfaces of TiO2 nanotube arrays using 1, 3, and 10% PLGA solutions. The 3% PLGA group showed a perfect sustained release of rhBMP-2, lasting for 28 days. Meanwhile, the 3% PLGA group showed improved cell proliferation and osteogenic mRNA expression levels. In the in vivo experiments, the 3% PLGA group had the ability to promote osteogenesis in experimental animals. The anodized TiO2 nanotube coated with a certain thickness of the PLGA layer was an ideal and suitable rhBMP-2 carrier. This modified surface enhances osseointegration and could be useful in clinical dental implant treatment.


Effect of GNP functionalisation and multiple N-methylation of β-amyloid residue (32-37) on Gram-positive bacterium.
In the previous report, the authors showed the gold nanoparticle (GNP) functionalised multiple N-methylated fragments of the residue (32-37) of beta (β)-amyloid protein (1-42), CGGIGLMVG and CGGGGGIGLMVG toward disruption of β-amyloid (1-42), the predominant component of senile plaques. Herein the in vitro antimicrobial activities of both normal and multiple N-methylated sequences of CGGIGLMVG and CGGGGGIGLMVG were screened and it was found that all the eight sequences including four (non-functionalised with GNP) to possess activity against both Gram-positive [Staphylococcus aureus (ATCC 43300) and Enterococcus faecalis (ATCC 5129)] and Gram-negative [Escherichia coli (ATCC 35218), Pseudomonas aeruginosa (ATCC 27853) and Klebsiella pneumoniae (ATCC 700603)] bacteria. Among them, N-methylated sequences CGGIGLMVG and CGGGGGIGLMVG shown remarkable activity against Gram-positive bacteria.


Spontaneous or intentional? Involuntary versus voluntary episodic memories in older and younger adults.
Involuntary episodic memories are memories of past events that come to mind with no preceding attempt of retrieval. Such memories have received little attention in relation to aging compared with voluntary episodic memories (i.e., intentionally retrieved memories of past events). It is well documented that older compared with younger adults have reduced access to episodic memories, when retrieval is voluntary, but little is known about their involuntary episodic recall. Recent evidence suggests that involuntary autobiographical memories are at least as frequent as voluntary autobiographical memories in daily life, but this research has been limited to younger adults. Here older and younger adults recorded involuntary and voluntary episodic memories in relation to a film of a simulated event (Study 1) and during a normal day in their lives (Study 2). Across both studies, no age differences were found regarding the frequency of involuntary episodic memories, whereas older adults showed slower (Study 1) and less frequent (Study 2) voluntary remembering compared with younger adults. The findings suggest that involuntary relative to voluntary episodic remembering is enhanced in older adults, consistent with reduced executive functioning and increased processing of task irrelevant information with aging. Involuntary episodic remembering may provide an adaptive compensation for reductions in strategic retrieval in later adulthood. (PsycINFO Database Record


Polysaccharides From the Aerial Parts of Tetrastigma Hemsleyanum Diels et Gilg Induce Bidirectional Immunity and Ameliorate LPS-Induced Acute Respiratory Distress Syndrome in Mice.
Tetrastigma hemsleyanum Diels et Gilg (Sanyeqing, SYQ) has traditionally been used to treat inflammation, high fever and improve immune function of patients. Polysaccharides have been proved to be one of the important components of SYQ. Previous studies have confirmed the antipyretic and antitumor effects of polysaccharides from SYQ (SYQP), and clarified that SYQP could enhance immunity through TLR4 signalling pathway. However, there were more possibilities for the mechanism by which SYQP exerted immunomodulatory effects and the role of SYQP in acute respiratory distress syndrome (ARDS) is elusive. The purpose of this study was further to explain the bidirectional modulation of immunity mechanism of SYQP in vitro and its effect in LPS-induced ARDS in vivo. Experimental results showed that SYQP significantly stimulated gene expressions of TLR1, TLR2 and TLR6 and secretion of cytokines in RAW264.7 cells. Individual or combined application of TLR2 antagonist C29 and TLR4 antagonist TAK-242 could reduce SYQP-mediated stimulation of cytokine secretion in RAW264.7 cells and mouse peritoneal macrophages (MPMs) to varying degrees. On the other hand, SYQP markedly inhibited the expression levels of inflammatory cytokines, NO, iNOS and COX-2 in LPS-treatment RAW264.7 cells. Moreover, in vivo results indicated that SYQP significantly reduced LPS-induced damage in ARDS mice through alleviating LPS-induced pulmonary morphological damage, inhibiting myeloperoxidase (MPO) expression levels, ameliorating the inflammatory cells in bronchoalveolar lavage fluid (BALF) and improving hematological status. Meanwhile, SYQP evidently reduced IL-6, TNF-α and IFN-γ secretion, the overexpression levels of TLR2 and TLR4, as well as the phosphorylation of NF-κB p65. In addition, SYQP reduced the phosphorylation of JAK2 and STAT1 and the overexpression of NLRP3, caspase-1, caspase-3 and caspase-8 in lung tissues of ARDS mice. In summary, our study confirmed that SYQP induced bidirectional immunity and ameliorated LPS-induced acute respiratory distress syndrome in mice through TLR2/TLR4-NF-κB, NLRP3/caspase and JAK/STAT signaling pathways, which provided a theoretical basis for further use of SYQP.


Kaposi's sarcoma associated with multiple myeloma.
A 62-year-old black female with Kaposi's sarcoma associated with multiple myeloma is reported. The co-existence of the two entities in the same patient appears more than coincidental. The case is the first woman and only the fifth described with Kaposi's sarcoma associated with multiple myeloma.


Roles of active site residues and the HUH motif of the F plasmid TraI relaxase.
Bacterial conjugation, transfer of a single strand of a conjugative plasmid between bacteria, requires sequence-specific single-stranded DNA endonucleases called relaxases or nickases. Relaxases contain an HUH (His-hydrophobe-His) motif, part of a three-His cluster that binds a divalent cation required for the cleavage reaction. Crystal structures of the F plasmid TraI relaxase domain, with and without bound single-stranded DNA, revealed an extensive network of interactions involving HUH and other residues. Here we study the roles of these residues in TraI function. Whereas substitutions for the three His residues alter metal-binding properties of the protein, the same substitution at each position elicits different effects, indicating that the residues contribute asymmetrically to metal binding. Substitutions for a conserved Asp that interacts with one HUH His demonstrate that the Asp modulates metal affinity despite its distance from the metal. The bound metal enhances binding of ssDNA to the protein, consistent with a role for the metal in positioning the scissile phosphate for cleavage. Most substitutions tested caused significantly reduced in vitro cleavage activities and in vivo transfer efficiencies. In summary, the results suggest that the metal-binding His cluster in TraI is a finely tuned structure that achieves a sufficient affinity for metal while avoiding the unfavorable electrostatics that would result from placing an acidic residue near the scissile phosphate of the bound ssDNA.


Intrapulmonary channel for one-stage correction of aortic arch obstruction.
There are several methods of surgical repair of aortic coarctation or interruption; the optimal technique is still controversial. The purpose of this study was to assess a new surgical method: intrapulmonary channel for one-stage repair of aortic coarctation or interruption associated with intracardiac anomalies. Between 1993 and 1995, 4 patients with aortic coarctation or interruption and intracardiac anomalies received one-stage surgical correction. Their ages ranged from 5 to 26 years (mean, 16 years). The aortic arch lesions were preductal coarctation in 2, and type B interruption in 2. Coexisting anomalies consisted of patent ductus arteriosus in 4, ventricular septal defect in 3, and aortopulmonary window in 1. An intrapulmonary channel was constructed in all patients, and co-existing anomalies were corrected simultaneously. There was no hospital death or late mortality. A cerebral complication occurred in one patient because of air embolism. Mean follow-up was 9.5 years (range, 8.5-11.5 years). There was no evidence of recoarctation or late aneurysm formation. For selected patients with aortic coarctation or interruption and intracardiac anomalies, an intrapulmonary channel might be an option for one-stage correction.


Millennial scale maximum intensities of typhoon and storm wave in the northwestern Pacific Ocean inferred from storm deposited reef boulders.
Typhoons and associated storm waves in the northwestern Pacific Ocean commonly cause coastal disasters. The possibility remains that an even stronger typhoon than the strongest one observed to date might have occurred before. The development of a method to estimate a maximum intensity of past typhoons over thousands of years is important for paleoclimatology, paleoceanography and disaster prevention. Numerous storm wave boulders exist on reefs in the Ryukyu Islands, Japan, which have been deposited to their present position by the cumulative effects of the past storm waves. These boulders can be used as proxies for the hydrodynamic conditions of the largest waves from past events. Here, we present numerical computations for storm waves and boulder transport with the boulder distribution as a constraint factor to estimate the maximum intensities of storm waves and their causative typhoon events over the past 3500 years. Though the intensities of the maximum estimated waves and associated typhoon events were slightly stronger than those recorded over the past ~70 years in the Ryukyu Islands, our results suggest that no abnormally intense typhoon has struck the Ryukyu Islands in the past 3500 years. The potential impact from tsunamis remains uncertain; however, our results are meteorologically reasonable.


Social relationships as predictors of depression and suicidal ideation in older adults.
The prevalence of depression and suicidal ideation among older adults is considered to be a major mental health concern among this age group. The present study investigated the human relatedness variables of marital status, social support resources and sense of belonging as predictors of depression and suicidal ideation in older adults. A community sample of 110 older adults (M age 76.67 years, SD = 8.11) completed the Social Support Subscale of the Coping Resources Inventory, the Sense of Belonging Instrument, the Zung Depression Inventory and the Suicide Subscale of the General Health Questionnaire. Results indicated that fewer social support resources were associated with higher levels of depression and suicidal ideation. Sense of belonging to the community was not an additional predictor of mental health. The results of the present study suggest that enhancing social support resources in older adults could reduce depression and suicidal ideation.


Effects of platelet-rich fibrin and dexamethasone on nerve regeneration after acute facial-nerve injury.
Acute facial-nerve injury. To investigate the effects of platelet-rich fibrin (PRF) and dexamethasone on nerve regeneration. Thirty-six rats were randomly divided into six groups. Facial-nerve injury was created using a full-thickness incision in all groups except Group E. Next, primary anastomosis, PRF application, topical dexamethasone application, primary anastomosis with topical PRF and dexamethasone application, and no facial-nerve repair were performed in Groups A, B, C, D, and F, respectively. Clinical, functional, and structural improvements were evaluated at eight weeks. The mean eye-closure movement score in Group B was significantly higher than that in Group F (p < .001). The mean whisker-movement score in Group B was significantly higher than that in Group F (p = .001). The mean amplitude of whisker movement in Group F was significantly lower than those in Groups A, B, C, and E, and the mean amplitude in Group D was significantly lower than that in Group E (p < .001). Furthermore, an improvement in nerve ultrastructure was observed in Group B. PRF application has a positive effect on nerve recovery after anastomosis. Contribute to the literature to improve nerve regeneration.


Transcriptomics and proteomics: tools for optimising phytoremediation activities.
Negligent industrial development has greatly contributed to environmental pollution through the contamination of water and soil by xenobiotic organic chemicals Remedial strategies to deal with chemical pollution require reliable methods to identify and monitor contamination, as well as effective procedures to attenuate or to eliminate the pollutant. In the food chain, plants are ideally placed as early bio-indicators of environmental pollution as they experience and respond to environmental toxicants sooner than organisms at higher trophic levels. Furthermore, some plants are capable of detoxifying anthropogenic chemicals by metabolic transformation and could prove useful for the remediation of contaminated water and soil: so-called phytoremediation. So far research technologies aimed at developing plants for bio-indication/bio-monitoring and for remediation have largely relied on standardised chemical and biochemical procedures to evaluate phytotoxicity, metabolic fate and persistence of organic pollutants in plants. The next stage in the evolution of these plant-based technologies is the improvement and optimisation of any innate phytoremediation activities identified in selected plants. In general, uptake followed by metabolism and compartmentation is responsible for the detoxification of organic xenobiotics in plants. These are complex cellular systems that may be organised in well-defined pathways and are often controlled by large families of genes. In order to elucidate complex traits such as detoxification, an emerging idea is to make use of global approaches such as the new "omic" technologies to identify molecular changes in plant tissues exposed to specific organic xenobiotics. From expression profiles at the messenger RNA level, transcriptomics permit the identification of function-related gene clusters and at the protein level proteomics provide information on where, when and at what level specific proteins accumulate. We conclude that these global approaches may be a useful way of widening screening capability to identify appropriate molecular markers that can be used to improve detoxification activity.


A study of endodontically apexified teeth.
This study was undertaken to determine the clinical and radiographic success of calcium hydroxide apexification in a group of 48 patients requiring endodontic therapy because of pulpal necrosis prior to root-end closure. The study examined tooth number, etiology of pulpal necrosis, age, sex, size of root-end opening, size of radiolucency, crown discoloration, interappointment symptoms, and total treatment time from initial instrumentation to completion of apexification. Apexification required an average of 1 year +/- 7 months. A statistically significant relationship was found between: the presence of a radiolucency and development of interappointment symptoms (p less than 0.04); and the size of apex opening and development of interappointment symptoms (p less than 0.02). If symptoms did develop, apexification was delayed an additional 5 months when compared to patients who did not have symptoms. Calcium hydroxide apexification was found to be statistically highly successful regardless of the clinical variables encountered.


Evidence for fungal and chemodenitrification based N2O flux from nitrogen impacted coastal sediments.
Although increasing atmospheric nitrous oxide (N2O) has been linked to nitrogen loading, predicting emissions remains difficult, in part due to challenges in disentangling diverse N2O production pathways. As coastal ecosystems are especially impacted by elevated nitrogen, we investigated controls on N2O production mechanisms in intertidal sediments using novel isotopic approaches and microsensors in flow-through incubations. Here we show that during incubations with elevated nitrate, increased N2O fluxes are not mediated by direct bacterial activity, but instead are largely catalysed by fungal denitrification and/or abiotic reactions (e.g., chemodenitrification). Results of these incubations shed new light on nitrogen cycling complexity and possible factors underlying variability of N2O fluxes, driven in part by fungal respiration and/or iron redox cycling. As both processes exhibit N2O yields typically far greater than direct bacterial production, these results emphasize their possibly substantial, yet widely overlooked, role in N2O fluxes, especially in redox-dynamic sediments of coastal ecosystems.


In vitro assembly of coiled bodies in Xenopus egg extract.
When demembranated sperm nuclei are placed in a Xenopus egg extract, they become surrounded by a nuclear envelope and then swell to form morphologically typical pronuclei. Granules ranging from < 1.0 to approximately 3.0 microns in diameter appear within such nuclei. Bell et al. identified four nucleolar proteins in these "prenucleolar bodies" by immunofluorescent staining (fibrillarin, nucleolin, B23/NO38, 180-kDa nucleolar protein). By in situ hybridization we show that these bodies also contain U3 and U8 small nuclear RNAs (snRNAs), known to be involved in pre-rRNA processing. Moreover, they contain all the snRNAs involved in pre-mRNA splicing (U1, U2, U4, U5, and U6), as well as U7, which is required for histone pre-mRNA 3' end formation. In addition to the nucleolar antigens previously identified, we demonstrated staining with antibodies against the Sm epitope, trimethylguanosine, and coilin. Because the composition of these prenucleolar bodies is closer to that of coiled bodies than to nucleoli, we propose that they be referred to as coiled bodies. The existence of large coiled bodies in transcriptionally inactive pronuclei suggests that they may play a role in the import, assembly, and storage of RNA processing components but are not themselves sites of processing. In transcriptionally active nuclei coiled bodies could serve as sites for initial preassembly and distribution of snRNP complexes for the three major RNA processing pathways: pre-mRNA splicing, pre-rRNA processing, and histone pre-mRNA 3' end formation.


Central and peripheral fat and subclinical vascular damage in older women.
the aim of this study was to evaluate the relationship between fat distribution and arterial compliance in a group of elderly women, in particular to test a possible independent role of abdominal fat mass and peripheral fat mass on subclinical vascular damage, defined by a pulse wave velocity (PWV) >12 m/s. in 96 women with age range 60-80 years (68.65 ± 4.98 years) and BMI range from 18.8 to 41.2 kg/m(2) (27.07 ± 4.61 kg/m(2)), we evaluated the body mass index, waist circumference, systolic and diastolic blood pressure, fasting glucose, cholesterol, LDL and HDL cholesterol, triglycerides and body composition by dual energy X-ray absorptiometry (DXA). Arterial stiffness was assessed by carotid-femoral (PWVcf) and carotid-radial pulse wave velocity (PWVcr). significant associations were found between PWVcf, age, waist circumference, BMI and trunk fat assessed by DXA, as well as TG and HDL cholesterol. After adjustment for the total fat mass a negative statistically significant association between PWVcf and leg fat mass was shown. In multiple regression analyses the mean arterial pressure, trunk fat mass and leg fat mass were significant predictors of vascular damage with OR, respectively, of 1.06 (CI: 1.01-1.11), 1.25 (CI: 1.06-1.48) and 0.73 (CI: 0.53-0.99). the results of this study show, in a sample of apparently healthy elderly women, that central and peripheral adiposity are independent predictors, with an opposite effect on subclinical vascular damage, confirming and strengthening the protective role of the gluteal-femoral fat on cardiovascular risk even in elderly.


Gender and Conflict Resolution Strategies in Spanish Teen Couples: Their Relationship With Jealousy and Emotional Dependency.
Previous research has pointed to the need to address the study of violence in teen couples. However, research has not delved into the study of the variables related to the different types of violence employed by boys and girls. The purpose of this study was to test whether gender, jealousy, and dependency predict specific strategies for conflict resolution (psychological aggression and mild physical aggression). Another objective of the study was to test gender differences in the conflict resolution strategies used by Spanish teen couples and to test the association between these variables and jealousy and emotional dependency. A sample of 296 adolescent high school students between 14 and 19 years of age of both genders from the south of Spain participated in this study. Hierarchical regression models were used to estimate the relationship between psychological aggression and mild physical aggression, and jealousy, and dependency. Results showed that jealousy correlated with psychological aggression and mild physical aggression in girls but not in boys. Psychological aggression and mild physical aggression were associated with dependency in boys. Girls scored higher in psychological aggression and jealousy than did boys. Finally, the interaction between jealousy and dependency predicted psychological aggression only in girls. These results highlight the need to address the role of the interaction between dependence and jealousy in the types of violence employed in teen dating. However, it is necessary to delve into the gender differences and similarities to develop appropriate prevention programs.


Platelet transfusion improves liver function in patients with chronic liver disease and cirrhosis.
Chronic liver disease (CLD), such as hepatitis C, is a progressive disease consisting of the destruction and regeneration of the liver parenchyma, leading to fibrosis and cirrhosis. Platelets contain various growth factors and may play important roles in liver regeneration. Thus, to investigate whether platelet transfusion improves liver function in patients with CLD and cirrhosis, we conducted an exploratory clinical trial. The study included 10 patients with CLD and cirrhosis (Child-Pugh class A or B), who all presented thrombocytopenia (platelet counts between 50,000 and 100,000 /µl). The subjects received 10 units of platelet concentrate once a week for 12 weeks. They were followed up for 9 months after the last transfusion. One patient discontinued platelet transfusion because of pruritus, and 2 patients discontinued because of platelet transfusion refractoriness. One patient was excluded from the analysis for receiving a procedural treatment after 12 platelet transfusions. Thus, the remaining 6 patients were analyzed. The platelet count did not increase significantly after the last transfusion. Significant improvement of serum albumin was observed at 1 month and 3 months after the last transfusion. Serum cholinesterase improved significantly at 1 week, 3 months, and 9 months after the last transfusion. Serum hyaluronic acid showed a tendency toward improvement after the last transfusion. In conclusion, platelet transfusion improved some of the indicators of liver function in patients with CLD and cirrhosis, though adverse events related to platelet transfusion were observed in some patients. Platelet increment therapy could be a new strategy for treating CLD and cirrhosis.


Enhanced opsonisation of Rhesus D-positive human red blood cells by recombinant polymeric immunoglobulin G anti-G antibodies.
Anti-RhD antibodies (anti-D) are important in the prophylaxis of haemolytic disease of the foetus and newborn (HDFN) due to RhD incompatibility. Current preparations of anti-D are sourced from hyperimmune human plasma, so its production carries a risk of disease and is dependent on donor availability. Despite the efforts to develop a monoclonal preparation with similar prophylactic properties to the plasma-derived anti-D, no such antibody is yet available. Here we studied the agglutinating, opsonic and haemolytic activities of two recombinant polymeric immunoglobulins (Ig) against the G antigen of the Rh complex. Recombinant polymeric anti-G IgG1 (IgG1μtp) and IgG3 (IgG3μtp) were produced in vitro, purified by protein G-affinity chromatography, and analysed by gel electrophoresis. Their agglutinating, opsonic and haemolytic activities were evaluated using haemagglutination, erythrophagocytosis, and complement activation assays. The recombinant IgG1μtp and IgG3μtp anti-G antibodies ranged from 150,000 to 1,000,000 Da in molecular weight, indicating the formation of polymeric IgG. No complement activation or haemolytic activity was detected upon incubation of RhD-positive red-blood cells with the polymeric anti-G IgG. Both polymers were better opsonins than a prophylactic preparation of plasma-derived anti-D. The enhanced opsonic properties of the polymeric anti-G IgG1μtp and IgG3μtp could allow them to mediate the clearance of RhD-positive red blood cells from circulation more efficiently than natural or other synthetic prophylactic anti-D options. Their inability to induce complement-mediated haemolysis would be prophylactically convenient and is comparable in vitro to that of the available plasma-derived polyclonal anti-D preparations. The described properties suggest that polymeric antibodies like these (but with anti-D specificity) may be testable candidates for prophylaxis of HDFN caused by anti-D.


Ternary choline chloride/benzene sulfonic acid/ethylene glycol deep eutectic solvents for oxidative desulfurization at room temperature.
Deep eutectic solvents (DESs) have been extensively studied as promising green solvents to attain a better removal efficiency of sulfide. A new DES system formed from choline chloride (ChCl), benzene sulfonic acid (BSA), and ethylene glycol (EG) as a class of ternary DESs was prepared and used in the oxidative desulfurization (ODS) of different sulfides. Ternary DESs have distinct advantages such as volatility and high activity compared with organic acid-based binary DESs. Under the optimum conditions with VDES/VOil = 1 : 5, O/S (molar ratio of oxygen to sulfur) = 5, and T = 25 °C, the desulfurization efficiencies of dibenzothiophene (DBT), 4,6-dimethyldibenzothiophene (4,6-DMDBT), and benzothiophene (BT) were all achieved to 100% in 2 h. Through experimental and density functional theory (DFT) calculation methods, this new system as a class of ternary DESs shows good stability and excellent desulfurization performance at room temperature. The investigation of this study could supply a new idea of ternary DESs for oxidative desulfurization.


Traditional Chinese medicine for acute coronary syndrome: A meta-analysis of clinical manifestations and objective indicators.
Modern clinical trials and experimental researches of traditional Chinese medicine (TCM) have been conducted for decades and provided support for the prevention and treatment of acute coronary syndrome (ACS). However the level of evidence and the proper application of TCM were still barely satisfactory. In this study, we divided ACS into 3 different stages, including unstable angina, acute myocardial infarction, and post myocardial infarction. Then we systematically reviewed and meta-analyzed the existing randomized controlled trials on both clinical manifestations and objective indicators, in these 3 aspects. The results indicate that TCM can both improve the clinical manifestations and ameliorate the objective parameters in different courses of ACS, including C-reactive protein in unstable angina, left ventricular ejection fraction in acute myocardial infarction and post myocardial infarction. And the incidence of short-term cardiovascular events are lower in TCM intervention group. Some of the improvements lead to potential long-term benefits. TCM treatment is beneficial to different courses of ACS. To acquire more solid and comprehensive evidence of TCM in treating ACS, more rigorously designed randomized controlled trials with longer follow-up duration are warranted.


Explorative Data Analysis Methods: Application to Laser-Induced Breakdown Spectroscopy Field Data Measured on the Island of Vulcano, Italy.
One of the strengths of laser-induced breakdown spectroscopy (LIBS) is that a large amount of data can be measured relatively easily in a short time, which makes LIBS interesting in many areas, from geomaterial analysis with portable handheld instruments to applications for the exploration of planetary surfaces. Statistical methods, therefore, play an important role in analyzing the data to detect not only individual compositions but also trends and correlations. In this study, we apply two approaches to explore the LIBS data of geomaterials measured with a handheld device at different locations on the Aeolian island of Vulcano, Italy. First, we use the established method, principal component analysis (PCA), and second we adopt the principle of the interesting features finder (IFF), which was recently proposed for the analysis of LIBS imaging data. With this method it is possible to identify spectra that contain emission lines of minor and trace elements that often remain undetected with variance-based methods, such as PCA. We could not detect any spectra with IFF that were not detected with PCA when applying both methods to our LIBS field data. The reason for this may be the nature of our field data, which are subject to more experimental changes than data measured in laboratory settings, such as LIBS imaging data, for which the IFF was introduced first. In conclusion, however, we found that the two approaches complement each other well, making the exploration of the data more intuitive, straightforward, and efficient.


Handler statement on smale case.
Philip Handler, chairman of the National Science Board, has issued the following statement, reprinted in part, concerning the relationship between Stephen Smale, the Berkeley mathematician, and the National Science Foundation, of which the board is the highest-ranking advisory body. The statement was delivered to Science following completion of an article on the Smale case for the issue of 15 September, but prior to publication.


Hsp70-associated chaperones have a critical role in buffering protein production costs.
Proteins are necessary for cellular growth. Concurrently, however, protein production has high energetic demands associated with transcription and translation. Here, we propose that activity of molecular chaperones shape protein burden, that is the fitness costs associated with expression of unneeded proteins. To test this hypothesis, we performed a genome-wide genetic interaction screen in baker's yeast. Impairment of transcription, translation, and protein folding rendered cells hypersensitive to protein burden. Specifically, deletion of specific regulators of the Hsp70-associated chaperone network increased protein burden. In agreement with expectation, temperature stress, increased mistranslation and a chemical misfolding agent all substantially enhanced protein burden. Finally, unneeded protein perturbed interactions between key components of the Hsp70-Hsp90 network involved in folding of native proteins. We conclude that specific chaperones contribute to protein burden. Our work indicates that by minimizing the damaging impact of gratuitous protein overproduction, chaperones enable tolerance to massive changes in genomic expression.