Evolution of immunoglobulin and mannose binding protein levels after renal transplantation: association with infectious complications.
Hypogammaglobulinemia (hypo-Ig) and low mannose binding protein (MBP) levels might be involved in the infectious risk in renal transplantation. In 152 kidney transplant recipients treated with calcineurin inhibitors (CNI) and mycophenolate mofetil (MMF), during the first year, we prospectively recorded the incidence of hypogammaglobulinemia, and low MBP levels. Their influence on infectious complications was evaluated in 92 patients at 3 and 12 months (T3 and T12). The proportion of deficiency increased significantly: hypo-IgG: 6% (T0), 45% (T3), and 30% (T12) (P < 0.001); hypo-MBP: 5%, 11%, and 12% (P = 0.035). Hypo-IgG at T3 was not associated with an increased incidence of first-year infections. A significantly higher proportion of patients with combined hypogammaglobulinemia [IgG+ (IgA and/or IgM)] at T3 and with isolated hypo-IgG at T0 developed infections until T3 compared with patients free of these deficits (P < 0.05). Low MBP levels at T3 were associated with more sepsis and viral infections. Hypogammaglobulinemia is frequent during the first year after renal transplantation in patients treated with a CNI and MMF. Hypo-IgG at T0 and combined Igs deficts at T3 were associated with more infections. MBP deficiency might emerge as an important determinant of the post-transplant infectious risk.


Expression and Retention of Thymidine Phosphorylase in Cultured Reticulocytes as a Novel Treatment for MNGIE.
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal metabolic disorder caused by thymidine phosphorylase (TP) deficiency. Successful therapeutic interventions for this disease rely on a means for efficient and long-lasting circulation of the TP enzyme. In this study we exploit lentiviral transduction of hematopoietic stem cells and an erythroid cell line (BEL-A) to generate reticulocytes that contain active TP. Significant loss of overexpressed TP during erythroid differentiation can be reduced by addition of the ubiquitination inhibitor MG132. However, the ubiquitination sites are located in the substrate binding site in human TP, and their removal abolished enzyme activity. Examination of the TP structure and mechanism suggested that these sites are only exposed in the absence of substrate. We show that supplementation of culture media with thymidine during differentiation reduces enzyme degradation, doubling the amount of TP retained in reticulocytes. This study provides proof of principle that therapeutic reticulocytes expressing TP can be generated in vitro and that ubiquitin-mediated degradation can be subverted through masking ubiquitination sites to ensure retention of human TP in reticulocytes following erythroid differentiation.


Prognostic value of NDRG1 and SPARC protein expression in breast cancer patients.
An increasing number of studies have shown altered expression of secreted protein acidic and rich in cysteine (SPARC) and N-myc down-regulated gene (NDRG1) in several malignancies, including breast carcinoma; however, the role of these potential biomarkers in tumor development and progression is controversial. In this study, NDRG1 and SPARC protein expression was evaluated by immunohistochemistry on tissue microarrays containing breast tumor specimens from patients with 10 years of follow-up. NDRG1 and SPARC protein expression was determined in 596 patients along with other prognostic markers, such as ER, PR, and HER2. The status of NDRG1 and SPARC protein expression was correlated with prognostic variables and patient clinical outcome. Immunostaining revealed that 272 of the 596 cases (45.6%) were positive for NDRG1 and 431 (72.3%) were positive for SPARC. Statistically significant differences were found between the presence of SPARC and NDRG1 protein expression and standard clinicopathological variables. Kaplan-Meier analysis showed that NDRG1 positivity was directly associated with shorter disease-free survival (DFS, P < 0.001) and overall survival (OS, P < 0.001). In contrast, patients expressing low levels of SPARC protein had worse DFS (P = 0.001) and OS (P = 0.001) compared to those expressing high levels. Combined analysis of the two markers indicated that DFS (P < 0.001) and OS rates (P < 0.001) were lowest for patients with NDRG1-positive and SPARC-negative tumors. Furthermore, NDRG1 over-expression and SPARC down-regulation correlated with poor prognosis in patients with luminal A or triple-negative subtype breast cancer. On multivariate analysis using a Cox proportional hazards model, NDRG1 and SPARC protein expression were independent prognostic factors for both DFS and OS of breast cancer patients. These data indicate that NDRG1 over-expression and SPARC down-regulation could play important roles in breast cancer progression and serve as useful biomarkers to better define breast cancer prognosis.


Aldosterone antagonists. 2. Synthesis and biological activities of 11,12-dehydropregnane derivatives.
Several steroid derivatives having the delta 11-pregnane skeleton with a 17-gamma-spirolactone function were synthesized to evaluate their antialdosterone activity and to elucidate the relation between their binding affinity to mineralocorticoid receptor (MR) and their mineralo- and/or antimineralocorticoid activity. Although many of the synthesized compounds showed strong binding affinity for the MR and aldosterone agonist activity, 3-(17 beta-hydroxy-3-oxoandrosta-1,4,6,11-tetraen-17 alpha-yl)propionic acid gamma-lactone exhibited good aldosterone antagonist activity in an in vivo assay. Its in vivo antiandrogenic activity was also found to be relatively weak.


Phoneme quality and quantity are processed independently in the human brain.
In speech perception, the primary cue of phoneme recognition is typically the spectral quality of the speech sound. In some languages, however, even speech-sound duration may serve as a phonological cue. This distinction is called quantity. We used a component of event-related potential, the mismatch negativity, to determine whether phoneme quality and quantity are processed independently in the human brain. We found that the mismatch negativity responses to phoneme quality and quantity changes are additive, indicating that the analysis of these features is independent of each other. This suggests that phoneme quality and quantity are processed by separate neural processes that, in a system model, may be regarded as different levels in the phonological system.


Guidance on oxygen use in adults.
Essential facts Oxygen is one of the most commonly used drugs in emergency medicine and before publication of the first British Thoracic Society (BTS) 2008 guideline, emergency departments and ambulance services gave oxygen to almost all breathless or seriously ill patients.


Explicit finite-difference lattice Boltzmann method for curvilinear coordinates.
In this paper a finite-difference-based lattice Boltzmann method for curvilinear coordinates is proposed in order to improve the computational efficiency and numerical stability of a recent method [R. Mei and W. Shyy, J. Comput. Phys. 143, 426 (1998)] in which the collision term of the Boltzmann Bhatnagar-Gross-Krook equation for discrete velocities is treated implicitly. In the present method, the implicitness of the numerical scheme is removed by introducing a distribution function different from that being used currently. As a result, an explicit finite-difference lattice Boltzmann method for curvilinear coordinates is obtained. The scheme is applied to a two-dimensional Poiseuille flow, an unsteady Couette flow, a lid-driven cavity flow, and a steady flow around a circular cylinder. The numerical results are in good agreement with the results of previous studies. Extensions to other lattice Boltzmann models based on nonuniform meshes are also discussed.


A southern African origin and cryptic structure in the highly mobile plains zebra.
The plains zebra (Equus quagga) is an ecologically important species of the African savannah. It is also one of the most numerous and widely distributed ungulates, and six subspecies have been described based on morphological variation. However, the within-species evolutionary processes have been difficult to resolve due to its high mobility and a lack of consensus regarding the population structure. We obtained genome-wide DNA polymorphism data from more than 167,000 loci for 59 plains zebras from across the species range, encompassing all recognized extant subspecies, as well as three mountain zebras (Equus zebra) and three Grevy's zebras (Equus grevyi). Surprisingly, the population genetic structure does not mirror the morphology-based subspecies delineation, underlining the dangers of basing management units exclusively on morphological variation. We use demographic modelling to provide insights into the past phylogeography of the species. The results identify a southern African location as the most likely source region from which all extant populations expanded around 370,000 years ago. We show evidence for inclusion of the extinct and phenotypically divergent quagga (Equus quagga quagga) in the plains zebra variation and reveal that it was less divergent from the other subspecies than the northernmost (Ugandan) extant population.


Development of Delirium in the Intensive Care Unit in Patients after Endovascular Aortic Repair: A Retrospective Evaluation of the Prevalence and Risk Factors.
Delirium is an acute form of nervous system dysfunction often observed in patients in the intensive care unit. Endovascular aortic repair (EVAR) is considered a minimally invasive surgical treatment for abdominal aortic aneurysm. Although the operation method is widely used, there are few investigations of the rate and risk factors of delirium development after the operation. In this study, we retrospectively examined the rate of delirium development in the intensive care unit (ICU) after EVAR, as well as the associated preoperative risk factors and effects on the lengths of ICU and hospital stays. We examined the 81 consecutive patients who underwent elective EVAR between November 2013 and August 2014. The Intensive Care Delirium Screening Checklist was used to diagnose delirium. Twenty patients (24.7%) were diagnosed with delirium in this study. The ICU and hospital length of stays of patients with delirium were 3.3 ± 2.4 days and 14.5 ± 11.9 days, respectively, the latter of which was significantly longer than that of patients without delirium (p = 0.019). Additionally, renal dysfunction, preoperative benzodiazepine use, and intraoperative transfusion were found to be risk factors for the development of delirium after elective EVAR.


[Thyrotropin-secreting pituitary adenoma:a clinicopathological analysis of seven cases].
To study the clinicopathological features of thyrotropin-secreting pituitary adenoma (TSH adenoma). Clinical and pathological features of 7 TSH adenoma cases were studied by review of patients' medical records, light and electronic microscopy, and immunohistochemistry. All seven patients presented with clinical hyperthyroidism and high levels of plasma free T3, free T4, total T3 and total T4. The levels of TSH failed to be suppressed by thyroxin administration. MRI showed macro or giant pituitary adenomas in all seven patients with tumor diameters ranging from 2.0 to 5.0 cm. Under light microscope, there were 5 cases of chromophobe cell adenoma, 1 case of acidophil cell adenoma, and 1 case of mixed acidophil and chromophobe cell adenoma. Immunohistochemical stains showed a strong positivity of TSH in all the tumors, PRL positive cells in 1 tumor, GH positive cells in 2 tumors and scattered GH and PRL double positive cells in 3 tumors. Ki-67 proliferation index ranged from 0 approximately 0.4%. P53 immunostain was negative in all tumors. After initial surgery, 2 cases had recurrences. However, the Ki-67 proliferation index was not elevated in these two tumors. The histological features of TSH pituitary adenomas are heterogeneous with chromophobe as the most common subtype. Secretion of TSH was detected by immunohistochemistry in all cases. P53 mutation is not a feature of TSH adenoma and the proliferation marker, such as Ki-67, may not predict clinical behavior of the tumor. Recurrence is likely due to incomplete resection.


Non-Governmental Organizations Delivering Global Cardiac Surgical Care: A Quantitative Impact Assessment.
In low- and middle-income countries (LMICs), 93% of the population lacks safe, timely, and affordable access to cardiac surgical care when needed. As countries slowly build or expand local, independent cardiac centers, non-governmental organizations (NGOs) partially bridge the gap in cardiac surgical care delivery in LMICs. However, little is known about the current scope of cardiac NGOs. Here, we perform an analysis of active NGOs involved with the delivery of cardiac surgical services in LMICs or for patients from LMICs. Cardiac surgery NGOs were identified from medical literature, established NGO databases, and Google Scholar searches. The search was performed between December 2019 and May 2020. NGOs whose websites were not updated or described missions or projects taking place no later than 2015 were considered inactive. Eighty-six NGOs are actively providing cardiac surgery services in LMICs or treating patients from LMICs. Five NGOs performed adult cardiac surgery only, 56 performed pediatric cardiac surgery only, and 25 performed both adult and pediatric cardiac surgery. NGOs originated from 23 different countries and were operational in a total of 111 countries, 96 of them being LMICs. Fifty-three NGOs reported data on annual surgical volume, of which half performed less than 50 operations per year. NGOs effectively address the burden of cardiac surgical disease in LMICs and contribute to local capacity-building. Increased, more detailed, and standardized reporting of the impact and outcomes of NGOs is necessary to better understand annual cardiac surgical volume and to support local centers working towards independent services.


Pharmacogenetics of anthracyclines.
Anthracyclines constitute a fundamental part of the chemotherapy regimens utilized to treat a number of different malignancies both in pediatric and adult patients. These drugs are one of the most efficacious anticancer agents ever invented. On the other hand, anthracyclines are cardiotoxic. Childhood cancer survivors treated with anthracyclines often undergo cardiac complications which are influenced by genetic variations of the patients. The scientific literature comprises numerous investigations in the subject of the pharmacogenetics of anthracyclines. In this review, we provide a comprehensive overview of this research topic. Genetic variants are proposed targets in the personalized treatment in order to individualize dosing and therefore reduce side effects.


Pilomatricoma with florid osseous metaplasia: A common tumor with rare histopathological finding.
Pilomatricoma, also known as calcifying epithelioma of Malherbe, is a common benign skin adnexal tumor with differentiation toward hair cortex cells, commonly seen in head and neck region of children. It is usually solitary. Herein, we present a rare case of pilomatricoma with extensive osseous metaplasia as a thigh swelling in an adult female, considered clinically to be a sebaceous cyst. Florid osseous metaplasia is extremely rare in cases of pilomatricoma. To date, fewer than 10 cases of pilomatricoma with extensive osseous metaplasia at different sites have been reported in the English literature.


Simple and sensitive detection of microRNAs with ligase chain reaction.
A simple and sensitive miRNA assay was developed with ligase chain reaction (LCR) based on specific ligation of DNA probes by using miRNAs as the templates.


Synthesis and antimineralocorticoid activities of some 7alpha-cyano and 7alpha-alkoxycarbonylamino steroidal spirolactones.
The synthesis and antimineralocorticoid potencies of several steroidal spirolactones bearing novel nitrogenous substituents in the 7alpha position are reported. These substituents include the cyano, the isocyanato, and the alkoxycarbonylamino groupings. The nitrile 1b and the N-carbomethoxy compound 1h showed good antimineralocorticoid potency (MED less than or equal to 0.79 mg) on subcutaneous administration to adrenalectomized rats.


Inclusion body myopathy and frontotemporal dementia caused by a novel VCP mutation.
Hereditary inclusion body myopathy (IBM) with Paget's disease of the bone (PDB) and frontotemporal dementia (FTD) is a rare autosomal dominant disease caused by mutations in the valosin-containing protein (VCP) gene. We report a novel heterozygous VCP gene mutation (R159C) in a 69-year-old Italian patient presenting with slowly progressive muscle weakness of the distal upper and proximal lower limbs since the age of 50 years, 18 years later FTD supervened. No dementia or myopathies were revealed in the family history covering two generations. Degenerative changes and rimmed vacuoles together with VCP- and ubiquitin-positive cytoplasmic and nuclear aggregates were observed at the muscle biopsy. Several elements support the pathogenic role of the R159C VCP gene mutation: the occurrence at the same codon of a different, previously identified pathogenic mutation within a VCP gene mutational hot-spot, the histopathological and biochemical evidence of muscle VCP accumulation and the combined clinical presentation of IBM and FTD. These findings suggest VCP gene investigation even in apparently sporadic cases.


Fetal organ dosimetry for the Techa River and Ozyorsk Offspring Cohorts, part 2: radionuclide S values for fetal self-dose and maternal cross-dose.
One of the many objectives of the European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project is to quantify the radiation dose-response following chronic in utero exposures to ionizing radiation. The project is presently conducting a pooled analysis of two cohorts of individuals born to exposed mothers-the Techa River Offspring Cohort (TROC) and the Ozyorsk Offspring Cohort (OOC). The TROC includes the offspring of mothers with external exposures to contaminated riverbanks and internal ingestions of (89)Sr, (90)Sr/(90)Y, and (137)Cs/(137m)Ba, while the OOC includes the offspring of mothers with external exposures seen within the Mayak plutonium production facilities and internal inhalation of (239)Pu and possibly (131)I. In the present study, a newly created Urals-based series of fetal and maternal models is employed to assess S values for all seven radionuclides. Among all fetal ages, S values ranged in magnitude from 10(-14) to 10(-10) Gy per Bq-s for fetal source organs and from 10(-18) to 10(-14) Gy per Bq-s from maternal source organs, depending upon particle type, particle energy, and fetal age. For a given radionuclide and fetal age, S values for fetal source organs were approximately two orders of magnitude higher than for maternal source organs. Little variation in S values was observed among fetal source organs, while variations of over 100 % with respect to the mean were observed for maternal source organs near the fetus. S value variations from maternal cross-fire were highly dependent on fetal position and separation distance from the maternal source organ. These radionuclide S values have been coupled with biokinetic models for use in cohort dose assessment within the SOLO project.


Integrated backscatter of the brain of preterm infants.
We measured integrated backscatter (IBS) in the brain of preterm infants using acoustic ultrasound. The study group consisted of 25 preterm infants (gestational age, 32.4+/-2.5 weeks; birth weight, 1488+/-422 g). In parasagittal scans through the posterior horn of the lateral ventricle, regions of interest (ROI) were positioned in the cerebral white matter near the posterior horn (P), anterior horn (A) of the lateral ventricle, and the thalamus (T). IBS of the ROI was measured and IBS of P minus T (P-T) and IBS of A minus T (A-T) were calculated. A-T was greater than P-T. A-T and P-T decreased with increasing gestational age and birth weight. These changes may represent maturation of the cerebrum. A-T or P-T may be useful parameters of cerebral tissue characterization.


Lack of Variability in Cerebral Oximetry Tendency in Infants with Severe Hypoxic-Ischemic Encephalopathy Under Hypothermia.
Cerebral oximetry using near-infrared spectroscopy (NIRS) provides continuous, noninvasive assessment of the degree of hemoglobin saturation of the brain tissue. Previous studies suggest that high values of regional cerebral tissue oxygen saturation (rScO2) during the first days in neonates with significant hypoxic-ischemic encephalopathy (HIE) are correlated with an adverse neurological outcome. However, the results are not consistent among the studies. To examine the correlation of rScO2 values and their variability over time with HIE severity, amplitude integrated electroencephalography (aEEG) background and seizure activity, neuron-specific enolase levels in cerebrospinal fluid, magnetic resonance imaging (MRI) findings, and neurological outcome. Retrospective study that included all consecutive infants with moderate-to-severe HIE born at ≥35 weeks gestational age admitted between January 2011 and December 2014. NIRS monitoring was initiated at admission and maintained during therapeutic hypothermia up to 12 hours after rewarming. To analyze rScO2, different periods (0-6, 6-24, 24-48, 48-72, and 72-100 hours of life) and three ranges (<55%, 55-90%, >90%) were considered. Variability in each patient was considered ≤5% when changes in rScO2 values in all periods were ≤5%. Twenty-three newborns were included. Infants who suffered from severe HIE, seizures, abnormal aEEG background, altered MRI or death, and abnormal outcome had rScO2 values >90% and with less variability (≤5%). rScO2 values >90% and a lack of variability over time in infants with HIE during cooling provide useful information about the severity of neurological status.


Brown adipose tissue cell respiration in hypo- and hyperthyroidism after stimulation with selective and non selective beta-adrenergic agonists.
Brown adipocyte respiration was measured in isolated cells from hypothyroid, hyperthyroid and euthyroid Sprague-Dawley male rats. Hypothyroidism was induced by providing drinking water containing methimazole and hyperthyroidism was induced by addition of thyroid powder to the diet. Brown adipose tissue (BAT) cells were isolated by collagenase digestion and oxygen consumption (VO2) was measured by Clark type oxygen electrodes. BAT cell respiration was stimulated by selective and nonselective beta-adrenergic agonists: BRL 35135A (BRL) and Isoprenaline (ISO). Basal BAT cells respiration did not differ according to thyroid status. Maximal VO2 responses of BAT adipocytes from hypothyroid rats were significantly lower than in euthyroidism after ISO and BRL. The reduced response was more marked for ISO than for BRL. The thermogenic sensitivity was significantly greater in euthyroid than is hypothyroid cells for ISO, but not for BRL. The euthyroid-hyperthyroid differences were not significantly different. These results suggest: basal respiration of BAT cells in hypo- and hyperthyroidism does not reflect the overall changes in whole body metabolism; the decreased thermogenic response in hypothyroidism might be due to decreased beta-adrenoceptor numbers and/or decreased intracellular thyroxine-triiodothyronine conversion; changes in sensitivity to ISO and BRL in vitro reflect the changes seen in VO2 in vivo.


Recyclable CRISPR/Cas9 mediated gene disruption and deletions in Histoplasma.
Targeted gene disruption is challenging in the dimorphic fungal pathogen Histoplasma due to the low frequency of homologous recombination. Transformed DNA is either integrated ectopically into the genome or maintained extra chromosomally by de novo addition of telomeric sequences. Based on a system developed in Blastomyces, we adapted a CRISPR/Cas9 system to facilitate targeted gene disruption in Histoplasma with high efficiency. We express a codon-optimized version of Cas9 as well as guide RNAs from a single ectopic vector carrying a selectable marker. Once the desired mutation is verified, one can screen for isolates that have lost the Cas9 vector by simply removing the selective pressure. Multiple mutations can then be generated in the same strain by retransforming the Cas9 vector carrying different guides. We used this system to disrupt a number of target genes including RYP2 and SRE1 where loss-of-function mutations could be monitored visually by colony morphology or color, respectively. Interestingly, expression of two guide RNAs targeting the 5' and 3' ends of a gene allowed isolation of deletion mutants where the sequence between the guide RNAs was removed from the genome. Whole-genome sequencing showed that the frequency of off-target mutations associated with the Cas9 nuclease was negligible. Finally, we increased the frequency of gene disruption by using an endogenous Histoplasma regulatory sequence to drive guide RNA expression. These tools transform our ability to generate targeted mutations in Histoplasma.


Real-time acoustic observations in the Canadian Arctic Archipelago.
The main sources of noise in the Arctic Ocean are naturally occurring, rather than related to human activities. Sustained acoustic monitoring at high latitudes provides quantitative measures of changes in the sound field attributable to evolving human activity or shifting environmental conditions. A 12-month ambient sound time series (September 2018 to August 2019) recorded and transmitted from a real-time monitoring station near Gascoyne Inlet, Nunavut is presented. During this time, sound levels in the band 16-6400 Hz ranged between 10 and 135 dB re 1 μPa2/Hz. The average monthly sound levels follow seasonal ice variations with a dependence on the timing of ice melt and freeze-up and with higher frequencies varying more strongly than the lower frequencies. Ambient sound levels are higher in the summer during open water and quietest in the winter during periods of pack ice and shore fast ice. An autocorrelation of monthly noise levels over the ice freeze-up and complete cover periods reveal a ∼24 h periodic trend in noise power at high frequencies (>1000 Hz) caused by tidally driven surface currents in combination with increased ice block collisions or increased stress in the shore fast sea ice.


An outbreak of mushroom poisoning in Israel during the 2020 fall and winter season: an unexpected outcome of COVID-19 restrictions?
Mushroom poisonings occur every year in Israel, mainly in the fall and winter seasons. During the fall/winter of 2020, we experienced an increase in calls to the Israel Poison Information Center (IPIC) concerning mushroom ingestions. We conducted a retrospective review of mushroom poisonings reported to the IPIC during 2015-2020 using the electronic IPIC data base. For all calls about mushroom poisonings in 2020, we extracted data on patient demographics, geographic location of the picked mushroom, mycological identification (if available), IPIC recommendations, and clinical outcomes. The IPIC received 105 calls concerning mushrooms ingestion in 2020, 65 (62%) during the last quarter. This corresponded to a 2.5-fold increase compared to the median annual rate between 2015 and 2019, and a 5-fold increase compared to the same fall/winter period in 2019. Most cases had no or only minor signs and symptoms, but 6% had moderate to severe poisoning. The severe poisonings, including one life-threatening were due to Lepiota brunneoincarnata and Amanita proxima ingestion. Possible explanations for this outbreak include favorable climate conditions and increased outdoor activities of the public in response to restrictions on other leisure activities imposed during the COVID-19 pandemic.


Predicting first-trimester spontaneous abortion. Ratio of mean sac diameter to crown-rump length compared to embryonic heart rate.
First-trimester spontaneous abortions have been predicted from alterations in the gestational sac size and embryonic heart rate. To evaluate which parameter or combination of parameters has the greatest predictive value, a prospective study was carried out during the first trimester of pregnancy. Pregnancy sac size, crown-rump length and heart rate were measured in 603 embryos, of which 580 continued beyond 13 weeks' gestation and 23 ended in first-trimester spontaneous abortions. Based on the continuing pregnancies, we constructed nomograms relating the ratio of mean sac diameter to crown-rump length (S/CR) to gestational age (last menstrual period [LMP]), to crown-rump length (CRL) and to embryonic heart rate (EHR). The S/CR ratios of the 23 embryos that spontaneously aborted in the first trimester were plotted on these nomograms to determine the significance of values falling outside the 95% confidence limits. Plotting the S/CR ratios of the aborted fetuses on the S/CR versus LMP nomogram gave a sensitivity of 78.3%, a specificity of 97.8% and a false-positive rate of 2.2%. The same population was evaluated for abortion risk using EHR nomograms, giving a sensitivity of 65.2%, specificity of 98.2% and false-positive rate of 1.8%. Our findings suggest that S/CR measurement in early pregnancy may be a simple and reliable method of predicting first-trimester abortions.


[Possibilities of a quality control in the diagnosis of tuberculosis (author's transl)].
A method is described which allows a quality control for demonstrating mycobacteria in the diangosis of tuberculosis. It does not test the differentiating procedures, but the manner of culturing and concentrating the bacteria by applying a statistical evaluation of serial experiments, thus allowing the statistically proven determination of the bacterial count. For this an evaluation method given by Cavalli-Storza was employed.


Enhanced conductivity of sodium versus lithium salts measured by impedance spectroscopy. Sodium cobaltacarboranes as electrolytes of choice.
The development of new types of ion conducting materials is one of the most important challenges in the field of energy. Lithium salt polymer electrolytes have been the most convenient, and thus the most widely used in the design of the new generation of batteries. However, in this work, we have observed that Na+ ions provide a higher conductivity, or at least a comparable conductivity to that of Li+ ions in the same basic material. This provides an excellent possibility to use Na+ ions in the design of a new generation of batteries, instead of lithium, to enhance conductivity and ensure wide supply. Our results indicate that the dc-conductivity is larger when the anion is [Co(C2B9H11)2]-, [COSANE]-, compared to tetraphenylborate, [TPB]-. Our data also prove that the dc-conductivity behavior of Li+ and Na+ salts is opposite with the two anions. At 40 °C, the conductivity values change from 1.05 × 10-2 S cm-1 (Li[COSANE]) and 1.75 × 10-2 S cm-1 (Na[COSANE]) to 2.8 × 10-3 S cm-1 (Li[TPB]) and 1.5 × 10-3 S cm-1 (Na[TPB]). These findings indicate that metallacarboranes can be useful components of mixed matrix membranes (MMMs), providing excellent conductivity when the medium contains sufficient amounts of ionic components and a certain degree of humidity.


Reliability and Validity Study of the Turkish Version of the Clinical Opiate Withdrawal Scale.
The aim of the present study was to perform reliability and validity analyses of the Turkish version of the Clinical Opiate Withdrawal Scale which is used to determine the severity of opiate withdrawal. Initially, the Clinical Opiate Withdrawal Scale (COWS) was translated into Turkish and subsequently back-translated into English. The originality of the back-translated version was approved by the author who developed the scale. After the translation was completed, the scale was used to assess the withdrawal symptoms of 100 patients with opiate withdrawal and 41 patients with alcohol withdrawal. Cronbach's alpha was used in the reliability assessment; explanatory and confirmatory factor analyses were used in structural validity assessment; and in scale validity, ROC analysis was used among diagnosis groups. The Cronbach's alpha internal consistency coefficient was calculated as 0.74 in reliability analyses. The correlation coefficient was found to be 0.975 (p<0.001) for inter-rater reliability. Factor analysis was conducted for the structural validity of the scale and findings that support the unidimensional structure of the scale were observed. In the confirmatory factor analysis, CFI, GFI and RMSEA values were found to be 0.905, 0.905 and 0.079, respectively. It was detected that COWS was successful in distinguishing between opiate and alcohol withdrawal symptoms and the area under the ROC curve was 0.878. This study showed that the Turkish version of COWS can be used reliably and validly for assessing opiate withdrawal.


The acute respiratory distress syndrome: role of nutritional modulation of inflammation through dietary lipids.
The acute respiratory distress syndrome (ARDS) is the most serious form of acute hypoxic respiratory failure. ARDS represents the expression of an acute, diffuse, inflammatory process in the lungs consequent to a variety of infectious and noninfectious conditions. It is characterized pathologically by damage to pulmonary epithelial and endothelial cells, with subsequent alveolar-capillary leak and exudative pulmonary edema. The main clinical features of ARDS include rapid onset of dyspnea, severe defects in gas exchange, and imaging studies demonstrating diffuse pulmonary infiltrates. The role of nutrition in the management of ARDS has traditionally been supportive. Recent research has demonstrated the potential of certain dietary oils (eg, fish oil, borage oil) to modulate pulmonary inflammation, thereby improving lung compliance and oxygenation, and reducing time on mechanical ventilation. This article reviews the alterations in the immune response that underlie ARDS, discusses the physiology of dietary oils as immunonutrients, summarizes animal and human studies that explore the therapeutic effects of dietary oils, and provides clinical recommendations for their use.


Diagnosis of dengue fever in a patient with early pregnancy loss.
Dengue is a mosquito-borne virus that causes an influenza-like illness ranging in severity from asymptomatic to fatal. Dengue in pregnancy has been associated with adverse outcomes including miscarriage, preterm birth and fetal and neonatal death. We present the case of a multiparous woman who presented at 9 weeks' gestation with vaginal bleeding and abdominal cramping after a 1 month stay in Mexico. She was initially diagnosed with miscarriage with plan for outpatient follow-up. She was readmitted 3 days later with fever, retro-orbital pain, arthralgia, rash, pancytopenia and transaminitis and managed with intravenous fluids and acetaminophen. Of note, dengue serology was initially negative but retesting 2 days later was positive. It is imperative that clinicians have heightened suspicion for dengue in pregnant women with history of travel to or residence in a dengue-endemic area and consistent clinical evidence.


Brønsted Acid/Lewis Acid Cooperatively Catalyzed Addition of Diazoester to 2H-chromene Acetals.
A novel Brønsted acid/Lewis acid dual catalyst system has been developed to promote an efficient C-C bond formation between a range of oxocarbenium precursors derived from chromene acetals and ethyl diazoacetate. The reaction proceeds under mild conditions and is tolerant of common functionalized 2H-chromene and isochromene acetals. In addition, an asymmetric variant of diazoacetate addition towards 2H-chromene acetal is described. Continued investigations include the further optimization of asymmetric induction towards the formation of diazo ester substituted 2H-chromene.


Effects of cyclic staining on the color, translucency, surface roughness, and substance loss of contemporary adhesive resin cements.
The staining resistance of the adhesive resin cements is critical to the long-term success of a restoration, but only limited evidence is available regarding the effects of cyclic staining on adhesive resin cements. The purpose of this in vitro study was to investigate the effects of staining solutions on the color, translucency, substance loss, and surface roughness of contemporary adhesive resin cements. Six commercially available adhesive resin cements (Clearfil SA Cement, Panavia F2.0, RelyX U200, RelyX Veneer, NX-3 Light Polymerize, NX-3 Dual Polymerize) were tested. The specimens were subjected to a cyclic staining model with 4 different solutions (deionized water, cola, coffee, and red wine). All specimens were immersed in the respective solutions 12 times for 15 minutes daily over 96 days. Between staining cycles, the specimens were stored in artificial saliva. The color parameters, surface profile, and surface roughness of the specimens were measured before and after cyclic staining for 16, 32, 48, 64, 80, and 96 days. Repeated-measure ANOVA was used to evaluate the effect of the staining solutions on the color difference (ΔE), translucency change (ΔTP), substance loss, and surface roughness (Ra) of the tested adhesive resin cements (α=.05). All the tested materials exhibited similar behaviors with longer durations of immersion in the staining solutions. Specifically, ΔE increased, TP decreased, and the surface profile and roughness remained stable. The tested adhesive resin cements exhibited variations in color and TP stability after staining. The light-polymerized adhesive resin cements were generally more color-stable than the dual-polymerized resin cements. The effects of cyclic staining on the color, translucency, surface profile, and surface roughness of adhesive resin cements were not categorical but material-specific.


Fluorescent LYVE-1 antibody to image dynamically lymphatic trafficking of cancer cells in vivo.
The lymphatic system is a major route for cancer cell dissemination, and a potential target for antitumor therapy. Despite ongoing interest in this area of research, the real-time behavior of cancer cells trafficking in the lymphatic system is poorly understood due to lack of appropriate tools to image this process. We have used monoclonal-antibody and fluorescence technology to color-code lymphatic vessels and the cancer cells inside them in a living animal. Monoclonal anti-mouse LYVE-1 antibody was conjugated to a green fluorophore and delivered to the lymphatic system of a nude mouse, allowing imaging of mouse lymphatics. Tumor cells engineered to express red fluorescent protein were then imaged traveling within the labeled lymphatics in real time. AlexaFluor-labeled monoclonal anti-mouse LYVE-1 created a durable signal with clear delineation of lymphatic architecture. The duration of fluorescent signal after conjugated LYVE-1 delivery was far superior to that of fluorescein isothiocyanate-dextran or control fluorophore-conjugated IgG. Tumor cells engineered to express red fluorescent protein delivered to the inguinal lymph node enabled real-time tracking of tumor cell movement within the green fluorescent-labeled lymphatic vessels. This technology offers a powerful tool for the in vivo study of real-time trafficking of tumor cells within lymphatic vessels, for the deposition of the tumor cells in lymph nodes, as well as for screening of potential antitumor lymphatic therapies.


Structural Health Monitoring in Long-Span Steel Structures Based on the BeiDou Navigation Satellite System.
The BeiDou navigation satellite system (BDS) provides precise positioning, navigation, and timing (PNT) services in the Asia-Pacific Region, but the BDS-based structural health monitoring (SHM) approach (SHM) is rarely studied, especially in civil engineering. Moreover, how BDS can be applied to complete the tasks of SHM in a real project is also not fully investigated, especially working in conjunction with other techniques. This study aims to propose a BDS-based approach for SHM in civil engineering. The performance of the proposed approach is investigated through a case study-the Tianhan Grand Theater (TGT). A specific Tianhan system corresponding to BDS is proposed to complete the SHM tasks of TGT. Based on the collected data, the trusses with maximum displacement and stress are found by BDS to evaluate structural health in the construction stage. The results show that the maximum displacement and stress have certain safety reserves and meet the requirements of the specifications and regulations. Thus, BDS can satisfactorily complete the tasks of SHM for Long-span steel structures. This study gives a clear view to engineers and researchers that how to apply BDS in structural construction and provides a valuable real case for evaluating the performance of BDS in SHM.


Organic osmolytes increase expression of specific tight junction proteins in skin and alter barrier function in keratinocytes.
The epidermal barrier is important for water conservation, failure of which is evident in dry-skin conditions. Barrier function is fulfilled by the stratum corneum, tight junctions (TJs, which control extracellular water) and keratinocyte mechanisms, such as organic osmolyte transport, which regulate intracellular water homeostasis. Organic osmolyte transport by keratinocytes is largely unexplored and nothing is known regarding how cellular and extracellular mechanisms of water conservation may interact. We aimed to characterize osmolyte transporters in skin and keratinocytes, and, using transporter inhibitors, to investigate whether osmolytes can modify TJs. Such modification would suggest a possible link between intracellular and extracellular mechanisms of water regulation in skin. Immunostaining and quantitative polymerase chain reaction of organic osmolyte-treated organ-cultured skin were used to identify changes to organic osmolyte transporters, and TJ protein and gene expression. TJ functional assays were performed on organic osmolyte-treated primary human keratinocytes in culture. Immunostaining demonstrated the expression of transporters for betaine, taurine and myo-inositol in transporter-specific patterns. Treatment of human skin with either betaine or taurine increased the expression of claudin-1, claudin-4 and occludin. Osmolyte transporter inhibition abolished this response. Betaine and taurine increased TJ function in primary human keratinocytes in vitro. Treatment of skin with organic osmolytes modulates TJ structure and function, which could contribute to the epidermal barrier. This emphasizes a role for organic osmolytes beyond the maintenance of intracellular osmolarity. This could be harnessed to enhance topical therapies for diseases characterized by skin barrier dysfunction.


Antimicrobial Activity of Nitrogen-Containing 5-Alpha-androstane Derivatives: In Silico and Experimental Studies.
We evaluated the antimicrobial activity of thirty-one nitrogen-containing 5-alpha-androstane derivatives in silico using computer program PASS (Prediction of Activity Spectra for Substances) and freely available PASS-based web applications (www.way2drug.com). Antibacterial activity was predicted for 27 out of 31 molecules; antifungal activity was predicted for 25 out of 31 compounds. The results of experiments, which we conducted to study the antimicrobial activity, are in agreement with the predictions. All compounds were found to be active with MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) values in the range of 0.0005-0.6 mg/mL. The activity of all studied 5-alpha-androstane derivatives exceeded or was equal to those of Streptomycin and, except for the 3β-hydroxy-17α-aza-d-homo-5α-androstane-17-one, all molecules were more active than Ampicillin. Activity against the resistant strains of E. coli, P. aeruginosa, and methicillin-resistant Staphylococcus aureus was also shown in experiments. Antifungal activity was determined with MIC and MFC (Minimum Fungicidal Concentration) values varying from 0.007 to 0.6 mg/mL. Most of the compounds were found to be more potent than the reference drugs Bifonazole and Ketoconazole. According to the results of docking studies, the putative targets for antibacterial and antifungal activity are UDP-N-acetylenolpyruvoylglucosamine reductase and 14-alpha demethylase, respectively. In silico assessments of the acute rodent toxicity and cytotoxicity obtained using GUSAR (General Unrestricted Structure-Activity Relationships) and CLC-Pred (Cell Line Cytotoxicity Predictor) web-services were low for the majority of compounds under study, which contributes to the chances for those compounds to advance in the development.


Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricectomy with sharpulse carbon dioxide laser.
The effectiveness of partial nail avulsion followed by matricectomy with carbon dioxide (CO2) laser for the treatment of ingrown great toenails remains unclear. This study sought to determine the effectiveness of partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of recurrent ingrown great toenails associated with granulation tissue. Fourteen patients with a total of 18 recurrent ingrown great toenails were randomly selected for participation in this study. Partial nail avulsions followed by matricectomy with sharpulse CO2 laser were performed on the involved nails. After at least 6 months, we evaluated the recurrence of ingrown toenails, regrowth of the nail spike, duration of post-treatment pain and post-treatment infection. Partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of ingrown toenails resulted in a high cure rate, short postoperative pain duration and low risk of postoperative infection. This method we advocate is convenient and effective for the treatment of recurrent ingrown great toenail associated with granulation tissue.


Cognitive underpinnings of social interaction.
Human social interaction is part of what defines us. Here I present an overview of recent studies of imitation, a subdomain of social interaction that can be dissected and examined in a scientific fashion. I use these studies to test two core claims: (a) that there is more than one copying mechanism in the human brain and (b) that mimicry (a form of copying) is particularly relevant for understanding social behaviour. Evidence in favour of the first claim comes from neuroimaging studies that show distinct brain systems for understanding action kinematics, action goals, and irrational actions. Further studies of participants with autism show abnormal copying of irrational actions. Evidence in favour of the second claim comes from behavioural studies of the social cues that prime mimicry and from neuroimaging studies of the pathways involved in this priming. These studies suggest that medial prefrontal cortex has a core role in controlling mimicry responses and support the STORM (social top-down response modulation) model. Future work should determine what organizing principles govern the control of social responses and how these critical mechanisms for interpersonal connection differ in autism.


[Human albumin or dextran 60 for the restoration of the blood volume, with special reference to the colloid osmotic pressure (author's transl)].
The high cost and limited availability of human albumin as a plasma substitute make it desirable to limit its use to special cases and to replace it by inexpensive and easily obtainable colloids. Patients about to undergo major abdominal surgery were given either human albumin or dextran 60 during the operation and for three days afterwards. Although both groups received the same quantity of colloidal plasma substitutes they differed significantly in respect to the serum albumin and protein concentrations. However, the osmotic pressure, for the maintenance of which the albumin fraction is mainly responsible, showed a marked fall in both groups, indicating that human albumin is not superior to dextran. All other parameters, particularly the clotting mechanism, remained within the normal range and did not differ between the two groups. The results of the study, in conjunction with the known facts regarding the metabolism and function of albumin, suggest that dextran 60 can adequately replace human albumin in a large number of cases. Great importance belongs to measurement of the colloid osmotic pressure.


The antinociceptive effects of intraplantar injections of 2-arachidonoyl glycerol are mediated by cannabinoid CB2 receptors.
2-arachidonoyl glycerol (2-AG) is an endogenous cannabinoid with central antinociceptive properties. Its degradation is catalysed by monoacylglycerol lipase (MGL) whose activity is inhibited by URB602, a new synthetic compound. The peripheral antinociceptive effects of 2-AG and URB602 in an inflammatory model of pain are not yet determined. We have evaluated these effects with and without the cannabinoid CB(1) (AM251) and CB(2) (AM630) receptor antagonists. Inflammation was induced in rat hind paws by intraplantar injection of formalin. Nociception was assessed behaviourally over the next 60 min, in 19 experimental groups: (1) control; (2-6) 2-AG (0.01-100 microg); (7) AM251 (80 microg); (8) AM251+2-AG (10 microg); (9) AM630 (25 microg); (10) AM630+2-AG (10 microg); (11-16) URB602 (0.1-500 microg); (17) 2-AG+URB602 (ED(50)); (18) AM251+URB602 (ED(50)); (19) AM630+URB602 (ED(50)). Drugs were injected s.c. in the dorsal surface of the hind paw (50 microl), 15 min before formalin injection into the same paw. 2-AG and URB602 produced dose-dependent antinociceptive effects for the late phases of the formalin test with ED(50) of 0.65+/-0.455 mug and 68+/-14.3 microg, respectively. Their combination at ED(50) doses produced an additive antinociceptive effect. These effects were inhibited by AM630 but not by AM251 for 2-AG and by the two cannabinoid antagonists for URB602. Locally injected 2-AG and URB602 decreased pain behaviour in a dose-dependent manner in an inflammatory model of pain. The antinociceptive effect of 2-AG was mediated by the CB(2) receptor.


Homozygosity for uromodulin disorders: FJHN and MCKD-type 2.
Autosomal-dominant medullary cystic kidney disease type 2 (MCKD2) and familial juvenile hyperuricemic nephropathy (FJHN) are heritable renal diseases with autosomal-dominant transmission and shared features, including polyuria, progressive renal failure, and abnormal urate handling, which leads to hyperuricemia and gout. Mutations of the UMOD gene, disrupting the tertiary structure of uromodulin, cause MCKD2 and FJHN. Haplotype analysis of a large Spanish family with MCKD was carried out to determinate genetic linkage to MCKD2 locus. Mutation detection was performed by direct sequencing of the UMOD gene. The level of Tamm-Horsfall protein in the urine was measured by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analysis. Linkage to MCKD2 locus was demonstrated (LOD score: 4.13), and a known pathogenic uromodulin mutation was found in exon 4, corresponding to Cys255Tyr, disrupting the light chain binding domain of the protein. In this consanguineous family there were three patients homozygous for the C255Y mutation, and multiple heterozygous cases, allowing the MCKD phenotypes associated with one or two mutant alleles to be compared. The homozygous individuals survived to adulthood, although presenting an earlier onset of hyperuricemia and faster progression to end-stage renal disease than heterozygous individuals. Western analysis revealed lower levels of urine THP in one heterozygous patient compared with a normal control patient, both with normal renal function. The study shows that individuals with two UMOD mutations are viable, but they do have more severe disease on average than heterozygotes. This family sheds light on the possible disease mechanism in this disorder.


Encoding of tensile stress and strain during stretch by muscle mechano-nociceptors.
Groups III and IV muscle mechano-nociceptors (MNs) can be stimulated during noxious stretch, as may occur during hyperextension of a joint. However, the mechanical state (characterized by stress and strain) encoded by MNs during stretch has not previously been determined. The current study used an ex vivo gracilis muscle-nerve preparation in a rat model to apply either a uniform uniaxial or pseudo-shear-loading paradigm. Single mechanically sensitive group III or IV MNs were mechanically stimulated while plane stress and strain were measured at the location of the MN's receptive field. Linear regression was used to evaluate the relationships between neural response and mechanical stress and strain. The mean neural response (threshold, 47.2 kPa; sensitivity, 0.05 Hz/kPa) was highly correlated to tensile stress, tensile strain, and in-plane compressive strain but was significantly and substantially less correlated with shear strain. Although the overall stress and strain relationship was nonlinear, it was reasonably linear (r2 = 0.92) for levels suprathreshold for MNs. Hence, at tensile loads sufficient to stimulate MNs, the muscle was acting as a pseudo-elastic tissue. Thus, muscle MNs encode noxious stretch differently than compression and exhibit different encoding of stretch than cutaneous MNs.


Pt single atoms meet metal-organic frameworks to enhance electrocatalytic hydrogen evolution activity.
The electrochemical hydrogen evolution reaction (HER) effectively produces clean, renewable, and sustainable hydrogen; however, the development of efficient electrocatalysts is required to reduce the high energy barrier of the HER. Herein, we report two excellent single-atom (SA)/metal-organic framework (MOF) composite electrocatalysts (PtSA-MIL100(Fe) and PtSA-MIL101(Cr)) for HER. The obtained PtSA-MIL100(Fe) and PtSA-MIL101(Cr) electrocatalysts exhibit overpotentials of 60 and 61 mV at 10 mA cm-2, respectively, which are close to that of commercial Pt/C (38 mV); they exhibit overpotentials of 310 and 288 mV at 200 mA cm-2, respectively, which are comparable to that of commercial Pt/C (270 mV). Theoretical simulations reveal that Pt SAs modulate the electronic structures of the MOFs, leading to the optimization of the binding strength for H* and significant enhancement of the HER activity. This study describes a novel strategy for preparing desirable HER electrocatalysts based on the synergy between SAs and MIL-series MOFs. Using MIL-series MOFs to support SAs could be valuable for future catalyst design.


The calcium-binding protein S100B reduces IL6 production in malignant melanoma via inhibition of RSK cellular signaling.
S100B is frequently elevated in malignant melanoma. A regulatory mechanism was uncovered here in which elevated S100B lowers mRNA and secreted protein levels of interleukin-6 (IL6) and inhibits an autocrine loop whereby IL6 activates STAT3 signaling. Our results showed that S100B affects IL6 expression transcriptionally. S100B was shown to form a calcium-dependent protein complex with the p90 ribosomal S6 kinase (RSK), which in turn sequesters RSK into the cytoplasm. Consistently, S100B inhibition was found to restore phosphorylation of a nuclear located RSK substrate, CREB, which is a potent transcription factor for IL6 expression. Thus, elevated S100B reduces IL6-STAT3 signaling via RSK signaling pathway in malignant melanoma. Indeed, the elevated S100B levels in malignant melanoma cell lines correspond to low levels of IL6 and p-STAT3.


The association between hypothermia, prehospital cooling, and mortality in burn victims.
Hypothermia is associated with increased morbidity and mortality in trauma victims. The prognostic value of hypothermia on emergency department (ED) presentation in burn victims is not well known. The objective of this study was to determine the incidence of hypothermia in burn victims and its association with mortality and hospital length of stay (LOS). The study also examined the potential causative role of prehospital cooling in hypothermic burn patients. This was a retrospective review of a county trauma registry. The county was both suburban and rural, with a population of 1.5 million and with one burn center. Burn patients between 1994 and 2007 who met trauma registry criteria were included. Demographic and clinical data including prehospital cooling, burn size and depth, and presence of inhalation injury were collected. Hypothermia was defined as a core body temperature of less than or equal to 35 degrees C. Data analysis consisted of univariate associations between patient characteristics and hypothermia. There were 1,215 burn patients from 1994 to 2007. Mean age (+/-standard deviation [+/-SD]) was 29 (+/-24) years, 67% were male, 248 (26.7%) had full-thickness burns, and 24 (2.6%) had inhalation injury. Only 17 (1.8%) had a burn larger than 70% total body surface area (TBSA). A total of 929 (76%) patients had an initial ED temperature recorded. Only 15/929 (1.6%) burn patients had hypothermia on arrival, and all were mild (lowest temperature was 32.6 degrees C). There was no association between sex, year, and presence of inhalation injury with hypothermia. Hypothermic patients were older (44 years vs. 29 years, p = 0.01), and median Injury Severity Score (ISS) was higher (25 vs. 4, p = 0.002) than for nonhypothermic patients. Hypothermia was present in 6/17 (35%) patients with a TBSA of 70% or greater and in 8/869 (0.9%) patients with a TBSA of <70% (p < 0.001). Mortality was higher in hypothermic patients (60% vs. 3%, p < 0.001). None of the hypothermic patients received prehospital cooling. Hypothermia on presentation to the ED was noted in 1.6% of all burn victims in this trauma registry. Hypothermia was more common in very large burns and was associated with high mortality. In this series, prehospital cooling did not appear to contribute to hypothermia.


Bacterial expression, characterization, and disulfide bond determination of soluble human NTPDase6 (CD39L2) nucleotidase: implications for structure and function.
The ectonucleoside triphosphate diphosphohydrolases (NTPDases) control extracellular nucleotide concentrations, thereby modulating many important biological responses, including blood clotting and pain perception. NTPDases1-4 are oligomeric integral membrane proteins, whereas NTPDase5 (CD39L4) and NTPDase6 (CD39L2) are soluble monomeric enzymes, making them more amenable to thorough structural and functional analyses than the membrane-bound forms. Therefore, we report here the bacterial expression, refolding, purification, and biochemical characterization of the soluble portion of human NTPDase6. Consistent with the enzyme expressed in mammalian cells, this recombinant NTPDase6 efficiently hydrolyzes GDP, IDP, and UDP (specific activity of approximately 50000 micromol mg(-1) h(-1)), with slower hydrolysis of CDP, ITP, GTP, CTP, ADP, and UTP and virtually no hydrolysis of ATP. The K(m) for GDP (130 +/- 30 microM) is similar to that determined for the soluble rat NTPDase6 expressed in mammalian cells. The secondary structure of the refolded enzyme was determined by circular dichroism to be 33% alpha-helix, 18% beta-sheet, and 49% random coil, consistent with the secondary structure predicted from the amino acid sequence of soluble NTPDase6. Four of the five cysteine residues in the soluble NTPDase6 are highly conserved among all the NTPDases, while the fifth residue is not. Mutation of this nonconserved cysteine resulted in an enzyme very similar to wild type in its enzymology and secondary structure, indicating that this cysteine exists as a free sulfhydryl and is not essential for structure or function. The disulfide pairing of the other four cysteine residues was determined as Cys(249)-Cys(280) and Cys(340)-Cys(354) by HPLC and mass spectral analysis of tryptic peptides. Due to conservation of these cysteine residues, these two disulfide bonds are likely to exist in all NTPDases. A structural model for NTPDase6, incorporating these and other findings obtained with other NTPDases, is proposed.


Estimation of platelet count in unstained peripheral blood smears in comparison with stained smears and evaluation of its efficacy.
Assessment of platelet count is an important diagnostic parameter in haematology. Automated blood cell counters have largely replaced the manual method. However, all abnormal platelet counts are verified in Leishman's stained peripheral blood smear. Platelets also can be identified in the unstained blood smears. The objective of this study is to compare the unstained peripheral blood smears with the stained smears and determination of the effectiveness of unstained smears in the estimation of platelet count. 250 Venous blood samples sent for blood cell counts were analyzed. Platelets were counted in the unstained smear under 100× objective in 10 fields without placing immersion oil and the average number of platelets was calculated. Same smear was stained by Leishman's stain and platelets were counted under 100× objective after placing a drop of immersion oil. Collected data were analyzed for intra-class correlation coefficient (ICC). ICC showed excellent agreement (ICC > 0.85). The unstained smears were found to be as effective as stained smears for platelet count in most of the cases. However, in case of doubt a stained preparation has to be made to confirm the count. The turnaround time was 3-5 minutes compared to 15-20 minutes by stained smear technique, thus this technique may be used as an initial screening method whenever there is large sample load.


Correlation of Sagittal Imbalance and Recollapse after Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture: A Multivariate Study of Risk Factors.
A retrospective case control study. This study aimed to assess the clinical significance of sagittal balance for predicting and managing the recollapse of cemented vertebra following percutaneous vertebroplasty (PVP) in patients with thoracolumbar osteoporotic vertebral fracture (OVF). Recently, the recollapse of cemented vertebra following PVP for OVF has been reported. Although the risk factors for recollapse have been determined, the association between sagittal spinopelvic parameters and sagittal imbalance with recollapse has not been established. Ambulatory patients who underwent single-level PVP for thoracolumbar OVF with a follow-up of at least 24 months were retrospectively reviewed. The patients were divided into two groups depending on the presence of symptomatic recollapse at the cemented vertebra: (1) recollapsed (RC) group and (2) noncollapsed (NC) group. The patient characteristics and radiographic measurements associated with sagittal imbalance were analyzed at each follow-up visit. Overall, 134 patients (RC group, n=28; NC group, n=106) were enrolled. The mean fracture-free interval was 3.2 months (range, 1.2-25.1 months). The multivariate binary logistic regression analysis identified low bone mineral density (p =0.047), degree of dynamic mobility within the vertebra (p =0.025), and sagittal imbalance as significant risk factors for recollapse (p =0.013; odds ratio, 5.405). The progression of sagittal imbalance and thoracolumbar kyphosis (T10-L2) was more significant in the RC and sagittal imbalance groups than in the NC group (both p =0.000). Sagittal imbalance, lower bone mineral density, and dynamic mobility within the vertebra are associated with the recollapse of cemented vertebrae following PVP. Sagittal imbalance, rather than local kyphosis or thoracolumbar kyphosis, is particularly significant in that it results in more progressive collapse and sagittal deformity and is accompanied by substantial back pain and neurological deficits. Therefore, a stricter and more active management, including anti-osteoporosis medication, is required for the treatment of OVF with sagittal imbalance of the spine.


FA-GAN: Fused attentive generative adversarial networks for MRI image super-resolution.
High-resolution magnetic resonance images can provide fine-grained anatomical information, but acquiring such data requires a long scanning time. In this paper, a framework called the Fused Attentive Generative Adversarial Networks(FA-GAN) is proposed to generate the super- resolution MR image from low-resolution magnetic resonance images, which can reduce the scanning time effectively but with high resolution MR images. In the framework of the FA-GAN, the local fusion feature block, consisting of different three-pass networks by using different convolution kernels, is proposed to extract image features at different scales. And the global feature fusion module, including the channel attention module, the self-attention module, and the fusion operation, is designed to enhance the important features of the MR image. Moreover, the spectral normalization process is introduced to make the discriminator network stable. 40 sets of 3D magnetic resonance images (each set of images contains 256 slices) are used to train the network, and 10 sets of images are used to test the proposed method. The experimental results show that the PSNR and SSIM values of the super-resolution magnetic resonance image generated by the proposed FA-GAN method are higher than the state-of-the-art reconstruction methods.


Plasma d-dimer levels increase with the severity of community acquired pneumonia.
The aim of this study is to investigate the relationship of the plasma D-Dimer (D-d) level and the severity of the pneumonia in patients who have not any disease that may increase the D-d level, but pneumonia. This is prospective controlled study. Using the ATS 2001 Community Acquired Pneumonia (CAP) Guideline we divided the patients into two groups [severe (n= 14) and non-severe (n= 37) CAP] and looked for any significant difference in D-d levels with ELISA method among the patients groups and control group. Plasma D-d levels were 2438 +/- 2158 ng/mL in severe CAP group, 912.6 +/- 512.6 ng/mL in non-severe CAP group and 387 +/- 99.56 ng/mL in the control group. Patients with non-severe CAP and those with severe CAP group both showed an increase in plasma levels of D-d compared to control group (p< 0.05, p< 0.001, respectively). We also found that the severe CAP group had increased in plasma levels of D-d compared to the non-severe CAP group (p< 0.001). Plasma D-d level increases significantly in patients with CAP compared to control group. Plasma D-d levels increases significantly with the severity of the CAP.


Epigenomic and functional analyses reveal roles of epialleles in the loss of photoperiod sensitivity during domestication of allotetraploid cottons.
Polyploidy is a pervasive evolutionary feature of all flowering plants and some animals, leading to genetic and epigenetic changes that affect gene expression and morphology. DNA methylation changes can produce meiotically stable epialleles, which are transmissible through selection and breeding. However, the relationship between DNA methylation and polyploid plant domestication remains elusive. We report comprehensive epigenomic and functional analyses, including ~12 million differentially methylated cytosines in domesticated allotetraploid cottons and their tetraploid and diploid relatives. Methylated genes evolve faster than unmethylated genes; DNA methylation changes between homoeologous loci are associated with homoeolog-expression bias in the allotetraploids. Significantly, methylation changes induced in the interspecific hybrids are largely maintained in the allotetraploids. Among 519 differentially methylated genes identified between wild and cultivated cottons, some contribute to domestication traits, including flowering time and seed dormancy. CONSTANS (CO) and CO-LIKE (COL) genes regulate photoperiodicity in Arabidopsis. COL2 is an epiallele in allotetraploid cottons. COL2A is hypermethylated and silenced, while COL2D is repressed in wild cottons but highly expressed due to methylation loss in all domesticated cottons tested. Inhibiting DNA methylation activates COL2 expression, and repressing COL2 in cultivated cotton delays flowering. We uncover epigenomic signatures of domestication traits during cotton evolution. Demethylation of COL2 increases its expression, inducing photoperiodic flowering, which could have contributed to the suitability of cotton for cultivation worldwide. These resources should facilitate epigenetic engineering, breeding, and improvement of polyploid crops.


SEM-induced shrinkage and site-selective modification of single-crystal silicon nanopores.
Solid-state nanopores with feature sizes around 5 nm play a critical role in bio-sensing fields, especially in single molecule detection and sequencing of DNA, RNA and proteins. In this paper we present a systematic study on shrinkage and site-selective modification of single-crystal silicon nanopores with a conventional scanning electron microscope (SEM). Square nanopores with measurable sizes as small as 8 nm × 8 nm and rectangle nanopores with feature sizes (the smaller one between length and width) down to 5 nm have been obtained, using the SEM-induced shrinkage technique. The analysis of energy dispersive x-ray spectroscopy and the recovery of the pore size and morphology reveal that the grown material along with the edge of the nanopore is the result of deposition of hydrocarbon compounds, without structural damage during the shrinking process. A simplified model for pore shrinkage has been developed based on observation of the cross-sectional morphology of the shrunk nanopore. The main factors impacting on the task of controllably shrinking the nanopores, such as the accelerating voltage, spot size, scanned area of e-beam, and the initial pore size have been discussed. It is found that single-crystal silicon nanopores shrink linearly with time under localized irradiation by SEM e-beam in all cases, and the pore shrinkage rate is inversely proportional to the initial equivalent diameter of the pore under the same e-beam conditions.


Landscape consequences of aggregation rules for functional equivalence in compensatory mitigation programs.
Mitigation and offset programs designed to compensate for ecosystem function losses due to development must balance losses from affected ecosystems with gains in restored ecosystems. Aggregation rules applied to ecosystem functions to assess site equivalence are based on implicit assumptions about the substitutability of functions among sites and can profoundly influence the distribution of restored ecosystem functions on the landscape. We investigated the consequences of rules applied to the aggregation of ecosystem functions for wetland offsets in the Beaverhill watershed in Alberta, Canada. We considered the fate of 3 ecosystem functions: hydrology, water purification, and biodiversity. We set up an affect-and-offset algorithm to simulate the effect of aggregation rules on ecosystem function for wetland offsets. Cobenefits and trade-offs among functions and the constraints posed by the quantity and quality of restorable sites resulted in a redistribution of functions between affected and offset wetlands. Hydrology and water purification functions were positively correlated with one another and negatively correlated with biodiversity function. Weighted-average rules did not replace functions in proportion to their weights. Rules prioritizing biodiversity function led to more monofunctional wetlands and landscapes. The minimum rule, for which the wetland score was equal to the worst performing function, promoted multifunctional wetlands and landscapes. The maximum rule, for which the wetland score was equal to the best performing function, promoted monofunctional wetlands and multifunctional landscapes. Because of implicit trade-offs among ecosystem functions, no-net-loss objectives for multiple functions should be constructed within a landscape context. Based on our results, we suggest criteria for the design of aggregation rules for no net loss of ecosystem functions within a landscape context include the concepts of substitutability, cobenefits and trade-offs, landscape constraints, heterogeneity, and the precautionary principle.


Primary pulmonary hypertension in a patient with systemic lupus erythematosus: partial improvement with cyclophosphamide.
Pulmonary hypertension was diagnosed in a patient with SLE after her 5th delivery. Time of onset and absence of thromboembolism and severe interstitial lung disease suggested primary pulmonary hypertension. Administration of vasodilators did not decrease pulmonary artery pressure which amounted to 82/30 mm Hg. Cyclophosphamide infusions, 0.5 g/m2 monthly for 6 months followed by once/3 months, in combination with 7.5 mg prednisolone daily resulted in decrease of pulmonary artery pressure to 66/34 mm Hg after 6 months of treatment persisting for 30 months. Intermittent infusions of cyclophosphamide with low dose prednisolone may be effective in primary pulmonary hypertension in SLE, suggesting an immune mediated pathogenesis.


Role of the renin-angiotensin system in isoprenaline-induced vasopressin release.
We examined whether the activation of the renin-angiotensin system after intramuscular isoprenaline injection contributes to the simultaneous increase in vasopressin release. Plasma concentrations of vasopressin and angiotensin II were measured in conscious rats using specific radioimmunoassays. Intravenous infusions of angiotensin II caused a dose-dependent increase in vasopressin release. Intravenous infusions of the angiotensin II antagonist saralasin did not diminish the isoprenaline-induced vasopressin release. However, the curve relating the isoprenaline-induced decrease in blood pressure and the concomitant increase in vasopressin levels was shifted to the right and no longer linear in saralasin-treated rats. Nephrectomy diminished the vasopressin release caused by isoprenaline when compared to sham-operation. The correlation between the decrease in blood pressure and the simultaneous vasopressin release was changed in a strikingly similar manner by nephrectomy and by saralasin infusions. It may be concluded that small doses of isoprenaline, which cause only minor decreases in blood pressure, induce vasopressin release via the renin-angiotensin system. However, the contribution of this system to vasopressin release declines as hypotension becomes more severe.


Parents underestimate fatigue in younger children aged 5-7 years with asthma but not in older children.
To assess fatigue in children aged 2-17 years with asthma from both child and parent perspectives and describe associated factors. Fatigue scores were self-reported by children aged 5-17 years old and proxy-reported by parents or carers for all children. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale was used. Fatigue scores ranged from 0 to 100, higher scores meant less fatigue. There were 527 children and parents enrolled. The mean overall fatigue score by self-report was 72.7 ± 15.8 and by proxy report was 75.8 ± 16.3. Self-reported fatigue score was lower in children aged 5-7 years (71.5 ± 15.9) compared to proxy-reported score (76.3 ± 15.5). Proxy and self-reported fatigue scores were similar between parents and older children. Fatigue scores were lower in association with poor asthma control and receipt of social support. Lower self-reported, but not proxy-reported, fatigue score was related to asthma severity. Lower proxy-reported, but not self-reported, fatigue score was related to the child being older and having shortness of breath. Parents underestimated the fatigue of younger children aged 5-7 years, but fatigue scores were similar between parents and older children. Both clinical and social factors are associated with fatigue in children with asthma.


Isocyanide-Induced Activation of Copper Sulfate: Direct Access to Functionalized Heteroarene Sulfonic Esters.
A novel and direct approach to alkyl/aryl heteroarene sulfonic esters using copper sulfate as the environmentally benign inorganic sulfonation reagent was first realized with the aid of isocyanide. A variety of heterocycles reacted to afford the corresponding sulfonic esters through C-H functionalization. In this transformation, the otherwise inert copper sulfate was unusually activated by an isocyanide and employed as the source of the sulfonic substituents in an unprecedented fashion. The findings suggest that an appropriate activator may liberate the chemical activities of some relatively inert inorganic salts for organic synthesis.


Use of total lymphoid irradiation (TLI) in studies of the T cell-dependence of autoantibody production in rheumatoid arthritis.
The effect of total lymphoid irradiation (TLI) on T cell-dependent and -independent humoral immune responses was studied in patients with intractable rheumatoid arthritis (RA). The serum levels of several autoantibodies and of antibodies to diphtheria (DT) and tetanus (TT) toxoids and to pneumococcal polysaccharide (PPS; 12 antigenic types) were studied before and after TLI. In addition, the patients were given a booster injection of DT and TT and a single injection of pneumococcal vaccine after radiotherapy. Antibody levels to DT and TT decreased about twofold after TLI and did not rise significantly (p greater than 0.05) after a booster injection. However, there was no reduction in antibody levels to PPS after TLI, and a significant rise in titers was observed after a single vaccination (p less than 0.01). The serum levels of rheumatoid factor (RF), anti-nuclear antibody (ANA), and granulocyte associated IgG rose slightly after TLI. Thus, the autoantibodies and antibodies to polysaccharides appear to be relatively independent of helper T cell function, which is markedly reduced after TLI. On the other hand, antibodies to protein antigens such as DT and TT appear to be more closely dependent upon T helper function in man, as has been reported in rodents. The findings suggest that T cell-independent autoantibody responses alone do not maintain the joint disease activity in RA, because improvement in joint disease after TLI has been reported.


The effect of health and nutrition management classes on nutrition choices: a case study on diabetics in huntsville, alabama, United States.
This study evaluated the effectiveness of a one-day nutrition education seminar utilizing a sample of 26 confirmed diabetics who had at least once before, participated in nutrition classes. The participants were exposed to a seminar that promoted, evaluated, and rewarded good nutrition choices in an effort to educate this group about coping with diabetes through nutrition management. A 24-hour food recall was used as a pre-test, meal plans constructed by trained graduate-level diet interns were used as the standard by which proper nutrition was judged, and participants' choices were used as the post-test evaluation. Significant differences were found between the 24-hour recall and the ideal meal plans in all of the three nutrient measured (energy, protein and fat). Participants showed a preference for personally constructed meal plans as opposed to those constructed by the interns. However, significant diet adjustments were shown in the short term. Discussion focused on the need for repeated involvement in diet interventions, and the challenges faced in changing diet habits of a group of middle-aged individuals who are even slightly obese.


Therapeutic management of acute pulmonary embolism.
Acute pulmonary embolism (PE) is a potentially fatal manifestation of venous thromboembolism. Prompt anticoagulant treatment is crucial for PE patients, which can decrease morbidity and mortality. Risk assessment is the cornerstone of the therapeutic management of PE. It guides physicians to the most appropriate treatment and selects patients for early discharge or home treatment. Areas covered: Here, we review the current treatments of acute PE according to contemporary risk stratification strategies, highlighting each step of PE therapeutic management. Expert commentary: Currently, direct oral anticoagulants (DOACs) represent the first-line therapy of patients presenting with non-high risk PE with a better risk-benefit ratios than vitamin K antagonists (VKAs) due to lower risk of major bleeding. Only high-risk patients with PE who present in shock should be treated with systematic thrombolysis, while surgical thrombectomy or catheter direct thrombolysis (CDT) should only be considered when thrombolysis is contraindicated because of too high bleeding risk.


Analytical techniques to study microbial biofilm on abiotic surfaces: pros and cons of the main techniques currently in use.
Biofilm is a bacterial lifestyle widespread in microbial world and represents a concern in health care. Despite the great life expectancy related to advanced health care, the increasing numbers of biofilm-mediated infections remain a significant public health challenge. Moreover, the problem of biofilm-mediated infections becomes much more severe when biofilm colonizes medical devices and biomaterials. The public health risk due to microbial biofilm-related infections is a concern that requires full attention. However, the complexity of biofilm makes difficult its exhaustive analysis. Although biofilm represents a major challenge in both microbiological and hygiene areas, at now methods aimed to analyse biofilm formation and development are not standardized yet. Different methods have been employed to qualitatively and quantitatively evaluate biofilm each of which is useful to estimate a peculiar aspect of biofilm lifestyle. In the present review, fifteen assays for the qualitative and quantitative evaluation of bacterial biofilm colonizing abiotic substrates, such as medical devices, prosthesis or surfaces for food production together with advantages and limitations of each method were described and compared. Some methods are suited to quantify biofilm matrix while others are capable to evaluate both living and dead cells or quantify exclusively viable cells in biofilm. In particular, colorimetric methods to evaluate biofilm matrix (crystal violet; 1,9-dimethyl methylen blue and fluorescein-di-acetate methods) or viable cells (LIVE/DEAD BacLight, BioTimer Assay, resazurin, tetrazolium hydroxide salt methods) and genetic methods to estimate the bacterial population (PCR and FISH) are reported. Moreover, a section is dedicated to examine the performances of advanced microscopic techniques employed to study microbial biofilms (mass spectrometry; confocal laser scanning microscopy; Raman spectroscopy and electron microscopy). Because of its complexity, an exhaustive study of biofilm requires a combination of different experimental approaches as biochemical, genetic or physical ones.


Purification of calmodulin from rice bran and activation of glutamate decarboxylase by Ca2+/calmodulin.
gamma-Aminobutyric acid (GABA) is an important bioactive regulator, and its biosynthesis is primarily through the alpha-decarboxylation of glutamate by glutamate decarboxylase (GAD). In plants, it was verified that the production of GABA is regulated, in part, via Ca(2+)/calmodulin (CaM). Our preliminary studies showed that rice bran GAD is probably also a Ca(2+)/CaM dependent enzyme; hence, in the current investigation, we purified calmodulin from rice bran, and studied the effect of the Ca(2+)/calmodulin complex on the activity of rice bran GAD in vitro. CaM was purified to homogeneity from the rice bran by a combined protocol involving TCA precipitation, heat treatment, and hydrophobic interaction chromatography, with the purification fold and recovery of 851.7 and 55.6%, respectively. This protein had similar amino acid composition as the CaMs from other higher plants. The rice bran GAD was found to be quite sensitive to the Ca(2+)/CaM complex at pH 7.0, and addition of exogenous EGTA or TFP efficiently inhibited the stimulatory effect of Ca(2+)/CaM complex. At a separate concentration of Ca(2+) and CaM of 200 micromol L(-1) and 150 nmol L(-1), the rice bran GAD was significantly enhanced 3-fold. Moreover, upon binding Ca(2+), CaM underwent a conformational change that facilitated a more obvious emergency of phenylalanine and tyrosine residues. This investigation provided preliminary information for the development of a GABA-based, cost-effective rice bran GAD-related functional food.


Changes in exercise heart rate in lowlanders after prolonged stay at high altitude (4000 m).
Studies were conducted on cardiac frequency during submaximal and maximal work on 26 sea-level residents prior to transfer to and during stay at high altitude for 1, 10, and 20 months. Maximal O2 uptake and performance in a 1.6 km run were observed. Results indicated a significant drop in Vo2 after arrival at altitude followed by recovery with further stay. The mean maximum heart rate decreased to 182.8 beats/min after 1 month at high altitude from a seal-level mean value of 188.4 beats/min. It increased to 199.2 beats/min and decreased to 185.6 beats/min after 10 and 20 months, respectively. Heart rate, during submaximal work requiring 1.0 and 1.5 102/min, indicated the highest rate after 1 month at altitude and decreased with prolonged stay, but remained higher than the sea-level value. These changes were compared with the high-altitude native residents.


Age-dependent adrenergic actions in the main olfactory bulb that could underlie an olfactory-sensitive period.
Many sensory systems are endowed with mechanisms of neural plasticity that are restricted to a sensitive period in the young developing animal. In this study, we performed experiments in slices of the main olfactory bulb (OB) from rats to examine possible age-dependent cellular mechanisms of plasticity in the olfactory system. We focused on the neurotransmitter norepinephrine (NE), shown to be important in different forms of olfactory learning, examining whether two specific cellular effects of NE previously observed in rats less than P14 extended to older animals. These included an acute reduction in GABAergic synaptic transmission from granule cells (GCs) onto output mitral cells (MCs) and an enhancement in gamma frequency (30-70 Hz) oscillations that persists long after removal of NE. We found that NE failed to reduce GC-to-MC transmission or enhance gamma oscillations in older rats at P18-23. The loss of NE actions on both phenomena appeared to reflect an age-dependent loss of function of α(2)-adrenergic receptors. In addition, we found that NE induced an age-dependent enhancement of transient excitation in MCs, providing a mechanism to link the acute decrease in GC-to-MC inhibition to the long-term increase in gamma oscillations through increases in intracellular calcium. The age-dependent cellular mechanisms that we describe could underlie an olfactory-sensitive period in newborn rodents.


Individuation training with other-race faces reduces preschoolers' implicit racial bias: a link between perceptual and social representation of faces in children.
The present study examined whether perceptual individuation training with other-race faces could reduce preschool children's implicit racial bias. We used an 'angry = outgroup' paradigm to measure Chinese children's implicit racial bias against African individuals before and after training. In Experiment 1, children between 4 and 6 years were presented with angry or happy racially ambiguous faces that were morphed between Chinese and African faces. Initially, Chinese children demonstrated implicit racial bias: they categorized happy racially ambiguous faces as own-race (Chinese) and angry racially ambiguous faces as other-race (African). Then, the children participated in a training session where they learned to individuate African faces. Children's implicit racial bias was significantly reduced after training relative to that before training. Experiment 2 used the same procedure as Experiment 1, except that Chinese children were trained with own-race Chinese faces. These children did not display a significant reduction in implicit racial bias. Our results demonstrate that early implicit racial bias can be reduced by presenting children with other-race face individuation training, and support a linkage between perceptual and social representations of face information in children.


Ultrastructural study on the pleural stomata in human.
The ultrastructure of human diaphragmatic, thoracic wall and visceral pleura was studied by scanning and transmission electron microscope. Human pleural stomata, which are usually round or oval in shape with about 6.2 microns in diameter, were present on the diaphragmatic pleura. They were never found on the thoracic or visceral wall. Majority of human pleural stomata were quite deep, forming channels which seemed to connect pleural cavity with underlying lymphatic lacunae. Some of them occurred as shallow pits exposing components of the underlying connective tissue. In some areas of the diaphragmatic pleura the pleural stomata were furnished with great microvilli of mesothelial cells surrounding their openings. These microvilli were always longer and had denser network of filaments in comparison with other on the surface of mesothelial cell. In this way the mesothelial cells formed valve-like cytoplasmic processes into the channels. The results of the present study suggested that the pleural stomata, as permanent structures, provided a rapid removal of fluid, particles and cells from the pleural cavity into the diaphragmatic lymphatics.


Effects of incentive on working memory capacity: behavioral and pupillometric data.
We evaluated the hypothesis that individual differences in working memory capacity are explained by variation in mental effort, persons with low capacity exerting less effort than persons with high capacity. Groups previously rated high and low in working memory capacity performed the reading span task under three levels of incentive. The effort hypothesis holds that low span subjects exert less effort during task performance than do high spans. Subjects' pupil sizes were recorded online during task performance as a measure of mental effort. Both recall performance and pupil diameter were found to be increased under incentives, but were additive with span (incentives increased performance and pupil diameter equivalently for both span groups). Contrary to the effort hypothesis, task-evoked pupillary responses indicated that if anything, low span subjects exert more effort than do high spans.


Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy.
An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days. He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months. He presented with hypercalcemia, low levels of parathyroid hormone (PTH), and very high serum 25-hydroxyvitamin D (25-OHD) levels. Renal ultrasound showed nephrocalcinosis. He did not have sign or symptom of vitamin A intoxication. Patient was successfully treated with intravenous hydration, furosemide, and prednisolone. With treatment, serum calcium returned rapidly to the normal range and serum 25-OHD levels were reduced progressively. In conclusion the diagnosis of vitamin D deficiency rickets without checking 25-OHD levels may cause redundant treatment that leads to vitamin D intoxication (VDI).


Smoking History Decreases Survival in Patients with Squamous Cell Carcinoma of the Mouth: A Retrospective Study with 15 Years of Follow-up.
Background: The purpose of this study was to evaluate the influence of smoking history on the clinical-pathological, sociodemographic and prognostic characteristics of patients with oral squamous cell carcinoma (SCC). Materials and Methods: A retrospective cohort study was carried out with the records of 136 smokers with SCC and 68 nonsmokers with oral SCC who were diagnosed and treated at Haroldo Juaçaba Hospital (2000-2014). Data on patient sex, age, race, education level, tumor location, tumor size, lymph node involvement, distant metastasis, treatment type, marital status, method of health care access (public or private health systems) and overall survival (15 years) were analyzed by the X² test, Mantel-Cox tests and multinomial and Cox logistic regression models (SPSS 20.0, p <0.05). Results: Smoking history was directly associated with male sex (p <0.001), low levels of education (p = 0.001), tumors of the mouth and palate (p = 0.001), stage T3/4 tumors (p = 0.014), lymph node metastasis (N+) (p = 0.024), palliative treatment (p = 0.024) and receiving health care through the public health system (p = 0.006), with education level being the only independently associated factor (p = 0.039). Lower survival was observed in patients who were smokers (p = 0,002), with low levels of education (p = 0.001), who had stage T3/4 tumors (p = 0.004), with N+ (p = 0.021), and had received palliative treatment (p = 0.002). Age (>65 years old, p = 0.015) and T staging (T3/4, p = 0.033) decreased the survival of SCC patients regardless of the other factors. Conclusions: Smoking history had an independent association with low education level and a history of alcoholism, and survival was negatively associated with older age and larger tumor size, which were more prevalent in smokers.


The use of alloplastic materials in secondary rhinoplasties: 32 years of clinical experience.
A retrospective evaluation of the authors' 32 years of experience in revision rhinoplasty is presented. The authors suggest that iatrogenic nasal deformities are studied under four groups on the basis of their location and the affected structures: lower third, middle third, upper third, and combined deformities. The authors also present the vertical columellar incision for insertion of alloplastic implants and cartilage grafts, a genuine approach avoiding contamination with the nasal flora. A total of 182 cases were studied, as follows: lower third (n = 81), middle third (n = 65), upper third (n = 17), and combined (n = 19) deformities. The mean age of the patients was 40 years. Our follow-up was a minimum of 2 years, and some of the cases with Proplast implants have been followed for as long as 21 years. During this rather long follow-up, only two of the Proplast implants had to be removed (one because of an acute infection and the other because of a chronic infection causing extrusion after 5 years). The authors have always preferred to use autogenous cartilage grafts for tip deformities and Proplast implants for middle and upper third saddle nose deformities whenever necessary. Their long-term results with Proplast for more than 20 years show that alloplastic materials may be as reliable as autogenous implants if the surgical principles are met and the cases are carefully selected.


[Personal experience with endoscopic therapy of chronic pancreatitis].
Endoscopic drainage is a modern and effective therapy in patients with chronic obstructive pancreatitis. The authors demonstrate their experience with this therapy in 20 patients. It resulted in pain disappearance in 60% of the patients and in body weight increase within 1 year after therapy in 55% of the patients. Steatorrhea was not significantly influenced by the therapy. The main complication of endoscopic therapy were frequent restenoses (30%). (Tab. 4, Fig. 2, Ref. 12.)


Sleep duration, daytime napping, and risk of peripheral artery disease: multinational cohort and Mendelian randomization studies.
Sleep duration has been associated with cardiovascular disease, however the effect of sleep on peripheral artery disease (PAD) specifically remains unestablished. We conducted observational and Mendelian randomization (MR) analyses to assess the associations of sleep duration and daytime napping with PAD risk. Sleep traits were assessed for associations with incident PAD using cohort analysis among 53 416 Swedish adults. Replicated was sought in a case-control study of 28 123 PAD cases and 128 459 controls from the veterans affairs Million Veteran Program (MVP) and a cohort study of 452 028 individuals from the UK Biobank study (UKB). Two-sample Mendelian randomization (MR) was used for casual inference-based analyses of sleep-related traits and PAD (31 307 PAD cases 211 753 controls). Observational analyses demonstrated a U-shaped association between sleep duration and PAD risk. In Swedish adults, incident PAD risk was higher in those with short sleep [<5 h; hazard ratio (HR) 1.74; 95% confidence interval (CI) 1.31-2.31] or long sleep (≥8 h; HR 1.24; 95% CI 1.08-1.43), compared to individuals with a sleep duration of 7 to <8 h/night. This finding was supported by the analyses in MVP and UKB. Observational analysis also revealed positive associations between daytime napping (HR 1.32, 95% CI 1.18-1.49) with PAD. MR analysis supported an inverse association between sleep duration [odds ratio (OR) per hour increase: 0.79, 95% CI, 0.55, 0.89] and PAD and an association between short sleep and increased PAD (OR 1.20, 95% CI, 1.04-1.38). Short sleep duration was associated with an increased risk of PAD.


[Tuberculous liver abscess in an immigrant patient with pulmonary tuberculosis].
Liver abscess due to Mycobacterium tuberculosis associated with pulmonary tuberculosis is a rare diagnosis, particularly in patients without AIDS. We report the case of a male immigrant with no HIV infection who developed a tuberculous liver abscess and pulmonary tuberculosis simultaneously. Ziehl-Neelsen stain, PCR and Löwenstein-Jensen culture of material sampled from the abscess established the microbiological diagnosis. The patient's course was good, with disappearance of symptoms and the abscess after tuberculostatic treatment and drainage of the abscess with monitoring by computed tomography.