Aural foreign body extraction in children: a double-edged sword.
Foreign body insertion into the ear in children is common world-wide. The goal of this work is to describe the procedural complications of aural foreign body extraction in children. A retrospective analysis of records of children with aural foreign bodies was conducted. Patients' bio data, type of foreign bodies, referrals, techniques of removal and complications were extracted from the case files. The foreign bodies were categorized into graspable and non-graspable objects. Patients with complications caused directly by the foreign body were excluded. There were 136 cases. Eighty-seven (64.0%) were males while forty-nine (36.0%) were females. Their age range from 5 days to 16 years with 109 (80.2%) aged below 8 years. Eighty-nine (65.4%) and 47 (34.6%) cases were treated by otolaryngologists and non-otolaryngologists with a complication rate of 15.7% and 68.1% respectively. One case suffered severe hearing loss following complicated attempt at removing foreign body in the only hearing ear. Overall, the complication rate was higher (44.4%) with removal of non-graspable than (28.6%) with graspable objects. Procedural complication is an ever-present hazard of aural foreign body extraction in children. Its occurrence can be prevented or largely reduced if health care-givers know their limitation based on their clinical skills and acquaint themselves with established criteria for referral. As a rule, we suggest that, foreign body in the only hearing ear and failed attempted first removal should be considered criteria for otolaryngologic referral.


Revealing hot executive function in children with motor coordination problems: What's the go?
Recent research suggests that children with Developmental Coordination Disorder (DCD) often show deficits in executive functioning (EF) and, more specifically, the ability to use inhibitory control in 'hot', emotionally rewarding contexts. This study optimized the assessment of sensitivity of children with DCD to emotionally significant stimuli by using easily discriminable emotional expressions in a go/no-go task. Thirty-six children (12 with DCD), aged 7-12years, completed an emotional go/no-go task in which neutral facial expressions were paired with either happy or sad ones. Each expression was used as both, a go and no-go target in different runs of the task. There were no group differences in omission errors; however, the DCD group made significantly more commission errors to happy no-go faces. The particular pattern of performance in DCD confirms earlier reports of (hot) EF deficits. Specifically, a problem of inhibitory control appears to underlie the atypical pattern of performance seen in DCD on both cold and hot EF tasks. Disrupted coupling between cognitive control and emotion processing networks, such as fronto-parietal and fronto-striatal networks, may contribute to reduced inhibitory control in DCD. The implications for a broader theoretical account of DCD are discussed, as are implications for intervention.


Single-Molecule Imaging of mRNA Localization and Regulation during the Integrated Stress Response.
Biological phase transitions form membrane-less organelles that generate distinct cellular environments. How molecules are partitioned between these compartments and the surrounding cellular space and the functional consequence of this localization is not well understood. Here, we report the localization of mRNA to stress granules (SGs) and processing bodies (PBs) and its effect on translation and degradation during the integrated stress response. Using single mRNA imaging in living human cells, we find that the interactions of mRNAs with SGs and PBs have different dynamics, very few mRNAs directly move between SGs and PBs, and that specific RNA-binding proteins can anchor mRNAs within these compartments. During recovery from stress, we show that mRNAs that were within SGs and PBs are translated and degraded at similar rates as their cytosolic counterparts. Our work provides a framework for using single-molecule measurements to directly investigate the molecular mechanisms of phase-separated compartments within their cellular environment.


Oral activated charcoal suppresses hyperphosphataemia in haemodialysis patients.
Hyperphosphataemia is almost inevitable in end stage renal disease (ESRD) patients and is associated with increased morbidity and mortality. In this study we examined whether oral activated charcoal (oAC) reduces serum phosphate level in haemodialysis patients. This was an open-label, prospective, uncontrolled study. One hundred and thirty-five haemodialysis patients were included in this study, with cessation of treatment with any phosphate binders during a 2 week washout period. Patients with serum phosphate levels greater than 5.5 mg/dL during the washout period were included for treatment with oAC. oAC was started at a dose of 600 mg three times per day with meals and was administered for 24 weeks. oAC dose was titrated up during the 24 week period to achieve phosphate control (3.5-5.5 mg/dL). A second 2 week washout period followed the end of oAC treatment. In the 114 patients who successfully completed the trial, the mean dose of activated charcoal was 3190 ± 806 mg/day. oAC reduced mean phosphate levels to below 5.5 mg/dL, with mean decreases of 2.60 ± 0.11 mg/dL (P < 0.01) and 103 (90.4%) of the patients reached the phosphate target. After the second washout period the phosphate levels increased to 7.50 ± 1.03 mg/dL (P < 0.01). Serum intact parathyroid hormone (iPTH) levels declined from 338.75 ± 147.77 pg/mL to 276.51 ± 127.82 pg/mL (P < 0.05) during the study. oAC had no influence on serum prealbumin, total cholesterol, triglycerides, serum ferritin, haemoglobin or platelet levels and the levels of 1,25-dihydroxyvitamin D were stable during the study. In this open-label uncontrolled study, oAC effectively controls hyperphosphataemia and hyperparathyroidism in haemodialysis patients. The safety and efficacy of oAC needs to be assessed in a randomized controlled trial.


Polyvinyl Alcohol-Few Layer Graphene Composite Films Prepared from Aqueous Colloids. Investigations of Mechanical, Conductive and Gas Barrier Properties.
Quasi all water soluble composites use graphene oxide (GO) or reduced graphene oxide (rGO) as graphene based additives despite the long and harsh conditions required for their preparation. Herein, polyvinyl alcohol (PVA) films containing few layer graphene (FLG) are prepared by the co-mixing of aqueous colloids and casting, where the FLG colloid is first obtained via an efficient, rapid, simple, and bio-compatible exfoliation method providing access to relatively large FLG flakes. The enhanced mechanical, electrical conductivity, and O2 barrier properties of the films are investigated and discussed together with the structure of the films. In four different series of the composites, the best Young's modulus is measured for the films containing around 1% of FLG. The most significant enhancement is obtained for the series with the largest FLG sheets contrary to the elongation at break which is well improved for the series with the lowest FLG sheets. Relatively high one-side electrical conductivity and low percolation threshold are achieved when compared to GO/rGO composites (almost 10-3 S/cm for 3% of FLG and transport at 0.5% FLG), while the conductivity is affected by the formation of a macroscopic branched FLG network. The composites demonstrate a reduction of O2 transmission rate up to 60%.


Acute kidney injury among adult patients undergoing major surgery in a tertiary hospital in Nigeria.
Acute kidney injury (AKI) is an underreported but major cause of morbidity and mortality among patients undergoing major surgical interventions in sub-Saharan Africa (SSA). Whereas AKI is often seen following major cardiac surgery in high-income countries, a similar spectrum of surgical diseases and interventions is not seen in developing countries. The impacts on surgical outcomes have also not been well characterized in SSA. This study aimed at identifying risk factors, incidence and determinants and short-term outcomes of AKI among patients undergoing major surgery. This was a cohort study of adult patients undergoing major surgery at the University College Hospital, Ibadan, Nigeria. Data obtained were sociodemographic details, risk factors for AKI, details of surgery, anaesthesia and intra-operative events and short-term outcomes. Blood samples were obtained for pre-operative (pre-op) full blood count, serum electrolytes, blood urea and creatinine (SCr). Post-operatively (Post-op) SCr was determined at 24 h, Day 7 post-op and weekly until each patient was discharged. A total of 219 subjects who had major surgery (86.3% elective) were enrolled. The median age of the patients was 46 (range 18-73) years and 72.6% were females. The surgeries performed were mostly simple mastectomies (37.4%), exploratory laparotomies (22.8%) and total thyroidectomies (16.4%). The incidences of AKI were 18.7% at 24 h and 17.4% at Day 7 post-op, while cumulative AKI incidence was 22.5% at 1-week post-op. Pre-op elevated SCr [odds ratio (OR) 3.86], sepsis (OR 2.69), anaemia (OR 2.91) and duration of surgery >120 min (OR 1.75) were independently associated with AKI. In-patient mortality was 20.4% in individuals with AKI and 5.3% in those without AKI (P < 0.01). Peri-operative risk factors for AKI are common among patients undergoing major surgery in SSA hospitals. The cumulative incidence of AKI was high and independently associated with pre-op sepsis, anaemia, pre-existing kidney dysfunction and duration of surgery >120 min.


The functional polymorphism of the hemoglobin-binding protein haptoglobin influences susceptibility to idiopathic Parkinson's disease.
Oxidative stress and iron have been widely implicated in the etiology of Parkinson's disease (PD). Hemoglobin is the richest source of iron in the body. The human Haptoglobin (Hp) protein is a plasma alpha-2 glycoprotein that removes free Hemoglobin from the circulation and tissues and is important in protection from oxidative stress, in immune system regulation, and angiogenesis. A common genetic polymorphism of Hp exists in the population, where the Hp 1-1, Hp 2-1, and Hp 2-2 forms exhibit profound functional differences. In this study, the Hp genotype corresponding to phenotypes Hp 1-1, 2-1 and 2-2 was determined in 312 idiopathic PD patients and 420 normal control subjects. A significant increase in the number of subjects carrying the Hp 2-1 genotype was present among PD patients. The distribution of Hp genotypes among PD patients (16.0% Hp 1-1, 56.4% Hp 2-1, 27.6% Hp 2-2) was significantly different from the distribution in controls (15.2% Hp 1-1, 48.1% Hp 2-1, 36.7% Hp 2-2) (chi(2) = 6.99, P = 0.030). The odds ratios for PD risk for Hp 2-1 and Hp 1-1 versus Hp 2-2 genotype were 1.51 (1.07-2.12) and 1.36 (0.86-2.15), respectively. Overall, the association of Hp-1 allele with PD resulted stronger among subjects who were never-smokers as compared to ever-smokers. Also, among ever-smokers, Hp genotypes were significantly associated with PD only among women, but not men, indicating the presence of a gene x gender x smoking interaction. To our knowledge, this is the first study that investigates the association of Hp genotypes with the risk of PD.


Cholesteatoma of the upper urinary tract.
Cholesteatoma of the urinary tract is a rare condition which can be diagnosed radiographically. The radiographic findings of stringy intraluminal defects or nodules that may lightly calcify or coalesce to form a discrete mass in association with calculi and/or obstruction are characteristic. A history of chronic urinary tract infection, renal colic, and desquamated epithelial cells in the urine further support the diagnosis.


Efficacy of Botulinum Toxin B Injection for Raynaud's Phenomenon and Digital Ulcers in Patients with Systemic Sclerosis.
The efficacy and safety of botulinum toxin B (BTX-B) for treatment of Raynaud's phenomenon and digital ulcers in patients with systemic sclerosis was assessed. A total of 45 patients with systemic sclerosis who had Raynaud's phenomenon were blinded and divided randomly into 4 groups: a no-treatment control group, and 3 treatment groups, using 250, 1,000 or 2,000 international units (U) of BTX-B injections in the hand with more severe symptoms. Four weeks after injection, pain/numbness visual analogue scale scores and Raynaud's score in the groups treated with 1,000 and 2,000 U BTX-B were significantly lower than in the control group and the group treated with 250 U BTX-B. These beneficial effects were sustained until 16 weeks after the single injection. At 4 weeks after injection skin temperature recovery in the group treated with 2,000 U BTX-B was significantly improved. The numbers of digital ulcers in the groups treated with 1,000 and 2,000 U BTX-B were significantly lower than in the control group. In conclusion, 1,000 and 2,000 U BTX-B injections significantly suppressed the activity of Raynaud's phenomenon and digital ulcers in patients with SSc without serious adverse events.


Concordant occipital encephalocele in monoamniotic twins.
Anomalies occur with a greater frequency in twin gestations. Due to its multifactorial inheritance, twins are usually discordant for encephalocele. We present a case of monoamniotic twins concordant for occipital encephalocele and discordant for lung and cord anomalies. Ultrasonographic examination at 17 weeks' gestation revealed occipital encephalocele in both fetuses. The maternal serum level of alpha-fetoprotein was increased. Fetal autopsy revealed occipital encepaholocele in both twins and right pulmonary hypoplasia and one umbilical artery in one sibling. Monoamniotic twins concordant for encephalocele occur with extreme rarity. To the best of our knowledge, monoamniotic twins concordant for this neural tube defect have not been previously reported.


Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients.
The risk of death in hemodialysis patients treated with calcium-containing phosphate binders or sevelamer is not known. We assessed all-cause mortality in 127 patients new to hemodialysis assigned to calcium-containing binders or sevelamer after a median follow-up of 44 months from randomization. This was a predetermined secondary end point of a randomized clinical trial designed to assess progression of coronary artery calcium (CAC) scores in the two treatment arms. Thirty-four deaths occurred during the follow-up period: 23 in subjects randomized to calcium-containing phosphate binders and 11 in subjects randomized to sevelamer. Baseline CAC score was a significant predictor of mortality after adjustment for age, race, gender, and diabetes with increased mortality proportional to baseline score (P=0.002). Mortality was borderline significantly lower in subjects randomized to sevelamer (5.3/100 patient years, confidence interval (CI) (2.2-8.5) compared to those randomized to calcium-containing binders (10.6/100 patient years, CI 6.3-14.9) (P=0.05). The greater risk of death for patients treated with calcium-containing phosphate binders persisted after full multivariable adjustment (P=0.016, hazard ratio 3.1, CI 1.23-7.61). In subjects new to hemodialysis baseline CAC score was a significant predictor of all-cause mortality. Treatment with sevelamer was associated with a significant survival benefit as compared to the use of calcium-containing phosphate binders.


Decreased overall virulence in coinfected hosts leads to the persistence of virulent parasites.
Multiple infections are known to affect virulence evolution. Some studies even show that coinfections may decrease the overall virulence (the disease-induced mortality of a coinfected host). Yet, epidemiological studies tend to overlook the overall virulence, and within-host models tend to ignore epidemiological processes. Here, I develop an epidemiological model where overall virulence is an explicit function of the virulence of the coinfecting strains. I show that in most cases, a unique strain is evolutionarily stable (in accordance with the model I use here). However, when the overall virulence is lower than the virulence of each of the coinfecting strains (i.e., when coinfections decrease virulence), the evolutionary equilibrium may be invaded by highly virulent strains, leading to the coexistence of two strains on an evolutionary timescale. This model has theoretical and experimental implications: it underlines the importance of overall virulence and of epidemiological feedbacks on virulence evolution.


Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome - A challenging diagnosis not to be missed.
SAPHO syndrome manifests as chronic inflammation of bones and joints, which may or may not be accompanied by skin changes. The term SAPHO is an acronym that stands for synovitis, acne, pustulosis (usually palmoplantar), hyperostosis and osteitis. The bones most commonly affected are those in the anterior chest wall (mainly the sternum, clavicles and sternocostoclavicular joints), the vertebrae and the sacroiliac joints, but peripheral and flat bones may also be involved, especially in children. There are no validated diagnostic criteria for SAPHO, and diagnosis is based on clinical and radiological findings. One of the main challenges in diagnosis is that the clinical features may occur many years apart. Additionally, patients may not develop all manifestations. Delayed diagnosis, as a result of a lack of awareness of SAPHO, can lead to patients suffering ongoing pain and disfiguring skin manifestations. One theory is that Propionibacterium acnes (isolated from bone biopsies in many SAPHO patients) triggers an auto-immune mediated chronic inflammation in genetically predisposed individuals. Treatment involves the use of nonsteroidal anti-inflammatory drugs, intra-articular steroids, bisphosphonates and biologicals. The course of SAPHO is often prolonged but, despite the challenges in diagnosis and treatment, the long-term prognosis is good.


Guide for Nuclear Medicine Applications During the COVID-19 Outbreak.
A viral pneumonia rapidly spread from Wuhan, China to all countries in late 2019. In February 2020, WHO named as Coronavirus Disease 2019 (COVID-19) and declared the pandemic on March 11, 2020. To prevent the spread of COVID-19, Ministry of Health of Republic of Turkey and international institutions have published documents defining hygiene rules. After the lung computerized tomography (CT) findings which are important in the diagnosis of COVID-19 are described, protection measures against infection were defined in radiology departments. There is no publication involving protection measures for diagnostic and therapeutic procedures in nuclear medicine (NM) (appointment, patient acceptance, imaging and treatment procedures, disinfection etc). There are two reports on CT findings suggesting COVID-19 in 18F-fluorodeoxyglucose positron emission tomography/CT scan. These lung findings detected in hybrid images will be helpful in the early diagnosis of pulmonary involvement. Infected cases may be asymptomatic and can unintentionally disseminate the virus to surrounding people. This advisory guide has been prepared to avoid infection risk in NM clinics. During the COVID-19 outbreak, staff must use proper personal protective equipment and patients should be evaluated as the elective case according to clinical status. A questionnaire should be made for COVID-19. In cancer cases requiring urgent treatment, radionuclide treatment (RNT) should be planned according to the COVID-19 test result. If the result is negative, RNT can be applied; but if not or if the symptoms are present, RNT must be postponed. Following imaging procedures, scanners and room surfaces should be cleaned by personnel with proper disinfection training.


The Dualistic Effect of COX-2-Mediated Signaling in Obesity and Insulin Resistance.
Obesity and insulin resistance are two major risk factors for the development of metabolic syndrome, type 2 diabetes and associated cardiovascular diseases (CVDs). Cyclooxygenase (COX), a rate-limiting enzyme responsible for the biosynthesis of prostaglandins (PGs), exists in two isoforms: COX-1, the constitutive form, and COX-2, mainly the inducible form. COX-2 is the key enzyme in eicosanoid metabolism that converts eicosanoids into a number of PGs, including PGD2, PGE2, PGF2α, and prostacyclin (PGI2), all of which exert diverse hormone-like effects via autocrine or paracrine mechanisms. The COX-2 gene and immunoreactive proteins have been documented to be highly expressed and elevated in adipose tissue (AT) under morbid obesity conditions. On the other hand, the environmental stress-induced expression and constitutive over-expression of COX-2 have been reported to play distinctive roles under different pathological and physiological conditions; i.e., over-expression of the COX-2 gene in white AT (WAT) has been shown to induce de novo brown AT (BAT) recruitment in WAT and then facilitate systemic energy expenditure to protect mice against high-fat diet-induced obesity. Hepatic COX-2 expression was found to protect against diet-induced steatosis, obesity, and insulin resistance. However, COX-2 activation in the epidydimal AT is strongly correlated with the development of AT inflammation, insulin resistance, and fatty liver in high-fat-diet-induced obese rats. This review will provide updated information regarding the role of COX-2-derived signals in the regulation of energy metabolism and the pathogenesis of obesity and MS.


Radiation Enhances the Epithelial- Mesenchymal Transition of A549 Cells via miR3591-5p/USP33/PPM1A.
Radiotherapy plays a critical role in lung cancer treatment. Radiation can activate transforming growth factor-β (TGF-β) signaling and induce the epithelial-mesenchymal transition (EMT), which may lead to distant metastases. MicroRNAs (miRNAs) have been suggested to affect radiotherapy in lung cancer. miRNA Next-Generation Sequencing was performed to investigate the effects of irradiation on the miRNA profile of lung cancer A549 cells. The functions of identified miRNA on the radiation induced EMT and TGF-β activation in A549 cells were then explored. Protein expression was evaluated by western blotting. Immunofluorescence staining was performed to detect the localization of Snail. Luciferase Assay was used to determine the target gene regulated by the identified miRNA. Radiation time-dependently induced EMT in A549 lung cancer cells as indicated by the changes of morphology, the expression of EMT marker proteins (E-cadherin, α-SMA and Vimentin) and the nuclear localization of Snail. Moreover, miR-3591-5p was identified as the most significant increased miRNA in response to radiation, and further experiments indicated that miR-3591-5p was required for radiation induced EMT and TGF-β/ Smad2/3 activation. Ubiquitin Specific Peptidase 33 (USP33) was a downstream target of miR-3591-5p as predicted by TargetScan and validated by 3' untranslated regions (UTRs) Luciferase Assay. USP33 could deubiquitinate PPM1A (protein phosphatase, Mg2+/Mn2 + dependent 1A), a phosphatase for Smad2/3. Ectopic expression of USP33 or PPM1A partially abolished the effects of miR-3591-5p on EMT and TGF-β/ Smad2/3 activation. The present study revealed the critical role of miR-3591-5p/USP33/PPM1A in radiation-induced EMT via TGF-β signaling and may suggest novel radiation sensitise strategies for lung cancer.


Active and passive case detection strategies for the control of leishmaniasis in Bangladesh.
Two subdistricts in Bangladesh, Fulbaria and Trishal, which are hyperendemic for leishmaniasis. To determine 1) the numbers of patients diagnosed with visceral leishmaniasis (VL) and post-kala azar dermal leishmaniasis (PKDL) using an active case detection (ACD) strategy in Fulbaria and a passive case detection (PCD) strategy in Trishal, and 2) the time taken from symptoms to diagnosis in the ACD subdistrict. A cross-sectional descriptive study of patients diagnosed from May 2010 to December 2011. The ACD strategy involved community education and outreach workers targeting households of index patients using symptom-based screening and rK-39 tests for suspected cases. In the ACD subdistrict (Fulbaria) and PCD sub-district (Trishal), respectively 1088 and 756 residents were diagnosed with VL and 1145 and 37 with PKDL. In the ACD subdistrict, the median time to diagnosis for patients directly referred by outreach workers or self-referred was similar, at 60 days for VL and respectively 345 and 360 days for PKDL. An ACD strategy at the subdistrict level resulted in an increased yield of VL and a much higher yield of PKDL. As PKDL acts as a reservoir for infection, a strategy of ACD and treatment can contribute to the regional elimination of leishmaniasis in the Indian sub-continent.


Long-term outcomes of hepatocellular carcinoma that underwent chemoembolization for bridging or downstaging.
Prospective study of 200 patients with hepatocellular carcinoma (HCC) that underwent liver transplant (LT) after drug-eluting beads transarterial chemoembolization (DEB-TACE) for downstaging versus bridging. Overall survival and tumor recurrence rates were calculated, eligibility for LT, time on the waiting list and radiological response were compared. After TACE, only patients within Milan Criteria (MC) were transplanted. More patients underwent LT in bridging group. Five-year post-transplant overall survival, recurrence-free survival has no difference between the groups. Complete response was observed more frequently in bridging group. Patients in DS group can achieve post-transplant survival and HCC recurrence-free probability, at five years, just like patients within MC in patients undergoing DEB-TACE. To determine long-term outcomes of patients with HCC that underwent LT after DEB-TACE for downstaging vs bridging. Prospective cohort study of 200 patients included from April 2011 through June 2014. Bridging group included patients within MC. Downstaging group (out of MC) was divided in 5 subgroups (G1 to G5). Total tumor diameter was ≤ 8 cm for G1, 2, 3, 4 (n = 42) and was > 8 cm for G5 (n = 22). Downstaging (n = 64) and bridging (n = 136) populations were not significantly different. Overall survival and tumor recurrence rates were calculated by the Kaplan-Meier method. Additionally, eligibility for LT, time on the waiting list until LT and radiological response were compared. After TACE, only patients within MC were transplanted. More patients underwent LT in bridging group 65.9% (P = 0.001). Downstaging population presented: higher number of nodules 2.81 (P = 0.001); larger total tumor diameter 8.09 (P = 0.001); multifocal HCC 78% (P = 0.001); more post-transplantation recurrence 25% (P = 0.02). Patients with maximal tumor diameter up to 7.05 cm were more likely to receive LT (P = 0.005). Median time on the waiting list was significantly longer in downstaging group 10.6 mo (P = 0.028). Five-year post-transplant overall survival was 73.5% in downstaging and 72.3% bridging groups (P = 0.31), and recurrence-free survival was 62.1% in downstaging and 74.8% bridging groups (P = 0.93). Radiological response: complete response was observed more frequently in bridging group (P = 0.004). Tumors initially exceeding the MC down-staged after DEB-TACE, can achieve post-transplant survival and HCC recurrence-free probability, at five years, just like patients within MC in patients undergoing DEB-TACE.


Control of cardiac development by an evolutionarily conserved transcriptional network.
Formation of the heart is dependent on an intricate cascade of developmental decisions. Analysis of the molecules and mechanisms involved in the specification of cardiac cell fates, differentiation and diversification of cardiac muscle cells, and morphogenesis and patterning of different cardiac cell types has revealed an evolutionarily conserved network of signaling pathways and transcription factors that underlies these processes. The regulatory network that controls the formation of the primitive heart in fruit flies has been elaborated upon to form the complex multichambered heart of mammals. We compare and contrast the mechanisms involved in heart formation in fruit flies and mammals in the context of a network of transcriptional interactions and point to unresolved questions for the future.


Giant aneurysm of the ascending aorta.
An ascending aortic aneurysm is a rare entity. The authors encountered an 85-year-old female patient with an uncomplicated ascending aortic aneurysm measuring 9 cm in diameter. She underwent an urgent operation involving replacement of the ascending aorta. Postoperatively, she developed mild renal failure and atrial flutter requiring direct current cardioversion. However, further recovery was good. The authors present this case including the operative management and a brief overview of this rare condition to reiterate that with an ageing population, this procedure can be done with an acceptable morbidity.


Susac syndrome.
The objective of this study was to describe the clinical manifestations; radiographic, audiometric, and retinal fluorescein angiography findings; pathogenesis and treatment of Susac syndrome with review of the literature. We conducted a retrospective case review. This study was conducted at a tertiary referral center. A 50-year-old woman presented with recurrent episodes of neurologic symptoms, bilateral sensorineural hearing loss, and silent retinal artery occlusion. The patient underwent complete evaluation, including magnetic resonance image studies, audiometric tests, and retinal fluorescein angiography. She was treated initially with corticosteroids and later with other immunosuppressive agents. The patient was initially diagnosed with left sudden sensorineural hearing loss. Despite comprehensive clinical and laboratory studies that did not reveal systemic disease, 3 weeks later, the patient developed vertigo, sensorineural hearing loss, and tinnitus in the opposite ear. The neurologic involvement and the bilateral audiologic manifestations raised the possibility of Susac syndrome. Susac syndrome is a rare disorder of unknown origin characterized by the triad of encephalopathy, fluctuating hearing loss, and visual loss resulting from microangiopathy of the brain, cochlea, and retina. The multiple organ involvement seen in Susac syndrome raises a differential diagnosis ranging from autoimmune disease, through systemic vasculitis, to multiple sclerosis. Otolaryngologists should be aware of this syndrome as a result of the vestibulocochlear manifestations and the multidisciplinary evaluation that is required.


High-Pressure Phases of a S-Based Compound: Dimethyl Sulfide.
The high-pressure behavior of dimethyl sulfide was investigated at room temperature by Raman scattering measurements with pressures up to 30.1 GPa. Phase transitions at 1.3, 3.6-5.8, and 17.2 GPa were found and evidenced by the frequency shifts, pressure coefficients, and changes in fwhm of related modes. These phase transitions were suggested to result from the changes in the inter- and intramolecular bonding of the material. Interestingly, the CH3 groups was compelled to be frozen in positions at a relatively low pressure, suggested by the disappearance of the relative modes softening. In addition, the appearance of lattice mode can also be found at a modest pressure, which makes it possible to gain a superiority for this compound to further investigate the superconductivity with high transition temperatures of bulk hydrogen.


The genetics of ovarian cancer: molecular biology and clinical application.
Ovarian cancer is the fifth most common malignancy among American women and the fourth leading cause of cancer death. The rapid advances in molecular genetic analysis, presymptomatic detection, and treatment of ovarian cancer are staggering. In this review, both the genetic component and the molecular biology of ovarian cancer are discussed, as well as current recommendations for genetic counseling. It is important for the practicing obstetrician and gynecologist to become familiar with these concepts, for it is he or she who will likely serve as a primary resource of information for these patients.


The clinical dilemma of "silent desensitization" in aspirin-exacerbated respiratory disease.
Aspirin desensitization is a treatment option for patients with aspirin-exacerbated respiratory disease (AERD). Some patients with an excellent history of aspirin or nonsteroidal anti-inflammatory drug (NSAID) reactions have negative aspirin challenges/desensitization. This study discusses the clinical entity of silent desensitization in AERD and the dilemma that this presents to the practicing allergist/immunologist. We discuss a series of patients with a strong history of NSAID reactions who initially underwent a negative challenge/silent desensitization. These patients were subsequently proven to have AERD after a second positive aspirin challenge. Silent desensitization is an uncommon but important outcome to recognize in AERD. Clinicians performing aspirin desensitization should understand that this can occur and consider a second confirmatory aspirin challenge in some patients.


210Polonium bioaccessibility assessment in algae for human consumption: An in vitro gastrointestinal digestion method.
The occurrence and mobility of natural radioactive element as 210Polonium (210Po) in 13 commercial algae consumed in Italy by humans were determined because the effects on human health need to take into account the bioavailability of these elements. The simulation of gastrointestinal (GIT) digestion was divided into three stages and was accomplished using three different artificial solutions: saliva, gastric, and synthetic bile-pancreas solution. The same sample was treated in two different ways: a) only gastric digestion and b) complete GIT digestion (gastric digestion followed by bile-pancreas solution). The difference between Po gastric mobility with respect to that found for GIT digestion was not significant; in fact, Po mobility exhibited a mean value 17.2 ± 15.1% and 19.5 ± 11.5% for gastric and GIT digestion, respectively.


Improvements to a cryosystem to observe ice nucleating in a variable pressure scanning electron microscope.
The variable pressure scanning electron microscope (VPSEM) has expanded the scope of the SEM to allow the imaging of dynamic, electrically insulating systems. The use of water vapor as the imaging gas present in the chamber allows the successful imaging of hydrated samples. As awareness of the system capabilities becomes more well known, greater pressure has been put onto the microscopist to push the boundaries of both temperature and resolution for the study of diverse hydrated samples whose dynamics may not occur at the usual room temperatures in a VPSEM. In this article we discuss the stages in the development of a cryosystem that has led to the successful observation of the nucleation of ice from a solution in situ. This investigation also leads to further possibilities of imaging hydrated samples in the little explored temperature range of 188-238 K (from -85 to-35 degrees C). This study includes the exploration of how the temperature of various surfaces inside the microscope will change the system's ability to keep a sample hydrated or in its native state.


Alignment of the aberration-free XUV Raman spectrometer at FLASH.
An extreme-ultraviolet (XUV) double-stage Raman spectrometer is permanently installed as an experimental end-station at the PG1 beamline of the soft X-ray/XUV free-electron laser in Hamburg, FLASH. The monochromator stages are designed according to the Czerny-Turner optical scheme, adapted for the XUV photon energy range, with optical elements installed at grazing-incidence angles. Such an optical scheme along with the usage of off-axis parabolic mirrors for light collimation and focusing allows for aberration-free spectral imaging on the optical axis. Combining the two monochromators in additive dispersion mode allows for reaching high resolution and superior stray light rejection, but puts high demands on the quality of the optical alignment. In order to align the instrument with the highest precision and to quantitatively characterize the instrument performance and thus the quality of the alignment, optical laser interferometry, Hartmann-Shack wavefront-sensing measurements as well as off-line soft X-ray measurements and extensive optical simulations were conducted. In this paper the concept of the alignment scheme and the procedure of the internal optical alignment are presented. Furthermore, results on the imaging quality and resolution of the first monochromator stage are shown.


Support for the use of objective comorbidity indices in the assessment of noncancer death risk in prostate cancer patients.
Prostate cancer management involves a balance between the risks of cancer death against those from other causes. To evaluate the performance of several comorbidity indices in predicting comorbid death in a prostate cancer radiotherapy cohort. 2,131 men with localised prostate cancer treated with radical radiotherapy between 1999 and 2007 were studied. Tumour features, androgen deprivation usage, age, number of prescription medications (PMN) and Adult Comorbidity Evaluation-27 Index (ACE-27) were recorded. Death from prostate cancer (DPC) and death from other causes (DOC) were analysed as competing causes of death using a competing risks model, with discrimination assessed using the concordance index. ACE-27 scores correlated with patient's PMN (median PMN = 2). Tumour features were independent of ACE-27 scores. Estimated cumulative incidences of DOC and DPC at 10 years were 16.4% and 7.7% respectively. In the low/intermediate risk group (n = 1026) there was a 3.4-fold predominance of DOC inside 10 years (cumulative incidence: 15.8% DOC vs 3.4% DPC). High-risk men had approximately equal rates of DPC and DOC at 10 years. Multivariable analysis showed age, ACE-27 score ≥ 1 and PMN to have significant associations with DOC (P < 0.002 for all). A multivariable model incorporating all 3 variables resulted in C-Index = 0.646. Age, ACE-27 score and PMN act as independent prognostic factors for DOC in prostate cancer patients and can improve patient's life expectancy prediction.


What are the ideal screw lengths in volar locking plate fixation for distal radius fractures?
This study aimed to specify the optimal lengths of the distal locking screws (in a female population undergoing distal radius fracture fixation with a volar locking plate) to avoid damaging the dorsal extensor tendon compartments while preserving stability. Twenty-five female adult patients underwent volar locking plate fixation with four 2.4 mm locking screws inserted distally. Our modified dorsal tangential fluoroscopic view (DTV) was taken perioperatively followed by postoperative CT scans to compare the accuracy in determining the distal screw lengths. Our modified DTV was 88 %, 84 %, 88 %, and 76 % sensitive in detecting screw lengths in the first, second, third, and fourth distal plate holes, respectively. According to the CT scans, none of the screws were over-penetrated in the third dorsal compartment, over-penetration was found in the second and fourth dorsal compartment. The most-accurate screw lengths in the four most distal plate holes in female distal radius fracture are 14, 20, 20, and 20 mm from the radial to the ulnar aspect. In dorsal cortex comminution, when perioperative measuring is imprecise, inserting the most-suitable distal locking screw for problematic hole and then applying our modified DTV seems to be a simpler and safer option (Tab. 3, Fig. 4, Ref. 33).


Crosstalk between Epigenetic Modulations in Valproic Acid Deactivated Hepatic Stellate Cells: An Integrated Protein and miRNA Profiling Study.
Reverting activated hepatic stellate cells (HSCs) to less activation or quiescent status is a promising strategy for liver fibrosis. Histone deacetylase inhibitor (HDACI) could suppress HSCs activation. Our previous study demonstrated a critical role of miRNAs in HSCs activation. Here, we explored the involvement of miRNAs in HDACI induced HSCs deactivation. Human cell line LX2 that resembled activated HSCs was treated with an HDACI - valproic acid (VPA). The effects of VPA on the protein and miRNA profile of LX2 were comprehensively analyzed by iTraq quantitative proteomics and miRNA microarray. The interaction between miRNA and proteins was investigated systematically. The biofunctions of differentially expressed proteins and miRNA targeted proteins were annotated. VPA treatment attenuated the activation phenotype of LX2. In VPA treated LX2, among 1548 quantified proteins, only 86 proteins were differentially expressed (VPA-proteins). While among 282 high-abundance miRNAs, 123 were differentially expressed (VPA-miRNAs), with 104 down-regulated and 19 up-regulated. The top biofunctions of VPA-proteins were closely related to HSCs activation, including cell death and survival, cell movement, cellular growth and proliferation. Furthermore, 22 out of the 36 VPA-proteins involved in cell death and survival, and 19 out of the 30 VPA-proteins involved in cellular movement were predicted targets of VPA-miRNAs. A direct regulatory effect of histone acetylation on miRNA expression was also established. In conclusion, our data provided the molecular mechanisms for VPA induced HSCs deactivation at the protein level and suggested crosstalk between histone acetylation and miRNAs in the inhibitory effects of HDACI on HSCs activation.


A new antifungal antibiotic, trichostatin.
A new antibiotic, trichostatin, was isolated from the metabolites of strains of Streptomyces hygroscopicus. It is active against trichophytons and some fungi. The structure was determined to be a derivative of a primary hydroxamic acid by chemical and spectroscopic evidences.


Prevalence of the NTEKPC-I on IncF Plasmids Among Hypervirulent Klebsiella pneumoniae Isolates in Jiangxi Province, South China.
Infection caused by carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) has become a tricky health care threat in China and KPC-2 enzyme is a main factor mediating resistance to carbapenems of K. pneumoniae. Here, we report the characterization of the genetic environment of the blaKPC-2 gene in CR-hvKP clinical isolates from South China. Forty-five non-duplicated CR-hvKP isolates collected in Jiangxi Province from 2018 to 2019 were analyzed. Each of them were multidrug-resistant due to the presence not only of blaKPC-2 gene but also of other resistance determinants, including Metallo-β-lactamases (NDM-1), extended-spectrum β-lactamases (TEM-1, CTX-M-14, SHV-1), and plasmid-mediated quinolone resistance determinants (qnrS, aac(6')-Ib-cr). After plasmid analyses of PCR-based replicon typing (PBRT), mapping PCR, amplicon sequencing, and whole-genome sequencing (WGS) were used to analyze the genetic environment of the blaKPC-2 gene. PCR analysis of pLVPK-like plasmids, Southern Blot, and mouse lethality assay were used to characterize the virulence phenotype of K. pneumoniae. Multilocus sequence typing (MLST) analysis showed ST11 CR-hvKP was the predominant clone. In conclusion, this is the first analysis of diverse genetic structures blaKPC-2 gene in CR-hvKP isolates from south China. Both the NTEKPC-I on the IncF plasmids and pLVPK-like virulence plasmids make contributions to the formation of CR-hvKP especially ST11 which need more attention.


Enhanced Dissipation of Triazole and Multiclass Pesticide Residues on Grapes after Foliar Application of Grapevine-Associated Bacillus Species.
Disease management in vineyards with fungicides sometimes results in undesirable residue accumulations in grapes at harvest. Bioaugmentation of the grape fructosphere can be a useful approach for enhancing the degradation rate and reducing the residues to safe levels. This paper reports the in vitro and in vivo biodegradation of three triazole fungicides commonly used in Indian vineyards, by Bacillus strains, namely, DR-39, CS-126, TL-171, and TS-204, which were earlier found to enhance the dissipation rate of profenophos and carbendazim. The strains utilized the triazoles as carbon source and enhanced their in vitro rate of degradation. Myclobutanil, tetraconazole, and flusilazole were applied in separate vineyard plots at field doses of 0.40 g L(-1), 0.75 mL L(-1), and 0.125 mL L(-1), respectively. Residue analysis of field samples from the treated fields reflected 87.38 and >99% degradations of myclobutanil and tetraconazole, respectively, by the strain DR-39, and 90.82% degradation of flusilazole by the strain CS-126 after 15-20 days of treatment. In the respective controls, the corresponding percent degradations were 72.07, 58.88, and 54.28, respectively. These Bacillus strains could also simultaneously degrade the residues of profenofos, carbendazim, and tetraconazole on the grape berries and can be useful in multiclass pesticide residue biodegradation.


THE GENETIC ARCHITECTURE OF PLASTICITY TO DENSITY IN IMPATIENS CAPENSIS.
Plant responses to crowding may be mediated by resource availability and/or by a specific environmental cue, the ratio of red:far red wavelengths (R:FR) perceived by phytochrome. This study examined the contribution of phytochrome-mediated photomorphogenesis to genetic variation in plastic responses to density in the annual plant Impatiens capensis. Inbred lines derived from open and woodland populations were grown under low density high density, and high density with selective removal of FR wavelengths to block phytochrome-mediated perception of neighbor proximity. Genetic variation in plasticity to density and to the R:FR cue was detected for several traits Plants grown at high density displayed increased internode elongation; decreased branch, flower, and node production; increased menstem dormancy; and decreased leaf area and specific leaf weight compared to plants grown at low density. Stem elongation responses to density were suppressed when phytochrome perception was blocked at high density. For these phytochrome-mediated traits, a genotype's plasticity to density was strongly correlated with its response to R:FR. Phytochrome-mediated traits were tightly correlated with one another, regardless of the density environment. However, the responses to density of meristem allocation to branching and leaf traits were less strongly phytochrome-mediated. These traits differed in patterns of plasticity, and their genetic correlations often differed across environments. In particular, genetic trade-offs involving meristem allocation to branching were expressed only at low density. The observed density dependence of phenotypic and genetic correlations implies that indirect selection and the potential for correlated response to selection will depend upon the competitive environment. Thus the differential sensitivity of characters to the R:FR cue can influence the evolution of integrated plastic responses to density.


Immune reconstitution: the foundation for safe living after an allogeneic hematopoietic stem cell transplantation.
With increasing frequency, oncology nurses are providing long-term care to hematopoietic stem cell transplantation (HSCT) recipients in nontransplantation settings. This may be a result of more patients receiving HSCTs, recipients living longer, and recipients' desire to return to their hometowns as soon as possible. Although critical to patients' initial recovery after HSCT, immune reconstitution also must remain a priority of oncology nursing care long beyond the date of discharge from a transplantation center. As patients resume their normal lives, oncology nurses need to be diligent in assessment and education to facilitate the ultimate goal, a safe life after HSCT. This article provides concise details about the short- and long-term immunologic effects of HSCT and focuses on the long-standing threat of opportunistic infections that can persist months and years after HSCT.


Multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis: epidemiology and control.
The emergence of multidrug-resistant (MDR)-TB and, more recently, of extensively drug-resistant (XDR)-TB is a real threat to achieve TB control and elimination. Over 400,000 new cases of MDR-TB occur each year and, although their number is currently unknown, XDR cases are recognized in every setting where there has been the capacity to detect them. The long-term vision for the full control of MDR-TB requires the scaling-up of culture and drug-susceptibility testing capacity, which is very limited in disease-endemic countries, and the expanded use of high-technology assays for rapid determination of resistance. MDR cases are treatable and well designed regimens, largely based on second-line anti-TB drugs, can considerably improve cure rates. However, treatment regimens need to be markedly improved through the introduction of less toxic and more powerful drugs, thus reducing duration of treatment and tolerability. This is of utmost importance for XDR-TB cases. The prevalence of MDR-TB and XDR-TB are inversely correlated with the quality of TB control and the proper use of second-line anti-TB drugs. Adherence to proper standards of care and control is imperative and a top priority of all TB control efforts. However, the risk of an uncontrollable epidemic of MDR- and XDR-TB is real considering current levels of financing and commitment to care.


Characterization of exoelectrogenic bacteria enterobacter strains isolated from a microbial fuel cell exposed to copper shock load.
Microorganisms capable of generating electricity in microbial fuel cells (MFCs) have gained increasing interest. Here fourteen exoelectrogenic bacterial strains were isolated from the anodic biofilm in an MFC before and after copper (Cu) shock load by Hungate roll-tube technique with solid ferric (III) oxide as an electron acceptor and acetate as an electron donor. Phylogenetic analysis of the 16S rRNA gene sequences revealed that they were all closely related to Enterobacter ludwigii DSM 16688T within the Enterobacteriaceae family, although these isolated bacteria showed slightly different morphology before and after Cu shock load. Two representative strains R2B1 (before Cu shock load) and B4B2 (after Cu shock load) were chosen for further analysis. B4B2 is resistant to 200 mg L-1 of Cu(II) while R2B1 is not, which indicated the potential selection of the Cu shock load. Raman analysis revealed that both R2B1 and B4B2 contained c-type cytochromes. Cyclic voltammetry measurements revealed that strain R2B1 had the capacity to transfer electrons to electrodes. The experimental results demonstrated that strain R2B1 was capable of utilizing a wide range of substrates, including Luria-Bertani (LB) broth, cellulose, acetate, citrate, glucose, sucrose, glycerol and lactose to generate electricity, with the highest current density of 440 mA·m-2 generated from LB-fed MFC. Further experiments indicated that the bacterial cell density had potential correlation with the current density.


Diplotriaena-An Air Sac Nematode Found in a New Holland Honeyeater (Phylidonyris novaehollandiae).
A New Holland honeyeater (Phylidonyris novaehollandiae), a common species found mostly in the southern parts of Australia, was examined after a presumed traumatic incident but died several hours after presentation. At necropsy, a Diplotriaena nematode was found in a cranial air sac. Although no obvious gross pathologic changes were attributed to the nematode, histologic changes of bronchial epithelial hyperplasia and goblet cell metaplasia, consistent with chronic airway irritation were found in the lungs associated with Diplotriaena eggs. Diplotriaena species are parasitic nematodes found in the air sacs of birds. These parasites have an indirect life cycle; larval stages develop in insects, and when eaten by the host, these larvae migrate to the air sac and become adults. Although Diplotriaena species have been found in birds worldwide, none, to our knowledge, have previously been described in New Holland honeyeaters.


Mucinous cystadenocarcinoma of ovary with metastasis in 14-year-old girl.
Ovarian mucinous tumors in <15 years old are rare with <50 cases reported till date in the literature. Majority of them are benign or borderline epithelial ovarian tumors with only 12 cases of cystadenocarcinomas reported at a young age. We report a case of mucinous cystadenocarcinoma in 14-year-old girl with metastasis to omentum at the time of presentation. Management of such cases is tricky as conservative approach sparing fertility of the patient is adopted. This case is presented for its rarity and unique presentation. To the best of our knowledge, this is the thirteenth case of ovarian cystadenocarcinoma being reported at a very young age and the first case being reported from Indian subcontinent. Extensive review of the previously published cases in the literature has been done in this study.


Acute leukemia in Malaysian children.
A review of acute childhood leukemia in the University Hospital, Kuala Lumpur reveals no significant differences in either the epidemiological or clinical features between Malaysian and Caucasian children. BCG does not appear to have conferred any protection against the occurrence of leukemia. With the introduction of total therapy 4 of 10 patients with good prognostic features and 3 of 15 patients with poor prognostic features have survived 3 years. Prognosis appears to correlate with adopted clinical criteria.


Medication reconciliation matters.
Medication reconciliation is a powerful and effective tool in the fight against preventable ADEs. Consequently, it is a focus of national patient safety and health care organization initiatives. Nurses need to understand the requirements and actively support the process as the right thing to do for their patients.


Longitudinal Associations Between Respiratory Infections and Asthma in Young Children.
We examined temporal dependencies between repeated assessments of respiratory tract infections (RTIs) and asthma in children in the Leicester Respiratory Cohort, Leicestershire, United Kingdom. Information associated with asthma (i.e., doctor diagnosis, health care visits, wheeze frequency) and RTIs (i.e., cold duration and frequency, cough with colds, ear infections) in the previous 12 months was assessed repeatedly at ages 1, 4, and 6 years for children born between April 1996 and April 1997. We determined associations between contemporaneous and lagged measures of asthma and RTIs, using structural equation modelling. In 1,995 children, asthma was positively associated with contemporaneous infections. Asthma at age 6 years was positively associated with asthma at age 4 years (regression coefficient = 0.87; 95% confidence interval (CI): 0.76, 0.97), but not with asthma at age 1 year (regression coefficient = -0.01; 95% CI: -0.14, 0.11). We found no evidence for direct protective effect of infections at age 1 year on asthma either at age 4 (regression coefficient = -0.20; 95% CI: -0.51, 0.10) or 6 (regression coefficient = 0.24; 95% CI: -0.04, 0.52) years. Adjusting for potential confounders did not qualitatively change those relationships. Based on our findings, we suggest that asthma at age 6 years is directly influenced by asthma history and only indirectly, if at all, by earlier infection episodes. We found little support for a protective effect of preschool infections on asthma at early school age.


Central, but not basolateral, amygdala involvement in the anxiolytic-like effects of midazolam in rats in the elevated plus maze.
The role of the amygdala in the mediation of fear and anxiety has been extensively investigated. However, how the amygdala functions during the organization of the anxiety-like behaviors generated in the elevated plus maze (EPM) is still under investigation. The basolateral (BLA) and the central (CeA) nuclei are the main input and output stations of the amygdala. In the present study, we ethopharmacologically analyzed the behavior of rats subjected to the EPM and the tissue content of the monoamines dopamine (DA) and serotonin (5-HT) and their metabolites in the nucleus accumbens (NAc), dorsal hippocampus (DH), and dorsal striatum (DS) of animals injected with saline or midazolam (20 and 30 nmol/0.2 µL) into the BLA or CeA. Injections of midazolam into the CeA, but not BLA, caused clear anxiolytic-like effects in the EPM. These treatments did not cause significant changes in 5-HT or DA contents in the NAc, DH, or DS of animals tested in the EPM. The data suggest that the anxiolytic-like effects of midazolam in the EPM also appear to rely on GABA-benzodiazepine mechanisms in the CeA, but not BLA, and do not appear to depend on 5-HT and DA mechanisms prevalent in limbic structures.


An Inter-Ethnic Comparison Study of Ziprasidone Plasma Levels, Dosage and Clinical Response in Patients with Schizophrenia.
The aim of this study was to investigate ziprasidone plasma concentration, daily dose and clinical efficacy and safety in Han Chinese and Mongolian patients with first-episode schizophrenia. A total of 123 inpatients affected by schizophrenia were recruited from the Mental Health Center of Inner Mongolia in China. Ziprasidone plasma concentration, clinical efficacy and side effects were systematically evaluated at baseline, and at 1, 2, 4, and 6 weeks. Metabolic measures such as changes in weight, body mass index (BMI), fasting blood glucose (FBG), triglycerides, and cholesterol, were also recorded. 90 patients completed the study. Compared with Han patients, on average, Mongolian patients received a significantly higher ziprasidone dosage for adequate symptom control during the 6-week period and had a lower plasma concentration-to-dose ratio. The Mongolian patients also experienced greater increases in weight and BMI. No significant differences between the two ethnic groups were found in the rate of reduction in the Positive and Negative Syndrome Scale (PANSS) score, Treatment Emergent Symptom Scale (TESS) total score, FBG, triglycerides, cholesterol or Q-Tc interval. Compared to Han Chinese patients, Mongolian patients appeared to have increased ziprasidone clearance and require higher doses to achieve effective treatment for schizophrenia.


Hydrolysis of the potato glycoalkaloid alpha-chaconine by filamentous fungi.
Three strains of filamentous fungi have been isolated from potato sprouts to obtain an enzyme degrading the glycoalkaloids. All of the strains hydrolyzed alpha-chaconine and not alpha-solanine when grown on the sprouts. From strain HP341, identified as Plectosphaerella cucumerina, the enzyme hydrolyzing alpha-chaconine was purified on columns of DEAE-Toyopearl and Phenyl-Toyopearl. The partially purified enzyme hydrolyzed alpha-chaconine to beta1-chaconine but not to beta2- or gamma-chaconine, suggesting that the enzyme is a rhamnosidase specific for the hydrolysis of the rhamnose (C1-C4) glucose linkage in alpha-chaconine. Conversion of alpha-chaconine to beta1-chaconine may be the first step of detoxification for filamentous fungi to grow on potato sprouts that accumulated antifungal alpha-chaconine.


Micro-metastases into the uterine leiomyoma from invasive ductal breast cancer under adjuvant tamoxifen therapy: case report.
Metastasis of breast cancer to the uterus is extremely rare. However, breast cancer is the leading tumor metastasizing from extragenital organs to the uterus. The most common signs of uterine metastasis are bleeding and mass effect. Tamoxifen use is known to increase risk of endometrial cancer. Immunohistochemical staining with GCDFP can be useful in differentiating primary uterine tumors from breast cancer metastasis. Metastasis to the uterus has been reported to worsen the prognosis. Although hysterectomy has been effective on survival, treatment modality to be used in the presence of other systemic metastases is not clear. Locoregional treatments can be used in oligometastatic cases. In addition, removal of solitary organ metastasis together with bone metastasis provides improvement in survival.


What parents want to know.
Parents have specific ideas and concerns that are important when developing consumer-oriented child health care services. Some child health clinics are encouraging families and children to assume active responsibilities for their health care. Parents identify how they would like to receive information about their children and families and what specific information they need. Most of parents' concerns are normal developmental concerns. These concerns must be addressed so that parents can get on with parenting. The key is identifying parents' concerns and then addressing those concerns through a mechanism that parents will utilize.


Role of curvature elasticity in sectorization and ripple formation during melt crystallization of polymer single crystals.
The present article focuses on theoretical elucidation of possible effect of mechanical deformation on spatio-temporal emergence of unusual polymer morphology subjected to quiescent isothermal crystallization conditions. The present theory developed is based on a phase field model consisted of non-conserved time dependent Ginzburg-Landau equation having an asymmetric double well potential in the crystal order parameter signifying metastability for crystallization, coupled with the chain tilt angle involving curvature elasticity and strain recovery potentials. Under quiescent crystallization conditions, the curvature elasticity term is needed to discern the emergence of sectorized single crystals. Upon coupling with the strain recovery potential, the numerical calculation captures ripple formation running across the long lamellar growth front, which may be attributed to lamellar buckling caused by the volume shrinkage. Of particular interest is that these simulated topologies of the single crystals are in good accord with the growth character of syndiotactic polypropylene single crystals observed experimentally by us during isothermal crystallization from the melt.


Pupal behavior emerges from unstructured muscle activity in response to neuromodulation in Drosophila.
Identifying neural substrates of behavior requires defining actions in terms that map onto brain activity. Brain and muscle activity naturally correlate via the output of motor neurons, but apart from simple movements it has been difficult to define behavior in terms of muscle contractions. By mapping the musculature of the pupal fruit fly and comprehensively imaging muscle activation at single-cell resolution, we here describe a multiphasic behavioral sequence in Drosophila. Our characterization identifies a previously undescribed behavioral phase and permits extraction of major movements by a convolutional neural network. We deconstruct movements into a syllabary of co-active muscles and identify specific syllables that are sensitive to neuromodulatory manipulations. We find that muscle activity shows considerable variability, with sequential increases in stereotypy dependent upon neuromodulation. Our work provides a platform for studying whole-animal behavior, quantifying its variability across multiple spatiotemporal scales, and analyzing its neuromodulatory regulation at cellular resolution.


Acute Subdural Haemorrhage as a Complication of Diagnostic Lumbar Puncture.
Lumbar puncture (LP) is done daily for both spinal anesthesia and emergency cases for cerebrospinal fluid (CSF) analysis. Subdural hemorrhage (SDH) is a rare but severe complication following diagnostic LP, which could be potentially fatal, and early diagnosis may be life-saving. We present a 28-year-old female patient who presented to our emergency department with a headache, fever, and vomiting, with normal initial laboratory and imaging. Diagnostic lumbar puncture was done to exclude central nervous system infection. After CSF results and cultures were negative, and nasal influenza B detected, medication was started and she was discharged home. Three days post-procedure, she was complaining of a severe, persistent headache and a head computed tomography (CT) was done, which revealed acute SDH. Extensive workup searching for the cause of SDH was negative, and with a stationary course of SDH, she has discharged home again with a diagnosis of SDH post LP complication. In conclusion, a headache post LP is common and usually benign and self-limited. Severe persistent headache that is not positional and doesn't respond to analgesics with caffeine should be considered a red flag after LP and should be investigated carefully for other possibilities such as SDH.


Pine processionary caterpillar Thaumetopoea pityocampa envenomation in 109 dogs: A retrospective study.
Contact with the caterpillars of the pine processionary moth (CPPM) Thaumetopoea pityocampa induces severe local allergic reactions. The purpose of this large-scale retrospective cohort-study was to describe the clinical manifestations and related risk factors of CPPM exposure. This cohort-study included 109 dogs between the years of 2000 and 2016. Tongue lesions ranging from oedema to severe necrosis were observed in 94/109 dogs (86%). The following systemic signs were observed in 60/109 dogs (55%): vomiting (52/109, 48%), dyspnoea (6/109, 5%), hypovolemia (4/109, 4%) and diarrhoea (2/109, 2%). Based on the time elapsed from CPPM contact to the first oral flushing, three groups were defined: <2 h (group 1, 37/105, 35%), 2 h-6 h (group 2, 39/105, 37%) and >6 h (group 3, 29/105, 28%). Tongue necrosis (TN) at admission was significantly more common in the dogs in group 3 than those in groups 1 and 2 (45% vs. 5% and 5% respectively, p = 0.0002). In addition, the development of TN during hospitalisation was significantly more common in the dogs in group 3 (65%) than in those in the other groups (21% in group 1, p = 0.02) and 31% in group 2, p = 0.001). The dogs in group 3 presented a 14.63-fold higher risk of TN at admission and a 3.78-fold higher risk of developing necrosis during hospitalisation compared with the other groups. The survival rate after exposure was 97%. Long-term follow-up data were available for 69/109 dogs (63%). Twenty-three dogs (37%) had persistent, definitive TN without major consequences on quality of life. Elapsed time between contact and first oral flushing appears to be a key determinant for the progression of necrotic lesions, and the best results were observed when flushing occurred within 6 h of contact. The prognosis of CPPM envenomation is excellent, with a short hospitalisation duration.


Irritable bowel syndrome - The role of complementary medicines in treatment.
Irritable bowel syndrome (IBS) is a common gut problem that interferes with many people's enjoyment of life. Irritable bowel syndrome (IBS) is a common gut problem that interferes with many people's enjoyment of life. The underlying pathophysiology of IBS is not yet fully understood. People's experience of IBS can fluctuate over time and various bowel symptoms may predominate. Many complementary medicines are used to treat IBS symptoms. Currently there is good evidence to recommend the use of probiotics, peppermint oil capsules and psyllium. Other therapies such as Chinese and Ayuvedic herbs and psychological techniques look promising, but further high quality trials are required before these approaches can be recommended.


Effect of 1-year dairy product intervention on fat mass in young women: 6-month follow-up.
Previous results from this laboratory suggest that a 1-year dairy intake intervention in young women does not alter fat mass. The objective of this study was to determine the impact of the 1-year dairy intervention 6 months after completion of the intervention. Previously, normal-weight young women (n = 154) were randomized to one of three calcium intake groups: control (<800 mg/d), medium dairy (1000 to 1100 mg/d), or high dairy (1300 to 1400 mg/d) for a 1-year trial (n = 135 completed). In the current study, 51 women were assessed 6 months after completion of the intervention trial. Body compositions (body fat, lean mass) were measured using DXA. Self-report questionnaires were utilized to measure activity and dietary intake (kilocalories, calcium). The high-dairy group (n = 19) maintained an elevated calcium intake (1027 +/- 380 mg/d) at 18 months compared with the control group (n = 18, 818 +/- 292; p = 0.02). Mean calcium intake over the 18 months predicted a negative change in fat mass (p = 0.04) when baseline BMI was controlled in regression analysis (model R(2) = 0.11). 25-Hydroxyvitamin D levels were correlated with fat mass at each time-point (baseline, r = -0.41, p = 0.003; 12 months, r = -0.42, p = 0.002; 18 months, r = -0.32, p = 0.02) but did not predict changes in fat mass. Dietary calcium intake over 18 months predicted a negative change in body fat mass. Thus, increased dietary calcium intakes through dairy products may prevent fat mass accumulation in young, healthy, normal-weight women.


Germline mutation analysis in the CYLD gene in Chinese patients with multiple trichoepitheliomas.
Trichoepithelioma is a benign neoplasm that primarily shows follicular germinative differentiation. Classic trichoepithelioma typically presents as a skin-colored papule or nodule on the face or upper trunk; lesions have a predilection for the nose. Trichoepithelioma can be sporadic or familial and solitary or multiple. Most previously reported multiple trichoepithelioma cases are familial, and germline CYLD mutations could be detected in some patients. We performed mutational analysis of the germline CYLD gene in 8 Chinese multiple trichoepitheliomas patients, 6 of which were sporadic cases. A heterozygous missense mutation (c.1112C>A) in the 9th exon of the CYLD gene was detected in some mother-daughter patients. However, the germline CYLD mutation could not be detected in the 6 non-familial cases. The results suggest that the pathogenesis of sporadic multiple trichoepitheliomas may differ from that of familial cases. Our findings also further confirmed the genetic heterogeneity of multiple trichoepitheliomas.


Circular Polarized Light Activated Chiral Satellite Nanoprobes for the Imaging and Analysis of Multiple Metal Ions in Living Cells.
Here, we construct a handedness-dependent circular polarized light (CPL)-activated chiral satellite assemblies formed from DNAzymes and spiny platinum modified with gold nanorods and upconversion nanoparticles (UCNPs), enabling the simultaneous quantitative analysis of multiple divalent metal ions in living cells. The chiral nanoprobes, in coordination with their corresponding divalent metal ions under 980 nm left circular polarized (LCP) light illumination, served as an in situ confocal bioimaging platform for the quantitation of the given intracellular metal ions. The limit of detection (LOD) of the chiral probes in living cells is 1.1 nmol/106 cells, 1.02 nmol/106 cells and 0.45 nmol/106 cells for Zn2+ , Mg2+ , and Cu2+ , respectively.


Huntingtin-associated protein 1 interacts with hepatocyte growth factor-regulated tyrosine kinase substrate and functions in endosomal trafficking.
Huntingtin-associated protein 1 (HAP1) is a novel protein of unknown function with a higher binding affinity for the mutant form of Huntington's disease protein huntingtin. Here we report that HAP1 interacts with hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs), a mammalian homologue of yeast vacuolar protein sorting protein Vps27p involved in the endosome-to-lysosome trafficking. This novel interaction was identified in a yeast two-hybrid screen using full-length Hrs as bait, and confirmed by in vitro binding assays and co-immunoprecipitation experiments. Deletion analysis reveals that the association of HAP1 with Hrs is mediated via a coiled-coil interaction between the central coiled-coil domains of both proteins. Immunofluorescence and subcellular fractionation studies show that HAP1 co-localizes with Hrs on early endosomes. Like Hrs, overexpression of HAP1 causes the formation of enlarged early endosomes, and inhibits the degradation of internalized epidermal growth factor receptors. Whereas overexpression of HAP1 does not affect either constitutive or ligand-induced receptor-mediated endocytosis, it potently blocks the trafficking of endocytosed epidermal growth factor receptors from early endosomes to late endosomes. These findings implicate, for the first time, the involvement of HAP1 in the regulation of vesicular trafficking from early endosomes to the late endocytic compartments.


Combining Diffusion-Weighted Imaging and T2-Weighted Imaging to Delineate Tumorous Tissue in Peritoneal Carcinomatosis: A Comparative Study with 18F-Fluoro-Deoxyglucose Positron Emission Tomography with Computed Tomography (FDG PET/CT).
BACKGROUND The high rate of malignancy of peritoneal carcinomatosis makes its accurate detection vital in treatment planning. The combination of anatomical and functional information, provided by T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), respectively, could potentially aid in the segmentation of tumors. The aim of this study was to compare the functional tumor volume estimated by a T2WI- and DWI-derived apparent diffusion coefficient (ADC) map, with metabolic tumor volume measured by 18F-fluoro-deoxyglucose positron emission tomography with computed tomography (FDG PET/CT). MATERIAL AND METHODS In 108 lesions from 108 patients with peritoneal carcinomatosis, gross tumor volume (GTV) was manually delineated on DWI. Within each region of interest, k-means clustering was used to exclude non-tumorous tissue from tumorous tissue. The high-cellularity tumor volume estimated from ADC (HCTVADC) and combined high-cellularity tumor volume (HCTVC), which was estimated by combining anatomical information from T2WI and functional information from ADC, were generated. Taking metabolic tumor volume (MTV) in PET/CT as a reference, GTV, HCTVADC, and HCTVC were compared with MTV. RESULTS GTV (P=0.017) and HCTVADC (P=0.048) differed significantly from MTV. However, the HCTVC measured by combining DWI and T2WI showed high concordance (ICC=0.99) with the MTV measured by FDG PET/CT in differentiating tumorous tissues with high cellularity from non-tumorous tissues. CONCLUSIONS In conclusion, our results suggested the potential value of this semiautomatic method serving as an alternative to PET/CT in radiotherapy tumor contouring.


Rituximab in combination with platinum-containing chemotherapy in patients with relapsed or primary refractory diffuse large B-cell lymphoma.
The aim of the study was to evaluate the efficacy of a regimen consisting of rituximab and a platinum-containing chemotherapy with either Ifosfamide, Carboplatin and Etoposide (ICE) or Cisplatin, high-dose Ara-C and Dexamethasone (DHAP) in patients with relapsed or primary refractory diffuse large B-cell lymphoma. Ten patients with relapsed or primary refractory diffuse large B-cell lymphoma were treated from June 2000 until May 2001 with a platinum-containing chemotherapy regimen according to the ICE- or DHAP-protocol in combination with rituximab at the University of Muenster. Two cycles of ICE or DHAP and rituximab were given. In case of at least a minor response after 2 cycles, 2 additional cycles of the same combination were applied. Response rate, remission duration and duration of survival were evaluated. All 10 patients could be analysed with respect to these endpoints. No treatment related mortality was observed. The response rate (CR/PR) was 60% (10/50%). Twenty percent of the patients had progressive disease. The median duration of remission and survival was 3 and 3.5 months, respectively (range: 1-6 and 1-7 months, respectively), the survival rate was 10%. Eight of 10 patients died because of their underlying disease with short remission duration, 1 patient died of complications of allogeneic transplantation in CR. In conclusion, the combination of platinum-containing chemotherapy (ICE or DHAP) with rituximab demonstrates significant activity in intensively pretreated patients with relapsed or primary refractory diffuse large B-cell lymphoma. Considering the short duration of remission and survival, respectively, other experimental therapeutic approaches (e.g. allogeneic stem cell transplantation, radioimmunotherapy) should be pursued following this treatment in order to induce long-term remission.


Therapeutic strategies in Parkinson's disease: what we have learned from animal models.
Parkinson's disease (PD), the second most common neurodegenerative disorder, is characterized by a loss of dopaminergic neurons in the substantia nigra, as well as in other brain areas. The currently available dopamine replacement therapy provides merely symptomatic benefit and is ineffective because habituation and side effects arise relatively quickly. Studying the genetic forms of PD in animal models provides novel insight that allows targeting of specific aspects of this heterogenic disease more specifically. Among others, two important cellular deficits are associated with PD; these deficits relate to (1) synaptic transmission and vesicle trafficking, and (2) mitochondrial function, relating respectively to the dominant and recessive mutations in PD-causing genes. With increased knowledge of PD, the possibility of identifying an efficient, long-lasting treatment is becoming more conceivable, but this can only be done with an increased knowledge of the specific affected cellular mechanisms. This review discusses how discoveries in animal models of PD have clarified the therapeutic potential of pathways disrupted in PD, with a specific focus on synaptic transmission, vesicle trafficking, and mitochondrial function.


[Monitored cicatrization].
Directed healing is a therapeutic process that Raymond Vilain conceived as a sequence of: cleaning, granulation and formation of the epidermis. He suggested, to aid healing, the use of sofra-tulle and washing with isotonic solution or tap water, we have added the use of a hair dryer, in order to decrease the exudation from the wound. Such directed healing is particularly of interest for the integument and is difficult to apply to such structures as fat, fibrous tissues, bone and cartilage, or nerves and vessels. The "star" of directed healing is the granulation tissue. If healthy, it will support progressive marginal formation of the epidermis if the loss of tissue is not too great; if this loss is extensive, a graft will easily take on top of the layer of granules. If abnormal, the granules will lack tone. Healing will have to be renewed by appropriate treatment. We are all programmed to heal, except if we hinder the process by technical and psychological errors.


Is a delay in the diagnosis of bipolar disorder inevitable?
A diagnosis of bipolar disorder (BD) is often preceded by an initial diagnosis of depression, creating a delay in the accurate diagnosis and treatment of BD. Although previous research has focused on predictors of a diagnosis change from depression to BD, the research on this delay in diagnosis is sparse. Therefore, the present study examined the time taken to make a BD diagnosis following an initial diagnosis of major depressive disorder in order to further understand the patient characteristics and psychological factors that may explain this delay. A total of 382 patients underwent a clinical evaluation by a psychiatrist and completed a series of questionnaires. Ninety patients were initially diagnosed with depression with a later diagnosis of BD, with a mean delay in diagnostic conversion of 8.74 years. These patients who were later diagnosed with BD were, on average, diagnosed with depression at a younger age, experienced more manic symptoms, and had a more open personality style and better coping skills. Cox regressions showed that depressed patients with diagnoses that eventually converted to BD had been diagnosed with depression earlier and that this was related to a longer delay to conversion and greater likelihood of dysfunctional attitudes. The findings from the present study suggested that an earlier diagnosis of depression is related to experiencing a longer delay in conversion to BD. The clinical implications of this are briefly discussed, with a view to reducing the seemingly inevitable delay in the diagnosis of BD.


Pretreatment with monosialoganglioside GM1 protects the brain of fetal sheep against hypoxic-ischemic injury without causing systemic compromise.
The purpose of this study was to determine whether prophylaxis with monosialoganglioside GM1 can protect the fetus from hypoxic-ischemic encephalopathy in utero. Because some protective strategies can compromise the fetus, the effect of GM1 treatment on metabolic status and blood pressure was also evaluated. Chronically instrumented near-term fetal sheep (119-133 d) were subjected to 30 min of severe cerebral ischemia. Six were given 30 mg/kg GM1 through the umbilical vein 2 h before insult followed by continuous infusion of 30 mg/kg/d over the next 60 h, and these were compared with seven vehicle-treated control sheep. The time course of electrocorticographic activity and cytotoxic edema within the parasagittal cortex were determined with real-time spectral analysis and continuous impedance measurements, respectively. Histologic outcome was assessed 72 h later. Pretreatment with GM1 improved recovery of primary edema, reduced the duration of epileptiform activity (15 +/- 2 versus 31 +/- 5 h; p < 0.05) and the magnitude of secondary edema (p < 0.05). At 72 h, histologic damage was reduced, particularly in the cortex (p < 0.05) and hippocampus (p < 0.01), and residual electrocorticographic activity was increased in the GM1-treated group (-5 +/- 1 versus -9 +/- 3 dB, p < 0.01). GM1 infusion did not alter arterial blood pressure or metabolic status. These results indicate that GM1 can protect the fetal brain against hypoxic-ischemic injury without causing hypotension or metabolic compromise.


Stigma and difficulty accessing medical care in a sample of adults with serious mental illness.
Wellness of people with mental illness is increasingly a public health priority. This study examined factors associated with difficulties receiving medical care in adults with mental illness. In a sample of 1,670 adults with mental illness, we assessed difficulties in accessing medical care and stigma. A total of 465 (28%) participants reported difficulties in accessing medical care; 211 (13%) attributed difficulties in access to stigma. Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.


Positive conceptions of perfectionism: approaches, evidence, challenges.
Almost 30 years ago, Hamachek (1978) suggested that 2 forms of perfectionism be distinguished, a positive form labeled "normal perfectionism" and a negative form labeled "neurotic perfectionism." Focusing on the positive, we present an overview of the different empirical conceptions of the 2 forms of perfectionism and a common framework for the 2 basic approaches: the dimensional approach differentiating 2 dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns) and the group-based approach differentiating 2 groups of perfectionists (healthy perfectionists and unhealthy perfectionists). Moreover, we review the evidence demonstrating that (a) perfectionistic strivings are associated with positive characteristics and (b) healthy perfectionists show higher levels of positive characteristics compared to unhealthy perfectionists and nonperfectionists. Although questions on core facets, positive effects, and developmental antecedents of positive forms of perfectionism remain, our findings suggest that self-oriented perfectionistic strivings are positive, if perfectionists are not overly concerned about mistakes and negative evaluations by others.


A comparative analysis of vertebrate sex determination.
Sex determination in vertebrates is controlled by a variety of mechanisms. We compared the expression of SF1, DAX1, DMRT1, SOX9 and AMH during gonadogenesis in the mouse, chicken and alligator embryo. In contrast to the expression profile of Sf1 in mouse embryos, chicken and alligator embryos show higher levels of Sf1 expression in the developing ovaries compared to testes. This may reflect the higher level of sex hormone synthesis in the ovary compared to the testis in chickens and alligators. The DAX1 gene has a similar expression profile in all three vertebrate species but appears to have different gene structure. As in mouse, DMRT1 was expressed at very high levels in the chicken and alligator male gonad. The male-specific up-regulation of SOX9 expression appears to be a common feature in all three vertebrates. In the chicken and alligator AMH is expressed prior to SOX9, suggesting that in these species SOX9 cannot initiate AMH expression as it does in mammals. SOX9 acts at multiple points in the vertebrate testis pathway but it appears that only some of these functions have been conserved through evolution.


Microbial and enzymatic changes in cigar tobacco leaves during air-curing and fermentation.
Metabolic enzyme activity and microbial composition of the air-curing and fermentation processes determine the quality of cigar tobacco leaves (CTLs). In this study, we reveal the evolution of the dominant microorganisms and microbial community structure at different stages of the air-curing and fermentation processes of CTLs. The results showed that the changes in metabolic enzymes occurred mainly during the air-curing phase, with polyphenol oxidase (PPO) being the most active at the browning phase. Pseudomonas, Bacteroides, Vibrio, Monographella, Bipolaris, and Aspergillus were the key microorganisms in the air-curing and fermentation processes. Principal coordinate analysis revealed significant separation of microbial communities between the air-curing and fermentation phases. Redundancy analysis showed that bacteria such as Proteobacteria, Firmicutes, Bacteroidota, and Acidobacteriota and fungi such as Ascomycota and Basidiomycota were correlated with enzyme activity and temperature and humidity. Bacteria mainly act in sugar metabolism, lipid metabolism, and amino acid metabolism, while fungi mainly degrade lignin, cellulose, and pectin through saprophytic action. Spearman correlation network analysis showed that Firmicutes, Proteobacteria, and Actinobacteria were the key bacterial taxa, while Dothideomycetes, Sordariomycetes, and Eurotiomycetes were the key fungal taxa. This research provides the basis for improving the quality of cigars by improving the air-curing and fermentation processes. KEY POINTS: • Changes in POD and PPO activity control the color change of CTLs at the air-curing stage. • Monographella, Aspergillus, Pseudomonas, and Vibrio play an important role in air-curing and fermentation. • Environmental temperature and humidity mainly affect the fermentation process, whereas bacteria such as Proteobacteria, Firmicutes, Bacteroidota, and Acidobacteriota and fungi such as Ascomycota and Basidiomycota are associated with enzyme activity and temperature and humidity.


Fatty acid metabolism in Saccharomyces cerevisiae.
Peroxisomes are essential subcellular organelles involved in a variety of metabolic processes. Their importance is underlined by the identification of a large group of inherited diseases in humans in which one or more of the peroxisomal functions are impaired. The yeast Saccharomyces cerevisiae has been used as a model organism to study the functions of peroxisomes. Efficient oxidation of fatty acids does not only require the participation of peroxisomal enzymes but also the active involvement of other gene products. One group of important gene products in this respect includes peroxisomal membrane proteins involved in metabolite transport. This overview discusses the various aspects of fatty acid beta-oxidation in S. cerevisiae. Addressed are the various enzymes and their particular functions as well as the various transport mechanisms to take up fatty acids into peroxisomes or to export the beta-oxidation products out of the peroxisome to mitochondria for full oxidation to CO2 and H2O.


Planar cell polarity, ciliogenesis and neural tube defects.
Cilia are microtubule-based protrusions that are found on the surface of most vertebrate cells. Long studied by cell biologists, these organelles have recently caught the attention of developmental biologists and human geneticists. In this review, I will discuss recent findings suggesting a link between cilia and the planar cell polarity signaling cascade. In particular, I will focus on how this interaction may influence the process of neural tube closure and how these results may be relevant to our understanding of common human birth defects in which neural tube closure is compromised.


Integrated multi-omics analysis of RB-loss identifies widespread cellular programming and synthetic weaknesses.
Inactivation of RB is one of the hallmarks of cancer, however gaps remain in our understanding of how RB-loss changes human cells. Here we show that pRB-depletion results in cellular reprogramming, we quantitatively measured how RB-depletion altered the transcriptional, proteomic and metabolic output of non-tumorigenic RPE1 human cells. These profiles identified widespread changes in metabolic and cell stress response factors previously linked to E2F function. In addition, we find a number of additional pathways that are sensitive to RB-depletion that are not E2F-regulated that may represent compensatory mechanisms to support the growth of RB-depleted cells. To determine whether these molecular changes are also present in RB1-/- tumors, we compared these results to Retinoblastoma and Small Cell Lung Cancer data, and identified widespread conservation of alterations found in RPE1 cells. To define which of these changes contribute to the growth of cells with de-regulated E2F activity, we assayed how inhibiting or depleting these proteins affected the growth of RB1-/- cells and of Drosophila E2f1-RNAi models in vivo. From this analysis, we identify key metabolic pathways that are essential for the growth of pRB-deleted human cells.


Functioning in the Real World: Using Storytelling to Improve Validity in the Assessment of Executive Functions.
Real-world contexts differ in the clarity of expectations for desired responses, as do assessment procedures, ranging along a continuum from maximal conditions that provide well-defined expectations to typical conditions that provide ill-defined expectations. Executive functions guide effective social interactions, but relations between them have not been studied with measures that are matched in the clarity of response expectations. In predicting teacher-rated social competence (SC) from kindergarteners' performance on tasks of executive functions (EFs), we found better model-data fit indexes when both measures were similar in the clarity of response expectations for the child. The maximal EF measure, the Developmental Neuropsychological Assessment, presents well-defined response expectations, and the typical EF measure, 5 scales from the Thematic Apperception Test (TAT), presents ill-defined response expectations (i.e., Abstraction, Perceptual Integration, Cognitive-Experiential Integration, and Associative Thinking). To assess SC under maximal and typical conditions, we used 2 teacher-rated questionnaires, with items, respectively, that emphasize well-defined and ill-defined expectations: the Behavior Rating Inventory: Behavioral Regulation Index and the Social Skills Improvement System: Social Competence Scale. Findings suggest that matching clarity of expectations improves generalization across measures and highlight the usefulness of the TAT to measure EF.


Postoperative management of dogs with gastric dilatation and volvulus.
The objective of the study was to review the veterinary literature for evidence-based and common clinical practice supporting the postoperative management of dogs with gastric dilatation and volvulus (GDV). GDV involves rapid accumulation of gas in the stomach, gastric volvulus, increased intragastric pressure, and decreased venous return. GDV is characterized by relative hypovolemic-distributive and cardiogenic shock, during which the whole body may be subjected to inadequate tissue perfusion and ischemia. Intensive postoperative management of the patients with GDV is essential for survival. Therapy in the postoperative period is focused on maintaining tissue perfusion along with intensive monitoring for prevention and early identification of ischemia-reperfusion injury (IRI) and consequent potential complications such as hypotension, cardiac arrhythmias, acute kidney injury (AKI), gastric ulceration, electrolyte imbalances, and pain. In addition, early identification of patients in need for re-exploration owing to gastric necrosis, abdominal sepsis, or splenic thrombosis is crucial. Therapy with intravenous lidocaine may play a central role in combating IRI and cardiac arrhythmias. The most serious complications of GDV are associated with IRI and consequent systemic inflammatory response syndrome and multiple organ dysfunction syndrome. Other reported complications include hypotension, AKI, disseminated intravascular coagulation, gastric ulceration, and cardiac arrhythmias. Despite appropriate medical and surgical treatment, the reported mortality rate in dogs with GDV is high (10%-28%). Dogs with GDV that are affected with gastric necrosis or develop AKI have higher mortality rates.


Root : shoot ratios, optimization and nitrogen productivity.
Plants respond to nitrogen availability by changing their root : shoot ratios. One hypothesis used to explain this allocation is that plants optimize their behaviour by maximizing their relative growth rate. The consequences of this hypothesis were investigated by formulating two models for root : shoot allocation, with and without explicit inclusion of maintenance respiration. The models also took into account that relative growth rate is a linear function of plant nitrogen concentration. The model without respiration gave qualitatively reasonable results when predictions were compared with observed results from growth experiments with birch and tomato. The explicit inclusion of maintenance respiration improved considerably the agreement between prediction and observation, and for birch was within the experimental accuracy. Further improvements will require additional details in the description of respiratory processes and the nitrogen uptake function. Plants growing under extreme nutrient stress may also optimize their behaviour with respect to other variables in addition to relative growth rate.


Three years experience with the prescription of anti-TNF-alpha inhibitors at Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia.
To document the difficulties that are associated with the prescription of anti-TNF inhibitors due to their high cost for patients with various autoimmune rheumatic diseases in the Kingdom of Saudi Arabia. Patients who had been prescribed anti-TNF inhibitors for the treatment of autoimmune rheumatic diseases at Dr. Soliman Fakeeh Hospital in the Kingdom of Saudi Arabia from 2005 to July 2008 were retrospectively included in this study. Data collected included patients' demographics, funding methods, treatment doses and assessment results. Thirty-six patients were included in this study. Seventy percent of these were covered by various insurance packages while 30% were paying cash for their treatment. Of those 36 patients, seven dropped out within the first 2 months of treatment. Thereafter, a gradually increasing number of patients either discontinued treatment or were no longer compliant with their scheduled injection dates. There was a statistically highly significant correlation between financial difficulties and discontinuing treatment and/or spacing-out the administration of anti-TNF agents (P < 0.001). On the other hand, neither safety nor efficacy profiles were shown to significantly impact drug discontinuation. The impact of financial difficulties tended to be more prominent during the first 6 months of treatment. Financial issues appear to be the major factor that is interfering with the compliance with treatment with anti-TNF agents in the Kingdom of Saudi Arabia. The anti-TNF agents studied were generally well tolerated and were effective.


Excited-state proton transfer dynamics of firefly's chromophore D-luciferin in DMSO-water binary mixture.
In this article we have investigated intermolecular excited-state proton transfer (ESPT) of firefly's chromophore D-luciferin in DMSO-water binary mixtures using steady-state and time-resolved fluorescence spectroscopy. The unusual behavior of DMSO-water binary mixture as reported by Bagchi et al. (J. Phys. Chem. B 2010, 114, 12875-12882) was also found using D-luciferin as intermolecular ESPT probe. The binary mixture has given evidence of its anomalous nature at low mole fractions of DMSO (below XD = 0.4) in our systematic investigation. Upon excitation of neutral D-luciferin molecule, dual fluorescence emissions (protonated and deprotonated form) are observed in DMSO-water binary mixture. A clear isoemissive point in the time-resolved area normalized emission spectra further indicates two emissive species in the excited state of D-luciferin in DMSO-water binary mixture. DMSO-water binary mixtures of different compositions are fascinating hydrogen bonding systems. Therefore, we have observed unusual changes in the fluorescence emission intensity, fluorescence quantum yield, and fluorescence lifetime of more hydrogen bonding sensitive anionic form of D-luciferin in low DMSO content of DMSO-water binary mixture.


High-speed wavelength-swept femtosecond source from 1055 to 1300 nm using a GHz femtosecond fiber laser.
In this Letter, we demonstrate a high-speed broadband wavelength-swept femtosecond source (WFS) that leverages the soliton self-frequency shift (SSFS) and intensity-wavelength encoding technologies. The optical wavelength of the high-speed WFS can be continuously swept from 1055 nm to nearly 1300 nm at a sweeping rate of 100 kHz. This WFS is especially seeded by a femtosecond mode-locked all-fiber laser at 1055 nm that has a fundamental repetition rate of ∼1.0 GHz, a maximum output power of 7 W, and a compressed pulse width of 220 fs. It is anticipated that this high-speed broadband WFS can be a promising source for applications that require fast wavelength scanning and high-speed data processing.