Evaluation of diametral tensile strength and Knoop microhardness of five nanofilled composites in dentin and enamel shades.
The purpose of this study was to evaluate and compare the mechanical behavior of five nanofilled composites with dentin and enamel shades trough diametral tensile strength and knoop microhardness. 4 Seasons (Ivoclar Vivadent), Esthet X improved (Dentsply), Filtek Supreme (3M), Grandio (Voco) and Palfique Estelite (Tokuyama Dental Corp.) were used in this research. Twenty samples (6 mm diameter and 3 mm thickness) of each material were used. Ten samples were submitted to knoop microhardness and the others to diametral tensile strength examinations. The results were submitted to ANOVA and Tukey statistical tests (a=0.05). There were significant differences between the tested groups (p<0.05). The diametral tensile strength ranged from 36.08 (4 Seansons dentin) to 49.24 (Grandio enamel). The knoop microhardness ranged from 54.45 (Esthet X improved enamel) to 123.90 (Grandio dentin). A great variability in the mechanical behavior of the nanofilled composites was observed. However it was not recorded with dentin and enamel shades with the exception of Grandio.


Peroral endoscopic myotomy using FlushKnife BT: a single-center series.
Peroral endoscopic myotomy (POEM) is an evolving new treatment strategy for achalasia. Although several kinds of electrosurgical knives have been used in performing POEM, the best device has yet to be determined. The FlushKnife BT is a waterjet-emitting short needle-knife with a small ball tip (BT) that offers the potential to perform all aspects of POEM with a single device. In this study, we evaluated the safety and efficiency of the FlushKnife BT for POEM. A total of 54 consecutive patients with achalasia and other spastic esophageal motility disorders, such as jackhammer esophagus or distal esophageal spasm, who underwent POEM between January 2016 and August 2016, were included in this retrospective study. The median operation time was 73.0 minutes (range 39 - 184 minutes). All procedures were completed using only the FlushKnife BT without changing to any other electrosurgical instrument. The median number of additional submucosal injections with an injection needle was 0 (range 0 - 1). Endoscopic vessel sealing was performed a mean of 3 times (range 0 - 7). The median number of bleeding episodes requiring treatment with hemostatic forceps was 0 (range 0 - 5). There were no significant adverse events. Seven of 52 patients (13.5 %) reported symptoms of gastroesophageal reflux disease such as heartburn or acid reflux at 3 month follow-up. The FlushKnife BT enabled POEM to be performed with very few device exchanges, either for re-injection or to control intraoperative bleeding. In this uncontrolled case series, the ability of the FlushKnife BT to perform nearly all aspects of the POEM procedure seems to make it particularly well suited to this procedure.


Practical method of drug administration in a peripheral hospital.
A system to reduce the dangers of drug-prescribing and administration has been evolved in the County Hospital, Hereford. Prescribing regulations have been designed which aim to reduce the possibility of error, and the prescription sheets virtually never leave the ward when in use. A copy of the prescription sheet, known as the pharmacy card, is sent to the pharmacy when new drugs or further supplies are required. The chief pharmacist has been able under the system to maintain supervision of safety in the use of drugs.


Impact of a Musculoskeletal "Mini-Residency" Professional Development Program on Knee Magnetic Resonance Imaging Orders by Primary Care Providers.
The US Department of Veterans Affairs has created a portfolio of educational programs to train primary care providers (PCPs) in the evaluation and management of common musculoskeletal (MSK) conditions. Appropriate resource utilization for evaluation of knee pain, including limiting unnecessary magnetic resonance imaging (MRI) studies, is an important theme of these initiatives. The objective of this study was to report the utilization of knee MRI by PCP providers before and after the MSK education program and to determine the appropriateness of these MRI orders. Twenty-six PCPs participated in the MSK Mini-Residency educational program held in Salt Lake City between April 2012 and October 2014. Knee MRI orders submitted by these providers 12 months before and 12 months after their participation were reviewed. Magnetic resonance imaging orders were categorized as "inappropriate," "probably inappropriate," or "possibly appropriate," based on accepted guidelines for knee MRI utilization. Differences in the numbers of precourse and postcourse MRI orders for each of these categories were compared using Student t test. Following our program, MRI orders decreased from 130 (precourse) to 93 (postcourse), a reduction of 28% ( p = 0.04). This reduction was observed entirely within the "inappropriate" and "probably inappropriate" categories; the number of orders categorized as "possibly appropriate" increased, but not significantly. The MSK Mini-Residency training program was a successful educational intervention and was associated with a reduction in inappropriate knee MRI utilization for some participants, while keeping appropriate MRI utilization stable.


Variability in 2-year training programs in vascular surgery based on results of an Association of Program Directors in Vascular Surgery survey.
Although a great deal of attention has recently focused on 5-year integrated (0+5) training programs in vascular surgery, a paucity of data exists concerning variability of daily assignments in 2-year (5+2) vascular fellowships. We polled Association of Program Directors in Vascular Surgery members with 2-year vascular fellowships to determine the number of days in a 5-day work week that first- and second-year fellows were assigned to open vascular operations, endovascular procedures (hospital vs nonhospital facility), arterial clinic, venous clinic, noninvasive vascular laboratory (NIVL), and research. Of the 103 program directors from 5+2 vascular training programs, 102 (99%) responded. The most common schedule for both first- and second-year fellows was performing both open and endovascular procedures in the hospital on the same day 4 days of the week and spending time in combined artery and vein clinic 1 day of the week. Program directors developed different schedules for each year of the 2-year fellowship in about half (55% [56]) of the programs. A small minority of programs devoted days to only open surgical cases (13% [13]), a separate venous clinic (17% [17]), or a separate arterial clinic (11% [11]) and performed endovascular procedures in a nonhospital facility (15% [15]). All but three programs had mandatory time in clinic both years. Approximately one-third (30% [31]) of programs designated time devoted to research, whereas the others expected fellows to find time on their own. Although passing the Registered Physician in Vascular Interpretation examination is required, there was devoted time in the NIVL in only 60% (61) of programs. Training assignments in terms of time spent performing open and endovascular procedures and participating in clinic, the NIVL, and research varied widely among Accreditation Council for Graduate Medical Education-accredited 5+2 vascular fellowships and did not always fulfill Accreditation Council for Graduate Medical Education guidelines. In the current era of emphasis on endovascular-based interventions, few programs devoted days to purely open surgical procedures. Endovascular experience in a nonhospital facility (where these procedures will likely become more common in the future), outpatient venous procedures, and designated time devoted to the NIVL and research were lacking in many programs. These results provide a valid data set for the Association of Program Directors in Vascular Surgery to consider establishing guidelines for training assignments in 5+2 vascular training programs.


Physical activity: is it time for emergency department nurses to step up?
Physical inactivity seems to be reaching pandemic proportions. People are becoming more obese and less physically active at an alarming rate, and physical inactivity is a significant societal and personal burden in terms of economic and health costs. Nurses are ideally placed to motivate patients and promote physical activity. This article examines the benefits of physical activity, and explores emergency nurses' role in promoting regular exercise. It also outlines physical activity recommendations and suggests a starting point for promoting healthy exercise to patients who attend emergency departments.


Effects of Amazake Produced with Different Aspergillus on Gut Barrier and Microbiota.
Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. To explore the preventive effects of dietary foods on IBD, we evaluated the effects of the traditional Japanese fermented beverage "Amazake" on gut barrier function in this study. Black koji Amazake (BA) derived from Aspergillus luchuensis MEM-C strain and yellow koji Amazake (YA) derived from Aspergillus oryzae were made in this study, and their nutrients were analyzed. Mice with mild gut barrier dysfunction induced by Western diet were administered with 10% of each Amazake for two months. Mice gut microbiota were analyzed by 16S rRNA gene sequencing. BA contained a higher amount of isomaltooligosaccharides, citric acid, and ferulic acid than YA. The animal data revealed that BA significantly induced the expressions of antioxidant factors and enzymes such as NF-E2-related factor 2 (Nfr2), heme oxygenase 1 (HO1), and superoxide dismutase-2 (SOD-2). The gut barrier protein, occludin, and fecal immunoglobulin A (IgA) were also significantly enhanced by BA. Furthermore, the levels of serum endotoxin and hepatic monocyte chemotactic protein-1 (MCP-1) were decreased in both the BA and YA groups. In gut microbiota, Lachnospiraceae was increased by BA while Akkermansia muciniphilia was increased by YA. Black koji Amazake contained a higher amount of isomaltooligosaccharides, citric acid, and ferulic acid than yellow koji Amazake and contributed to protecting gut barrier function to reduce endotoxin intrusion and inflammation.


A period prevalence study of being a parent in a secure psychiatric hospital and a description of the parents, the children and the impact of admission on parent-child contact.
Most secure psychiatric hospital patients are of childbearing age, but their parental status is minimally researched. The aim of the study is to describe the parent patients in one regional secure hospital and explore post-admission child-parent contact. A 9-year records survey of a complete secure hospital admissions cohort was conducted. Nearly half of the cohort of 165 patients (46%) were parents. Parent patients were less likely than childless patients to have diagnostic co-morbidity or to have received childhood mental health care but were more likely to have committed a homicide/life-threatening index offence with family or friend victims. Men, whether fathers or not, and childless women were unlikely ever to have harmed a child, but it was more likely than not that mother patients had. Records indicated minimal discussion about childlessness. Ninety-four (60%) of the 157 children involved were under 18 years on parental admission. Adult children who had been living with the parent patient before the parent's admission invariably maintained contact with them afterwards, but nearly half (48%) of such under 18-year-olds lost all contact. The only characteristic related to such loss was the index offence victim having been a nuclear family member. As the discrepancy in whether or not parent patients and their children continued contact with each other after the parent's admission seemed to depend mainly on the child's age and his or her resultant freedom to choose, acquisition of accurate data about affected children's perspective on visiting seems essential. Given that parent patients had experienced relative stability in interpersonal relationships and had rarely had childhood disorders, parenting support in conjunction with treatment seems appropriate. Copyright © 2017 John Wiley & Sons, Ltd.


Regional brain glucose metabolism in neuroacanthocytosis.
Two brothers with neuroacanthocytosis had [18F]-2-fluoro-2-deoxyglucose PET scans showing marked glucose hypometabolism of the caudate and putamen. MRIs showed no evidence of atrophy or modification of signal intensity in these structures. Decreased glucose utilization of the striatum can underlie hyperkinetic movement disorders of various etiologies.


Guest encapsulation and coronene-C60 exchange in supramolecular zinc porphyrin tweezers, grids and prisms.
Using a variant of the HETPHEN concept, heteroleptic 2D and 3D metallosupramolecular structures, such as tweezer T, grid G and tetragonal prism P, were fabricated quantitatively and characterised by (1)H NMR, (13)C NMR, (1)H-(1)H COSY, DOSY as well as ESI-MS. All structures encapsulate C60, with P showing the highest binding affinity (Kassoc = 3.3 × 10(6) M(-1)). The association constant increases along the series T < G < P, most likely due to the enhanced structural rigidity and better coplanarity of the two zinc porphyrin units. In contrast to T and G, the tetragonal prism P shows notable encapsulation of coronene (Kassoc = 1.1 × 10(4) M(-1)). In T and G, on the other hand, complexation of coronene is kinetically inhibited by the bulky mesityl rings at the porphyrin periphery. As illustrated in the facile displacement of coronene by C60 in coronene@P to furnish C60@P, P behaves as a flexible and guest-adaptive host.


Quantitative determination of cucurbitane-type triterpenes and triterpene glycosides in dietary supplements containing bitter melon (Momordica charantia) by HPLC-MS/MS.
Momordica charantia L. (Cucurbitaceae), commonly known as bitter melon, is widely cultivated in many tropical and subtropical areas of the world. It is a common food staple; its fruits, leaves, seeds, stems, and roots also have a long history of use in traditional medicine. In the United States, dietary supplements labeled as containing bitter melon can be purchased over-the-counter and from Internet suppliers. Currently, no quantitative analytical method is available for monitoring the content of cucurbitane-type triterpenes and triterpene glycosides, the major constituents of bitter melon, in such supplements. We investigated the use of HPLC-electrospray ionization (ESI)-MS/MS for the quantitative determination of such compounds in dietary supplements containing bitter melon. Values for each compound obtained from external calibration were compared with those obtained from the method of standard additions to address matrix effects associated with ESI. In addition, the cucurbitane-type triterpene and triterpene glycoside contents of two dietary supplements determined by the HPLC-ESI-MS/MS method with standard additions were compared with those measured by an HPLC method with evaporative light scattering detection, which was recently developed for quantification of such compounds in dried fruits of M. charantia. The contents of five cucurbitane-type triterpenes and triterpene glycosides in 10 dietary supplements were measured using the HPLC-ESI-MS/MS method with standard additions. The total contents of the five compounds ranged from 17 to 3464 microg/serving.


Structural and genetic analyses of a par locus that regulates plasmid partition in Bacillus subtilis.
The Bacillus plasmid pLS11 partitions faithfully during cell division. Using a partition-deficient plasmid vector, we randomly cloned DNA fragments of plasmid pLS11 and identified the locus that regulates plasmid partition (par) by cis complementation in Bacillus subtilis. The cloned par gene conferred upon the vector plasmid a high degree of segregational stability. The par locus was mapped to a 167-base-pair segment on pLS11, and its nucleotide sequence was determined. The cloned par fragment regulated the partition of several different Bacillus replicons, and it only functioned in cis; it did not contain the replication function nor elevate the plasmid copy number in B. subtilis. The expression of par was orientation specific with respect to the replication origin on the same plasmid. We propose that the pLS11-derived par functions as a single-stranded site that interacts with other components involved in plasmid partition during cell division.


Computational approach for protein structure prediction.
To predict the structure of protein, which dictates the function it performs, a newly designed algorithm is developed which blends the concept of self-organization and the genetic algorithm. Among many other approaches, genetic algorithm is found to be a promising cooperative computational method to solve protein structure prediction in a reasonable time. To automate the right choice of parameter values the influence of self-organization is adopted to design a new genetic operator to optimize the process of prediction. Torsion angles, the local structural parameters which define the backbone of protein are considered to encode the chromosome that enhances the quality of the confirmation. Newly designed self-configured genetic operators are used to develop self-organizing genetic algorithm to facilitate the accurate structure prediction. Peptides are used to gauge the validity of the proposed algorithm. As a result, the structure predicted shows clear improvements in the root mean square deviation on overlapping the native indicates the overall performance of the algorithm. In addition, the Ramachandran plot results implies that the conformations of phi-psi angles in the predicted structure are better as compared to native and also free from steric hindrances. The proposed algorithm is promising which contributes to the prediction of a native-like structure by eliminating the time constraint and effort demand. In addition, the energy of the predicted structure is minimized to a greater extent, which proves the stability of protein.


Biochemical composition and bioactivity screening of various extracts from Dunaliella salina, a green microalga.
The current study examines the antimicrobial and antioxidant properties of different extracts of the microalga Dunaliella salina Teodoresco (Dunaliellaceae), their fatty acid composition and the antimicrobial activity of the oil. Antimicrobial and antioxidant activities were evaluated by obtaining extracts of D. salina in n-hexane, dichloromethane, ethanol, and methanol. To evaluate the antimicrobial activity, the extracts, and fatty acids from D. salina were assessed by the disc diffusion and microdilution techniques against pathogenic microorganisms including fish and clinical/food-borne. The MBC or MFC values of the extracts and fatty acids ranged from 0.63 to 10.00 mg/ml. The antioxidant activity was studied by phosphomolybdenum and DPPH assays and ß-carotene/linoleic acid tests. In addition, the total phenolic and flavonoid contents were evaluated and the fatty acid composition was determined using gas chromatography. Palmitic, alpha-linolenic, and oleic acids were discovered to be the major components of the fatty acids. These findings have demonstrated that the extracts and oil from D. salina could be used as natural antimicrobials and antioxidants in the food/feed and pharmaceutical industry and as a biodiesel because of its high unsaturated fatty acid content.


Human Figure Drawings in Children with Autism Spectrum Disorders: A Possible Window on the Inner or the Outer World.
Tests based on human figure drawings (HFD) have captured the attention of clinicians and psychologists for a long time. The aim of the present study was to evaluate the performance of HFD of children with autism spectrum disorders (ASDs) relative to typically developing (TD) controls. All children were asked to draw three human figures (man, woman, self-portrait) and were evaluated with a neuropsychological battery. HFD were scored according to the Maturity Scale, and correlative approaches testing maturity against neuropsychological scores were applied. ASDs presented marked deficits in maturity. No significant correlation emerged for both groups between maturity and the theory of mind test. On the contrary, positive and significant correlations between maturity and the affect recognition test (AR) were found, with group-specific patterns. In TD, this result regarded drawings of others, but not self-portraits, while an opposite pattern emerged for ASD, whose sole maturity in self-portraits significantly correlated with the AR scores. These findings suggest that the use of HFD tests with individuals with autism may not be used in clinical practices. However, in basic research, HFDs could be used to highlight dependencies between drawing performance and neuropsychological features, thus possibly providing hints on the functioning of autism.


Parkinson's disease: neuron loss in the nucleus basalis without concomitant Alzheimer's disease.
A representative region of the nucleus basalis of Meynert was investigated in 11 patients with idiopathic Parkinson's disease and compared with the identical region in 13 age-matched control subjects. Simultaneously, the cerebral cortex and the nucleus basalis in the patients with Parkinson's disease were examined for senile plaques and Alzheimer's neurofibrillary tangles. The nucleus basalis was significantly depleted of its large neurons in Parkinson's disease (p less than 0.001 versus controls; Student t tests), but in the majority of cases the neuron loss was not associated with Alzheimer's disease.


Do Age and Weightbearing Radiographs Affect Lateral Joint Space and Fibular Height Measurements in Patients With Discoid Lateral Meniscus?
Several radiographic parameters have been associated with a discoid lateral meniscus. However, limited information is available regarding the radiographic findings of a discoid meniscus in the pediatric population. To determine the effect of age and weightbearing (WB) on radiographic parameters associated with discoid lateral menisci in pediatric patients. Cohort study (diagnosis); Level of evidence, 3. Radiographs of pediatric patients with arthroscopically confirmed lateral discoid menisci were compared with age-, side-, and sex-matched individuals with confirmed normal menisci. Radiographic parameters of lateral joint space width (LJSW) and fibular head height (FHH) were measured by 3 physicians. Significant differences were found between the discoid and control groups when LJSW (P = .002) and FHH (P < .001) were compared. Interrater reliability was good for LJSW (intraclass correlation coefficient [ICC], 0.635) and excellent for FHH (ICC, 0.759). WB radiographs were noted to have better interrater reliability compared with non-WB radiographs for LJSW (ICC, 0.729 vs 0.514, respectively) but had reduced interrater reliability for FHH (ICC, 0.625 vs 0.868, respectively). Subgroup analysis with age stratification indicated that FHH was significantly decreased (indicative of a high fibular head) in the discoid group for all age groups (P < .001 for <10 years and 10-14 years; P = .030 for >14 years); however, LJSW was significantly different only in patients older than 14 years. Increased LJSW and FHH were associated with discoid lateral menisci and showed satisfactory interrater reliability. Radiographic evaluation for potential discoid meniscus in pediatric and adolescent patients may be improved by use of fibular height to indicate the presence of a discoid lateral meniscus across age groups, while lateral joint space may be more reliable for older patients.


Aliskiren reduces vascular pathology in diabetic retinopathy and oxygen-induced retinopathy in the transgenic (mRen-2)27 rat.
We examined whether the renin inhibitor, aliskiren, provides similar or greater protection than ACE inhibition from non-proliferative diabetic retinopathy and from the proliferative neoangiogenesis of oxygen-induced retinopathy. Transgenic (mRen-2)27 rats, which overexpress mouse renin and angiotensin in extra-renal tissues, were studied. For diabetic studies, non-diabetic, diabetic (streptozotocin, 55 mg/kg), diabetic + aliskiren (10 mg kg(-1) day(-1), pump), or diabetic + lisinopril (10 mg kg(-1) day(-1), drinking water) rats were evaluated over 16 weeks. For oxygen-induced retinopathy studies, rats were exposed to 80% oxygen (22 h/day) from postnatal days 0 to 11, and then room air from postnatal days 12 to 18. Aliskiren (10 or 30 mg kg(-1) day(-1), pump) or lisinopril (10 mg kg(-1) day(-1), drinking water) was administered during retinopathy development between postnatal days 12 and 18. Systolic BP in diabetic (mRen-2)27 rats was reduced with 10 mg kg(-1) day(-1) aliskiren, but only lisinopril normalised systolic blood pressure. In diabetic (mRen-2)27 rats, 10 mg kg(-1) day(-1) aliskiren and lisinopril reduced retinal acellular capillaries and leucostasis to non-diabetic levels. In oxygen-induced retinopathy, neoangiogenesis and retinal inflammation (leucostasis, ED-1 immunolabelling) were partially reduced by 10 mg kg(-1) day(-1) aliskiren and normalised by 30 mg kg(-1) day(-1) aliskiren, whereas lisinopril normalised neoangiogenesis and reduced leucostasis and ED-1 immunolabelling. Aliskiren and lisinopril normalised retinal vascular endothelial growth factor expression; however, only aliskiren reduced intercellular adhesion molecule-1 to control levels. Aliskiren provided similar or greater retinal protection than ACE inhibition and may be a potential treatment for diabetic retinopathy.


Prediction of the Risk of Laparoscopy-Assisted Gastrectomy by Comparing Visceral Fat Area and Body Mass Index.
The purpose of this study was to compare the accuracy of visceral fat area (VFA) and body mass index (BMI) in predicting the risk of laparoscopic-assisted gastrectomy. Clinicopathological and imaging data of 133 patients who underwent laparoscopy-assisted gastrectomy were recorded, including 17 cases of conversion to open surgery. The remaining 116 patients were retrospectively analyzed after we excluded 17 patients who had been transferred to laparotomy. The patients were divided into two groups according to BMI (≤25 kg/m2: BMI-L group; >25 kg/m2: BMI-H group) and VFA (≤100 cm2: VFA-L group; >100 cm2: VFA-H group). Clinical outcomes were compared between the BMI and VFA subgroups. There were no differences in intraoperative blood loss and the number of harvested lymph nodes between low and high patients defined by BMI and VFA (p > 0.050). However, in the comparison of patients who underwent laparoscopic resection only, it was found that the operation time and intraoperative blood loss of the VFA-H group were more than those of the VFA-L group (p < 0.050). Compared to the VFA-L group, the VFA-H group had later first exhaust time (p = 0.018), more complications (p < 0.001), and longer hospital stays (p = 0.049). However, no similar conclusion was obtained in the BMI group (p > 0.050). This study demonstrates that VFA better evaluates the difficulty of laparoscopy-assisted gastrectomy and the risk of postoperative complications than BMI.


The htpG gene of Bacillus subtilis belongs to class III heat shock genes and is under negative control.
We show that the htpG gene of Bacillus subtilis is induced by heat, as has been reported for the Escherichia coli homolog. Analysis of different mutants revealed that the htpG gene belongs to class III heat shock genes in B. subtilis. An about 10-fold induction after thermal upshock was found at the levels of both transcription and translation, and this induction resulted from enhanced synthesis of mRNA. By primer extension, we identified one potential transcription start site immediately downstream of a putative sigmaA-dependent promoter which became activated after thermal upshift. Northern blot analysis revealed that htpG is part of a monocistronic transcriptional unit. An operon fusion where the complete region between htpG and its upstream gene was fused to the bgaB reporter gene accurately reflected htpG expression. Analysis of this fusion revealed that, in contrast to other class III heat shock genes, htpG was not induced by osmotic upshock, by ethanol, or by oxygen limitation, suggesting that it belongs to a subgroup within class III. Deletion of the region upstream of the putative promoter resulted in an enhanced basal level of htpG expression, but the 10-fold induction was retained, suggesting that the upstream sequences are involved in the regulation of expression in the absence of heat shock.


DNA barcoding Korean birds.
DNA barcoding, an inventory of DNA sequences from a standardized genomic region, provides a bio-barcode for identifying and discovering species. Several recent studies suggest that the sequence diversity in a 648 bp region of the mitochondrial gene for cytochrome c oxi- dase I (COI) might serve as a DNA barcode for identify- ing animal species such as North American birds, in- sects and fishes. The present study tested the effective- ness of a COI barcode in discriminating Korean bird species. We determined the 5' terminus of the COI bar- code for 92 species of Korean birds and found that spe- cies identification was unambiguous; the genetic differ- ences between closely related species were, on average, 25 times higher than the differences within species. We identified only one misidentified species out of 239 specimens in a genetic resource bank, so confirming the accuracy of species identification in the banking system. We also identified two potential composite species, calling for further investigation using more samples. The finding of large COI sequence differences between species confirms the effectiveness of COI barcodes for identifying Korean bird species. To bring greater reliability to the identification of species, increased in- tra- and interspecies sampling, as well as supplementa- tion of the mitochondrial barcodes with nuclear ones, is needed.


Comparison of single-step reverse transepithelial all-surface laser ablation (ASLA) to alcohol-assisted photorefractive keratectomy.
To evaluate postoperative pain, corneal epithelial healing, development of corneal haze, refractive outcomes, and corneal aberrations in a novel one-step, modified transepithelial photorefractive keratectomy (PRK), termed All-surface laser ablation (ASLA), compared to conventional, alcohol-assisted PRK. Sixty eyes of 30 myopic patients were prospectively recruited to a randomized fellow eye study. Patients underwent conventional alcohol-assisted PRK in one eye (control group) and ASLA-modified transepithelial PRK in the other (30 eyes in each treatment arm). Primary endpoints were postoperative pain and haze scores at 1 day, 3 days, 1 week, and 1, 3, 6, and 12 months. Secondary endpoints included visual acuity at 1, 3, 6, and 12 months, corneal aberrations at 3, 6, and 12 months, and early and late onset haze. Refractive predictability, safety, and efficacy of the two methods were considered. The average age of the cohort was 29 years (standard deviation [SD]: 9; range: 18-46), and the average spherical equivalent refractive error was -4.18 diopters (SD: 1.9). At 3 days after surgery, the average pain score was 64% lower in the ASLA group (P < 0.0005). At this point, 96% of ASLA eyes had no epithelial defect, whereas 43% in the alcohol-assisted group did not achieve complete epithelial healing, and required replacement of bandage contact lens. The haze level was consistently lower in the ASLA group at all time points from 1 to 6 months. This study shows that the ASLA technique may have a future role in refractive surgery, due to the fact that it offers faster epithelial healing, lower pain scores, and significantly less haze formation.


Differential Effects of Isoproterenol on Regional Myocardial Mechanics in Rat Using Three-Dimensional Cine DENSE Cardiovascular Magnetic Resonance.
The present study assessed the acute effects of isoproterenol on left ventricular (LV) mechanics in healthy rats with the hypothesis that β-adrenergic stimulation influences the mechanics of different myocardial regions of the LV wall in different ways. To accomplish this, magnetic resonance images were obtained in the LV of healthy rats with or without isoproterenol infusion. The LV contours were divided into basal, midventricular, and apical regions. Additionally, the midventricular myocardium was divided into three transmural layers with each layer partitioned into four segments (i.e., septal, inferior, lateral, and anterior). Peak systolic strains and torsion were quantified for each region. Isoproterenol significantly increased peak systolic radial strain and circumferential-longitudinal (CL) shear strain, as well as ventricular torsion, throughout the basal, midventricle, and apical regions. In the midventricle, isoproterenol significantly increased peak systolic radial strain, and induced significant increases in peak systolic circumferential strain and longitudinal strain in the septum. Isoproterenol consistently increased peak systolic CL shear strain in all midventricular segments. Ventricular torsion was significantly increased in nearly all segments except the inferior subendocardium. The effects of isoproterenol on LV systolic mechanics (i.e., three-dimensional (3D) strains and torsion) in healthy rats depend on the region. This region dependency is also strain component-specific. These results provide insight into the regional response of LV mechanics to β-adrenergic stimulation in rats and could act as a baseline for future studies on subclinical abnormalities associated with the inotropic response in heart disease.


Identification of 146 Metagenome-assembled Genomes from the Rumen Microbiome of Cattle in Japan.
The rumen contains a complex microbial ecosystem that degrades plant materials, such as cellulose and hemicellulose. We herein reconstructed 146 nonredundant, rumen-specific metagenome-assembled genomes (MAGs), with ≥50% completeness and <10% contamination, from cattle in Japan. The majority of MAGs were potentially novel strains, encoding various enzymes related to plant biomass degradation and volatile fatty acid production. The MAGs identified in the present study may be valuable resources to enhance the resolution of future taxonomical and functional studies based on metagenomes and metatranscriptomes.


How to explain multidrug resistance in epilepsy?
Despite advancements in antiepileptic therapy, about one third of people with epilepsy will remain intractable to medication. The initial response to antiepileptic drug therapy is highly predictive of long-term outcome. However, the mechanisms of medical intractability of epilepsy are only incompletely understood. Current interest is focused on two hypotheses: overexpression of drug efflux transporters and alterations in drug targets in the brain, with the most relevant causative mechanism(s) still to be elucidated.


Transitional care issues influencing access to health care: employability and insurability.
Addressing the issues of employability and insurability remains a challenge for young adults with CHD, their parents, and health care professionals who care for this patient group. Because of their chronic condition, these young persons require ongoing access to health care, throughout their adult lives. Because most individuals obtain insurance through their place of employment (unless it is obtained under a spouse's policy), adolescents with CHD should begin to look carefully at career options that are compatible with their interests and their physical abilities. If it is more appropriate, assistance with referral to vocational rehabilitation programs may be given. Finally, guidance should include how to avoid issues of discrimination during a job interview and when working at one's place of employment. Legislation now supports many workers as long as they can carry out the job for which they were hired. With the continuing rise in cost of health care and health insurance coverage, young persons with CHD must understand the high importance of maintaining health care coverage for their chronic health condition, usually through a group plan in their place of employment. Current legislation supports supplemental coverage and portability of coverage when changing jobs, which minimizes or eliminates waiting periods for pre-existing conditions. Suggestions for ongoing health care are included not only for care by a cardiologist but noncardiac care, including a primary care practitioner, dental care, and obstetric-gynecologic care. With the size and life expectancy of this patient group growing each year, the issues of employability and insurability must continually be addressed by health care professionals in conjunction with government policy makers and insurance representatives. As additional long-term survival data become available on the natural history of CHD, it is hoped that insurance requirements will be modified to afford this group the insurance coverage needed to obtain adequate medical and financial security, with facilitated access to appropriate, high quality, and affordable health care.


Molecular basis of a redox switch: molecular dynamics simulations and surface plasmon resonance provide insight into reduced and oxidised angiotensinogen.
Angiotensinogen fine-tunes the tightly controlled activity of the renin-angiotensin system by modulating the release of angiotensin peptides that control blood pressure. One mechanism by which this modulation is achieved is via angiotensinogen's Cys18-Cys138 disulfide bond that acts as a redox switch. Molecular dynamics simulations of each redox state of angiotensinogen reveal subtle dynamic differences between the reduced and oxidised forms, particularly at the N-terminus. Surface plasmon resonance data demonstrate that the two redox forms of angiotensinogen display different binding kinetics to an immobilised anti-angiotensinogen monoclonal antibody. Mass spectrometry mapped the epitope for the antibody to the N-terminal region of angiotensinogen. We therefore provide evidence that the different redox forms of angiotensinogen can be detected by an antibody-based detection method.


Effects of breathing on multijoint control of center of mass position during upright stance.
Breathing exerts destabilizing effects on postural stability during quiet stance. The authors conducted an experiment to evaluate the role of motor abundance in the organization of the postural synergy compensating for the effects of breathing. They measured the kinematic pattern of covariation among the major joints of the postural chain (ankle, knee, hip, trunk, and neck) as a function of different breathing modes (spontaneous, paced, and increased volume) and different stance instructions (still vs. relaxed) using the uncontrolled manifold approach. Joint variability was structured to preserve the stable position of the center of mass. This result supports the hypothesis that motor abundance of the postural chain plays an important role in the flexible compensation for breathing during quiet stance.


Meaningful Use of Electronic Health Records for Quality Assessment and Review of Clinical Ethics Consultation.
Evolving practice requires peer review of clinical ethics (CE) consultation for quality assessment and improvement. Many institutions have identified the chart note as the basis for this process, but to our knowledge, electronic health record (EHR) systems are not necessarily designed to easily include CE consultation notes. This article provides a framework for the inclusion of CE consultation notes into the formal EHR, describing a developed system in the Epic EHR that allows for the elaborated electronic notation of the CE chart note. The implementation of the "meaningful use" criteria for EHR, mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, requires that health professionals meet certain standards for quality, efficiency, and safety, all of which overlap with the goals of standardization, peer review, and quality improvement within CE consultation.


Clinical and morphologic features of hepatic angiosarcoma in vinyl chloride workers.
Fifteen male workers exposed to vinyl chloride developed angiosarcoma of the liver. Thirteen died of disease and two are currently living for short periods after diagnosis. Their ages ranged from 36 to 58 years (average 47.5 years). Their exposure time ranged from 4 to 27.8 years (average 16.9 years). The most common presenting symptoms were fatigue, weight loss, and abdominal pain. Hepatomegaly followed by splenomegaly were the most common physical findings. Biochemical profiles yielded variable results and proved to be of little value in the detection or diagnosis. Of eight patients autopsied, distant organ involvement was present in two cases, duodenal involvement in one, and direct extension of tumor to adjacent organs or tissues in four additional ones. The remainder, diagnosed by open liver biopsy, revealed no tumor extension. The gross features of the tumors were hemorrhagic necrosis, cystic degeneration, fibrosis, and apparent multicentricity. The histologic features were those of the typical angiosarcoma found in a variety of sites with a wide range of cellular differentiation. The histologic diagnosis was often impaired by the extensive tumor necrosis. Elsewhere in the liver subcapsular fibrosis, a distinct type of portal fibrosis, and endothelial cell hyperplasia with or without sinusoidal dilatation were noted. The reduction of industrial chemical exposure has already been achieved and will hopefully eliminate this chemically related tumor in the future. There is, however, a significant group of previously exposed workers who will require careful monitoring to detect functional abnormalities of the liver and possible early neoplastic changes.


Benign mesothelioma of the epididymis: case report.
A case of benign mesothelioma of the epididymis, successfully treated with local resection, is reported. Conservative surgery is allowed when malignancy is excluded by frozen section.


Combined tibial plateau levelling osteotomy and lateral fabellotibial suture for cranial cruciate ligament rupture with severe rotational instability in dogs.
To report the use of tibial plateau levelling osteotomy and lateral fabellotibial suture in combination for treatment of severe internal tibial rotational stifle instability in cranial cruciate-deficient stifles. Twenty-three stifles in 19 dogs were diagnosed with cranial cruciate ligament rupture with severe stifle instability, characterised by marked cranial tibial translation and internal tibial rotation that was evident during orthopaedic examination. A combined tibial plateau levelling osteotomy and lateral fabellotibial suture procedure were performed to stabilise the stifle joint. The surgical complications, short-term lameness scores and owner satisfaction were evaluated. The postoperative complication rate was 21 · 7% with one minor (4 · 3%) and four major (17 · 4%) complications. At short-term follow-up one dog had an intermittent low-grade lameness and two dogs had mild tibial internal rotational instability present on palpation without lameness. Owner's overall satisfaction with the operation and recovery was good (21 · 4%) to excellent (78 · 6%). The use of lateral fabellotibial suture in combination with tibial plateau levelling osteotomy was an effective technique for managing cranial cruciate ligament rupture with severe internal tibial rotational stifle instability.


Combination of Taxol® and dichloroacetate results in synergistically inhibitory effects on Taxol-resistant oral cancer cells under hypoxia.
Cancer cells preferentially catalyze glucose through the glycolytic pathway in the presence of adequate oxygen. This phenomenon is known as the Warburg effect. As is the case with numerous cancer therapeutic agents, resistance remains a significant problem when using Taxol® to treat malignancies. The present study reported that expression of pyruvate dehydrogenase kinase 1 (PDK1) was induced by Taxol treatment at low toxic concentrations in oral cancer cells. In addition, Taxol‑resistant cells exhibited upregulated PDK1 protein and mRNA expression. Elevated PDK1 levels contribute to Taxol resistance under hypoxic conditions. Inhibition of PDK1 expression was observed when oral cancer cells were treated with the PDK1 inhibitor dichloroacetate (DCA). The combination of Taxol with DCA showed synergistic inhibitory effects on Taxol‑resistant cells under hypoxic conditions; these effects were not observed in Taxol‑sensitive oral cancer cells under normoxic conditions. The present study provides a novel mechanism for overcoming Taxol resistance in oral cancer cells, and will contribute towards the development of clinical therapeutics for cancer patients.


Safety of Etanercept in the treatment of rheumatic disease patients with Hepatitis C virus infection.
Hepatitis C virus (HCV) infection is a major public health problem. Because Tumour Necrosis Factor (TNF) seems to have an important role in immune response to HCV infection, suppression by TNFi (TNF inhibitors) may pose a potential worsening of chronic HCV infection. We report our experience with 3 cases of patients with chronic HCV infection and advanced liver disease, with different Rheumatic diseases, treated with a TNFi, etanercept (ETN), for a period ranging from 4 months to 4 years without hepatitis C treatment and, in two of them, concomitant therapy with direct-acting antiviral agents (DAA) and afterwards. Although increasing number of clinical reports support the short-term safety and efficacy of TNFi in patients with HCV, some uncertainties remain regarding long-term. These cases suggests that the risk of HCV reactivation related to TNFi remains low even without concomitant antiviral therapy. Nevertheless, a strict collaboration between rheumatologists and gastroenterologists/hepatologists. Our results also showed a good tolerance and efficacy when used concomitantly the new direct-acting antivirals drugs with ETN.


Role of biological sex in normal cardiac function and in its disease outcome - a review.
Biological sex plays an important role in normal cardiac physiology as well as in the heart's response to cardiac disease. Women generally have better cardiac function and survival than do men in the face of cardiac disease; however, this is progressively lost when comparing postmenopausal women with age matched men. Animal model of cardiac disease mirror what is seen in humans. Sex hormones contribute significantly to sex based difference in cardiac functioning and in its disease outcome. Estrogen is considered to be cardioprotective, whereas testosterone is detrimental to heart function.


Ultraviolet-blue photoluminescence of ZnSe quantum dots.
Zinc blende, sphericity, monodisperse, high luminescence ZnSe quantum dots (QDs) were synthesized by a one-step mild hydrothermal route with Zn and Se dissolved in aqueous NaOH as the source material. The structure and the morphology of the sample were examined by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The results indicated that the products were cubic blende ZnSe ranging from 3.2 to 4.5 nm in size. TEM images showed that the QDs have very good dispersibility and distribution. The characteristic features of the absorption and photoluminescence spectra of ZnSe quantum dots were studied at room temperature. Compared with the bulk ZnSe, the absorption edges and luminescent peaks of ZnSe QDs were blue shifted to higher energies due to the quantum confinement effect. Photoluminescence at ultraviolet excitation showed the strong emission at 390 nm related to the higher excitonic states. ZnSe QDs exhibiting photoluminescence line widths as narrow as 40-60 nm. Meanwhile, we simply explored the theoretical mechanism of luminescence in ZnSe QDs and analogized the relation of various point defect concentrations of ZnSe.


A novel three-dimensional tumorsphere culture system for the efficient and low-cost enrichment of cancer stem cells with natural polymers.
Cancer stem cells (CSCs) are considered to serve a key role in tumor progression, recurrence and metastasis. Tumorsphere culture is the most important method for enriching CSCs and is widely used in basic research and drug screening. However, the traditional suspension cell culture system has several disadvantages, including low efficiency, high cost and difficult procedure, making it difficult to produce tumorspheres on a large scale. In the present study, two biomaterials, methylcellulose (MC) and gellan gum (GG), were used to construct a novel culture system based on the traditional system. Subsequently, the characteristics of the novel three-dimensional (3D) culture system were evaluated, the design scheme was optimized, and the morphological and biological features of the tumorspheres cultured in this 3D system were compared with the traditional system. The results revealed that the tumorspheres cultured in the novel 3D system presented a higher seeding density and improved morphology, while maintaining stem-like properties. This evidence suggests that a simple, efficient and low-cost culture system that produces tumorspheres on a large scale was successfully constructed, which can be widely used in various aspects of stem cell research.


Constructing linkage maps in the genomics era with MapDisto 2.0.
Genotyping by sequencing (GBS) generates datasets that are challenging to handle by current genetic mapping software with graphical interface. Geneticists need new user-friendly computer programs that can analyze GBS data on desktop computers. This requires improvements in computation efficiency, both in terms of speed and use of random-access memory (RAM). MapDisto v.2.0 is a user-friendly computer program for construction of genetic linkage maps. It includes several new major features: (i) handling of very large genotyping datasets like the ones generated by GBS; (ii) direct importation and conversion of Variant Call Format (VCF) files; (iii) detection of linkage, i.e. construction of linkage groups in case of segregation distortion; (iv) data imputation on VCF files using a new approach, called LB-Impute. Features i to iv operate through inclusion of new Java modules that are used transparently by MapDisto; (v) QTL detection via a new R/qtl graphical interface. The program is available free of charge at mapdisto.free.fr. firstname.lastname@example.com. Supplementary data are available at Bioinformatics online.


Immunostimulated Arginase II Expression in Intestinal Epithelial Cells Reduces Nitric Oxide Production and Apoptosis.
Increased production of nitric oxide (NO) and subsequent local cytotoxicity to mucosal epithelial cells has been proposed as a putative mechanism involved in the development of necrotizing enterocolitis (NEC). Intestinal epithelial cells (IECs) metabolize L-arginine to either nitric oxide (NO) by NO synthase (NOS) or to L-ornithine and urea by arginase. L-ornithine is the first step in polyamine synthesis important for cell proliferation, while NO production can lead to apoptosis. We hypothesized that in IECs immunostimulation increases both NOS and arginase expression, and that arginase activity mitigates NO production and apoptosis. Rat intestinal epithelial cells (rIEC-6) were immunostimulated by either incubation with lipopolysaccharide (LPS) alone for 24 h or by incubation with conditioned media (CM) for 24 h. CM was obtained from RAW 264.7 cells (a macrophage cell line) treated with LPS (E. coli 0127:B8; 1 μg/ml) for 4 h. The rIEC-6 stimulated with LPS or with CM had significantly higher levels of inducible NOS (iNOS) protein, NO production, and arginase II protein than did the control cells. Direct LPS stimulation of rIEC-6 produced a less robust increase in iNOS expression and NO (represented as nitrite percent of control) than did CM stimulation. Inhibition of arginase using Nω hydroxyl-L-arginine (NOHA) further increased stimulated NO production in rIEC-6. Viable cell numbers were significantly lower in CM stimulated cells after 24 h than in controls, and inhibition of arginase activity with NOHA resulted in a further significant decrease in viable cell numbers. We conclude that immunostimulated arginase expression of rIEC-6 cells tempers cytokine-induced iNOS-derived NO production and apoptosis.


Using a novel NQO1 bioactivatable drug, beta-lapachone (ARQ761), to enhance chemotherapeutic effects by metabolic modulation in pancreatic cancer.
Novel, tumor-selective therapies are needed to increase the survival rate of pancreatic cancer patients. K-Ras-mutant-driven NAD(P)H:quinone oxidoreductase 1 (NQO1) is over-expressed in pancreatic tumor versus associated normal tissue, while catalase expression is lowered compared to levels in associated normal pancreas tissue. ARQ761 undergoes a robust, futile redox cycle in NQO1+ cancer cells, producing massive hydrogen peroxide (H2 O2 ) levels; normal tissues are spared by low NQO1 and high catalase expression. DNA damage created by ARQ761 in pancreatic cancer cells "hyperactivates" PARP1, causing metabolic catastrophe and NAD ± keresis cell death. NQO1: catalase levels (high in tumor, low in normal tissue) are an attractive therapeutic window to treat pancreatic cancer. Based on a growing body of literature, we are leading a clinical trial to evaluate the combination of ARQ761 and chemotherapy in patients with pancreatic cancer.


Therapeutic Potential and Critical Analysis of the PCSK9 Monoclonal Antibodies Evolocumab and Alirocumab.
To review the mechanism of action for PCSK9 monoclonal antibodies and critically evaluate the therapeutic potential of evolocumab and alirocumab in the treatment of hypercholesterolemia. Ovid MEDLINE search from 1980 to August 2015 using the terms PCSK9, evolocumab, and alirocumab with forward and backward citation tracking. English-language trials and studies assessing the mechanism, efficacy, or safety of PCSK9 monoclonal antibodies were included. PCSK9 monoclonal antibodies have a potent ability to reduce low-density lipoprotein (LDL) by almost 50% in controlled trials: -47.49% (95% CI = -69.6% to -25.4%). They have an acceptable safety profile with no significant elevations in Creatine Kinase (CK) (odds ratio [OR] = 0.72; 95% CI = 0.54 to 0.96) or serious adverse events (OR = 1.01; 95% CI = 0.87 to 1.18), and preliminary evidence suggests reductions in myocardial infarction (OR = 0.49; 95% CI = 0.26 to 0.93). Although it is effective in several familial hypercholesterolemia (FH) patient types, it does not work in homozygous patients with dual allele LDL receptor negative polymorphisms or those who are homozygous for autosomal recessive hypercholesterolemia. Although not preferred over statins because of limited clinical trial evidence of cardiovascular event reductions, dosing convenience, and expense, PCSK9 monoclonal antibodies will have a prominent role to play in the treatment of hypercholesterolemia, especially in patients needing large LDL reductions, including patients with many types of FH.


Altered phase-relationship between peripheral oscillators and environmental time in Cry1 or Cry2 deficient mouse models for early and late chronotypes.
The mammalian circadian system is composed of a light-entrainable central clock in the suprachiasmatic nuclei (SCN) of the brain and peripheral clocks in virtually any other tissue. It allows the organism to optimally adjust metabolic, physiological and behavioral functions to the physiological needs it will have at specific time of the day. According to the resonance theory, such rhythms are only advantageous to an organism when in tune with the environment, which is illustrated by the adverse health effects originating from chronic circadian disruption by jetlag and shift work. Using short-period Cry1 and long-period Cry2 deficient mice as models for morningness and eveningness, respectively, we explored the effect of chronotype on the phase relationship between the central SCN clock and peripheral clocks in other organs. Whereas the behavioral activity patterns and circadian gene expression in the SCN of light-entrained Cry1(-/-) and Cry2(-/-) mice largely overlapped with that of wild type mice, expression of clock and clock controlled genes in liver, kidney, small intestine, and skin was shown to be markedly phase-advanced or phase-delayed, respectively. Likewise, circadian rhythms in urinary corticosterone were shown to display a significantly altered phase relationship similar to that of gene expression in peripheral tissues. We show that the daily dissonance between peripheral clocks and the environment did not affect the lifespan of Cry1(-/-) or Cry2(-/-) mice. Nonetheless, the phase-shifted peripheral clocks in light-entrained mice with morningness and eveningness-like phenotypes may have implications for personalized preventive and therapeutic (i.e. chronomodulation-based) health care for people with early and late chronotypes.


Humulane-type sesquiterpenoids from the mushroom Lactarius mitissimus.
Five new humulane-type sesquiterpenes, mitissimols A (1), B (2), and C (3), and a mixture of mitissimol A oleate (4) and mitissimol A linoleate (5), were isolated from the fruiting bodies of Lactarius mitissimus. Their structures were elucidated on the basis of comprehensive spectroscopic techniques and necessary chemical methods. The relative stereochemistry of 1 was determined by single-crystal X-ray diffraction analysis.


Nonspecific resistance to tumor allograft.
The effects of an increased volume of reticulohistiocyte system and macrophage activation in the recipient after treatment with BCG and Zymosan on the course of antitumor concomitant allograft-immunity reaction were studied. The results were verified on animals affected with immunosuppression due to whole body irradiation. A factor of essential significance for resistance to tumor allograft is an increase of the total number of small lymphocytes supplied by the transplantation of syngeneic spleen cells. A substantially lower efficiency was shown by prophylactic administration of BCG and Zymosan. Transplantation of macrophages syngeneic to the host failed to affect the latter's resistance to subsequent tumor allograft. The irradiated host's reactivity was regenerated with a suspesion of spleen cells of purified small lymphocytes, but transplantation of syngeneic macrophages remained without effect.


Vascular disease in cocaine addiction.
Cocaine, a powerful vasoconstrictor, induces immune responses including cytokine elevations. Chronic cocaine use is associated with functional brain impairments potentially mediated by vascular pathology. Although the Crack-Cocaine epidemic has declined, its vascular consequences are increasingly becoming evident among individuals with cocaine use disorder of that period, now aging. Paradoxically, during the period when prevention efforts could make a difference, this population receives psychosocial treatment at best. We review major postmortem and in vitro studies documenting cocaine-induced vascular toxicity. PubMed and Academic Search Complete were used with relevant terms. Findings consist of the major mechanisms of cocaine-induced vasoconstriction, endothelial dysfunction, and accelerated atherosclerosis, emphasizing acute, chronic, and secondary effects of cocaine. The etiology underlying cocaine's acute and chronic vascular effects is multifactorial, spanning hypertension, impaired homeostasis and platelet function, thrombosis, thromboembolism, and alterations in blood flow. Early detection of vascular disease in cocaine addiction by multimodality imaging is discussed. Treatment may be similar to indications in patients with traditional risk-factors, with few exceptions such as enhanced supportive care and use of benzodiazepines and phentolamine for sedation, and avoiding β-blockers. Given the vascular toxicity cocaine induces, further compounded by smoking and alcohol comorbidity, and interacting with aging of the crack generation, there is a public health imperative to identify pre-symptomatic markers of vascular impairments in cocaine addiction and employ preventive treatment to reduce silent disease progression.


Vfr or CyaB promote the expression of the pore-forming toxin exlBA operon in Pseudomonas aeruginosa ATCC 9027 without increasing its virulence in mice.
Pseudomonas aeruginosa is a wide-spread γ-proteobacterium that produces the biosurfactant rhamnolipid that has a great commercial value due to excellent properties of low toxicity and high biodegradability. However, this bacterium is an opportunist pathogen that constitutes an important health hazard due to its production of virulence-associated traits and its high antibiotic resistance. Thus, it is highly desirable to have a non-virulent P. aeruginosa strain for rhamnolipid production. It has been reported that strain ATCC 9027 is avirulent in mouse models of infection, and it is still able to produce rhamnolipid. Thus, it has been proposed to be suitable for it industrial production, since it encodes a defective LasR quorum sensing (QS) transcriptional regulator that is the head of this regulatory network. However, the restoration of virulence factor production by overexpression of rhlR (the gene encoding a QS-transcriptional regulator which is under the transcriptional control of LasR) is not sufficient to restore its virulence in mice. It is desirable to obtain a deeper understanding of ATCC 9027 attenuated-virulence phenotype and to assess the safety of this strain to be used at an industrial scale. In this work we determined whether increasing the expression of the pore-forming toxin encoded by the exlBA operon in strain ATCC 9027 had an impact on its virulence using Galleria mellonella and mouse models of infections. We increased the expression of the exlBA operon by overexpressing from a plasmid its transcriptional activator Vfr or of the Vfr ligand cyclic AMP produced by CyaB. We found that in G. mellonella ATCC 9027/pUCP24-vfr and ATCC 9027/pUCP24-cyaB gained a virulent phenotype, but these strains remained avirulent in murine models of P. aeruginosa infection. These results reinforce the possibility of using ATCC 9027 for industrial biosurfactants production.


Medical aspects of pregnancy.
Physiologic changes during pregnancy can precipitate or exacerbate potentially serious maternal illnesses that may adversely affect the outcome for both mother and fetus. To review the common medical conditions that may complicate pregnancy. Venous thromboembolic disease is the most common medical disorder complicating pregnancy; heparin is the safest and most effective treatment and prophylactic agent in high-risk patients. Systemic lupus erythematosus may flare during pregnancy and may require therapy with corticosteroids, which may also be needed to treat immune thrombocytopenic purpura. Hypertension should be monitored closely throughout the pregnancy and puerperium; certain antihypertensive agents control blood pressure without affecting the fetus. Asthma may worsen or improve during pregnancy; therapy is similar to that for nonpregnant women. Diabetes mellitus may antedate pregnancy or become manifest during pregnancy; detection and strict glycemic control are the keys to a successful outcome. Approximately 30% of infants born to mothers with established HIV infection acquire the syndrome of immunodeficiency; testing must continue until 15 months of life. Mothers with epilepsy should use the lowest effective dose of a single antiepileptic agent to prevent congenital birth defects. When the internist, obstetrician, anesthesiologist, and perinatologist use a team approach, most patients can expect a successful outcome.


Tumour necrosis factor (TNF)alpha as a regulator of fat tissue mass in the Mediterranean gilthead sea bream (Sparus aurata L.).
The study was undertaken to analyze the lipolytic effect and transcriptional regulation of tumour necrosis factor (TNF)alpha in gilthead sea bream (Sparus aurata L.). The study was also focused on the transcriptional regulation and analysis of the 5-flanking region of lipoprotein lipase (LPL) in an attempt to identify cis-regulatory elements that would support the TNFalpha-mediated effects. The lipolytic effect of TNFalpha was evidenced by the increased release of glycerol in the culture medium of freshly isolated adipocytes. This observation, in addition to the summer up-regulation of TNFalpha transcripts in liver and mesenteric adipose tissue, supported a key role of TNFalpha as a fish limiting factor of tissue fat mass. Accordingly, TNFalpha expression in liver and mesenteric adipose tissue was reduced by fasting. Furthermore, the up-regulated expression of TNFalpha in the skeletal muscle of older fish can represent an adaptive response to limit the enhanced lipid influx towards muscle. A close positive association between LPL and TNFalpha transcripts supported the contribution of TNFalpha as a part of a regulatory network that exerts an inhibitory tonus upon the expression of LPL, which in turns limits the tissue uptake of fatty acids and the ultimate increase of tissue lipid reservoirs. The precise mechanism for the inhibition of LPL gene expression by TNFalpha remains to be established in fish, but analysis of the 5'-flanking region evidenced the conservation through vertebrate evolution of a functional OCT-1/NF-Y site that would mediate the TNFalpha effects on LPL expression.


Evaluation of a Localized Treatment Technique Using Three Ready-to-Use Products Against the Drywood Termite Incisitermes snyderi (Kalotermitidae) in Naturally Infested Lumber.
Twenty-one boards infested with drywood termites were examined for activity using a Termatrac® motion detector. Termite galleries were identified using a Resistograph drill and treated with one of three ready-to-use (RTU) products. Results indicated that the Termatrac was excellent at locating termite activity but provided 9.5% false negatives. The Resistograph located termite galleries with an average of 4.6 ± 2.7 holes drilled to find at least one gallery in a board. Treatments included three formulations and two active ingredients; a foam (imidacloprid), a dry (fipronil) and an experimental formulation in a pressurized can (fipronil). All treatments provided evidence for a reduction in mean termite populations per board compared to the control. Two treatments provided evidence of elimination of infestation but no formulation eliminated infestations in every board that was treated. The concept of local treatment for drywood termite control is discussed relative to our results.


Human subcutaneous dirofilariasis caused by Dirofilaria repens in Ibiza, Spain.
A case of human subcutaneous dirofilariasis contracted in Ibiza, Spain is reported. An incomplete nematode extracted from the eyelid of a woman patient was identified on the basis of its anatomic and histologic characteristics as a nongravid adult female of the species Dirofilaria repens. The subcutaneous location of the worm, together with the epidemiologic data, support this finding.


Feasibility of Implementing Community Partnerships to Provide Diabetes Prevention Services to Youth.
Type 2 diabetes (T2D) in youth has increased as a result of the obesity epidemic. Diabetes prevention programming is needed for youth, at risk for T2D, and their families. However, there is a lack of diabetes prevention services for this population. There is evidence for the benefit of lifestyle modification for decreasing diabetes risk, however there are barriers for youth to access these services in a traditional clinical setting. Our Youth Diabetes Prevention Clinic (YDPC) created partnerships within the community to increase access to diabetes prevention services for at risk youth. YDPC personnel approached community organizations who had the expertise and capacity to partner in needed areas. These partnerships allowed for the development and facilitation of a community-based diabetes prevention group. Youth and their families participated in a 12 week diabetes prevention group. We measured attendance and participant satisfaction with the program. Families attended an average of 5.1 sessions from January to October 2016. Participant satisfaction was collected five times. Physical activity was rated as "awesome" or "good" by 88% of the respondents. The nutrition activities were rated as "awesome" or "good" by 97% of respondents. Physicians and families express a desire for diabetes prevention services, however barriers make it difficult for families to fully participate. Creating partnerships within the community allows for increased access to diabetes prevention services for high-risk, underserved families.


Experimental measurements of water molecule binding energies for the second and third solvation shells of [Ca(H2O) n ]2+ complexes.
Further understanding of the biological role of the Ca2+ ion in an aqueous environment requires quantitative measurements of both the short- and long-range interactions experienced by the ion in an aqueous medium. Here, we present experimental measurements of binding energies for water molecules occupying the second and, quite possibly, the third solvation shell surrounding a central Ca2+ ion in [Ca(H2O) n ]2+ complexes. Results for these large, previously inaccessible, complexes have come from the application of finite heat bath theory to kinetic energy measurements following unimolecular decay. Even at n = 20, the results show water molecules to be more strongly bound to Ca2+ than would be expected just from the presence of an extended network of hydrogen bonds. For n > 10, there is very good agreement between the experimental binding energies and recently published density functional theory calculations. Comparisons are made with similar data recorded for [Ca(NH3) n ]2+ and [Ca(CH3OH) n ]2+ complexes.


Total knee arthroplasty in a young patient with achondroplasia.
Achondroplasia is a genetic skeletal dysplasia, characterised by dwarfism, with upper and lower limb deformities, that can lead to knee osteoarthritis; the surgical treatment is a challenge due to the particular joint anatomy variances. We present a 40-year-old woman, affected by achondroplasia with severe left knee osteoarthritis; the patient was treated conservatively with poor results. Between the ages of 12 and 17 years, she underwent multiple operative procedures for lower limb lengthening and a partial correction of the valgus deformity, by applying an external fixator. The patient was successfully treated with cemented posterior stabilised, fixed-bearing, total knee arthroplasty. The patient affected by achondroplasia, with severe knee osteoarthritis, should be considered for total joint replacement, which can be carried out with or without additional extra-articular osteotomy for alignment correction. Due to skeletal dysplasia in joint deformities, knee replacement requires careful preoperative planning and special technical considerations.


The complete mitochondrial genome of the Symphysodon aequifasciatus (Pellegrin, 1904).
In this study, the complete mitogenome sequence of the Symphysodon aequifasciatus has been sequenced by next-generation sequencing method. The mitogenome consists of 16 545 bp, including 13 protein-coding genes, 22 transfer RNAs and 2 ribosomal RNAs genes. The overall base composition of the fish is 28.8% for A, 30.1% for C, 15.0% for G, and 26.1% for T, suggesting a 99% identity to S. discus Heckel and a 98% identity to S. haraldi. It provides essential and important DNA molecular data for further phylogeography and evolutionary analysis for Symphysodon phylogeny.


Revisiting cultural awareness and cultural relevancy.
Comments on the original article by Christopher et al. (see record 2014-20055-001) regarding critical cultural awareness. The more insights and exploration of the meaning and influence of culture we receive, the better. There is no single treatment of any personal or collective culture(s) that can be inherently complete or totally exhaustive. New hermeneutics and skills are always needed, appreciated, and refreshing.


A role for exosomes in the constitutive and stimulus-induced ectodomain cleavage of L1 and CD44.
Ectodomain shedding is a proteolytic mechanism by which transmembrane molecules are converted into a soluble form. Cleavage is mediated by metalloproteases and proceeds in a constitutive or inducible fashion. Although believed to be a cell-surface event, there is increasing evidence that cleavage can take place in intracellular compartments. However, it is unknown how cleaved soluble molecules get access to the extracellular space. By analysing L1 (CD171) and CD44 in ovarian carcinoma cells, we show in the present paper that the cleavage induced by ionomycin, APMA (4-aminophenylmercuric acetate) or MCD (methyl-beta-cyclodextrin) is initiated in an endosomal compartment that is subsequently released in the form of exosomes. Calcium influx augmented the release of exosomes containing functionally active forms of ADAM10 (a disintegrin and metalloprotease 10) and ADAM17 [TACE (tumour necrosis factor a-converting enzyme)] as well as CD44 and L1 cytoplasmic cleavage fragments. Cleavage could also proceed in released exosomes, but only depletion of ADAM10 by small interfering RNA blocked cleavage under constitutive and induced conditions. In contrast, cleavage of L1 in response to PMA occurred at the cell surface and was mediated by ADAM17. We conclude that different ADAMs are involved in distinct cellular compartments and that ADAM10 is responsible for shedding in vesicles. Our findings open up the possibility that exosomes serve as a platform for ectodomain shedding and as a vehicle for the cellular export of soluble molecules.


Characteristics of tau oligomers.
In Alzheimer disease (AD) and other tauopathies, microtubule-associated protein tau becomes hyperphosphorylated, undergoes conformational changes, aggregates, eventually becoming neurofibrillary tangles (NFTs). As accumulating evidence suggests that NFTs themselves may not be toxic, attention is now turning toward the role of intermediate tau oligomers in AD pathophysiology. Sarkosyl extraction is a standard protocol for investigating insoluble tau aggregates in brains. There is a growing consensus that sarkosyl-insoluble tau correlates with the pathological features of tauopathy. While sarkosyl-insoluble tau from tauopathy brains has been well characterized as a pool of filamentous tau, other dimers, multimers, and granules of tau are much less well understood. There are protocols for identifying these tau oligomers. In this mini review, we discuss the characteristics of tau oligomers isolated via different methods and materials.


Meditation-Induced Psychosis: Trigger and Recurrence.
Meditation is regarded as a self-regulation approach to manage emotions. Meditation has a beneficial effect on mental health. Different kinds of meditation are practiced in many religions and cultures for the general wellbeing of an individual. However, meditation-related experiences and negative effects of meditation are not uncommon. Meditation-induced psychosis has been reported in the past. Here, we present a case of a 33-year-old male patient who developed acute and transient psychosis twice after meditation and discuss the role of meditation as a precipitating factor to psychosis.


The influence of cigarette smoke inhalation on bone density. A radiographic study in rats.
The aim of this study was to evaluate the influence of cigarette smoke inhalation (CSI) and its cessation on tibiae bone quality. Forty-one male Wistar rats were randomly assigned to one of the following groups: Group 1--control (n = 14), Group 2--3 months of CSI and 2 months without exposure to CSI (n = 12), and Group 3--5 months of CSI (n = 15). At the end of the experimental period, the animals were sacrificed, the tibiae removed and immediately radiographed for photodensitometric analysis. The results showed that continuous exposure to cigarette smoke promoted a significantly reduced bone density (p < 0.05) (3.22 mm Al eq +/- 0.58; 2.93 mm Al eq +/- 0.45; 1.86 mm Al eq +/- 0.35; for groups 1, 2 and 3, respectively). Similar levels of bone density were observed for the control and cessation groups (groups 1 and 2 - p > 0.05). Thus, within the limits of the present study, it can be concluded that CSI may affect tibiae bone quality, and CSI cessation results in a return towards the level of the control group.


Psoriasis: a review. II.
Notwithstanding the intense interest in systemic cytotoxic therapy in recent years, the great majority in psoriatics are likely to go on needing topical therapy with tar, dithranol or corticosteroids, and a welcome trend is the spreading of interest in day care centres such as those in Paris (GRUPPER), Stockholm (THYRESSON), Stanford (FARBER) and San Francisco (CRAM) evolving from the out-patient regimes advocated by INGRAM in Leeds a generation ago.


Hepatic gamma-glutamyl transferase and hepatic fibrosis in patients with alcoholic liver disease.
The activity of gamma-glutamyl transferase (GGT) in the liver of 22 patients with alcoholic liver disease, 24 with nonalcoholic liver disease and 12 normal controls was measured. The enhanced hepatic GGT activity was higher in alcoholic patients and nonalcoholic patients than in the normal controls. No statistical significance of difference could be found in hepatic GGT activity between alcoholic and nonalcoholic patients, while serum GGT activity was markedly elevated in alcoholic patients compared to nonalcoholic patients. There was better correlation between hepatic and serum GGT activity in alcoholic patients. Furthermore the enhanced hepatic GGT activity could contribute to the pathogenesis of liver fibrosis as a result of the investigation for hepatic GGT activity and histological liver fibrosis.


[Equipment for low reactive level laser therapy including that for light therapy].
Equipments used for light therapy include machinery used for irradiation by low reactive level laser, xenon light and linear polarized infra-red ray. Low reactive level laser is divided into two types of laser according to the medium by which laser is obtained ; semiconductor laser and helium-neon laser. Low reactive level laser has only one wave length and produces analgesia by action of light itself. On the other hands, Xenon light and linear polarized infra-red ray produce analgesia by warming effect induced by light in addition to the action of light itself. There are four methods of irradiation by these light sources; irradiation of acupuncture points, of trigger points, along nerves causing pain and of stellate ganglion area. Indication for light therapy includes various kinds of diseases such as herpes zoster, post herpetic neuralgia, cervical pain, lumbago due to muscle contracture, complex regional pain syndrome, arthralgia etc. However, we have to know that light therapy does not exert analgesic effects equally to all patients. But light therapy does not accompany pain and rarely shows any side effects. Therefore it is thought to be an alternative for patients who reject injection or patients who are not indicated for nerve block because of patients' conditions such as bleeding tendency.


Positive inotropic drug infusions for patients with heart failure: current controversies and best practice.
Patients who experience severe symptoms of heart failure and repeated hospitalizations for exacerbations may benefit from positive inotropic drug infusion therapy such as dobutamine or milrinone. This article provides an overview of inotropic drug delivery in the home including current controversies and best practices to ensure safe home care policies and practice.


Usefulness of radiological signs of pulmonary congestion in predicting failed spontaneous breathing trials.
Inspiratory fall in intrathoracic pressure during a spontaneous breathing trial (SBT) may precipitate cardiac dysfunction and acute pulmonary edema. We aimed to determine the relationship between radiological signs of pulmonary congestion prior to an SBT and weaning outcomes. This was a post hoc analysis of a prospective cohort study involving patients in an adult medical-surgical ICU. All enrolled individuals met the eligibility criteria for liberation from mechanical ventilation. Tracheostomized subjects were excluded. The primary endpoint was SBT failure, defined as the inability to tolerate a T-piece trial for 30-120 min. An attending radiologist applied a radiological score on interpretation of digital chest X-rays performed before the SBT. A total of 170 T-piece trials were carried out; SBT failure occurred in 28 trials (16.4%), and 133 subjects (78.3%) were extubated at first attempt. Radiological scores were similar between SBT-failure and SBT-success groups (median [interquartile range] = 3 [2-4] points vs. 3 [2-4] points; p = 0.15), which, according to the score criteria, represented interstitial lung congestion. The analysis of ROC curves demonstrated poor accuracy (area under the curve = 0.58) of chest x-rays findings of congestion prior to the SBT for discriminating between SBT failure and SBT success. No correlation was found between fluid balance in the 48 h preceding the SBT and radiological score results (ρ = -0.13). Radiological findings of pulmonary congestion should not delay SBT indication, given that they did not predict weaning failure in the medical-surgical critically ill population. (ClinicalTrials.gov identifier: NCT02022839 [http://www.clinicaltrials.gov/]).


Hip Arthroscopic Management Can Improve Osteitis Pubis and Bone Marrow Edema in Competitive Soccer Players With Femoroacetabular Impingement.
There is a dearth of knowledge regarding the correlation between femoroacetabular impingement (FAI) and osteitis pubis (OP) among symptomatic soccer players. To elucidate whether arthroscopic FAI correction is effective for young competitive soccer players with FAI combined with OP or perisymphyseal pubic bone marrow edema (BME). Case series; Level of evidence, 4. A total of 577 consecutive patients who underwent arthroscopic FAI correction were retrospectively reviewed with a minimum 2-year follow-up. Competitive soccer players who were professional, college, and high school athletes were included. The authors assessed the modified Harris Hip Score and Nonarthritic Hip Score preoperatively and at 6 months, 1 year, and 2 years after surgery. In addition, players were divided into groups according to radiographic evidence of OP and BME (2 groups each). Clinical outcomes, return to play, and radiographic assessments were compared between groups. Twenty-eight hips met the inclusion criteria. The median modified Harris Hip Score significantly improved after hip arthroscopy (81.4, preoperatively; 95.7 at 6 months, P = .0065; 100 at 1 year, P = .0098; 100 at 2 years, P = .013). The median Nonarthritic Hip Score also significantly improved (75.0, preoperatively; 96.3 at 6 months, P = .015; 98.8 at 1 year, P = .0029; 100 at 2 years, P = .015). Furthermore, 92.0% of players returned to play soccer at the same or higher level of competition at a median 5.5 months (range, 4-15 months); 67.8% had radiological confirmation of OP; and 35.7% had pubic BME. The alpha angle was significantly higher in pubic BME group than the no-pubic BME group (64.8° vs 59.2°, P = .027), although there was no significant difference between the OP and no-OP groups. The prevalence of tenderness of the pubic symphysis significantly decreased preoperatively (32.1%) to postoperatively (3.6%). Magnetic resonance imaging findings confirmed that pubic BME disappeared in all players at a median 11 months (range, 6-36) after initial surgery. Arthroscopic management for FAI provides favorable clinical outcomes, a high rate of return to sports, and, when present, resolution of pubic BME among competitive soccer players.


Comparison of self-reported and observed prevalence of safety belt and helmet use in Florence.
Safety belt and helmet use was estimated from PASSI data and measured through Ulisse observations. Between 2008 and 2012 a total of 2,081 cars and motorcycle users were interviewed in the LHU of Florence and a total of 59,787 drivers (11,870 front passengers, 1,129 rear passengers and 16,816 motorcyclists) were observed. The comparison between self-reported and observed prevalences was performed by calculating the over-reporting factor (ORF), defined as the ratio of the self-reported to the observed prevalence of seat belt or helmet use. The time trend of the prevalence (both from self-reported and observed data) and of the ORF was assessed by using linear regression and Poisson's regression, respectively. The correlation between self-reported and observed prevalence is high, with a Pearson's correlation coefficient of 0.95 (p <0.05). Regarding front seat belt use rates, the difference between self-reported and observed data increases over time and the ORF range varies from 1.12 to 1.32. Rear seat belt data show a great variability, and the ORF varies from 0.67 to 1.37. In 2011 and 2012, the observed prevalence was higher than the self-reported one (ORF <1). Helmet use rates are very high, close to 100% with both methods; ORF has very small oscillations and ranges from 0.98 to 1, showing a good correlation between self-reported and observational data. There are no significant temporal variations both for the prevalences of use and for the ORF. The reasonable accuracy of self-reported data makes this method fit in the routinary assessment of safety belts and helmet usage, in order to limit the observations of the Ulisse system at predetermined time intervals. However, self-reported estimates need to be adjusted using an appropriate over-reporting factor.


Who is bearing the financial burden of non-communicable diseases in Mongolia?
Non-communicable diseases (NCDs) pose a formidable health and development challenge for low- and middle-income countries (LMICs). However, translating this challenge into resource allocation is seriously constrained by a lack of country specific evidence on NCD financing and its distributional implications. This study estimated expenditures associated with NCDs in Mongolia and their distributions across socioeconomic groups, focusing especially on private out-of-pocket (OOP) spending on the major NCDs. Secondary data analysis of multiple data sources on NCD related health service use and expenditures including detailed administrative data, World Health Organization STEPwise approach to Surveillance (STEPs) survey for Mongolia, and household surveys. Sample-weighted estimates of OOP expenditures for NCDs were constructed using STEPs data. OOP payments per discharge and per outpatient visit were estimated by condition and type of service provider, and survey data on utilization, after adjusting for utilization in administrative records. NCDs in Mongolia accounted for more than one-third of total health expenditures in 2013. A significant fraction of this expenditure was borne by households in the form of OOP spending. CVD-related health spending is the major driver of NCD-spending in Mongolia, accounting for about 24.2% of total health expenditure. OOP health payments, largely driven by outpatient diagnostics and drugs, were incurred disproportionately by the better-off, seeking more specialist services and better quality private care. A high share of OOP spending for NCDs in Mongolia, which ostensibly enjoys universal health coverage, provides a cautionary tale for LMICs in a similar situation. Improvement in the quality of services at the primary care level and rural health care facilities, where the poor mainly attend, is desirable together with an effective exemption policy for user fees at higher level hospitals.


A novel, layered phase in Ti-rich SrTiO3 epitaxial thin films.
Sr2Ti7O14, a new phase, is synthesized by leveraging the innate chemical and thermo-dynamic instabilities in the SrTiO3-TiO2 system and non-equilibrium growth techniques. The chemical composition, epitaxial relationships, and orientation play roles in the formation of this novel layered phase, which, in turn, possesses unusual charge ordering, anti-ferromagnetic ordering, and low, glass-like thermal conductivity.


Mometasone versus betamethasone creams: a trial in dermatoses.
To compare the efficacy and safety of mometasone furoate cream 0.1% applied daily versus betamethasone valerate cream 0.1% applied twice daily in a variety of dermatoses. A 4 week study was undertaken of patients with at least moderately severe dermatoses as judged by scoring of a target lesion. Weekly global improvement was assessed, as well as change in target lesion scores. Local side effects were noted including observation of atrophy. Fifty eight patients in three centres completed the study, 30 in the betamethasone group and 28 in the mometasone. There was no difference in demographic variables or disease severity in each group or any difference between the three investigator gradings of initial severity. There was a rapid onset of improvement in both groups by day seven (scores being reduced by 72% in the betamethasone group and 65% in the mometasone group). By the fourth week visit there was 90% reduction in the betamethasone group score and 93% in the mometasone. There was no significant difference between the groups. Mometasone furoate cream 0.1% applied daily in dermatoses is as effective as betamethasone valerate 0.1% cream. Both creams had rapid onset of action and had no signs of atrophy. Better patient compliance could be expected with the convenience of mometasone cream being applied daily.


Multiscale optical imaging of rare-earth-doped nanocomposites in a small animal model.
Rare-earth-doped nanocomposites have appealing optical properties for use as biomedical contrast agents, but few systems exist for imaging these materials. We describe the design and characterization of (i) a preclinical system for whole animal in vivo imaging and (ii) an integrated optical coherence tomography/confocal microscopy system for high-resolution imaging of ex vivo tissues. We demonstrate these systems by administering erbium-doped nanocomposites to a murine model of metastatic breast cancer. Short-wave infrared emissions were detected in vivo and in whole organ imaging ex vivo. Visible upconversion emissions and tissue autofluorescence were imaged in biopsy specimens, alongside optical coherence tomography imaging of tissue microstructure. We anticipate that this work will provide guidance for researchers seeking to image these nanomaterials across a wide range of biological models.


Imaging of the cornea.
The aim of the LSU Eye Center Corneal Topography Project was to apply computer analysis to keratoscopy and develop graphic presentation methods to provide accurate and easily assimilated information regarding the status of patient corneal topography. The analysis contains four diagrams: a plot of the raw keratoscope data for quality control, a three-dimensional wire model of corneal surface power distribution, a plot of dioptric point surface powers, and a color-coded contour map of corneal surface powers. While the analysis uses a current generation 11 ring keratoscope for producing keratoscope photographs, it can be adapted to newer keratoscopes, which promise to give broader coverage of the corneal surface. Examples of normals and several surgical patients will be shown, including cases in which the method has pointed to potential refinements in the theory and application of refractive surgical techniques.


Prominent internal occipital protuberance misdiagnosed as fourth ventricular mass.
A prominent internal occipital protuberance was misdiagnosed as a fourth ventricular mass. The primary error was inattention to head positioning. The case is presented both to call attention to the need for careful topographic overlap and to discuss the interesting but normal variant.


Isolation and characterization of a novel endo-β-1,4-glucanase from a metagenomic library of the black-goat rumen.
The various types of lignocellulosic biomass found in plants comprise the most abundant renewable bioresources on Earth. In this study, the ruminal microbial ecosystem of black goats was explored because of their strong ability to digest lignocellulosic forage. A metagenomic fosmid library containing 115,200 clones was prepared from the black-goat rumen and screened for a novel cellulolytic enzyme. The KG35 gene, containing a novel glycosyl hydrolase family 5 cellulase domain, was isolated and functionally characterized. The novel glycosyl hydrolase family 5 cellulase gene is composed of a 963-bp open reading frame encoding a protein of 320 amino acid residues (35.1kDa). The deduced amino acid sequence showed the highest sequence identity (58%) for sequences from the glycosyl hydrolase family 5 cellulases. The novel glycosyl hydrolase family 5 cellulase gene was overexpressed in Escherichia coli. Substrate specificity analysis revealed that this recombinant glycosyl hydrolase family 5 cellulase functions as an endo-β-1,4-glucanase. The recombinant KG35 endo-β-1,4-glucanase showed optimal activity within the range of 30-50°C at a pH of 6-7. The thermostability was retained and the pH was stable in the range of 30-50°C at a pH of 5-7.


Diving response and apneic time in humans.
The aim of this study was to compare apneic time with the human diving response, defined as heart rate (HR) reduction and reduced skin blood flow, in groups with varying degrees of breath-hold diving experience. Apneic time and HR reduction at apneas in air and apneas with face immersion in cold water were thus recorded in nine groups. Skin capillary blood flow was recorded in six of the groups. All subjects received the same information on maximizing apneic duration, and no information about their progress during the apneas. The longest apneas and the most pronounced cardiovascular adjustments were found in the young, trained divers. It was found that apneic time was significantly correlated to HR reduction among the nine groups (r = 0.94, P < 0.001), and to skin capillary blood flow reduction among the six groups where the parameter was measured (r = 0.82, P < 0.05). The correlation between HR reduction and skin capillary blood flow reduction was also significant (r = 0.85, P < 0.05). When the difference in HR reduction and apneic time between apneas in air and apneas with face immersion were compared in the nine groups, it was found that all groups reacted with a more pronounced HR reduction during apneas with face immersion. All groups without prior breath-hold diving experience were found to perform shorter apneas with face immersion than apneas in air, or apneas of the same duration in both conditions, which has been reported in other studies. However, in all groups with diving experience, the apneic time was prolonged during apneas with face immersion. The results of this study suggest an oxygen-conserving effect of the diving response in trained apneic divers.


[Clinical trial of the first Polish levodopa preparation in the treatment of Parkinsonian patients].
In three neurological centres the therapeutic effects and adverse effects were compared of two levodopa preparations combined with carbidopa (25/250): 1. A foreign drug widely prescribed in Poland, and 2. Its Polish analogue produced by Polfa Stargard Works. The drugs were given to 30 patients (in two matched groups) with Parkinson disease or syndrome during 6 weeks. The trial was completed by 28 patients (one patient dropped out from each group for reasons not directly connected with the treatment). The therapeutic results were assessed on the basis of effects obtained in the NUDS and NSP scales and by measuring of the "on" phase at the beginning and at the end of the trial. In every case the global assessment of patient's condition by the patient and by the doctor was considered. The analysis of the results showed no significant statistically differences between both drugs respect to antiparkinsonian action and incidence of adverse effects.


Proangiogenic compositions of microvesicles derived from human umbilical cord mesenchymal stem cells.
Microvesicles (MVs) derived from mesenchymal stem cells (MSCs) have been shown to promote angiogenesis. This study was aimed to shed a light on the mechanisms by analyzing the angiogenesis-promoting compositions of MSC-MVs. Also we try to figure out the impact of hypoxia on angiogenesis. MVs were isolated from the culture supernatants of MSCs under hypoxia/normoxia and serum-deprivation condition. The morphological features of MVs were revealed by an electron microscope and the origin of the MVs was identified by a bead-bound assay. An antibody array was used to analyze the expression of angiogenic cytokines from MVs and the parent MSCs as well. The major candidate factors were screened and the results were validated by immune blotting. MSC-MVs were around 80 nm in diameter. They expressed CD29, CD44, and CD73, but not CD31 and CD45. Antibody array showed that both MSCs and MVs expressed many angiogenesis-promoting biomolecules, including interleukin-6 (IL-6), basic fibroblast growth factors (bFGF), and recptor of urokinase-type plasminogen activator (UPAR). MSC-MVs contained angiogenin, vascular endothelial growth factor (VEGF), monocyte chemotactic protein-1 (MCP-1) and the receptor-2 for vascular endothelial growth factor at higher levels than the parent MSCs. Under hypoxic condition most cytokines were expressed in greater quantity than normoxic in MSCs while in MVs there was no significant difference between hypoxic and normoxic conditions except UPAR, Angiogenin, VEGF, IGF, Tie-2/TEK, and IL-6 which were higher in MVs under hypoxic conditions than those in normoxic condition. Upon serum-deprivation condition, MSCs could secrete MVs that contain a variety of factors contributing to their angiogenesis-promoting function. And among them, Angiogenin, VEGF, MCP-1, VEGF R2 might be of greater importance than the other cytokines. Also UPAR, Angiogenin, VEGF, IGF, Tie-2/TEK, IL-6 might be responsible for hypoxia-augmented proangiogenic effects of MVs.