Application of lung ultrasound in monitoring bronchopulmonary dysplasia and pulmonary arterial pressure in preterm infants.
The aim of this study was to evaluate the application value of lung ultrasound in monitoring bronchopulmonary dysplasia (BPD) and pulmonary artery pressure in premature infants. A total of 98 preterm infants diagnosed with BPD in the Fourth Hospital in Shijiazhuang were recruited, and their disease severity was classified as mild (n=32), moderate (n=33), or severe BPD (n=33) based on gestational age and oxygen concentration. Lung ultrasonography of the children was performed. The correlation between lung ventilation scores and disease severity was statistically analyzed, and the discrete optimization results were documented. The pulmonary hypertension indexes of the three groups of children were compared. Aberrant alterations of the pleural line were observed in all included children, and the B-line rose as the disease progressed. The duration of invasive ventilation, medication, and hospital stay increased with disease exacerbation (p<0.05). The three groups significantly differed in terms of ultrasound pulmonary ventilation scores and clinical severity (p<0.05). Only mild BDP was identified by lung ultrasound on the first day of birth (T1), and severe BDP was detectable during the first and second week (T2-T3) as well as the third and fourth week (T4-T5). Severe BPD was associated with significantly higher levels of pulmonary hypertension indices vs. mild and moderate BPD (p<0.05). Pulmonary ultrasonography demonstrates great potential to predict pulmonary hypertension in children and assesses the disease severity. Pulmonary ultrasound allows for dynamical real-time observation of the pulmonary lesions in children with pulmonary hypertension, thereby revealing the severity of pulmonary hypertension in premature children.


[Pulmonary sequestration in an infant].
A case of intralobar pulmonary sequestration in an infant is reported. The lesion presented as recurrent bronchopulmonary infections. The chest film showed a density in the right lower lobe, in which air-filled images and air-fluid levels developed rapidly. Aortography demonstrated systemic blood supply to the lesion from three arteries stemming from the thoracic aorta. The pathological study of the operative specimen confirmed the diagnosis. Postoperative outcome was satisfactory.


83.4 W, 17.69 kHz spectral bandwidth, continuous-wave, beam densely folded Innoslab amplifier.
Combined with the advantages of the narrow bandwidth of a non-planar ring oscillator seed laser and the structure of a direct pumped Innoslab amplifier, a high-efficiency and high-power continuous-wave (CW) single-frequency laser was obtained by densely folding the seed laser beam in an Innoslab amplifier with a wedged multi-folded configuration. A maximum output power of 83.4 W of a single-frequency amplifier with a bandwidth of 17.69 kHz was obtained under a pump power of 234 W, corresponding to an optical-to-optical conversion efficiency of 33.2%. The beam quality factor M2 at the maximum output power in horizontal and vertical directions was measured to be 1.15 and 1.24, respectively. The long-term power instability in 2 h was less than 1.63%.


Electrically Switchable Anisometric Carbon Quantum Dots Exhibiting Linearly Polarized Photoluminescence: Syntheses, Anisotropic Properties, and Facile Control of Uniaxial Orientation.
Carbon quantum dots (CQDs) have been extensively explored in diverse fields because of their exceptional features. The nanometric particles with photoluminescence (PL) benefit various optical and photonic applications. However, the majority of previous reports have mainly focused on either unpolarized or circular-polarized (CP) PL. Linearly polarized (LP) emission of CQDs is limited mainly because of their isometric shape and difficulties in macroscopic orientation control. Herein, we report syntheses of anisometric CQDs and facile control of the uniaxial orientation on a macroscopic scale, which results in linearly polarized photoluminescence (LP-PL). The anisometric CQDs are synthesized from rigid-rod-shaped precursors and evenly dispersed in the rod-like liquid crystal (LC) host. As-synthesized CQDs exhibit a PL quantum yield as high as 35% in chloroform. In addition to uniform alignment, facile directional switching of the elongated CQD is established by employing the electrical responsiveness of the CQD and host LC. Therefore, the dichroic photophysical properties of anisometric CQDs have been beneficially adopted for fabrications of polarization-sensitive and electrically switchable PL devices. Also, anisometric CQDs are embedded in polymer films with molecular orientational patterns and clearly recognized by LP-PL.


Analysis of Genetic Diversity and Population Structure of Wild Strains and Cultivars Using Genomic SSR Markers in Lentinula edodes.
In this study, the genetic diversity and the population structure of 77 wild strains and 23 cultivars of Lentinula edodes from Korea were analyzed using 20 genomic SSRs, and their genetic relationship was investigated. The tested strains of L. edodes were divided into three sub-groups consisting of only wild strains, mainly wild strains and several cultivars, and mainly cultivars and several wild strains by distance-based analysis. Using model-based analysis, L. edodes strains were divided into two subpopulations; the first one consisting of only wild strains and the second one with mainly cultivars and several wild strains. Moreover, AMOVA analysis revealed that the genetic variation in the cultivars was higher than that in the wild strains. The expected and observed heterozygosity and values indicating the polymorphic information content of L. edodes cultivars from Korea were also higher than that of the wild strains. Based on these results, we presume that the cultivars in Korea have developed by using numerous strains from other countries. In conclusion, the usage of wild strains for the development of new cultivars could improve the adaptability of L. edodes to biotic and abiotic stress.


Recognizing genes differentially regulated in vitro by the multiple endocrine neoplasia type 1 (MEN1) gene, using RNA interference and oligonucleotide microarrays.
Data on downstream effects of MEN1 gene inactivation is scarce. In an effort to identify genes regulated by MEN1, we designed a silencing experiment in a human endocrine pancreatic tumor cell line (BON1). By using RNA interference, MEN1 mRNA expression was knocked-down by >85%. Gene expression was assessed by oligonucleotide microarrays and compared to expression in nonsilenced controls. We also investigated if genes were differentially expressed in 6 malignant endocrine pancreatic tumors (EPTs) with homozygous MEN1 inactivation compared to 2 without MEN1 gene alterations. Using a cut-off of > or =2 times, 66 genes were found to be upregulated, and 22 were downregulated in the MEN1-silenced clones. We corroborated the microarray findings by performing quantitative-PCR on the RNA from the silencing experiments for 7 of the 88 differentially regulated genes. Genes involved in endocrine cell fate determination, as well as genes known to be involved in NFkappaB, Notch, and Wnt signaling pathways, were among genes verified as differentially regulated in vitro. The demonstration of pathways affected by silencing of MEN1 in vitro provides novel insight into neoplastic processes of potential importance in vivo, which warrants further study.


Anomalous Heating and Plasmoid Formation in a Driven Magnetic Reconnection Experiment.
We present a detailed study of magnetic reconnection in a quasi-two-dimensional pulsed-power driven laboratory experiment. Oppositely directed magnetic fields (B=3 T), advected by supersonic, sub-Alfvénic carbon plasma flows (V_{in}=50 km/s), are brought together and mutually annihilate inside a thin current layer (δ=0.6 mm). Temporally and spatially resolved optical diagnostics, including interferometry, Faraday rotation imaging, and Thomson scattering, allow us to determine the structure and dynamics of this layer, the nature of the inflows and outflows, and the detailed energy partition during the reconnection process. We measure high electron and ion temperatures (T_{e}=100 eV, T_{i}=600 eV), far in excess of what can be attributed to classical (Spitzer) resistive and viscous dissipation. We observe the repeated formation and ejection of plasmoids, consistent with the predictions from semicollisional plasmoid theory.


Non-Operative Management of Delayed Splenic Rupture 4 Months Following Blunt Abdominal Trauma.
BACKGROUND Delayed splenic rupture is a rare complication of non-operative management of a primary splenic trauma which, without proper clinical vigilance, may result in life-threatening events. It usually occurs 4-8 days after injury and, in most cases, surgery is the treatment of choice. Since non-operative management of splenic trauma, which allows splenic salvage, has become increasingly popular, the same approach could also be applied in delayed splenic rupture. We herein present a case of delayed splenic rupture that occurred 4 months after the trauma and was successfully managed non-operatively. CASE REPORT A 32-year-old woman presented with diffuse abdominal pain, chest pain, and dyspnea 4 months after sustaining minor thoracoabdominal blunt trauma due to a car accident. That event was inadequately investigated and was not admitted for further monitoring. Computerized tomography revealed a rupture of a splenic hematoma in the context of the previous splenic trauma. She was closely monitored and remained hemodynamically stable. She was discharged and followed up, with no reported relapse of her clinical condition. CONCLUSIONS Delayed splenic rupture occurring 4 months after the primary splenic trauma is extremely rare. Due to its prolonged delay, delayed rupture of the spleen can easily be overlooked and not be included in the original differential diagnosis. Negligence of this event can result in dreaded complications with hemodynamic instability or even death. Furthermore, its higher mortality rate compared to primary splenic rupture highlights the importance of proper clinical vigilance. Non-operative management should be attempted in hemodynamically stable patients.


Inducible expression and cytogenetic effects of the EcoRI restriction endonuclease in Chinese hamster ovary cells.
The cytogenetic endpoints sister chromatid exchange (SCE) and chromosome aberrations are widely used as indicators of DNA damage induced by mutagenic carcinogens. Chromosome aberrations appear to result directly from DNA double-strand breaks, but the lesion(s) giving rise to SCE formation remains unknown. Most compounds that induce SCEs induce a spectrum of lesions in DNA. To investigate the role of double-strand breakage in SCE formation, we constructed a plasmid that gives rise to one specific lesion, a staggered-end ("cohesive") DNA double-strand break. This plasmid, designated pMENs, contains a selectable marker, neo, which is a bacterial gene for neomycin resistance, and the coding sequence for the bacterial restriction endonuclease EcoRI attached to the mouse metallothionein gene promoter. EcoRI recognizes G decreases AATTC sequences in DNA and makes DNA double-strand breaks with four nucleotides overhanging as staggered ends. Cells transfected with pMENS were resistant to the antibiotic G418 and contained an integrated copy of the EcoRI gene, detectable by DNA filter hybridization. The addition of the heavy metal CdSO4 resulted in the intracellular production of EcoRI, as measured by an anti-EcoRI antibody. Cytogenetic analysis after the addition of CdSO4 indicated a dramatic increase in the frequency of chromosome aberrations but very little effect on SCE frequency. Although there was some intercellular heterogeneity, these results confirm that DNA double-strand breaks do result in chromosome aberrations but that these breaks are not sufficient to give rise to SCE formation.


Systematic Elucidation of the Aneuploidy Landscape and Identification of Aneuploidy Driver Genes in Prostate Cancer.
Aneuploidy is widely identified as a remarkable feature of malignancy genomes. Increasing evidences suggested aneuploidy was involved in the progression and metastasis of prostate cancer (PCa). Nevertheless, no comprehensive analysis was conducted in PCa about the effects of aneuploidy on different omics and, especially, about the driver genes of aneuploidy. Here, we validated the association of aneuploidy with the progression and prognosis of PCa and performed a systematic analysis in mutation profile, methylation profile, and gene expression profile, which detailed the molecular process aneuploidy implicated. By multi-omics analysis, we managed to identify 11 potential aneuploidy driver genes (GSTM2, HAAO, C2orf88, CYP27A1, FAXDC2, HFE, C8orf88, GSTP1, EFS, HIF3A, and WFDC2), all of which were related to the development and metastasis of PCa. Meanwhile, we also found aneuploidy and its driver genes were correlated with the immune microenvironment of PCa. Our findings could shed light on the tumorigenesis of PCa and provide a better understanding of the development and metastasis of PCa; additionally, the driver genes could be promising and actionable therapeutic targets pointing to aneuploidy.


Six-membered metalla-coronands. synthesis and crystal packing: columns, compartments, and 3D-networks.
Reaction of various N-substituted diethanolamines H(2)L(3) (4) with calcium hydride and iron(III) chloride leads to the self-assembly of six-membered ferric wheels [Fe(6)X(6)(L(3))(6)] (5). Principally, all the iron coronands are isostructural; however, they differ fundamentally with respect to their crystal packing. Exemplarily, this is discussed for selected members of the space groups R, P, P2(1)/c, P2(1)/n, C2/c, and P. Depending on the nature of their sidearms, the ferric wheels create various substructures. For instance, the ferric wheels 5a-i of space group R or P are piled in parallel in cylindrical columns, which are surrounded by six parallel columns alternately dislocated by (1)/(3)c and (2)/(3)c against the central one. Pronounced van der Waals interactions give rise to compartmentation and incarceration of guest molecules as seen for 5e,g. However, in 5h strong pi-pi interactions create a three-dimensional scaffold. The most significant difference of the ferric wheels 5j-p of space groups P2(1)/c, P2(1)/n, and C2/c is that these ferric wheels are arranged in parallel in two orientations. They differ mainly only by the included angle of the two groups of parallel wheels. In the case of 5l, molecular chains are formed in the crystal due to pi-pi interactions. The ferric wheels 5q-y of space group P are packed in the crystal most simply, with all the ferric wheels piled in parallel.


Identification of marker genes for differential diagnosis of chronic fatigue syndrome.
Chronic fatigue syndrome (CFS) is a clinically defined condition characterized by long-lasting disabling fatigue. Because of the unknown mechanism underlying this syndrome, there still is no specific biomarker for objective assessment of the pathological fatigue. We have compared gene expression profiles in peripheral blood between 11 drug-free patients with CFS and age- and sex-matched healthy subjects using a custom microarray carrying complementary DNA probes for 1,467 stress-responsive genes. We identified 12 genes whose mRNA levels were changed significantly in CFS patients. Of these 12 genes, quantitative real-time PCR validated the changes in 9 genes encoding granzyme in activated T or natural killer cells (GZMA), energy regulators (ATP5J2, COX5B, and DBI), proteasome subunits (PSMA3 and PSMA4), putative protein kinase c inhibitor (HINT ), GTPase (ARHC), and signal transducers and activators of transcription 5A (STAT5A). Next, we performed the same microarray analysis on 3 additional CFS patients and 20 other patients with the chief complaint of long-lasting fatigue related to other disorders (non-CFS patients) and found that the relative mRNA expression of 9 genes classified 79% (11/14) of CFS and 85% (17/20) of the non-CFS patients. Finally, real-time PCR measurements of the levels of the 9 involved mRNAs were done in another group of 18 CFS and 12 non-CFS patients. The expression pattern correctly classified 94% (17/18) of CFS and 92% (11/12) of non-CFS patients. Our results suggest that the defined gene cluster (9 genes) may be useful for detecting pathological responses in CFS patients and for differential diagnosis of this syndrome.


The Evolutions of Microstructure, Texture and Hardness of A1050 Deformed by HPT at the Transition Area.
High-pressure torsion (HPT) is an effective severe plastic deformation method to produce ultrafine-grained (UFG) and nanocrystalline (NC) materials. In the past, most studies have focused on the evolutions in the microstructure, texture and mechanical properties of HPT-deformed materials at peripheral regions. The corresponding evolutions at a special area were observed in this study to reveal the potential plastic deformation mechanism for face-centred cubic (FCC) material with high stacking fault energy. A decreasing trend was found in grain size, and the final grain size was less than 1 μm. However, close observation revealed that the general trend could be divided into different sub-stages, in which grain elongation and grain fragmentation were dominant, respectively. Additionally, microhardness demonstrated a non-linear increase with the development of plastic deformation. Finally, the microhardness reached a high level of ~64 HV. At the early stages of HPT, the C component was transformed into a cube component, suggesting the material flows around the shear plane normal (SPN) axis at these stages. However, finally they will be replaced by ideal simple shear orientations.


Clinical significance of health status assessment measures in head and neck cancer: what do quality-of-life scores mean?
To determine the magnitude of clinically significant differences in domain scores for a quality-of-life questionnaire specific to head and neck cancer; and to demonstrate a clinically relevant method of presenting head and neck cancer-specific quality-of-life data using cutoff scores and clinical anchors. Anchor-based and distribution-based techniques for determining clinically significant differences in health-related quality-of-life scores were used. University-based tertiary care hospital. A total of 421 patients with head and neck cancer enrolled in a longitudinal outcomes project. The Head and Neck Cancer Inventory; clinical anchor health status in the domains of speech, eating, and social disruption; and distribution-based clinically significant score differences. Clinical anchor health states representing incremental levels of dysfunction were significantly correlated with domain scores for eating, speech, and social disruption. The anchor-based clinically important difference magnitudes were consistent with the values obtained using distribution-based techniques. For mean domain scores (minimum, 0; maximum, 100), differences of approximately 4, 10, and 14 or greater represented small, intermediate, and large clinically significant differences, respectively. Stratifying mean domain scores into low (0-30), intermediate (31-69), and high (70-100) categories allowed presentation of the health-related quality-of-life data in a clinically relevant format. This study provides benchmarks for small, intermediate, and large clinically significant changes in scores and demonstrates the presentation of health-related quality-of-life data in a clinically useful format.


[Bibliographic production about adherence/non-adherence to therapy].
Critical analysis of the Latin American bibliographical production over the last 10 years regarding the adherence/non-adherence to treatment of people with chronic health problems: leprosy, tuberculosis, hypertension, diabetes and AIDS. Thirty six articles were analyzed identifying the variables: year of publication, publication area and kind of study. Most of the articles (27) were produced by professionals of the medical area, in epidemiological studies, and of the nursing area (7) in qualitative and quanti-qualitative studies. The scientific production on the subject increased until 2002, when it began to drop. The authors repeatedly defended the idea that the role of the patient is to follow the recommendations of the health professional and that the patient is free to follow or not the treatment, the professional however being exempt from the responsibility for the consequences of this decision. The greater part of factors pointed out by the authors as contributing to non-adherence relates to the patient, showing that the major responsibility for the adherence / non-adherence to treatment is conferred upon him. The measures the authors indicate for solving the problem point to responsibility of professionals, health services, governments and teaching institutions.


The asymmetrical effects of some ionized n-octyl derivatives on the sodium current of the giant axon of Loligo forbesi.
The effects of octyltrimethylammonium ions (OTMA+), octyl sulphate ions (OS-) and octanoic acid (OA) on the sodium current of the voltage-clamped squid giant axon have been investigated using intracellular and extracellular application of the test substances. OTMA+ applied externally at concentrations of 0.8-5.0 mM produces a small reversible increase in the peak inward sodium current in both intact and CsF-perfused axons. Intracellular application of OTMA+ at 0.8 mM to CsF-perfused axons causes a reversible 50% suppression of peak inward sodium current. The inhibition of peak inward current by internal OTMA+ arises largely from a shift of the steady-state activation parameter (m infinity) in the depolarizing direction along the voltage axis. There is little use dependence of the current suppression by OTMA+ OA applied either internally or externally is more effective at suppressing peak inward sodium current at pH 6.0 than at pH 7.4. At pH 6.0 external application of 5 mM-OA to perfused axons causes approximately 60% suppression. This is associated with a depolarizing shift of m infinity of about 13 mV and a hyperpolarizing shift of the steady-state inactivation (h infinity) curve of about 4 mV. The effects of internal and external OA are broadly similar except that the h infinity shift is not seen with internal application. OS- at concentrations above 2.0 mM produces complete irreversible loss of sodium current. At 2.0 mM, OS- produces 10% current suppression and a small depolarizing shift of the m infinity curve. Internal and external applications of OS- differ little except that external OS- causes a 25% increase in the time constant of activation (tau m). The possible origins of these effects are discussed. It is proposed that the shift of m infinity caused by internal OTMA+ is due to a diminution of the lipid dipole potential at the internal surface of the membrane caused by OTMA+ adsorption. This effect could also account for the m infinity shift caused by OA. The results showing that OA produces shifts of opposite sign in the voltage dependence of m infinity and h infinity are discussed with respect to their implications for models of sodium channel gating.


Long non-coding RNA LOC285194 inhibits proliferation and migration but promoted apoptosis in vascular smooth muscle cells via targeting miR-211/PUMA and TGF-β1/S100A4 signal.
Long non-coding RNA LOC285194 (LOC285194) has reported to regulate vascular smooth muscle cells (VSMCs) proliferation and apoptosis in vitro and in vivo. Here we aimed to determine the role of LOC285194 in the proliferation, migration and apoptosis of VSMCs and its underlying mechanisms. A7r5 cells were transfected with Lv-LOC285194 or control Lv-NC for 24-72 h, or small interfering RNA targeting S100A4 (S100A4 siRNA) for 24-48 h, or co-transfected with Lv-LOC285194 and PUMA siRNA for 72 h, or treated with miR-211 inhibitor or co-transfected with Lv-LOC285194 and miR-211 mimics for 72 h. A7r5 cells were also treated with transforming growth factor - β(TGF-β) (5 ng/ml) after Lv-LOC285194 transfection for 24 h. The relationship between LOC285194 and TGF-β was confirmed using luciferase reporter assay. Cell proliferation and cell apoptosis were analyzed by Cell Counting Kit-8 (CCK-8) assay, ELISA and TUNEL staining. LOC285194 and miR-211 expression were detected by qPCR assay. S100A4, pro-apoptotic and anti-apoptotic protein were detected by Western blot assay. LOC285194 inhibited cell proliferation, invasion and migration and promoted cell apoptosis accompanied by upregulation of PUMA and downregulation of miR-211 and S100A4. Targeting PUMA reversed the effect of LOC285194 on cell apoptosis and proliferation. miR-211 mimic inhibited LOC285194-induced PUMA upregulation and decreased LOC285194-induced cell apoptosis. TGF-β (5 ng/ml) treatment reversed S100A4 siRNA or LOC285194-induced S100A4 expression. Luciferase reporter assay showed that TGF-β was the target of LOC285194. LOC285194 inhibits proliferation and promoted apoptosis in vascular smooth muscle cells via targeting miR-211/PUMA signal; In addition, LOC285194 decreased cell invasion and migration by targeting TGF-β1/S100A4 signal.


Recognition and reduction of artifacts from autolysis in paraffin-embedded tissue using DNA/nuclear protein flow cytometry.
Artifacts from autolysis can be a problem in retrospective flow-cytometric analyses of DNA content in paraffin-embedded tissues. Autolyzed tissue from rat liver, human liver, and rat spleen were stained for DNA and nuclear protein to determine if this technique would be useful in identifying partially degraded cells. After the tissue was deparaffinized and rehydrated, the nuclei were isolated using 0.5% pepsin. Propidium iodide (PI) and fluorescein isothiocyanate (FITC) were used to stain DNA and nuclear protein. When unfixed rat liver tissue was allowed to undergo autolysis at 4 degrees C for 24-48 h before fixation, there was a progressive broadening of the G1 and G2M DNA peaks and a slight increase in the average DNA contents of these peaks. Nuclei that stained more intensely with PI also stained more intensely with FITC. Similar results were obtained using human liver and rat spleen. Sometimes the increased PI staining resulted in a false aneuploid peak. The distinctive skewing of the DNA/nuclear protein histograms from autolysis was reduced by increasing the incubation of the tissue in 0.5% pepsin from 0.5 h to 1.5 h during the nuclei-isolation step. The DNA/nuclear protein method provides a means for identifying artifacts from autolysis, whereas the extended pepsin treatment provides a means for reducing these artifacts.


Task-Dependent Coordination Levels of SmI2.
Ligation plays a multifaceted role in the chemistry of SmI2. Depending on the ligand, two of its major effects are increasing the reduction potential of SmI2, and in the case of a ligand, which is also a proton donor, it may also enhance the reaction by protonation of the radical anion generated in the preceding step. It turns out that the number of ligand molecules that are needed to maximize the reduction potential of SmI2 is significantly smaller than the number of ligand molecules needed for a maximal enhancement of the protonation rate. In addition to the economical use of the ligand, this information can also be utilized as a diagnostic tool for the reaction mechanism in differentiating between single and multistep processes. The possible pitfalls in applying this diagnostic tool to PCET and cyclization reactions are discussed.


TRPC1, TRPC3, and TRPC4 in Rat Orofacial Structures.
TRPC (transient receptor potential cation channel subfamily C) members are nonselective monovalent cation channels and control Ca2+ inflow. In this study, immunohistochemistry for TRPC1, TRPC3, and TRPC4 was performed on rat oral and craniofacial structures to elucidate their distribution and function in the peripheries. In the trigeminal ganglion (TG), 56.1, 84.1, and 68.3% of sensory neurons were immunoreactive (IR) for TRPC1, TRPC3, and TRPC4, respectively. A double immunofluorescence method revealed that small to medium-sized TG neurons co-expressed TRPCs and calcitonin gene-related peptide. In the superior cervical ganglion, all sympathetic neurons showed TRPC1 and TRPC3 immunoreactivity. Parasympathetic neurons in the submandibular ganglion, tongue, and parotid gland were TRPC1, TRPC3, and TRPC4 IR. Gustatory and olfactory cells were also IR for TRPC1, TRPC3, and/or TRPC4. In the musculature, motor endplates expressed TRPC1 and TRPC4 immunoreactivity. It is likely that TRPCs are associated with sensory, autonomic, and motor functions in oral and craniofacial structures.


Impact of a Preoperative Exercise Program on General Fitness in Patients Awaiting Bariatric Surgery: A Pilot Randomized Trial.
Background Evidence supports the association between exercise and outcomes following bariatric surgery. However, there is a lack of knowledge regarding the short-term benefits of preoperative exercise. Objectives The objective of this pilot study was to evaluate the feasibility and functional benefits of a 12-week preoperative exercise program in patients awaiting bariatric surgery. The primary aim was the six-minute walk test (6MWT). The secondary aim of this study included anthropometric measures, strength, and quality of life. Methods A total of 54 patients were enrolled in this pilot randomized controlled study. Of them, 29 patients received standard multidisciplinary preoperative care, while 25 patients participated in a 12-week supervised exercise program in addition to standard preoperative care consisting of strength and aerobic exercises three times per week in a fitness facility. The primary outcome was improvement in 6MWT. Secondary outcomes included other functional outcomes, quality of life, and anthropometric measures. Results Average attendance for the intervention group was 27.2 (75.6%) of 36 sessions. There was a mean improvement of 27 ± 10 meters in the intervention group compared with a reduction of 5 ± 10 meters in the control group (p = 0.003). Patients in the intervention group had significant improvement in all self-reported quality-of-life domains, particularly in the variables related to symptoms, hygiene, and emotions. Conclusions A 12-week preoperative exercise intervention was feasible and showed association with a statistically significant improvement in 6MWT and quality-of-life measures in patients awaiting bariatric surgery. The results of this study will inform sample size calculations and recruitment planning for a future study that will assess the longer-term benefits of a pre-surgical fitness intervention.


Reversible switching between hydrophilic and hydrophobic superparamagnetic iron oxide microspheres via one-step supramolecular dynamic dendronization: exploration of dynamic wettability.
We describe the use of hydrophobic poly(aryl ether) dendrons to peripherally functionalize hydrophilic amine-containing superparamagnetic iron oxide microspheres (SPIO-NH2) in one step via imine formation. The reversible formation of imine bonds in the absence/presence of water renders dynamic control of the hydrophilicity and hydrophobicity of the microspheres (SPIO-Gn). The dynamic nature of the imine-containing dendronized microspheres (SPIO-Gn) can be "fixed" by locking the reversible 2,6-diiminopyridyl moieties with metal cations (Zn2+, Co2+, and Ni2+) to afford kinetically stable dendronized microspheres (SPIO-Gn-M). Isolation of these microspheres is facilitated by convenient magnetic separation by an externally applied magnetic field. Characterization of these novel organic-inorganic hybrid microspheres has been performed by various techniques using UV/visible absorption and Fourier transform infrared spectroscopies, transmission electron microscopy, thermogravimetric analysis, and a vibrating sample magnetometer. We have demonstrated the stability and reversible switching of hydrophilicity/hydrophobicity by contact-angle measurements. In particular, the hydrophilic SPIO-NH2 microspheres demonstrated a contact angle of 42 +/- 2 degrees when a drop of water was added to a SPIO-NH2-coated mica surface. On the other hand, the hydrophobic SPIO-Gn-M dendronized microspheres demonstrated a contact angle of 85 +/- 2 degrees , an observation that involves an increase of the contact angle of over 40 degrees . Furthermore, when a drop of water was placed on a dynamic SPIO-Gn-coated mica surface, the contact angle of the water droplet decreased in time. Comparatively, the rate of decrease of the contact angle is H2O > 1% Co(OAc)2/H2O > N,N'-dimethylformamide/H2O (1:1).


Facilitating patients' coping with fatigue during chemotherapy-pilot outcomes.
A pilot study was conducted to develop and test a nursing intervention to facilitate the management of fatigue in patients receiving chemotherapy. The intervention, named the "Beating Fatigue" program, has 4 elements: assessment/monitoring, education, coaching in the management of fatigue, and provision of emotional support. Beating Fatigue was implemented with and evaluated by 8 patients. Overall, patients were very positive about the program and perceived the opportunity to talk to someone about fatigue as the most beneficial strategy within the program, although individual patients varied in which aspect they most preferred. Data from the pilot work supported the view that a multifaceted approach to the management of cancer-related fatigue is appropriate because it enables an intervention package to be tailored to an individual's requirements. The approach appeared both feasible and practical. Although numeric data were limited, there was some evidence that the approach had the capacity to lessen fatigue and enhance emotional well-being.


Vibronics and plasmonics based graphene sensors.
A high sensitivity and selectivity sensor is proposed using graphene ribbons which are able to read molecular vibrations and molecular electrostatic potentials, acting as an amplifier and as a transducer converting molecular signals into current-voltage quantities of standard electronics. Two sensing mechanisms are used to demonstrate the concept using ab initio density functional methods. By using the terahertz region of the spectrum, we can characterize modes when single molecules are adsorbed on the ribbon surface. Characteristic modes can be obtained and used as fingerprints, which can be transduced into current by applying a voltage along the ribbons. On the other hand, the fully delocalized frontier molecular orbitals of graphene ribbons, commonly denominated plasmons in larger solid state structures, are extremely sensitive to any moiety approach; once plasmons are in contact with an "agent" (actually its molecular potential), the transport through the ribbons acting as electrodes catching the signals is strongly affected.


Promoting practical clinical management learning: the current situation about Information and Communications Technology capability development in student nurses.
This paper is about work-based learning in information management for student nurses. It seeks, through a literature review, to make a case for and promote Information and Communications Technology capability development in student nurses within their clinical environment. The profession of nursing, like many other jobs, is facing the increasing usage of information technology in day-to-day operations. Admission and discharges of patients have been held on computer databases since at least the 1980s. With the new Labour Government in 1997, increasing focus was placed on the effectiveness of the National Health Service and using computers as one way to assist in achieving greater effectiveness. Nurse education therefore needed to reflect this need and support trainee nurses to acquire skills in Information and Communications Technology. This paper is part of an ongoing professional doctorate inquiry into Information and Communications Technology capability development in student nurses. A literature search was conducted on teaching information and technology skills via Cumulative Index to Nursing and Allied Health Literature. Most of the available studies were neither based on the UK nor were they about student nurses. As there is a dearth of published work in this specific area, relevant, related and tangential literature was reviewed. It is argued that current practice and published work on Information and Communications Technology capability development by student nurses hardly exists. The literature confirmed that success in this area requires sound change management, an understanding of National Health Service culture, and effective people leadership skills. Nurse educators and managers need to pay more attention to understand how organizations work, particularly organizations where student nurses carry out their work. As the search revealed a significant gap in the literature in this area, a practical conceptual framework to fully analyse, develop and implement sustained Information and Communications Technology capability in student nurses is proposed.


PurUUpurU: An Oligonucleotide Virulence Factor in RNA Viruses.
Background The copy number of the oligonucleotide 5'-purine-uridine-uridine-purine-uridine-3' (purUUpurU) motif in a viral genome was previously shown to correlate with the severity of acute illness. This study aimed to determine whether purUUpurU content correlates with virulence in other single-strand RNA (ssRNA) viruses that vary in clinical severity. Methodology We determined the copy number of purUUpurU in the genomes of two subtypes of human respiratory syncytial virus (RSV), respiratory syncytial virus A (RSV-A), and respiratory syncytial virus B (RSV-B), which vary in clinical severity. In addition, we determined the purUUpurU content of the four ebolaviruses that cause human disease, dengue virus, rabies virus, human rhinovirus-A, poliovirus type 1, astrovirus, rubella, yellow fever virus, and measles virus. Viral nucleotide sequence files were downloaded from the National Center for Biotechnology Information (NCBI)/National Institutes of Health website. In addition, we determined the cumulative case fatality rate of 20 epidemics of the Ebola virus and compared it with that of the other human ebolaviruses. Results The genomic purUUpurU content correlated with the severity of acute illness caused by both subtypes of RSV and human ebolaviruses. The lowest purUUpurU content was in the genome of the rubella virus, which causes mild disease. Conclusions The quantity of genomic purUUpurU is a virulence factor in ssRNA viruses. Blood hyperviscosity is one mechanism by which purUUpurU causes pathology. Comparative quantitative genomic analysis for purUUpurU will be helpful in estimating the risk posed by emergent ssRNA viruses.


Camouflaging in autism spectrum disorder: Examining the roles of sex, gender identity, and diagnostic timing.
Camouflaging in autism spectrum disorder refers to behaviors and/or strategies that mask the presentation of autism spectrum disorder features in social contexts in order to appear "non-autistic" (Attwood, 2007). Camouflaging modifies the behavioral presentation of core autism spectrum disorder features (e.g. social and communication differences), but the underlying autistic profile is unaffected, yielding a mismatch between external observable features and the internal lived experience of autism. Camouflaging could be an important factor in later diagnosis of individuals without co-occurring intellectual disability, especially among those designated female sex at birth. Little research to date has examined how gender identity impacts camouflaging, however. Furthermore, no study has compared groups that differ in diagnostic timing to directly investigate if later-diagnosed individuals show elevated camouflaging relative to those receiving an earlier diagnosis. We used the Camouflaging Autistic Traits Questionnaire subscales (Assimilation, Compensation, and Masking) and investigated the roles of sex, gender identity (gender diverse vs cisgender), and diagnostic timing (childhood/adolescent-diagnosed vs adult-diagnosed), and the interactions of these factors, in autistic adults (N = 502; ages 18-49 years). Main effects of sex, gender identity, and diagnostic timing were revealed. Autistic females reported more camouflaging across all three Camouflaging Autistic Traits Questionnaire subscales compared to males. Gender diverse adults reported elevated camouflaging on the Compensation subscale compared to cisgender adults. Adulthood-diagnosed individuals reported elevated Assimilation and Compensation compared to childhood/adolescence-diagnosed individuals. We discuss how the aspects of camouflaging may have unique implications for later diagnostic timing and for the intersection of neurodiversity and gender diversity.


Regional Specializations of the PAZ Proteomes Derived from Mouse Hippocampus, Olfactory Bulb and Cerebellum.
Neurotransmitter release as well as structural and functional dynamics at the presynaptic active zone (PAZ) comprising synaptic vesicles attached to the presynaptic plasma membrane are mediated and controlled by its proteinaceous components. Here we describe a novel experimental design to immunopurify the native PAZ-complex from individual mouse brain regions such as olfactory bulb, hippocampus, and cerebellum with high purity that is essential for comparing their proteome composition. Interestingly, quantitative immunodetection demonstrates significant differences in the abundance of prominent calcium-dependent PAZ constituents. Furthermore, we characterized the proteomes of the immunoisolated PAZ derived from the three brain regions by mass spectrometry. The proteomes of the release sites from the respective regions exhibited remarkable differences in the abundance of a large variety of PAZ constituents involved in various functional aspects of the release sites such as calcium homeostasis, synaptic plasticity and neurogenesis. On the one hand, our data support an identical core architecture of the PAZ for all brain regions and, on the other hand, demonstrate that the proteinaceous composition of their presynaptic active zones vary, suggesting that changes in abundance of individual proteins strengthen the ability of the release sites to adapt to specific functional requirements.


Do bacteria isolated from ICU patients 'ESKAPE' antibiotic treatment? In vitro susceptibility of the Enterobacteriaceae family to tigecycline.
Enterobacteriaceae are currently causing the majority of healthcare-associated infections (HAI) and simultaneously expressing increasing levels of antibiotic resistance. The purpose of this study is to assess the in vitro sensitivity of MDR strains from the family Enterobacteriaceae to tigecycline in relation to their origin from patients hospitalized in intensive care units (ICUs) and non-ICUs. The study involved 156 clinically significant strains of the Enterobacteriaceae family isolated from patients with complicated intraabdominal infections (cIAIs) and/or complicated skin and skin structure infections (cSSSIs) hospitalized in ICUs and other surgical departments. Tigecycline MICs were determined by Etest. The highest percentage of tigecycline non-susceptible (intermediate + resistant strains) in vitro strains among the Enterobacteriaceae species were observed for Serratia spp. 77.3%, followed by Citrobacter spp. (76.9%) and Enterobacter spp. (70%); whereas K. pneumoniae and E. coli showed 73-73.8% tigecycline susceptibility rates. Tigecycline demonstrates a high level of antimicrobial in vitro activity when tested against E. coli and K. pneumoniae, even those with the ESBL-phenotype. Tigecycline retained activity against merely 22-30% of Enterobacter, Citrobacter and Serratia genera.


[An autopsied case of pachymeningitis associated with a ruptured, cerebral aneurysm due to Aspergillus infection].
We reported a 64-years-old woman with pachymeningitis associated with a ruptured mycotic cerebral aneurysm due to Aspergillus infection. She had suffered from diabetes mellitus and been treated since she was 49 years old. She complained of headache at the age of 62 and loss of her left visual acuity three months later. She was treated by the pulse therapy of methylprednisolone as neuritis retrobulbaris and her visual acuity recovered. But her headache continued. Three months later, her right visual acuity was lost, and the pulse therapy was not effective this time. Six months later, she died of subarachnoid hemorrhage following acute meningitis. The autopsy was granted, but limited to the cranial cavity. Macroscopically, it disclosed brownish thickened dura around sella turucica involving trigeminal ganglion and optic nerve, and fresh subarachnoid hemorrhage in the basal cisterns and a ruptured aneurysm (3 mm in diameter) between internal carotid and posterior cerebral artery on the left side. Histologically, the brownish thickened dura was infiltrated by lymphocytes, plasma cells, and multinucleated giant cells. The wall around the aneurysm was infiltrated by lymphocytes and plasma cells as well as many fungi. Immunohistochemistry demonstrated the presence of Aspergillus in the thickened dura and the arterial wall around the aneurysm. There were lymphocytes and plasma cell infiltration in the basal subarachnoid space and scattered microabcesses in the brain. Although the first entry of Aspergillus to the dura was unclear, we assume that the final intravascular dissemination of Aspergillus from the dura caused meningitis and mycotic aneurysm.


The role of psychosocial risks in burnout, psychosomatic disorders, and job satisfaction: lineal models vs a QCA approach in non-university teachers.
This study aims to assess the effect of psychosocial risks and resources on burnout, psychosomatic disorders, and job satisfaction using Hierarchical Regression Modelling (HRM) and Qualitative Comparative Analysis (QCA). The sample consisted of 9020 non-university public education teachers (Mage = 45.33 years, SD = 9.15; 72.5% women). Demands variables (Workload, Emotional labour, Imbalance, and Interpersonal conflict) were better predictors than resources variables (Job autonomy, Social support, and Resources at work). Resources also significantly improved the model's predictive capacity, except in the case of Indolence. In the QCA results, none of the conditions seems to be necessary. Regarding sufficiency, the combination of the different conditions explains between 44-49% of high levels of Burnout and between 40-47% of low levels of Burnout; between 44-47% of high levels of Psychosomatic disorders and 40-47% of low levels of Psychosomatic disorders; 49% of high Job satisfaction levels and 45-56% of low Job satisfaction levels. The results show that QCA models have better explanatory capacity than HRM. Some variables were not significant in HRM, but they were present in combination with other QCA model variables. The findings contribute to understanding how psychosocial risks affect workers' health and job satisfaction.


Estimating and projecting air passenger traffic during the COVID-19 coronavirus outbreak and its socio-economic impact.
Due to the coronavirus global crisis, most countries have put in place restrictive measures in order to confine the pandemia and contain the number of casualties. Among the restrictive measures, air traffic suspension is certainly quite effective in reducing the mobility on the global scale in the short term but it also has high socio-economic impact on the long and short term. The main focus of this study is to collect and prepare data on air passengers traffic worldwide with the scope of analyze the impact of travel ban on the aviation sector. Based on historical data from January 2010 till October 2019, a forecasting model is implemented in order to set a reference baseline. Making use of airplane movements extracted from online flight tracking platforms and on-line booking systems, this study presents also a first assessment of recent changes in flight activity around the world as a result of the COVID-19 pandemic. To study the effects of air travel ban on aviation and in turn its socio-economic, several scenarios are constructed based on past pandemic crisis and the observed flight volumes. It turns out that, according to these hypothetical scenarios, in the first Quarter of 2020 the impact of aviation losses could have negatively reduced World GDP by 0.02% to 0.12% according to the observed data and, in the worst case scenarios, at the end of 2020 the loss could be as high as 1.41-1.67% and job losses may reach the value of 25-30 millions. Focusing on EU27, the GDP loss may amount to 1.66-1.98% by the end of 2020 and the number of job losses from 4.2 to 5 millions in the worst case scenarios. Some countries will be more affected than others in the short run and most European airlines companies will suffer from the travel ban. We hope that these preliminary results may be of help for informed policy making design of exit strategies from this global crisis.


CT and MR imaging of fatty tumors of the liver.
The presence of fat in hepatic masses narrows the range of differential diagnoses down to hepatic angiomyolipoma, lipoma, adenoma, hepatoma, metastatic fatty tumors of the liver, focal fatty infiltration of the liver, and extrahepatic fatty masses such as intraperitoneal implants from malignant teratomas, and packed omentum. We report six hepatic tumors containing fat (lipoma, hepatocellular carcinoma, and calcified mass with fat-fluid level) with CT and magnetic resonance (MR) imaging. The distribution of fat was diffuse in the lipomas and some hepatocellular carcinomas and localized in other hepatocellular carcinomas and fat-fluid masses. The density ranged from - 100 to 0 HU. High intensity areas on both T1- and T2-weighted MR images corresponded to the hypodense areas on CT.


Role of megakaryoblastic acute leukemia-1 in ERK1/2-dependent stimulation of serum response factor-driven transcription by BDNF or increased synaptic activity.
Serum response factor (SRF)-mediated transcription contributes to developmental and adult brain plasticity. Therefore, we investigated the role of a newly identified SRF coactivator, MKL1, in the regulation of SRF-driven transcription in rat forebrain neurons. MKL1 expression was found in newborn rat cortical or hippocampal neurons in culture as well as in adult rat forebrain. Immunostaining demonstrated constitutive nuclear localization of MKL1 in the CA1 region of the hippocampus, in the deep layers of the neocortex, and in cultured neurons. Overexpression of MKL1 in primary cortical neurons elevated SRF-driven transcription and enhanced its stimulation by BDNF. In addition, inhibition of endogenous MKL1 by overexpression of a dominant-negative MKL1 mutant or by small interfering RNA reduced BDNF activation of SRF-driven transcription. In neurons, endogenous MKL1 was associated with SRF-regulated chromatin regions of several endogenous genes including c-fos, JunB, Srf, and Cyr61. BDNF activation of MKL1/SRF-driven transcription was dependent on the extracellular signal-regulated kinase 1/2 (ERK1/2) pathway, which also led to MKL1 phosphorylation. Finally, synaptic activity stimulation of SRF-driven transcription was reduced by inhibition of endogenous MKL1. Conversely, synaptic activity enhanced transcription by overexpressed MKL1. MKL1 regulation by synaptic activity was mediated through the NMDA receptor-activated ERK1/2. These results suggest that neuronal MKL1 contributes to SRF-regulated gene expression induced by BDNF or synaptic activity. In addition, MKL1 appears as a novel mediator of the signaling between ERK1/2 and SRF. Moreover, MKL1 is a likely regulator of SRF-driven transcription programs that underlie neuronal plasticity.


Encapsulated egg deposition pattern of Schistosoma japonicum in the peritoneal cavity of mice.
Thirty-four albino mice were each exposed to 20 cercariae of Schistosoma japonicum by the intraperitoneal or percutaneous route and killed after 60-127 days. The peritoneal cavity of each mouse was flushed and worms in the portal vein system were perfused with citrated saline. After sedimentation, washings were examined microscopically. Mature worms were only found in the portal vein system. The worm recovery rate was much higher by percutaneous infection (61.2%) than by intraperitoneal (37.1%). The encapsulated egg granulomas were observed either in the peritoneal cavity or on the intestinal wall; the mean number of encapsulated egg granulomas was also higher in the former (1.6) than in the latter (0.6). The average number of eggs per granuloma was very similar by both routes (10.7 and 11.4). The mean size of encapsulated egg granulomas (529 microns) was increased correspondingly with the number of eggs (range 181-985 microns). The percentage of viable eggs within the granulomas in the peritoneal cavity (77%) was much higher than those on the intestinal wall (18%). Encapsulated egg granulomas were usually ovoid although some had an irregular shape.


Brain MR Image Classification Using Superpixel-Based Deep Transfer Learning.
Nowadays, brain MR (Magnetic Resonance) images are widely used by clinicians to examine the brain's anatomy to look into various pathological conditions like cerebrovascular incidents and neuro-degenerative diseases. Generally, these diseases can be identified with the MR images as "normal" and "abnormal" brains in a two-class classification problem or as disease-specific classes in a multi-class problem. This article presents an ensemble transfer learning deep architecture that uses the simple linear iterative clustering (SLIC)-based superpixel algorithm along with CNN to classify the MR images into normal or abnormal. Superpixel algorithm is applied across the input MR images to segment into clusters of regions defined by similarity measures using perceptual feature space. These superpixel images are beneficial as they can provide a compact and meaningful image that plays a crucial role in computationally demanding applications. The superpixel images are then fed to the deep convolutional neural network (CNN) to classify the images. Three brain MR image datasets, NITR-DHH, DS-75, and DS-160, were used to conduct the experimentation. Through the use of deep transfer learning, the model managed to achieve the highest evaluated performance accuracy of 88.15% (NITR-DHH), 98.15% (DS-160), and 98.33% (DS-75) even with the small-scale medical image dataset. The experimentally obtained results demonstrate that our proposed method is promising and efficient for clinical applications for the diagnosis of different brain diseases via MR images.


The increasing threat of Rift Valley fever virus globalization: strategic guidance for protection and preparation.
Rift Valley fever virus (RVFV) (Bunyavirales: Phlebovirus) is a prominent vector-borne zoonotic disease threat to global agriculture and public health. Risks of introduction into nonendemic regions are tied to changing climate regimes and other dynamic environmental factors that are becoming more prevalent, as well as virus evolutionary factors and human/animal movement. Endemic to the African continent, RVFV has caused large epizootics at the decadal scale since the early 20th century but has spread to the Arabian Peninsula and shows increasing patterns of interepizootic transmission on the annual scale. This virus can be transmitted by mosquitoes as well as through direct contact with infected tissues and can cause sporadic to widespread morbidity and mortality in domestic ungulate livestock as well as humans. High viremias in infected livestock moved for legal and illegal trade as well as in infected mosquitoes or human travelers can spread this virus worldwide. With increasing global commerce, it is likely RVFV will be introduced to new areas with suitable hosts, mosquito vector species, and environments. However, the strong mosquito component of RVFV epidemiology combined with advancements in vaccines, diagnostics, and virus evolutionary factors create opportunities for strategies to leverage models of connectivity among potential source and emerging regions to target surveillance and mitigation activities to reduce the risk of RVFV introduction, or contain the virus should it be introduced, into new regions.


Processing of flavivirus structural glycoproteins: stable membrane insertion of premembrane requires the envelope signal peptide.
The flavivirus structural proteins capsid (C), premembrane (prM), and envelope (E) are cleaved in that order from the N-terminus of the polyprotein by the ER intralumenal enzyme signal peptidase. The prM-E and E-NS1 junctions contain hydrophobic domains with both transmembrane and signal function. These domains reside at the C-termini of prM and E, respectively, after cleavage. We studied the functions of the 37-amino-acid C-terminus of the dengue virus type 4 (DEN4) prM (amino acids 243-279 of the DEN4 polyprotein) in the processing of prM and E. Hydrophobicity in this domain is interrupted by a conserved Arg residue (Arg-264) within a short amphipathic segment. Hydrophobic amino acids upstream from Arg-264 (aa 243-263) were presumed to constitute the membrane anchor for prM (the "tm" segment). Previous results had suggested that sequences downstream from Arg-264 (aa 265-279) constitute the E signal peptide. RNA transcripts prepared from wild-type (wt) and deletion-mutant DEN4 cDNAs encoding the prM signal peptide, prM, E, and the N-terminus of the nonstructural glycoprotein, NS1, were translated in rabbit reticulocyte lysate in the presence of microsomes. Processing of wt prM and E in vitro appeared to mimic processing occurring during flavivirus infection. Analysis of mutants confirmed the localization of the E signal peptide within residues 265 to 279. However, deletions within either the E signal peptide or the tm segment resulted in a defect in both membrane insertion of prM and cleavage of the prM-E junction. Membrane anchoring of prM appeared to be a two-step process requiring function of both the tm segment and the E signal peptide, and fully efficient prM-E cleavage was also dependent upon the integrity of both hydrophobic domains. We propose a model for the processing of the flavivirus structural glycoproteins based on these results.


Chronic kidney disease in primary care.
It has been estimated that chronic kidney disease (CKD) affects about one in 200 of the population in the UK. There is an increased awareness of the need to identify patients in primary care with CKD at an earlier stage, so that treatments can be initiated to delay progression and prevent complications and appropriate nephrological referral can be made. In this article we will review how measures to identify patients with CKD can improve its management.


Prevalence and determinants of smoking initiation among school students in Bosnia and Herzegovina.
Tobacco smoking amongst the young is a matter of public health concern because of the immediate and long-term health consequences associated with tobacco use, such as asthma, cancers, and cardiovascular diseases. The purpose of this study was to identify the determinants of smoking initiation among a sample of high school students in Bosnia and Herzegovina. The study was conducted among 198 high school students in Zvornik, Bosnia and Herzegovina, during April 2013. A self-administered, pre-tested, structured, close-ended questionnaire was used for data collection. Fourth grade students mainly initiated smoking in high school (45%), while the majority of third and second grade students initiated smoking in primary school. Among students who smoke, an average duration of the smoking habit was <2 years. A multivariate analysis showed that males were 5.27 times more likely to have initiated smoking. For every unit increase in pro-smoking attitude towards smoking, students were 5.3 times more likely to have initiated smoking. Those with parents and friends who are smokers were 6.106 and 5.175 times, respectively, more likely to have initiated smoking. This study indicates that a high proportion of 15-18 year olds in the town of Zvornik are current smokers. Gender, age, and parent and peer influence were identified as important associations with smoking. Interventions should not only be confined to the secondary school environment but they should also extend to their places of residence so that influences in the home environment and social surroundings that contribute to tobacco use are also tackled.


Pressure ulcers.
Pressure ulcers are localized areas of tissue necrosis that result from unrelieved pressure. They are graded or staged according to the degree of tissue damage observed. The main etiologic factors include pressure, shearing forces, friction, and moisture. The clinical course may be complicated by several conditions including infection, sepsis, osteomyelitis, fistulas, and carcinoma. Preventive measures in persons at risk can significantly reduce the incidence of pressure ulcers. Successful management should address the four etiologic factors as well as the general condition of the patient.


Does knowledge make a difference? Understanding how the lay public and experts assess the credibility of information on novel foods.
Drawing on Metzger's dual-processing model of credibility assessment, this study examines how individuals with varying topical knowledge (laypersons vs experts) assess the credibility of information on novel foods. Online focus group discussions reveal that both groups share similar motivations for assessing the credibility of information on novel foods (e.g. personal relevance and concerns about the impact of unverified information on others). However, they differ in the barriers they encounter during the assessment of information credibility. Both groups employ analytical (e.g. evaluating content quality) and intuitive methods (e.g. looking at source credibility) to assess the credibility of novel food-related information. However, they differ in the cues used for credibility assessment. Laypersons tend to rely on superficial heuristics (e.g. social endorsement cues or surface features), whereas experts rely more on content features and scientific knowledge to evaluate information credibility. Theoretical and practical implications are discussed.


"Multisensory brand search: How the meaning of sounds guides consumers' visual attention": Correction to Knoeferle et al. (2016).
Reports an error in "Multisensory brand search: How the meaning of sounds guides consumers' visual attention" by Klemens M. Knoeferle, Pia Knoeferle, Carlos Velasco and Charles Spence (Journal of Experimental Psychology: Applied, 2016[Jun], Vol 22[2], 196-210). In the article, under Experiment 2, Design and Stimuli, the set number of target products and visual distractors reported in the second paragraph should be 20 and 13, respectively: "On each trial, the 16 products shown in the display were randomly selected from a set of 20 products belonging to different categories. Out of the set of 20 products, seven were potential targets, whereas the other 13 were used as visual distractors only throughout the experiment (since they were not linked to specific usage or consumption sounds)." Consequently, Appendix A in the supplemental materials has been updated. (The following abstract of the original article appeared in record 2016-28876-002.) Building on models of crossmodal attention, the present research proposes that brand search is inherently multisensory, in that the consumers' visual search for a specific brand can be facilitated by semantically related stimuli that are presented in another sensory modality. A series of 5 experiments demonstrates that the presentation of spatially nonpredictive auditory stimuli associated with products (e.g., usage sounds or product-related jingles) can crossmodally facilitate consumers' visual search for, and selection of, products. Eye-tracking data (Experiment 2) revealed that the crossmodal effect of auditory cues on visual search manifested itself not only in RTs, but also in the earliest stages of visual attentional processing, thus suggesting that the semantic information embedded within sounds can modulate the perceptual saliency of the target products' visual representations. Crossmodal facilitation was even observed for newly learnt associations between unfamiliar brands and sonic logos, implicating multisensory short-term learning in establishing audiovisual semantic associations. The facilitation effect was stronger when searching complex rather than simple visual displays, thus suggesting a modulatory role of perceptual load. (PsycINFO Database Record


Effects of statin therapy on coronary artery plaque volume and high-risk plaque morphology in HIV-infected patients with subclinical atherosclerosis: a randomised, double-blind, placebo-controlled trial.
HIV-infected patients have a high risk of myocardial infarction. We aimed to assess the ability of statin treatment to reduce arterial inflammation and achieve regression of coronary atherosclerosis in this population. In a randomised, double-blind, placebo-controlled trial, 40 HIV-infected participants with subclinical coronary atherosclerosis, evidence of arterial inflammation in the aorta by fluorodeoxyglucose (FDG)-PET, and LDL-cholesterol concentration of less than 3.37 mmol/L (130 mg/dL) were randomly assigned (1:1) to 1 year of treatment with atorvastatin or placebo. Randomisation was by the Massachusetts General Hospital (MGH) Clinical Research Pharmacy with a permuted-block algorithm, stratified by sex with a fixed block size of four. Study codes were available only to the MGH Research Pharmacy and not to study investigators or participants. The prespecified primary endpoint was arterial inflammation as assessed by FDG-PET of the aorta. Additional prespecified endpoints were non-calcified and calcified plaque measures and high risk plaque features assessed with coronary CT angiography and biochemical measures. Analysis was done by intention to treat with all available data and without imputation for missing data. The trial is registered with ClinicalTrials.gov, number NCT00965185. The study was done from Nov 13, 2009, to Jan 13, 2014. 19 patients were assigned to atorvastatin and 21 to placebo. 37 (93%) of 40 participants completed the study, with equivalent discontinuation rates in both groups. Baseline characteristics were similar between groups. After 12 months, change in FDG-PET uptake of the most diseased segment of the aorta was not different between atorvastatin and placebo, but technically adequate results comparing longitudinal changes in identical regions could be assessed in only 21 patients (atorvastatin Δ -0.03, 95% CI -0.17 to 0.12, vs placebo Δ -0.06, -0.25 to 0.13; p=0.77). Change in plaque could be assessed in all 37 people completing the study. Atorvastatin reduced non-calcified coronary plaque volume relative to placebo: median change -19.4% (IQR -39.2 to 9.3) versus 20.4% (-7.1 to 94.4; p=0.009, n=37). The number of high-risk plaques was significantly reduced in the atorvastatin group compared with the placebo group: change in number of low attenuation plaques -0.2 (95% CI -0.6 to 0.2) versus 0.4 (0.0, 0.7; p=0.03; n=37); and change in number of positively remodelled plaques -0.2 (-0.4 to 0.1) versus 0.4 (-0.1 to 0.8; p=0.04; n=37). Direct LDL-cholesterol (-1.00 mmol/L, 95% CI -1.38 to 0.61 vs 0.30 mmol/L, 0.04 to 0.55, p<0.0001) and lipoprotein-associated phospholipase A2 (-52.2 ng/mL, 95% CI -70.4 to -34.0, vs -13.3 ng/mL, -32.8 to 6.2; p=0.005; n=37) decreased significantly with atorvastatin relative to placebo. Statin therapy was well tolerated, with a low incidence of clinical adverse events. No significant effects of statin therapy on arterial inflammation of the aorta were seen as measured by FDG-PET. However, statin therapy reduced non-calcified plaque volume and high-risk coronary plaque features in HIV-infected patients. Further studies should assess whether reduction in high-risk coronary artery disease translates into effective prevention of cardiovascular events in this at-risk population. National Institutes of Health, Harvard Clinical and Translational Science Center, National Center for Research Resources.


[Biventricular inflow tract compression by chronic organized hemopericardium in Caplan syndrome].
We report the case of a 59-year old patient with the rare combination of silicosis and rheumatoid arthritis, which is called Caplan's syndrome. The patient presented with right heart failure caused by a pericardial tumor compressing the right and the left ventricle. By means of several imaging techniques it was possible to elucidate the topographic relations of the tumor. Definite signs of malignant growth were not found. Despite his elevated perioperative risk we decided to operate on the patient. During the operation macroscopic and histologic evidence revealed that the tumor was not a neoplastic process but consisted of an organized hemopericardium. This demonstrates that pericarditis in rheumatoid arthritis can be hemorrhagic and can mimick a malignant pericardial tumor. The decision to operate was first supported by the findings of the applied imaging techniques, the normal endomyocardial biopsy, and the clinical course and were later confirmed in situ.


Presence of Mycobacterium leprae-reactive lymphocytes in lymph nodes of lepromatous leprosy patients.
A critical problem in leprosy is the relative deficiency of antigen-specific T cell-mediated immunity. We were successful in detecting a significant response to viable M. leprae in mononuclear cells isolated from the lymph nodes of lepromatous leprosy patients in contrast to the apparent M. leprae-specific energy seen in the peripheral blood. This observation suggests that antigen-reactive lymphocytes are generated in the lymph nodes of lepromatous patients but the inability to detect them in the circulation may be due either to a different processing and presentation of mycobacterial antigens within the peripheral blood and lymph node compartments or to a selective sequestration of lymphocytes within the lymph node.


MULTI-RESOLUTION STATISTICAL ANALYSIS ON GRAPH STRUCTURED DATA IN NEUROIMAGING.
Statistical data analysis plays a major role in discovering structural and functional imaging phenotypes for mental disorders such as Alzheimer's disease (AD). The goal here is to identify, ideally early on, which regions in the brain show abnormal variations with a disorder. To make the method more sensitive, we rely on a multi-resolutional perspective of the given data. Since the underlying imaging data (such as cortical surfaces and connectomes) are naturally represented in the form of weighted graphs which lie in a non-Euclidean space, we introduce recent work from the harmonics literature to derive an effective multi-scale descriptor using wavelets on graphs that characterize the local context at each data point. Using this descriptor, we demonstrate experiments where we identify significant differences between AD and control populations using cortical surface data and tractography derived graphs/networks.


Assessment of the Effect of Orthodontic Treatment on the Periodontal Health of Endodontically Restored Tooth.
Intorduction: Patients usually undergo orthodontic treatment for achieving ideal interocclusal relationship between the dental tissue and bony tissue along with improving the speech, mastication, and facial esthetic appearance. Literature quotes paucity in the studies evaluating the effect of orthodontic treatment on the periodontal health of endodontically treated teeth. Hence, we planned the present study to assess the effect of orthodontic treatment on the periodontal health of endodonti-cally restored tooth. The present study included assessment of 80 patients who underwent orthodontic treatment. All the patients were divided broadly into two study groups: groups I and II. Group I included patients with the absence of endodontically treated teeth, while group II included patients which maxillary central incisors were resorted endodontically. Examination of the periodontal health of the patients was done using the community periodontal index of treatment need (CPITN) around the selected teeth. All the values were recorded during the preorthodontic time, postorthodontic time, and after the first 6 months of starting of the orthodontic treatment. All the results were recorded separately and analyzed. In the groups I and II, 28 and 25 patients respectively, had score of 1, while 10 patients in group I and 12 patients in group II had score of 2. Nonsignificant results were obtained while comparing the CPITN score in between the two study groups when measured at the pre-, intra-, and postortho time. In patients undergoing orthodontic treatment, having endodontically resorted teeth, no difference exists in relation to the periodontal health. Orthodontic treatment can be safely carried in patients with endodontically restored teeth.


Effect of Age and Sex on the QTc Interval in Children and Adolescents With Type 1 and 2 Long-QT Syndrome.
In congenital long-QT syndrome, age, sex, and genotype have been associated with cardiac events, but their effect on the trend in QTc interval has never been established. We, therefore, aimed to assess the effect of age and sex on the QTc interval in children and adolescents with type 1 (LQT1) and type 2 (LQT2) long-QT syndrome. QTc intervals of 12-lead resting electrocardiograms were determined, and trends over time were analyzed using a linear mixed-effects model. The study included 278 patients with a median follow-up of 4 years (interquartile range, 1-9) and a median number of 6 (interquartile range, 2-10) electrocardiograms per patient. Both LQT1 and LQT2 male patients showed QTc interval shortening after the onset of puberty. In LQT2 male patients, this was preceded by a progressive QTc interval prolongation. In LQT1, after the age of 12 years, male patients had a significantly shorter QTc interval than female patients. In LQT2, during the first years of life and from 14 to 26 years, male patients had a significantly shorter QTc interval than female patients. On the contrary, between 5 and 14 years, LQT2 male patients had significantly longer QTc interval than LQT2 female patients. There is a significant effect of age and sex on the QTc interval in long-QT syndrome, with a unique pattern per genotype. The age of 12 to 14 years is an important transitional period. In the risk stratification and management of long-QT syndrome patients, clinicians should be aware of these age-, sex-, and genotype-related trends in QTc interval and especially the important role of the onset of puberty.


Electrical transport of spin-polarized carriers in disordered ultrathin films.
Slow, nonexponential relaxation of electrical transport accompanied by memory effects has been induced in quench-condensed ultrathin amorphous Bi films by the application of a parallel magnetic field. This behavior, which is very similar to space-charge limited current flow, is found in extremely thin films well on the insulating side of the thickness-tuned superconductor-insulator transition. It may be the signature of a collective state that forms when the carriers are spin polarized at low temperatures and in high magnetic fields.


Needs of elderly patients in palliative care.
A pilot study on elderly patients' end-of-life needs was performed at a Swedish geriatric palliative ward. Thirty patients (15 men and 15 women; mean age, 79 years) with a primary diagnosis of cancer and admitted for palliative care were interviewed by a nurse using semistructured interviews. The study included demographic data, physical and psychologic status, and naming and ranking of individual needs. Elimination of physical pain was ranked as the primary need of half of the patients. Only when pain was eliminated or absent did other important needs (psychological, social, spiritual) appear frequently.


[A case of post-traumatic carotid-cavernous fistula in a 9-year-old girl].
The authors report a case of carotidocavernous fistula with late (after 5 months) development of clinical signs confirmed by right-sided carotic angiography. Such cases are rare in children.


Pancreatic islet surface bioengineering with a heparin-incorporated starPEG nanofilm.
Cell surface engineering could protect implanted cells from host immune rejections while modify the cellular landscape for better post-transplantation graft function and survival. Islet transplantation is considered the most promising therapeutic option with the potential to cure diabetes. Current approach to improve clinical efficacy of pancreatic islet transplantation is alginate encapsulation. However, disappointing outcomes have been reported in clinical trials due to larger islet size resulted by encapsulation and alginate-elicited host immune responses. We have developed an ultrathin nanofilm of starPEG with incorporated heparin (Hep-PEG) that binds covalently to the amine groups of islet surface membrane via its N-hydroxysuccinimide groups. The Hep-PEG nanocoating elicited minimal alteration on islet volume in culture. Hep-PEG-coated islets exhibited robust islet viability accompanied by uncompromised islet insulin secretory function. Instant blood-mediated inflammatory reaction was also reduced by Hep-PEG islet coating, accompanied by enhanced intra-islet revascularization. In addition, despite its semi-permeability, Hep-PEG islet coating promoted the survival of islets exposed to pro-inflammatory cytokines. Considering that inflammation and hypoxia are primary causes of immediate cell loss for cell therapy, the Hep-PEG nanofilm represents a viable approach for cell surface engineering which would improve the clinical outcome of cell therapies.


The use of multiple 8 compression suturing as a novel procedure to preserve fertility in patients with placenta accreta: case series.
Placenta accreta/percreta is a serious cause of intractable post-partum haemorrhage during caesarean section and a common cause of peripartum hysterectomy. In this case series, we evaluated the use of multiple 8 sutures as a novel procedure to preserve the uterus in these cases. Seven women with placenta accreta/percreta were initially managed with bilateral uterine artery ligation. The procedure was resorted to in cases that did not respond to ligation (five women). Women were followed up for up to 24 months to report complications.


Combination Therapies for Hidradenitis Suppurativa: A Retrospective Chart Review of 31 Patients.
Although a variety of medical and surgical interventions exist for the treatment of hidradenitis suppurativa (HS), it remains a challenging disease to manage because of its variable presentation and unpredictable clinical course. Apart from the combination of clindamycin and rifampin, the success of other combination therapies is largely unknown. The goal of our study was to examine the clinical utility of various combination therapies for the treatment of HS. We conducted a qualitative retrospective chart review of 31 patients with dermatologist-diagnosed HS who were seen at an academic teaching hospital between 2014 and 2018. Demographic data, disease location, disease severity, and treatment protocol were retrieved for analysis. Hurley stage was used to classify disease severity on initial presentation, and the International Hidradenitis Suppurativa Severity Score System (IHS4) was used to track changes across visits. Of the 31 patients (Mage = 37.7 years; 67.7% female) included in the study, 6 (19.4%), 11 (35.5%), and 14 (45.2%) patients were classified as Hurley stages I, II, and III, respectively. Although no statistical results are provided because of the small sample size, we have identified several drug combinations that show promising clinical response for patients with HS based on their IHS4 score, such as isotretinoin/spironolactone for mild disease, isotretinoin or doxycycline with adalimumab for moderate disease, and cyclosporine/adalimumab for severe disease. This preliminary work demonstrates that HS treatment with combination therapy appears to be a promising method of disease management.


Daily bedside electrophysiological testing following surgery for the WPW syndrome.
A simple technique is described that allows daily bedside evaluation of the results of surgery for the Wolff-Parkinson-White (WPW) syndrome, using standard postoperative myocardial wires, a single-channel ECG machine, and a temporary pacer capable of rapid stimulation. Rate incremental atrial and ventricular ramp pacing was performed daily in 40 postoperative WPW patients. This technique, together with underdrive pacing in some individuals permits quick assessment of anterograde and retrograde conduction. Two surgical failures were identified in early postoperative days, and promptly returned to the operating room for successful reoperation. No additional failures were identified at formal predischarge electrophysiological testing or following discharge. The technique permits reassurance on a daily basis to apparent successes and early identification in the event of failure, permitting prompt intervention.


Effect of White Kidney Beans (Phaseolus vulgaris L. var. Beldia) on Small Intestine Morphology and Function in Wistar Rats.
The chronic ingestion of raw or undercooked kidney beans (Phaseolus vulgaris L.) causes functional and morphological derangement in various tissues. The major objectives of this study were to investigate the gavage effects of a raw Beldia bean variety that is widely consumed in Tunisia, on the small intestine morphology and jejunal absorption of water, electrolytes, and glucose in Wistar rats. Twenty young male rats were randomly divided into two groups of 10 rats. The first group served as the control and was gavaged with 300 mg of a rodent pellet flour suspension (RPFS), whereas the second experimental group was challenged with 300 mg of a Beldia bean flour suspension (BBFS) for 10 days. Histological studies were performed using light and electron microcopy. The intestinal transport of water, sodium, potassium, and glucose was studied by perfusing the jejunal loops of the small bowels in vivo. The feeding experiments indicated that BBFS did not affect weight gain. Histomorphometric analyses showed that the villus heights, crypt depths, and crypt/villus ratios in the jejunum and ileum were greater in the BBFS-fed rats than controls. Electron microscopy studies demonstrated that the rats exposed to RPFS exhibited intact intestinal tracts; however, the BBFS-treated rats demonstrated intestinal alterations characterized by abnormal microvillus architectures, with short and dense or long and slender features, in addition to the sparse presence of vesicles near the brush border membrane. BBFS administration did not significantly affect glucose absorption. However, significant decreases were observed in water and electrolyte absorption compared with the uptake of the controls. In conclusion, raw Beldia beans distorted jejunum morphology and disturbed hydroelectrolytic flux.


PrP meets alpha-synuclein: Molecular mechanisms and implications for disease.
The discovery of prions has challenged dogmas and has revolutionized our understanding of protein-misfolding diseases. The concept of self-propagation via protein conformational changes, originally discovered for the prion protein (PrP), also applies to other proteins that exhibit similar behavior, such as alpha-synuclein (aSyn), a central player in Parkinson's disease and in other synucleinopathies. aSyn pathology appears to spread from one cell to another during disease progression, and involves the misfolding and aggregation of aSyn. How the transfer of aSyn between cells occurs is still being studied, but one important hypothesis involves receptor-mediated transport. Interestingly, recent studies indicate that the cellular prion protein (PrPC ) may play a crucial role in this process. PrPC has been shown to act as a receptor/sensor for protein aggregates in different neurodegenerative disorders, including Alzheimer's disease and amyotrophic lateral sclerosis. Here, we provide a comprehensive overview of the current state of knowledge regarding the interaction between aSyn and PrPC and discuss its role in synucleinopathies. We examine the properties of PrP and aSyn, including their structure, function, and aggregation. Additionally, we discuss the current understanding of PrPC 's role as a receptor/sensor for aSyn aggregates and identify remaining unanswered questions in this area of research. Ultimately, we posit that exploring the interaction between aSyn and PrPC may offer potential treatment options for synucleinopathies.


FK506: an immunosuppressive agent preserving HIF-1 activity.
During transplantation, donor organs or cells are subjected to hypoxia. Hypoxia-inducible factor-1 (HIF-1) is essential for cellular adaptation to hypoxia. Immunosuppressive agents should be used for preventing graft rejection, but of these, rapamycin and cyclosporine A have been reported to inhibit HIF-1. We examined whether or not another important immunosuppressant, FK506, inhibits HIF-1. In contrast to cyclosporine A, FK506 neither inhibits HIF-1alpha expression in 8 different cell lines, nor represses the transcriptional activity of HIF-1. Compared with cyclosporine A, FK506 significantly reduced the apoptotic cell death by hypoxia. FK506 could preserve HIF-1 activity in donor organs subjected to hypoxia.


A new species of the genus Leptolalax (Anura, Megophryidae) from Hunan, China.
A new species, Leptolalax mangshanensis sp. nov., is described from the Mangshan National Nature Reserve, in Hunan Province, China. The new species is genetically similar to Leptolalax liui, and morphologically similar to Leptolalax maoershanensis. Morphological characteristics that distinguish the new species from its congeners are a small body size (snout-vent length, SVL, 22.2 mm-27.8 mm in 27 adult males, and 30.2 mm in one adult female); nearly smooth dorsal skin with some small, orange, tubercles and irregular, dark brown stripes, throat and belly scattered with white speckles, weak lateral fringes on toes and rudimentary toe webbing; indistinct longitudinal ridges under toes, and not interrupted at the articulations, iris bicolored with bright orange in the upper half and greyish cream in the lower half. The new species is widely distributed in montane evergreen secondary forests and small bamboo forests in Mangshan Nature Reserve, at altitudes between 500-1600 m a.s.l.


Simian varicella infection in the African green monkey (Cercopithecus aethiops).
A severe and highly fatal disease occurred in African green monkeys (Cercopithecus aethiops). The disease was marked by an extensive maculo-vesicular rash. In fatal cases, multifocal necrosis and hemorrhage were found characteristically in many organs and tissues. New cases of the disease occurred over a 39-day period. Nine of 49 exposed African green monkeys were affected and five of the nine died. Four cynomolgus (Macaca fascicularis) and 31 stumptailed monkeys (Macaca arctoides) which were exposed were not affected. Delta Herposvirus was isolated from affected African green monkeys. Stumptailed monkeys housed in association with the African green monkeys, as well as those housed elsewhere, had significant serum concentrations of neutralizing antibodies to this agent.


Evaluation of a radiation protection cabin for invasive electrophysiological procedures.
Complex invasive electrophysiological procedures may result in high cumulative operator radiation exposure. Classical protection with lead aprons results in discomfort while radioprotection is still incomplete. This study evaluated the usefulness of a radiation protection cabin (RPC) that completely surrounds the operator. The evaluation was performed independently in two electrophysiology laboratories (E1-Leuven, Belgium; E2-Bordeaux, France), comparing operator radiation exposure using the RPC vs. a 0.5 mm lead-equivalent apron (total of 135 procedures). E1 used thermoluminiscent dosimeters (TLDs) placed at 16 positions in and out of the RPC and nine positions in and out of the apron. E2 used more sensitive electronic personal dosimeters (EPD), placed at waist and neck. The sensitivity thresholds of the TLDs and EPDs were 10-20 microSv and 1-1.5 microSv, respectively. All procedures could be performed unimpeded with the RPC. Median TLD dose values outside protected areas were in the range of 57-452 microSv, whereas doses under the apron or inside the RPC were all at the background radiation level, irrespective of procedure and fluoroscopy duration and of radiation energy delivered. In addition, the RPC was protecting the entire body (except the hands), whereas lead apron protection is incomplete. Also with the more sensitive EPDs, the radiation dose within the RPC was at the sensitivity threshold/background level (1.3+/-0.6 microSv). Again, radiation to the head was significantly lower within the RPC (1.9+/-1.2 microSv) than with the apron (102+/-23 microSv, P<0.001). The use of the RPC allows performing catheter ablation procedures without compromising catheter manipulation, and with negligible radiation exposure for the operator.


Cerebral vasculitis during FK 506 treatment in a liver transplant patient.
The immunosuppressive agent FK 506 is widely used in liver transplant patients. Neurotoxicity is a major complication of its use. We report progressive and irreversible neurologic complications occurring in a 39-year-old woman who underwent liver transplantation and was treated with FK 506. Neuropathologic examination revealed multiple vasculitic lesions. The possibility of an FK 506-mediated toxic effect on the cerebral vessels is suggested.


Antrochoanal polyposis: a review of 33 cases.
We report on a series of 33 consecutive cases of antrochoanal polyp (ACP) treated by endoscopic sinus surgery over a five-year period. All but one patient was treated by endoscopic sinus surgery alone. This method of treatment was quite effective for ACPs. These 33 patients represent 22.3% of all nasal polyp patients on whom we operated during the same period. This incidence of ACP is greater than that generally reported in the literature. Some authors have attempted to distinguish ACPs from common nasal polyps primarily on the basis of morphology, histology, and the clinical behavior of the ACPs. In our series, a multivariate analysis, including histopathologic correlation, did not support the notion that ACPs are clearly distinct from common nasal polyps. Some interesting differences between the polyp groups did, however, become evident in our data analysis. Generally, ACPs are not thought to be associated with allergic disease; however, in our series we found the association of allergic disease with ACPs to be statistically significant (Chi-square = 4.575, p < .05).


Periodic Lateralized Epileptiform Discharges can Survive Anesthesia and Result in Asymmetric Drug-induced Burst Suppression.
Drug-induced burst suppression (DIBS) is bihemispheric and bisymmetric in adults and older children. However, asymmetric DIBS may occur if a pathological process is affecting one hemisphere only or both hemispheres disproportionately. The usual suspect is a destructive lesion; an irritative or epileptogenic lesion is usually not invoked to explain DIBS asymmetry. We report the case of a 66-year-old woman with new-onset seizures who was found to have a hemorrhagic cavernoma and periodic lateralized epileptiform discharges (PLEDs) in the right temporal region. After levetiracetam and before anesthetic antiepileptic drugs (AEDs) were administered, the electroencephalogram (EEG) showed continuous PLEDs over the right hemisphere with maximum voltage in the posterior temporal region. Focal electrographic seizures also occurred occasionally in the same location. Propofol resulted in bihemispheric, but not in bisymmetric, DIBS. Remnants or fragments of PLEDs that survived anesthesia increased the amplitude and complexity of the bursts in the right hemisphere leading to asymmetric DIBS. Phenytoin, lacosamide, ketamine, midazolam, and topiramate were administered at various times in the course of EEG monitoring, resulting in suppression of seizures but not of PLEDs. Ketamine and midazolam reduced the rate, amplitude, and complexity of PLEDs but only after producing substantial attenuation of all burst components. When all anesthetics were discontinued, the EEG reverted to the original preanesthesia pattern with continuous non-fragmented PLEDs. The fact that PLEDs can survive anesthesia and affect DIBS symmetry is a testament to the robustness of the neurodynamic processes underlying PLEDs.


Prognostic indicators in cerebral venous sinus thrombosis.
Cerebral venous sinus thrombosis (CVT) can affect all age groups, particularly women of childbearing age. Overall prognosis for survival and functional independence is better than it was believed. Mortality usually ranges from 6-15% and transtentorial herniation is the major cause of death. Approximately 80% of patients are functionally independent in the long term. Altered mental status and cerebral haemorrhage at presentation are the strongest predictors of death and disability. Patients with CVT related to pregnancy and puerperium generally do better than patients with other causes. Septic CVT carries a worse prognosis than aseptic CVT and of the latter, patients with syndrome of isolated intracranial hypertension have a better prognosis than those with focal deficits or encephalopathy. Anticoagulation is believed to improve outcome in CVT although robust data are lacking. Epilepsy, headaches, visual loss, pyramidal deficits and cognitive impairment are some of the long term sequelae. The risk of recurrence of CVT is low, particularly after the first 12 months of the first episode.


[Formation of mean values in growth spurts and incremental growth humps].
When averaging growth spurts and increase humps the question arises as to how much this procedure will affect the shape of the combined curves. It is shown that the frequency distribution is the main bar, reducing effects of disshaping . Examples for the growth spurts and humps show this influence in selected cases. Generally anxieties about unaccountable deformances can be cut down for the growth spurts and restricted for the increase humps.


Mechanics of healthy and functionally diseased mitral valves: a critical review.
The mitral valve is a complex apparatus with multiple constituents that work cohesively to ensure unidirectional flow between the left atrium and ventricle. Disruption to any or all of the components-the annulus, leaflets, chordae, and papillary muscles-can lead to backflow of blood, or regurgitation, into the left atrium, which deleteriously effects patient health. Through the years, a myriad of surgical repairs have been proposed; however, a careful appreciation for the underlying structural mechanics can help optimize long-term repair durability and inform medical device design. In this review, we aim to present the experimental methods and significant results that have shaped the current understanding of mitral valve mechanics. Data will be presented for all components of the mitral valve apparatus in control, pathological, and repaired conditions from human, animal, and in vitro studies. Finally, current strategies of patient specific and noninvasive surgical planning will be critically outlined.


Visual impairment following stroke: do stroke patients require vision assessment?
the types of visual impairment followings stroke are wide ranging and encompass low vision, eye movement and visual field abnormalities, and visual perceptual difficulties. the purpose of this paper is to present a 1-year data set and identify the types of visual impairment occurring following stroke and their prevalence. a multi-centre prospective observation study was undertaken in 14 acute trust hospitals. Stroke survivors with a suspected visual difficulty were recruited. Standardised screening/referral and investigation forms were employed to document data on visual impairment specifically assessment of visual acuity, ocular pathology, eye alignment and movement, visual perception (including inattention) and visual field defects. three hundred and twenty-three patients were recruited with a mean age of 69 years [standard deviation (SD) 15]. Sixty-eight per cent had eye alignment/movement impairment, 49% had visual field impairment, 26.5% had low vision and 20.5% had perceptual difficulties. of patients referred with a suspected visual difficulty, only 8% had normal vision status confirmed on examination. Ninety-two per cent had visual impairment of some form confirmed which is considerably higher than previous publications and probably relates to the prospective, standardised investigation offered by specialist orthoptists. However, under-ascertainment of visual problems cannot be ruled out.


Ground-level geriatric falls: a not-so-minor mechanism of injury.
Introduction. Ground-level falls are typically regarded as a minor mechanism of injury that do not necessitate trauma team activation; however, they represent a significant proportion of hospitalised trauma and can result in multisystem injury. Case Presentation. A 79-year-old nursing home resident was brought to the emergency department following an unwitnessed fall. She suffered dementia and had a seizure in the department resulting in a reduced GCS, making history and examination difficult. She was diagnosed with a right proximal humerus fracture and admitted under joint orthopedic and medical care. Following orthopedic review, further X-rays were requested which showed bilateral neck of femur fractures. The following day she had bilateral hip hemiarthroplasties and K-wire stabilisation of the right shoulder. Several days later, when cognition had improved, she was noted to be avoiding use of the left arm and was found to also have a left proximal humerus fracture which was managed conservatively. Conclusion. Trauma patients with reduced cognitive function should undergo full ATLS assessment, and a prospective trial is required to see if age should be incorporated as a criteria for trauma team activation. More liberal use of advanced imaging such as a full body CT-scan may be beneficial.