[Unusual development of urothelioma of the upper urinary tract].
A case of extrarenal spreading of transitional cell carcinoma caused by rupture of ureterohydronephrosis by ureteral transitional cell carcinoma is reported. Ultrasonography and CT revealed the presence of a severe right ureterohydronephrosis with large septa and a 2 cm diameter exophytic neoplasia of the middle ureter. Nephroureterectomy was performed with excision of a perirenal mass. Histologic examination revealed the presence of transitional cell carcinoma in the perirenal mass, caused by dissemination after renal rupture. CT and ultrasonography were not able to differentiate hydronephrosis from pericapsular spreading because of the extreme disruption of the renal parenchyma.


The tricyclic antidepressant desipramine causes proteolytic degradation of lysosomal sphingomyelinase in human fibroblasts.
The effect of the tricyclic antidepressant desipramine on the processing of lysosomal sphingomyelinase (EC 18.104.22.168) was investigated by pulse-chase studies on [35S]methionine labeled cultured human skin fibroblasts. Desipramine induced rapid intracellular degradation of mature acid sphingomyelinase when added to the cells in the micromolar range, concomitantly abolishing the enzyme activity. Pulse chase labeling revealed the disappearance of mature enzyme forms when fibroblasts were treated with 25 microM desipramine. Incubation of cells with 25 microM leupeptin, an inhibitor of thiol proteases, 24 h prior to desipramine intoxication prevented this drug-induced effect. From these results we conclude that desipramine and possibly also similarly acting tricyclic antidepressants induce proteolytic degradation of acid sphingomyelinase.


Prognostic significance of CD133 and ezrin expression in colorectal carcinoma.
Despite the improvement in the diagnostic and the therapeutic modalities, colorectal cancer (CRC) morbidity and mortality remain high in both the developed and the developing countries. So, we are in a need to recognize new efficient diagnostic and prognostic biomarkers of CRC. That may help in providing individualized targeted therapy for this lethal malignancy. In this study, we investigated the expression and the prognostic significance of CD133 and ezrin mRNA and protein by quantitative RT-PCR and immunohistochemical analysis in primary CRC cases and the surrounding normal colonic mucosa. The correlations between the expression of both markers and clinicopathological parameters were performed. Compared to control, the expression of CD133 and ezrin mRNA and protein in CRC were significantly up-regulated (P < 0.05). In addition, a strong positive correlation between both markers was found (r = 0.867, P < 0.001). Moreover, elevated levels of both markers were significantly associated with the stage, lymph node involvement, distant metastasis, and recurrence at both mRNA and protein levels (P < 0.05). In conclusion, there is a clinical significance of CD133 and ezrin as potential biomarkers for predicting CRC patients of aggressive behavior and poor prognosis. © 2017 IUBMB Life, 69(5):328-340, 2017.


Evolution of the vertical reduction mammaplasty: the S approach.
The vertical reduction mammaplasty has been popularized over recent years. It always produces marked puckering of the excess skin and requires revision surgery for the persistent dog-ears that develop. Minor complications are often common. As a result, the evolution with S approach is developed. A series of 36 consecutive patients who underwent the S approach reduction mammaplasty is presented. The S approach can be described as having 1) superior dermoglandular pedicle, 2) simple and safe S-shaped skin marking, 3) suspension of the residual glandular tissues transversely to the periosteum of the 5th rib, and 4) short-scar closure. The surgical techniques are described in a step-by-step fashion. An analysis is made of the results obtained from these patients. The mean follow-up period of this study is 21 months. As a result of surgical operation, the symptoms of breast hypertrophy were markedly improved. According to patient assessment, neck, back, or chest pain decreased from 64% to 25%, shoulder grooving improved from 56% to 25%, stooped posture decreased from 42% to 14%, intetrigo improved from 36% to 8%, psychological embarrassment decreased from 33% to 8%. The postoperative complications included minimal areolar epidermolysis (11%), hypertrophic scar (8%), etc. All mammograms revealed hypertrophic patterns of the breast. The glandular tissues removed had a mean of 480 g from each breast. Two breasts (3%) had fibroadenomas. The sternal notch-nipple distance changed from a mean of 30.5 cm preoperatively to 20.5 cm, the length of infraareolar scar was 9 cm in average. Eighty-one percent of patients had minimal postoperative ptosis, and the sensitivity of nipple-areola complex was unchanged in 75% of patients. Nine patients (24%) retained the ability to lactate for more than 1 month postoperatively. Twenty-two patients (61%) were very satisfied with their operation, and eight (22%) were adequately satisfied. The technique presented is a simple and safe procedure that provides satisfactory results for patients with breast hypertrophy.


Recalcitrant deep and shallow nodes in Aristolochia (Aristolochiaceae) illuminated using anchored hybrid enrichment.
Recalcitrant relationships are characterized by very short internodes that can be found among shallow and deep phylogenetic scales all over the tree of life. Adding large amounts of presumably informative sequences, while decreasing systematic error, has been suggested as a possible approach to increase phylogenetic resolution. The development of enrichment strategies, coupled with next generation sequencing, resulted in a cost-effective way to facilitate the reconstruction of recalcitrant relationships. By applying the anchored hybrid enrichment (AHE) genome partitioning strategy to Aristolochia using an universal angiosperm probe set, we obtained 231-233 out of 517 single or low copy nuclear loci originally contained in the enrichment kit, resulting in a total alignment length of 154,756bp to 160,150bp. Since Aristolochia (Piperales; magnoliids) is distantly related to any angiosperm species whose genome has been used for the plant AHE probe design (Amborella trichopoda being the closest), it serves as a proof of universality for this probe set. Aristolochia comprises approximately 500 species grouped in several clades (OTUs), whose relationships to each other are partially unknown. Previous phylogenetic studies have shown that these lineages branched deep in time and in quick succession, seen as short-deep internodes. Short-shallow internodes are also characteristic of some Aristolochia lineages such as Aristolochia subsection Pentandrae, a clade of presumably recent diversification. This subsection is here included to test the performance of AHE at species level. Filtering and subsampling loci using the phylogenetic informativeness method resolves several recalcitrant phylogenetic relationships within Aristolochia. By assuming different ploidy levels during bioinformatics processing of raw data, first hints are obtained that polyploidization contributed to the evolution of Aristolochia. Phylogenetic results are discussed in the light of current systematics and morphology.


Concentrated ionic liquids for proteomics: Caveat emptor!
The use of concentrated ionic liquids (ILs) in the bioanalytical chemistry of proteins is sparse; typically, dilute aqueous IL solutions are used. Concentrated ILs have unique properties that may allow researchers to dissolve previously insoluble protein analytes, to increase the depth and robustness of sample preparation and the analysis of proteins. Previous research using concentrated ILs for this purpose is sparse and there is a need to systematically investigate the structure-activity relationship between the IL structure and its capacity to solubilise proteins. Here, bovine serum albumin was dissolved in various ionic liquids and monitored over time by light microscopy and SDS-PAGE. While qualitative, these measures provide a good estimate of, respectively, the dissolving power of an IL towards the given protein and the retained integrity of the protein. Hydrophilic ILs show the best solubilisation capacity and higher temperatures (in a restricted sense) improve the solubility of the protein. Higher temperatures and longer reaction times reduce the molecular weight of the protein, which could inhibit their applicability in proteomics, unless the conditions are judiciously controlled. Researchers should exercise caution when using concentrated ILs for protein analysis until the full scope and limitations are known, an aspect we are presently investigating.


Patient diagnostic, behavioral and demographic variables associated with changes in civil commitment procedures.
Examined diagnostic and demographic characteristics of six groups of voluntary and committed patients (N = 300) over a 3-year period in order to assess the impact of a change in civil commitment procedures in the state of Missouri. Committed and voluntary patients differed on the basis of several demographic and behavioral variables, including diagnosis, employment status, and instances of serious physical harm recorded on admission. No differences were found between patients committed under the old law (which stipulated that the presence of "mental illness" was a sufficient criterion) and patients committed under the new law (which requires the presence of serious physical harm as an essential criterion). These findings were interpreted to suggest that, in at least some settings, clinicians were restricting commitment to cases that gave evidence of physical harm prior to the enactment of new legislation.


[Iron treatment by effervescent tablets (author's transl)].
In a randomized double-blind study the new effervescent iron tablet Loesferron was tested in 57 postpartum patients. Hgb and red blood count rose significantly with this treatment. It was found that on effervescent tablet daily was sufficient for a satisfactory result of the treatment. No side effects were noted to this well tasting iron beverage. The reason is probably the prior dilution of the iron compound which delivers lower local iron potentials to the gastric mucosa.


Regional Cerebellar Volume Loss Predicts Future Disability in Multiple Sclerosis Patients.
Cerebellar symptoms in multiple sclerosis (MS) are well described; however, the exact contribution of cerebellar damage to MS disability has not been fully explored. Longer-term observational periods are necessary to better understand the dynamics of pathological changes within the cerebellum and their clinical consequences. Cerebellar lobe and single lobule volumes were automatically segmented on 664 3D-T1-weighted MPRAGE scans (acquired at a single 1.5 T scanner) of 163 MS patients (111 women; mean age: 47.1 years; 125 relapsing-remitting (RR) and 38 secondary progressive (SP) MS, median EDSS: 3.0) imaged annually over 4 years. Clinical scores (EDSS, 9HPT, 25FWT, PASAT, SDMT) were determined per patient per year with a maximum clinical follow-up of 11 years. Linear mixed-effect models were applied to assess the association between cerebellar volumes and clinical scores and whether cerebellar atrophy measures may predict future disability progression. SPMS patients exhibited faster posterior superior lobe volume loss over time compared to RRMS, which was related to increase of EDSS over time. In RRMS, cerebellar volumes were significant predictors of motor scores (e.g. average EDSS, T25FWT and 9HPT) and SDMT. Atrophy of motor-associated lobules (IV-VI + VIII) was a significant predictor of future deterioration of the 9HPT of the non-dominant hand. In SPMS, the atrophy rate of the posterior superior lobe (VI + Crus I) was a significant predictor of future PASAT performance deterioration. Regional cerebellar volume reduction is associated with motor and cognitive disability in MS and may serve as a predictor for future disease progression, especially of dexterity and impaired processing speed.


The Evaluation of the Awareness, Attitude and Practice of the Elderly Toward Self-Medication: A Cross-Sectional Study.
The prevalence of various diseases in the elderly has increased the use of drugs, which is coupled with age-related physiological changes and places the elderly at risk for multiple side effects. The present study aimed to determine awareness, attitudes and practices of elderly towards self-medication. The sample included 300 participants over 60 years under any of the health centers in urban and rural areas of Abadeh city, who were selected based on stratified random sampling method. In order to collect data, the questionnaire including demographic information, awareness, attitude and performance of the elderly and the checklist of drug intractable consumption. Based on the results, 76% of the elderly reported drug consumption. Regarding lifestyle, the average score of the elderly's awareness for the elderly who lived with and without families were 78.6±14.2 and 69.2±13.6, respectively. In other words, a significant difference was observed between these two groups. In addition, there was a significant between the elderly's performance score with and without family members about the self-medication (p=0.001). Considering the increase in self-medication among the elderly, adherence to prescription criteria for drug among this age group is recommended. Finally, designing and implementing various educational programs in health education center is necessary for the elderly and their families for the purpose of improving awareness and practice.


Working memory, negative affect and personal assets: How do they relate to mathematics and reading literacy?
Research has recently focused on the relationships between working memory, negative affect (e.g., general anxiety, depressive symptoms) and personal assets (e.g., self-concept, academic and competence dimensions, and ego-resiliency), and their influence on mathematics and reading literacy. Although these variables have been amply explored, previous research has usually considered each of these aspects in isolation. In the present study, 143 schoolchildren in sixth to eighth grade were tested on general anxiety, depressive symptoms, working memory, self-concept (academic and competence scales), ego-resiliency, and mathematics and reading literacy. Variance partitioning showed that all predictors, i.e., working memory, negative affect (i.e., general anxiety and depressive symptoms), and personal assets (i.e., self-concept, academic and competence dimensions, and ego-resiliency) explained a unique and shared portion of the variance in mathematics and reading literacy. Our findings point to the importance of investigating the relationship between these factors. Underlying implications and directions for future research are discussed.


Immediate postpartum intrauterine device and implant program outcomes: a prospective analysis.
In-hospital placement of intrauterine devices and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum intrauterine device insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the levonorgestrel intrauterine device may have a higher expulsion rate than the copper intrauterine device. This study evaluated in-hospital provision, expulsion, and 6-month continuation of immediate postpartum copper T380 intrauterine devices, levonorgestrel intrauterine devices, and contraceptive implants. We offered enrollment in this prospective observational trial to women presenting to the University of Utah labor and delivery unit from October 2013 through February 2016 who requested an intrauterine device or implant for postpartum contraception during prenatal care or hospitalization at the time of delivery. Following informed consent, participants completed questionnaires prior to hospital discharge and at 3 and 6 months postpartum. Data on expulsions at 6 months were validated by chart abstraction. During the study period, 639 patients requested a postpartum intrauterine device or implant and 350 patients enrolled in prospective follow-up prior to discharge from the hospital. Among enrollees, 325 (93%) received their preferred contraceptive device prior to hospital discharge: 88 (27%) copper intrauterine device users, 123 (38%) levonorgestrel intrauterine device users, and 114 (35%) implant users. Participants predominantly were Hispanic (90%), were multiparous (87%), reported a household income <$24,000 per year (87%), and underwent a vaginal delivery (77%). At 6 months postpartum, 289 of 325 device recipients (89%) completed follow-up. Among levonorgestrel intrauterine device users 17% reported expulsions relative to 4% of copper intrauterine device users. The adjusted hazard ratio for expulsion was 5.8 (confidence interval, 1.3-26.4). There was no statistically significant difference in expulsions by delivery type or continuation by device type. Among the 21 women who experienced intrauterine device expulsions, 14 (67%) requested a replacement long-acting reversible contraception device for contraception. The 6-month device continuation was ≥80% for all device types. An immediate postpartum long-acting reversible contraception program effectively provides women who desire highly effective reversible contraceptive devices with their method of choice prior to hospital discharge. Immediate postplacental levonorgestrel intrauterine device users have higher expulsion rates than copper intrauterine device users, but >8 of 10 women initiating an intrauterine device or implant continue use at 6 months postpartum.


High-power and high-temperature THz quantum-cascade lasers based on lens-coupled metal-metal waveguides.
A metal-metal waveguide quantum cascade laser with an abutted silicon hyperhemispherical lens is demonstrated at ~4.1 THz. The device produced 145 mW of peak pulsed power at 5 K with a wall-plug power efficiency of 0.7%, lasing up to a maximum operating temperature of 160 K. The far-field beam pattern has a full width at half-maximum value of ~4.8 degrees in the H plane. The same device produced ~26 mW of peak power using a Winston cone instead of a lens, lasing up to 165 K. The large increase in output power is mainly attributed to an increase in collection efficiency.


Possible Mechanism of Therapeutic Effect of 3-Methyl-1-phenyl-2-pyrazolin-5-one and Bone Marrow Stromal Cells Combination Treatment in Rat Ischemic Stroke Model.
The functional improvement following bone marrow stromal cells (BMSCs) transplantation after stroke is directly related to the number of engrafted cells and neurogenesis in the injured brain. Here, we tried to evaluate whether 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), a free radical scavenger, might influence BMSCs migration to ischemic brain, which could promote neurogenesis and thereby enhance treatment effects after stroke. Rat transient middle cerebral artery occlusion (MCAO) model was established. Two separate MCAO groups were administered with either MCI-186 or phosphate-buffered saline (PBS) solution to evaluate the expression of stromal cell-derived factor-1 (SDF-1) in ischemic brain, and compared to that in sham group (n = 5/ group/time point[at 1, 3, and 7 days after operation]). The content of chemokine receptor-4 (CXCR4, a main receptor of SDF-1) at 7 days after operation was also observed on cultured BMSCs. Another four MCAO groups were intravenously administered with either PBS, MCI-186, BMSCs (2 × 106), or a combination of MCI-186 and BMSCs (n = 10/group). 5-bromo-2-deoxyuridine (BrdU) and Nestin double-immunofluorescence staining was performed to identify the engrafted BMSCs and neuronal differentiation. Adhesive-removal test and foot-fault evaluation were used to test the neurological outcome. MCI-186 upregulated the expression of SDF-1 in ischemic brain and CXCR4 content in BMSCs was enhanced after hypoxic stimulation. When MCAO rats were treated with either MCI-186, BMSCs, or a combination of MCI-186 and BMSCs, the neurologic function was obviously recovered as compared to PBS control group (P < 0.01 or 0.05, respectively). Combination therapy represented a further restoration, increased the number of BMSCs and Nestin+ cells in ischemic brain as compared with BMSCs monotherapy (P < 0.01). The number of engrafted-BMSCs was correlated with the density of neuronal cells in ischemic brain (r = 0.72 , P < 0.01) and the improvement of foot-fault (r = 0.70, P < 0.01). MCI-186 might promote BMSCs migration to the ischemic brain, amplify the neurogenesis, and improve the effects of cell therapy.


The influence of sawmill wood wastes on the distribution and population of macroinvertebrates at Benin River, Niger Delta area, Nigeria.
The impact of sawmill wood wastes on the distribution of benthic macroinvertebrates at the Sapele section of Benin River, Niger Delta, Nigeria, was investigated from March 2005 to August 2005. A total of 434 individuals were collected by kick-sampling method, representing 21 taxa of benthic macroinvertebrates. Three stations, 1, 2, and 3, were selected from upstream of the site, receiving wood wastes discharge, the impacted site and its down stream, respectively. Among the water quality variables, conductivity, dissolved oxygen, biochemical oxigen demand (BOD(5)), nitrate-nitrogen, phosphate-phosphorus, transparency, and alkalinity were significantly different (P<0.05) among the stations. Orthogonal comparison by Duncan's multiple range test showed that station 2 (the impacted site) was the cause of the difference. More sensitive species such as Ephemeroptera or Plecoptera were completely absent from station 2, the impacted site. Species abundance was similar in station 1 and 3, indicating that the wood wastes must have adversely affected the distribution of these macroinvertebrates, especially the intolerant species. The wood waste discharge not only altered the water chemistry, but also stimulated the abundance of less-sensitive macroinvertebrate species.


Molecular characterization of a carnation etched ring virus isolate from India.
Incidence of the Carnation etched ring virus (CERV), the only DNA virus reported to date on carnation, was investigated by a bioassay using a partially purified virus as inoculum and then by a double-antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA). Out of 61 carnation cultivars analyzed 41 (67%) were found positive. The virus positivity was verified by polymerase chain reaction (PCR) and nucleotide sequencing. The amplified 1349 bp fragment was by about 98% and 96% identical with respect to coat protein (CP) and enzymatic polyprotein genes, respectively, as compared to the sequences available in the database. In terms of amino acid sequence similarity, the homology values were 99% and 97%, respectively. Comparison with other caulimoviruses revealed that CERV is most closely related to the Cauliflower mosaic virus (CaMV). High genetic stability of CERV may be attributed to the fact that it has evolved from the same initial sequence in an original host. Because of global market of cut flowers and vegetative propagation it has been dispersed around the world.


The risk of muscle involvement in focal venous malformations in children.
Venous malformations (VMs) are the most common vascular malformations, which can be classified as focal, multifocal, or diffuse types. But the risk of focal venous malformations with muscle involvement is not well defined. This is a single-center, retrospective review of patients treated for focal VMs between February 2021 and February 2022. We assessed 26 patients focal VMs with 47 lesions; 18 (69%) were unifocal, 3 (12%) were dual-focal, and 5 (19%) were multifocal type VMs, and 29 (62%) were intramuscular VMs. The lower limbs intramuscular VMs had a significantly elevated risk of focal VMs (relative risk [RR],1.7; 95% confidence interval [CI], 1.148-2.394). Intramuscular involvement of the body should be considered in focal VMs. The lower limbs intramuscular VMs had a significantly elevated risk of focal VMs.


Stem cells and stroke-how glowing neurons illuminate new paths.
A reliable method of cell tracing is essential in evaluating potential therapeutic procedures based on stem cell transplantation. Here we present data collected using neural stem cells isolated from a transgenic mouse line Thy1-YFP. When transplanted into a stroke affected brain these cells give rise to neurons that express a fluorescent signal which can be used for their detection and tracing. Observed processes were compared with those taking place during normal embryonic neurogenesis as well as during in vitro differentiation. Since the same neurogenic patterns were observed, we confirm that neural stem cell transplantation fits well into the paradigm of neuronal birth and differentiation.


Effect of soil properties and aging on the toxicity of copper for Enchytraeus albidus, Enchytraeus luxuriosus, and Folsomia candida.
In the present study, the effect of the heavy-metal salt copper chloride (CuCl2.2H2O) in soils freshly spiked (3 d) and aged (70 +/- 10 d; mean +/- SD) was studied in the test species Enchytraeus albidus, E. luxuriosus, and Folsomia candida. Up to nine soils were used: Besides the Organisation for Economic Co-operation and Development (OECD) artificial soil and the Agricultural Testing and Research Agency (Landwirtschaftliche Untersuchungs- und Forschungsanstalt, Speyer, Germany) 2.2 natural standard soils, the others were selected based on the EURO Soil approach, taking into account the effect of different soil parameters (pH, organic matter, grain size distribution, and carbon to nitrogen ratio). Additionally, the effect of the chloride ions was studied separately. The results revealed the following: First, a soil effect was observed; for example, in F. candida, median effective concentrations (EC50s) varied between 262 mg/kg in a sample from the same site as the original EURO Soil 5 soil and greater than 1,000 mg/kg in OECD soil. Second, an aging effect was observed, mainly in F. candida. For example, toxicity of offspring survival was increased twofold in the OECD soil and approximately eightfold with aging in the EURO Soil 7 soil, whereas the enchytraeid species did not react differently after aging. Third, an effect of chloride ions on reproduction of the animals was found; however, this effect was independent of the aging period. Fourth, species variation was seen in terms of sensitivity (EC50), decreasing in the following order: E. luxuriosus > E. albidus >> F. candida. Differences in toxicity of offspring survival between enchytraeids and F. candida might be explained by the different routes of uptake.


[Ibopamine--pharmacologic principles].
Ibopamine is the 3,4-diisobutyrylester of N-methyl-dopamine (epinine). Oral ibopamine is transferred during and after resorption (first-pass effect) to the active metabolite epinine by blood and tissue esterases. 200 mg ibopamine lead to maximal plasma concentrations of 60 to 100 nmol/l. The ratio of total epinine to free epinine is about 10:1. Epinine is intensively metabolized so that less than 1% of the oral dosage is eliminated via the kidneys. The plasma half-life of epinine amounts to about 45 min. Epinine activates dopamine (DA1, DA2)-, beta 1- and beta 2- as well as alpha-receptors. The affinity is of the other: DA1, DA2 greater than beta 1, beta 2 greater than alpha. Stimulation of postsynaptic DA1-receptors predominantly induces renal vasodilation and increase in diuresis. Stimulation of presynaptic DA2-receptors leads to a reduced liberation of noradrenaline (NA) from its presynaptic storage vesicles. This effects a decrease in NA-plasma concentration, peripheral resistance, and it is partly responsible for diuresis and natriuresis. Investigations in isolated organs have shown that the action on DA1, DA2-receptors occurs in the range of 100-700 nmol/l), whereas stimulation of beta 1- and beta 2-receptors affords significantly higher levels (affinity to human cardiac beta 1- and beta 2-receptors 5-10 mumol/l). alpha-receptors are only stimulated at still higher concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)


Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009.
Evidence from the US National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database suggests that the incidence of advanced breast cancer in young women is increasing. To quantify this trend and analyze it as a function of stage at diagnosis, race/ethnicity, residence, and hormone receptor status. Breast cancer incidence, incidence trends, and survival rates as a function of age and extent of disease at diagnosis were obtained from 3 SEER registries that provide data spanning 1973-2009, 1992-2009, and 2000-2009. SEER defines localized as disease confined to the breast, regional to contiguous and adjacent organ spread (eg, lymph nodes, chest wall), and distant disease to remote metastases (bone, brain, lung, etc). Breast cancer incidence trends in the United States. In the United States, the incidence of breast cancer with distant involvement at diagnosis increased in 25- to 39-year-old women from 1.53 (95% CI, 1.01 to 2.21) per 100,000 in 1976 to 2.90 (95% CI, 2.31 to 3.59) per 100,000 in 2009. This is an absolute difference of 1.37 per 100,000, representing an average compounded increase of 2.07% per year (95% CI, 1.57% to 2.58%; P < .001) over the 34-year interval. No other age group or extent-of-disease subgroup of the same age range had a similar increase. For 25- to 39-year-olds, there was an increased incidence in distant disease among all races and ethnicities evaluated, especially non-Hispanic white and African American, and this occurred in both metropolitan and nonmetropolitan areas. Incidence for women with estrogen receptor-positive subtypes increased more than for women with estrogen receptor-negative subtypes. Based on SEER data, there was a small but statistically significant increase in the incidence of breast cancer with distant involvement in the United States between 1976 and 2009 for women aged 25 to 39 years, without a corresponding increase in older women.


Occult Mönckeberg medial calcinosis of the facial and infraorbital arteries in an elderly edentulous patient.
Mönckeberg medial calcinosis (MMC) is a potentially serious vasculopathy involving calcification of the arterial tunica media of the extremities, heart, and other viscera. There are a limited number of cases reported in the dental literature, usually associated with the facial artery. Although MMC is often discerned as an occult radiologic finding in middle-aged adults, its presence may serve as a harbinger for end-stage renal disease, diabetes, other pathologic processes, and possible regional hypoperfusion. The objective of this report is to feature an elderly patient with MMC of the facial and infraorbital arteries. In addition, a brief review of published cases of MMC and its differential diagnosis have been provided. It is recommended that affected patients be referred for a comprehensive medical assessment. Timely discovery of calcified arteries may improve patient outcomes.


Prognostic Implications of Synchronous Subsolid Nodules in Patients with Resected Subsolid Lung Adenocarcinoma.
Background For multiple subsolid nodules (SSNs) observed at lung CT, current management focuses on removal of the dominant (≥6 mm) nodule and monitoring of remaining SSNs. Whether the presence of these synchronous SSNs is related to postoperative patient outcomes has not been well established. Purpose To evaluate the prognostic value of single versus multiple synchronous SSNs at preoperative CT in patients with resected subsolid lung adenocarcinoma nodules. Materials and Methods This retrospective study included patients who underwent lobectomy or sublobar resection for lung adenocarcinoma manifesting as an SSN and clinical stage IA from January 2010 to December 2017. The radiologic features of the resected SSN (dominant nodule) and synchronous SSNs were assessed on preoperative CT scans. The effects of synchronous SSNs on time to secondary intervention, time to recurrence (TTR), and overall survival (OS) were evaluated using Cox regression analysis. Results Of the 684 included patients (mean age, 60.9 years ± 9.5 [SD]; 389 female), 515 (75.3%) had a single SSN and 169 (24.7%) had multiple SSNs on preoperative CT scans. During follow-up (median, 71.8 months), 38 secondary interventions were performed, primarily due to growth of synchronous SSNs (21 of 38) or metachronous nodules (14 of 38). As the number of synchronous SSNs greater than or equal to 6 mm in size increased, the time to secondary intervention decreased (P < .001). No association was observed between synchronous SSNs and TTR (P = .53) or OS (P = .65), but these measures were associated with features of the resected nodule, specifically solid portion size for TTR (P = .01) and histologic subtype for TTR and OS (P < .001 for both). Conclusion In patients with subsolid lung adenocarcinoma, the presence of synchronous SSNs on preoperative CT scans was not associated with TTR or OS, but the presence of synchronous SSNs greater than or equal to 6 mm in size was associated with an increased likelihood of secondary intervention. © RSNA, 2023 Supplemental material is available for this article.


Incidence and risk factors of postoperative complications in patients with tuberculosis-destroyed lung.
The purpose of this study was to determine risk factors of postoperative complications in tuberculosis-destroyed lung (TDL) patients. We retrospectively analyzed the data from all consecutive TDL patients undergoing surgical treatment at the Beijing Chest Hospital from January 2001 to September 2019. Of 113 TDL cases experiencing surgery, 33 (29.2%) experienced postoperative complications. The patients with low BMI were more likely to have postoperative complications compared to those with normal BMI, whereas a significant lower rate of postoperative complications was noted in patients with BMI ≥ 25 kg/m2. In addition, significant increased risk was observed in patients with smoking history. We found that the patients with underlying infection, including aspergillus and nontuberculous mycobacteria (NTM), had significantly higher odds of having postoperative complications compared with those without underlying infection. The anaemia was another important independent factor associated with postoperative complication. Patients with blood transfusion above 1000 mL had a strongly increased frequency of postoperative complications than patients with blood transfusion below 1000 mL. In conclusion, our data demonstrate that approximate one third of TDL patients experience postoperative complications in our cohort. Patients with low BMI, anaemia, tobacco smoking, and coinfected aspergillus or NTM are at markedly higher risk to experience postoperative complications after pneumonectomy.


Calcium and phosphatidylserine inhibit lipid electropore formation and reduce pore lifetime.
Molecular dynamics simulations of electroporation of homogeneous phospholipid bilayers show that the pore creation time is strongly dependent on the magnitude of the applied electric field. Here, we investigated whether heterogeneous bilayers containing phospholipids with zwitterionic and anionic headgroups exhibit a similar dependence. To facilitate this analysis we divide the life cycle of an electropore into several stages, marking the sequence of steps for pore creation and pore annihilation (restoration of the bilayer after removal of the electric field). We also report simulations of calcium binding isotherms and the effects of calcium ions on the electroporation of heterogeneous lipid bilayers. Calcium binding simulations are consistent with experimental data using a 1:2 Langmuir binding isotherm. We find that calcium ions and phosphatidylserine increase pore creation time and decrease pore annihilation time. For all systems tested, pore creation time was inversely proportional to the bilayer internal electric field.


Effect of neurointensive care upon outcome following severe head injuries in childhood--a preliminary report.
From March 1978 till August 1981 neurointensive care was applied to 24 children with severe head injuries (Glasgow Coma Scale less than or equal to 7, mean 5 +/- 1) corresponding to 7% of a population with head injuries observed during the same period. The neurointensive care included continuous intracranial and arterial pressure monitoring and normalization of intracranial and cerebral perfusion pressure with intubation, hyperventilation, control of body temperature, dexamethason, barbiturates and osmotic agents. The follow-up time is 1.5 to 4.4 years (mean 2.5 years). The results obtained by check-ups every 3-6 months were analyzed as proposed by Lange-Cosack and Tepfer (1973) and used to group the children according to Jennett and Bond (1975). At the end of the follow-up four children were 1-5, twelve 6-14 years old and 3 older. Five patients (= 21%) died during the acute stage of head injury. Residual neurological signs were present in 42% of the children depending on the specific topics (cranial nerve deficits, hemiparesis, speech disorders, ataxic syndromes) at most in 1/4 of the cases. Minimal to distinct residual psychoorganic signs were found in 58%, an altered personality being somewhat more frequent than intelligence deficit or psychomotor retardation. Eleven of the twelve school children are back in school of whom are eight in regular and three in special schools. At a mean time of 1.5 years after the accident the EEG was normal in nine cases and displayed a slightly altered background activity and/or slow wave foci in eight and epileptiform foci in two cases.(ABSTRACT TRUNCATED AT 250 WORDS)


Biomolecular analysis of a defective nontransforming Epstein-Barr virus (EBV) from a patient with chronic active EBV infection.
A virus recovered from the saliva of a child with chronic active Epstein-Barr virus (EBV) infection for 8 years was shown to induce EBV early antigen (EBV-EA) in Raji cells and to be expressed into EBV-EA in fresh EBV-negative peripheral blood leukocytes. However, it did not replicate its DNA. Oropharyngeal epithelial cells scraped from recurrent mouth lesions were similarly positive for EBV-EA. DNA extracted from these cells and digested with BamHI contained a 6-kilobase-pair fragment homologous to BamHI fragment V and B1 EBV DNA probes. Furthermore, Southern blots of the BamHI and EcoRI digests of the DNA extracted from the cell lines of the patient (transformed with EBV strain B95-8) and of her mother (spontaneous) revealed, in addition to the expected BamHI G, H, H2, and B1 fragments used as probes, additional shorter ones of a presumably endogenous defective virus.


Cementless One-Stage Bilateral Total Hip Arthroplasty in Osteoarthritis Patients: Functional Outcomes and Complications.
Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.


Osteoporotic alterations in a group of different ethnicity Brazilian postmenopausal women: An observational study.
To compare peripheral bone mineral density alterations among Brazilian postmenopausal women from three ethnic groups considering age and body mass index influence; to correlate their bone mineral density with the mandibular cortical index (MCI); and to evaluate the influence of age, body mass index and ethnicity in the MCI using risk factor analysis. Osteoporosis risk is known to have ethical influences. However, little is known about the differences in ethnicity in radiomorphometric indices. A total of 150 postmenopausal women with different ethnicities (Caucasian, Asian and Afro-descendant) who underwent peripheral dual X-ray absorptiometry and panoramic examination were included. Bone mineral density and MCI were assessed. Adjusted odds ratio analyses were performed on bone density and MCI considering the effect of age, ethnicity and body mass index. The correlations between the MCI and the dual X-ray absorptiometry results were made. Old age, low body mass index and non-Afro-descendant were associated with low bone density. Compared with Afro-descendants, Asians and Caucasians have higher chances of having decreased bone mass. For the MCI, statistical analysis showed that age is the only variable associated with osteoporotic alterations in the mandible. Furthermore, an inverse correlation was found between the MCI and the T-scores. Bone density is higher in Brazilian Afro-descendant women than in Caucasians and Asians. Patient's age is associated with bone density and the MCI. The mandibular cortical index is inversely correlated with the peripheral densitometry results within the study ethnic population.


[Factors of physical development of healthy children in relation to 24-hour ambulatory blood pressure patterns].
The aim of this study was to assess which of the relationships between ambulatory blood pressure patterns and physical development factors in healthy children was the strongest and most significant. 24-hour ambulatory blood pressure monitoring (ABPM) was performed on 100 healthy children aged 10-18 years. Mean values of diurnal, nocturnal and 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated on its basis. Correlation coefficients were calculated for the associations between these mean values and physical development factors: age, body mass, body height, body mass index (BMI) and BMI centile. SBP levels were the strongest and most significant, positively associated with values of BMI, body mass and BMI centile. The correlation with age was weaker and with body height the most weak. DBP levels correlated significantly only with BMI centile and showed relationship of bordering significance with BMI value. There were no significant correlations between DBP levels and age, body mass or body height. In children BMI and its centile correlate with ambulatory blood pressure levels stronger and more significant than other physical development factors. Three-dimensional centile charts including age, BMI and blood pressure level could be the most accurate in diagnosing hypertension.


Inhibition of cell proliferation and migration through nucleobase-modified polyamidoamine-mediated p53 delivery.
The nucleobase 2-amino-6-chloropurine-modified polyamidoamine (AP-PAMAM) was used as a carrier for p53 gene delivery to achieve the antitumor effects. The condensation of p53 plasmid was studied through gel retardation assay, and the transfection efficiency was evaluated through the transfection assay of pEGFP-N3 and pGL-3 plasmids. Using human cervical carcinoma cell line HeLa as a model, the inhibition of cell proliferation and migration was studied through flow cytometry, wound healing and Transwell migration assays, respectively. The p53 expression level was detected through quantitative polymerase chain reaction and Western blotting analyses. The carrier could condense p53 plasmid into stable nanoparticles at N/P ratios of 2.0, and higher transfection efficiency than polyamidoamine (PAMAM) could be obtained at all the N/P ratios studied. AP-PAMAM-mediated p53 delivery could achieve stronger antiproliferative effect than PAMAM/p53. The antiproliferative effect was identified to be triggered by the induction of cell apoptosis (apoptotic ratio of 26.17%) and cell cycle arrest at S phase. Additionally, AP-PAMAM/p53 transfection has been found to suppress the cell migration and invasion of cancer cells. Finally, the enhanced p53 expression level could be detected after p53 transfection at mRNA and protein levels. The PAMAM derivative-mediated p53 delivery could be a promising strategy for achieving tumor gene therapy.


DC-SIGN, C1q, and gC1qR form a trimolecular receptor complex on the surface of monocyte-derived immature dendritic cells.
C1q modulates the differentiation and function of cells committed to the monocyte-derived dendritic cell (DC) lineage. Because the 2 C1q receptors found on the DC surface-gC1qR and cC1qR-lack a direct conduit into intracellular elements, we postulated that the receptors must form complexes with transmembrane partners. In the present study, we show that DC-SIGN, a C-type lectin expressed on DCs, binds directly to C1q, as assessed by ELISA, flow cytometry, and immunoprecipitation experiments. Surface plasmon resonance analysis revealed that the interaction was specific, and both intact C1q and the globular portion of C1q bound to DC-SIGN. Whereas IgG reduced this binding significantly, the Arg residues (162-163) of the C1q-A chain, which are thought to contribute to the C1q-IgG interaction, were not required for C1q binding to DC-SIGN. Binding was reduced significantly in the absence of Ca(2+) and by preincubation of DC-SIGN with mannan, suggesting that C1q binds to DC-SIGN at its principal Ca(2+)-binding pocket, which has increased affinity for mannose residues. Antigen-capture ELISA and immunofluorescence microscopy revealed that C1q and gC1qR associate with DC-SIGN on blood DC precursors and immature DCs. The results of the present study suggest that C1q/gC1qR may regulate DC differentiation and function through the DC-SIGN-mediated induction of cell-signaling pathways.


Management of patients with a calcified aorta or low ejection fraction undergoing multivessel coronary revascularization.
Off-pump coronary artery bypass surgery (OPCAB) provides an alternative method of surgical revascularization by allowing coronary anastomoses to be constructed without the use of cardiopulmonary bypass and without manipulation of the aorta. The presence of a calcified aorta is one of the strongest indications for OPCAB because both distal and proximal anastomoses can be performed without cannulation or clamping of the aorta. In patients with left ventricular dysfunction, OPCAB techniques allow for revascularization without the need for global myocardial ischemia associated with cardioplegic arrest.


Plasma leptin concentration in adult cattle: effects of breed, adiposity, feeding level, and meal intake.
An ovine-specific RIA, shown to be reliable for bovine leptin determination, was used to study the effects of breed, body fatness, feeding level, and meal intake on plasma leptin level in adult cattle. Eighteen fat Charolais, fat Holstein, and lean Holstein adult cows were either well-fed (130% of maintenance energy requirements [MER]) or underfed (60% of MER) for 3 wk. The breed tended to have a small effect on plasma leptin level, which was decreased by 70% (P < 0.05) in lean compared to fat Holstein cows. A strong curvilinear relationship was found between mean adipocyte volume and plasma leptin concentrations in well-fed (r = +0.95) and underfed (r = +0.91) cows. Underfeeding caused a significant decrease in plasma leptin levels from 8.0+/-3.1 to 6.1+/-2.3 ng/mL (P < 0.01). Nine adult Holstein cows initially fed at 130% of MER (control) were underfed to 21% of MER for 7 d, and five of them were refed to 237% of MER for 21 d. Plasma leptin measured 1 h before meal distribution was decreased from 5.9+/-0.4 to 3.8+/-0.2 ng/mL (P < 0.01) by underfeeding and increased to reach 8.8+/-1.0 ng/mL (P < 0.01) after refeeding. It was positively related to plasma glucose (r = +0.52, P < 0.01) and negatively related to plasma NEFA (r = -0.67, P < 0.001). Plasma leptin measured 4 h after meal distribution was positively related to feeding level and to plasma 3-OH-butyrate (r = +0.61, P < 0.005) and negatively related to plasma NEFA (r = -0.56, P < 0.01). Differences between pre- and postprandial leptin concentrations showed a decrease after meal intake in control and well-fed cows (-7 and -19%, P < 0.01, respectively) and an increase in underfed cows (+12%, P < 0.01). Leptin response to meal intake was positively related to glucose response (r = +0.66, P < 0.001) and negatively related to 3-OH-butyrate response (r = -0.78, P < 0.001). By using the "multispecies" commercial RIA, leptin concentrations were lower and we observed similar physiological responses, although less related to other hormones or metabolites. These data provide evidence, first, that a specific RIA for ruminant leptin determination is necessary to better understand leptin regulation, and second, that plasma leptin is strongly related to adipose cell size and positively related to feeding level in adult cattle, and that an effect of meal intake could be mediated by glucose and(or) ketone bodies.


Femorotibial surgery in the dog.
Although the femorotibial joint is subject to a number of common abnormalities which have been investigated in the last few years there is still no obvious and agreed optimal treatment in many instances of abnormality. The clinical derangements which occur in the joint are considered and an assessment is made of the state of aetiological knowledge. The most useful way of diagnosing and treating the conditions are also considered.


Anticancer/antiviral agent Akt inhibitor-IV massively accumulates in mitochondria and potently disrupts cellular bioenergetics.
Inhibitors of the PI3-kinase/Akt (protein kinase B) pathway are under investigation as anticancer and antiviral agents. Akt inhibitor-IV (ChemBridge 5233705, CAS 681281-88-9, AKTIV), a small molecule reported to inhibit this pathway, exhibits potent anticancer and broad-spectrum antiviral activity. However, depending on concentration, this cationic benzimidazole derivative exhibits paradoxical positive or negative effects on the phosphorylation of Akt that are not well understood. To elucidate its mechanism of action, we investigated its spectroscopic properties. This compound proved to be sufficiently fluorescent (excitation λmax = 388 nm, emission λmax = 460 nm) to enable examination of its uptake and distribution in living mammalian cells. Despite a low quantum yield of 0.0016, imaging of HeLa cells treated with AKTIV (1 μM, 5 min) by confocal laser scanning microscopy, with excitation at 405 nm, revealed extensive accumulation in mitochondria. Treatment of Jurkat lymphocytes with 1 μM AKTIV for 15 min caused accumulation to over 250 μM in these organelles, whereas treatment with 5 μM AKTIV yielded concentrations of over 1 mM in mitochondria, as analyzed by flow cytometry. This massive loading resulted in swelling of these organelles, followed by their apparent disintegration. These effects were associated with profound disruption of cellular bioenergetics including mitochondrial depolarization, diminished mitochondrial respiration, and release of reactive oxygen species. Because mitochondria play key roles in both cancer proliferation and viral replication, we conclude that the anticancer and antiviral activities of AKTIV predominantly result from its direct and immediate effects on the structure and function of mitochondria.


NetPhosBac - a predictor for Ser/Thr phosphorylation sites in bacterial proteins.
There is ample evidence for the involvement of protein phosphorylation on serine/threonine/tyrosine in bacterial signaling and regulation, but very few exact phosphorylation sites have been experimentally determined. Recently, gel-free high accuracy MS studies reported over 150 phosphorylation sites in two bacterial model organisms Bacillus subtilis and Escherichia coli. Interestingly, the analysis of these phosphorylation sites revealed that most of them are not characteristic for eukaryotic-type protein kinases, which explains the poor performance of eukaryotic data-trained phosphorylation predictors on bacterial systems. We used these large bacterial datasets and neural network algorithms to create the first bacteria-specific protein phosphorylation predictor: NetPhosBac. With respect to predicting bacterial phosphorylation sites, NetPhosBac significantly outperformed all benchmark predictors. Moreover, NetPhosBac predictions of phosphorylation sites in E. coli proteins were experimentally verified on protein and site-specific levels. In conclusion, NetPhosBac clearly illustrates the advantage of taxa-specific predictors and we hope it will provide a useful asset to the microbiological community.


Mental Imagery Skills in Competitive Young Athletes and Non-athletes.
Mental imagery is a fully immersive multi-sensory procedure that associates as numerous senses to create a mental image and process it without the presence of external stimuli. In the sport situation, imagery has been designated as the state in which people imagine themselves while effecting abilities to deal with the forthcoming duty or improve performance. Methodical analyses have revealed that imagery increases performance in motor tasks. This study aims at observing not the vividness of image but the cognitive abilities useful for the inspection, maintenance, generation, and manipulation of dissimilar classes of images, investigating modifications in mental imagery skills in competitive athletes and non-athletes. Participants were competitive athletes (n = 48) and non-athletes (n = 48) between the ages of 8 and 13 years (M age = 10.50, SD = 1.73). The athletes had a minimum of 5 years of training skill in the sport. They completed the Mental Imagery Test (MIT). Competitive athletes showed higher scores on mental imagery skills than non-athletes. The study contributed to increase the exploration in the definite area of mental imagery, supplying an added support for the pluridimensional nature of mental imagery and for its practicality in motor and sport sciences.


Studying MHC class II presentation of immobilized antigen by B lymphocytes.
The ability of B lymphocytes to capture external antigens (Ag) and present them as peptide fragments, loaded on Major Histocompatibility complex (MHC) class II molecules, to CD4(+) T cells is a crucial part of the adaptive immune response. This allows T-B cooperation, a cellular communication that is required for B cells to develop into germinal centers (GC) and form mature high-affinity antibody producing cells and to further develop B cell memory. MHC class II antigen presentation by B lymphocytes is a multistep process involving (1) Recognition and capture of external Ag by B lymphocytes through their B cell receptor (BCR); (2) Ag processing, which comprises the degradation of Ag in internal compartments within the B cell and loading of the corresponding peptide fragments on MHC class II molecules and (3) Presentation of MHC II-peptide complexes to CD4(+) T cells. Here, we describe how to study MHC class II antigen presentation by B lymphocytes at these three major levels.


The redox state of the plastoquinone pool controls the level of the light-harvesting chlorophyll a/b binding protein complex II (LHC II) during photoacclimation.
A cytochrome b (6) f deficient mutant of Lemna perpusilla maintains a constant and lower level of the light-harvesting chl a/b-binding protein complex II (LHC II) as compared to the wild type plants at low-light intensities. Inhibition of the plastoquinone pool reduction increases the LHC II content of the mutant at both low- and high-light intensities but only at high-light intensity in the wild type plants. Proteolytic activity against LHC II appears during high-light photoacclimation of wild type plants. However, the acclimative protease is present in the mutant at both light intensities. These and additional results suggest that the plastoquinone redox state serves as the major signal-transducing component in the photoacclimation process affecting both, synthesis and degradation of LHC II and appearance of acclimative LHC II proteolysis. The plastoquinol pool cannot be oxidized by linear electron flow in the mutant plants which are locked in a 'high light' acclimation state. The cytochrome b (6) f complex may be involved indirectly in the regulation of photoacclimation via 1) regulation of the plastoquinone redox state; 2) regulation of the redox-controlled thylakoid protein kinase allowing exposure of the dephosphorylated LHC II to acclimative proteolysis.


CRISPR Cas9 mediated knockout of sex determination pathway genes in Aedes aegypti.
The vector role of Aedes aegypti for viral diseases including dengue and dengue hemorrhagic fever makes it imperative for its proper control. Despite various adopted control strategies, genetic control measures have been recently focused against this vector. CRISPR Cas9 system is a recent and most efficient gene editing tool to target the sex determination pathway genes in Ae. aegypti. In the present study, CRISPR Cas9 system was used to knockout Ae. aegypti doublesex (Aaedsx) and Ae. aegypti sexlethal (AaeSxl) genes in Ae. aegypti embryos. The injection mixes with Cas9 protein (333 ng ul-1) and gRNAs (each at 100 ng ul-1) were injected into eggs. Injected eggs were allowed to hatch at 26 ± 1°C, 60 ± 10% RH. The survival and mortality rate was recorded in knockout Aaedsx and AaeSxl. The results revealed that knockout produced low survival and high mortality. A significant percentage of eggs (38.33%) did not hatch as compared to control groups (P value 0.00). Highest larval mortality (11.66%) was found in the knockout of Aaedsx female isoform, whereas, the emergence of only male adults also showed that the knockout of Aaedsx (female isoform) does not produce male lethality. The survival (3.33%) of knockout for AaeSxl eggs to the normal adults suggested further study to investigate AaeSxl as an efficient upstream of Aaedsx to target for sex transformation in Ae. aegypti mosquitoes.


The mouse homeobox gene Noto regulates node morphogenesis, notochordal ciliogenesis, and left right patterning.
The mouse homeobox gene Noto represents the homologue of zebrafish floating head (flh) and is expressed in the organizer node and in the nascent notochord. Previous analyses suggested that Noto is required exclusively for the formation of the caudal part of the notochord. Here, we show that Noto is also essential for node morphogenesis, controlling ciliogenesis in the posterior notochord, and the establishment of laterality, whereas organizer functions in anterior-posterior patterning are apparently not compromised. In mutant embryos, left-right asymmetry of internal organs and expression of laterality markers was randomized. Mutant posterior notochord regions were variable in size and shape, cilia were shortened with highly irregular axonemal microtubuli, and basal bodies were, in part, located abnormally deep in the cytoplasm. The transcription factor Foxj1, which regulates the dynein gene Dnahc11 and is required for the correct anchoring of basal bodies in lung epithelial cells, was down-regulated in mutant nodes. Likewise, the transcription factor Rfx3, which regulates cilia growth, was not expressed in Noto mutants, and various other genes important for cilia function or assembly such as Dnahc5 and Nphp3 were down-regulated. Our results establish Noto as an essential regulator of node morphogenesis and ciliogenesis in the posterior notochord, and suggest Noto acts upstream of Foxj1 and Rfx3.


Association of Nef with p21-activated kinase 2 is dispensable for efficient human immunodeficiency virus type 1 replication and cytopathicity in ex vivo-infected human lymphoid tissue.
Interaction of the human immunodeficiency virus type 1 (HIV-1) Nef protein with p21-activated kinase 2 (PAK2) has been proposed to play a role in T-cell activation, viral replication, apoptosis, and progression to AIDS. However, these hypotheses were based on results obtained using Nef mutants impaired in multiple functions. Recently, it was reported that Nef residue F191 is specifically involved in PAK2 binding. However, only a limited number of Nef activities were investigated in these studies. To further evaluate the role of F191 in Nef function and to elucidate the biological relevance of Nef-PAK2 interaction, we performed a comprehensive analysis of HIV-1 Nef mutants carrying F191H and F191R mutations. We found that the F191H mutation reduces and the F191R mutation disrupts the association of Nef with PAK2. Both mutants upregulated the major histocompatibility complex II (MHC-II)-associated invariant chain and downregulated CD4, MHC-I, and CD28, although with reduced efficiency for the latter. Furthermore, the F191H/R changes neither affected the levels of interleukin-2 receptor expression and apoptosis of HIV-1-infected primary T cells nor reduced Nef-mediated induction of NFAT. Unexpectedly, the F191H change markedly reduced and the F191R mutation disrupted the ability of Nef to enhance virion infectivity in P4-CCR5 indicator cells but not in TZM-bl cells or peripheral blood mononuclear cells. Most importantly, all HIV-1 Nef mutants replicated efficiently and caused CD4+ T-cell depletion in ex vivo-infected human lymphoid tissue. Altogether, our data show that the interaction of Nef with PAK2 does not play a major role in T-cell activation, viral replication, and apoptosis.


DIGLYCERIDE RELEASE FROM INSECT FAT BODY: A POSSIBLE MEANS OF LIPID TRANSPORT.
Lipid is released in the form of diglyceride from the fat body of the cecropia silkmoth (Hyalophora cecropia), in both adults and pupae. This diglyceride, in the form of a complex with hemolymph protein, is the most probable means by which lipid is transported in this insect.


Ubiquitylated histone H2A: a molecular Jekyll and Hyde in the epidermis.
The epidermis of the skin provides a barrier between the organism and the external environment. It is constantly subjected to physical and chemical insults, and thus susceptible to wounding and to neoplastic transformation. Long-lasting epigenetic modifications in epidermal stem cells are now shown to link responses to skin injuries with cell priming for carcinoma development, through regulation of histone H2A ubiquitylation.


Upper esophageal sphincter (UES) metrics on high-resolution manometry (HRM) differentiate achalasia subtypes.
The upper esophageal sphincter (UES) reflexively responds to bolus presence within the esophageal lumen, therefore UES metrics can vary in achalasia. Within consecutive patients undergoing esophageal high-resolution manometry (HRM), 302 patients (58.2±1.0 year, 57% F) with esophageal outflow obstruction were identified, and compared to 16 asymptomatic controls (27.7±0.7 year, 56% F). Esophageal outflow obstruction was segregated into achalasia subtypes 1, 2, and 3, and esophagogastric junction outflow obstruction (EGJOO with intact peristalsis) using Chicago Classification v3.0. UES and lower esophageal sphincter (LES) metrics were compared between esophageal outflow obstruction and normal controls using univariate and multivariate analysis. Linear regression excluded multicollinearity of pressure metrics that demonstrated significant differences across individual subtype comparisons. LES integrated relaxation pressure (IRP) had utility in differentiating achalasia from controls (P<.0001), but no utility in segregating between subtypes (P=.27). In comparison to controls, patients collectively demonstrated univariate differences in UES mean basal pressure, relaxation time to nadir, recovery time, and residual pressure (UES-RP) (P≤.049). UES-RP was highest in type 2 achalasia (P<.0001 compared to other subtypes and controls). In multivariate analysis, only UES-RP retained significance in comparison between each of the subgroups (P≤.02 for each comparison). Intrabolus pressure was highest in type 3 achalasia; this demonstrated significant differences across some but not all subtype comparisons. Nadir UES-RP can differentiate achalasia subtypes within the esophageal outflow obstruction spectrum, with highest values in type 2 achalasia. This metric likely represents a surrogate marker for esophageal pressurization.


Newborn screening for inborn errors of metabolism in Japan. A history of the development of newborn screening.
In 1977, the Ministry of Health and Welfare (MHW) directed prefectural officials in charge of maternal and child health to start publicly funded newborn mass-screening (NBS) for phenylketonuria (PKU), maple syrup urine disease (MSUD), histidinemia, homocystinuria and galactosemia and a study group of MHW formulated the treatment guideline for the target diseases. In 1980, MHW launched the Japan Cooperative Project on Special Formula (JCPSF) to ensure a stable supply of special formula and also organized the committee for JCPSF. From 1977 to 2003, a study group of MHW conducted a follow-up study of the patients detected by the screening. From the follow-up it was concluded that dietary therapy was unnecessary for histidinemia and the screening for the disease was discontinued. In 1995, the guideline for the treatment of PKU was revised to keep lower blood phenylalanine levels. The guideline committee for the treatment of BH4 deficiency was establish in 1996 to obtain better prognosis. In 2012, the MHW decided to initiate publicly funded NBS using MS/MS for inborn errors of amino acid, organic acid, and fatty acid metabolism. The Japanese nationwide NBS has been performed for 35 years. This paper reviews the Japanese history of the development of NBS which has enabled more IEM patients to lead active and productive lives today.


Historical nile floods and their implications for climatic change.
Analysis of Nile flood stages from A.D. 640 to 1921 reveals major episodes of low Nile discharge during the years 930 to 1070 and 1180 to 1350 and major episodes of high Nile floods during 1070 to 1180 and 1350 to 1470. Examination of Nile flood maxima and minima and comparison with water levels in Lake Chad reveal a correlation between high Nile discharge and greater rainfall in equatorial East Africa. There is also apparently a correlation between low Nile discharge and cold climate in Europe.


Titanium Sulfides as Intercalation-Type Cathode Materials for Rechargeable Aluminum Batteries.
We report the electrochemical intercalation-extraction of aluminum (Al) in the layered TiS2 and spinel-based cubic Cu0.31Ti2S4 as the potential cathode materials for rechargeable Al-ion batteries. The electrochemical characterizations demonstrate the feasibility of reversible Al intercalation in both titanium sulfides with layered TiS2 showing better properties. The crystallographic study sheds light on the possible Al intercalation sites in the titanium sulfides, while the results from galvanostatic intermittent titration indicate that the low Al3+ diffusion coefficients in the sulfide crystal structures are the primary obstacle to facile Al intercalation-extraction.


Mechanism of Photoinduced Dihydroazulene Ring-Opening Reaction.
The photoinduced ring-opening reaction is a key process in the functioning of dihydroazulene/vinylheptafulvene (DHA/VHF) photoswitches. Over the years, the mechanism of this reaction has been extensively debated. Herein, by means of nonadiabatic trajectory dynamics simulations and quantum chemistry calculations, we present the first detailed and comprehensive investigation on the mechanism of the photoinduced ring-opening reaction of DHA. The results show the crucial role of the excited-state ring planarization process for the bond breaking. Our dynamics simulations show that the DHA ring opening is an ultrafast reaction that does not follow exponential kinetics but exhibits ballistic dynamics. Upon photoexcitation, the planarization occurs within 300-500 fs. This leads to the ring-opening reaction and concurrent decay of the molecule to the ground state within 100 fs through an S1 → S0 internal conversion process toward forming the VHF isomer. These results are consistent with previous ultrafast time-resolved experiments and lead to a thorough understanding of the DHA/VHF photoconversion.


Long-term operation and performance of cryogenic sapphire oscillators.
Cryogenic sapphire oscillators (CSO) developed at the University of Western Australia (UWA) have now been in operation around the world continuously for many years. Such oscillators, due to their excellent spectral purity are essential for interrogating atomic frequency standards at the limit of quantum projection noise; otherwise aliasing effects will dominate the frequency stability due to the periodic sampling between successive interrogations of the atomic transition. Other applications, which have attracted attention in recent years, include tests on fundamental principles of physics, such as tests of Lorentz invariance. This paper reports on the long-term operation and performance of such oscillators. We compare the long-term drift of some different CSOs. The drift rates turn out to be linear over many years and in the same direction. However, the magnitude seems to vary by more than one order of magnitude between the oscillators, ranging from 10(14) per day to a few parts in 10(13) per day.


Babesiosis.
Babesiosis is an emerging infection caused by protozoal parasites and transmitted by the same tick that transmits Lyme disease. Babesiosis is found throughout the world, but most cases have been described from the northeastern and northern midwestern United States. Patients experience a flulike illness that usually lasts for 1 or 2 weeks but may require hospital admission. Those at greatest risk of fatal disease include individuals older than age 50 years; asplenic individuals; and immunocompromised individuals as a result of immunosuppressive drugs, malignancy, or HIV infection. Specific diagnosis is made through examination of a Giemsa-stained thin blood smear, DNA amplification using polymerase chain reaction, or detection of specific antibody. Treatment consists of clindamycin and quinine or atovaquone and azithromycin and, in severe cases, exchange transfusion.


Dual convolutional neural network for aberration pre-correction and image quality enhancement in integral imaging display.
This paper proposes a method that utilizes a dual neural network model to address the challenges posed by aberration in the integral imaging microlens array (MLA) and the degradation of 3D image quality. The approach involves a cascaded dual convolutional neural network (CNN) model designed to handle aberration pre-correction and image quality restoration tasks. By training these models end-to-end, the MLA aberration is corrected effectively and the image quality of integral imaging is enhanced. The feasibility of the proposed method is validated through simulations and optical experiments, using an optimized, high-quality pre-corrected element image array (EIA) as the image source for 3D display. The proposed method achieves high-quality integral imaging 3D display by alleviating the contradiction between MLA aberration and 3D image resolution reduction caused by system noise without introducing additional complexity to the display system.


Structure, chromosomal localization, and expression of 12 genes of the MAGE family.
We reported previously that human gene MAGE-1 directs the expression of a tumor antigen recognized on a melanoma by autologous cytolytic T lymphocytes. Probing cosmid libraries with a MAGE-1 sequence, we identified 11 closely related genes. The analysis of hamster-human somatic cell hybrids indicated that the 12 MAGE genes are located in the q terminal region of chromosome X. Like MAGE-1, the 11 additional MAGE genes have their entire coding sequence located in the last exon, which shows 64%-85% identity with that of MAGE-1. The coding sequences of the MAGE genes predict the same main structural features for all MAGE proteins. In contrast, the promoters and first exons of the 12 MAGE genes show considerable variability, suggesting that the existence of this gene family enables the same function to be expressed under different transcriptional controls. The expression of each MAGE gene was evaluated by reverse transcription and polymerase chain reaction amplification. Six genes of the MAGE family including MAGE-1 were found to be expressed at a high level in a number of tumors of various histological types. None was expressed in a large panel of healthy tissues, with the exception of testis and placenta.


Regulation of Cholesterol Sulfotransferase SULT2B1b by Hepatocyte Nuclear Factor 4α Constitutes a Negative Feedback Control of Hepatic Gluconeogenesis.
The cholesterol sulfotransferase SULT2B1b converts cholesterol to cholesterol sulfate (CS). We previously reported that SULT2B1b inhibits hepatic gluconeogenesis by antagonizing the gluconeogenic activity of hepatocyte nuclear factor 4α (HNF4α). In this study, we showed that the SULT2B1b gene is a transcriptional target of HNF4α, which led to our hypothesis that the induction of SULT2B1b by HNF4α represents a negative feedback to limit the gluconeogenic activity of HNF4α. Indeed, downregulation of Sult2B1b enhanced the gluconeogenic activity of HNF4α, which may have been accounted for by the increased acetylation of HNF4α as a result of decreased expression of the HNF4α deacetylase sirtuin 1 (Sirt1). The expression of Sult2B1b was also induced by HNF4α upon fasting, and the Sult2B1b null (Sult2B1b-/-) mice showed increased gluconeogenic gene expression and an elevated fasting glucose level, suggesting that SULT2B1b also plays a restrictive role in HNF4α-mediated fasting-responsive gluconeogenesis. We also developed thiocholesterol, a hydrolysis-resistant derivative of CS, which showed superior activity to that of the native CS in inhibiting gluconeogenesis and improving insulin sensitivity in high-fat-diet-induced diabetic mice. We conclude that the HNF4α-SULT2B1b-CS axis represents a key endogenous mechanism to prevent uncontrolled gluconeogenesis. Thiocholesterol may be used as a therapeutic agent to manage hyperglycemia.


3D localization of surface 10-20 EEG electrodes on high resolution anatomical MR images.
A method to visualize surface EEG electrodes on conventional high-resolution magnetic resonance (MR) images is presented. Because conventional silver or gold electrodes generate an insignificant artifactual signal signature in MR images, a plastic capsule filled with gadolinium-doped water was designed to mold onto each electrode, thereby outlining the electrode surfaces as a negative imprint on MR images. MR images of the head with capsules affixed clearly demonstrated the location and shape of the electrodes. Selected cranial tissues were identified by using semi-automatic image segmentation to determine their three-dimensional spatial relationship to the electrodes. Such representations could be used as a starting point for more precise EEG source localization modeling applicable to individual patients.


The bioassay-guided isolation of antifungal saponins from Hosta plantaginea leaves.
Four new steroidal saponins hostaside Ⅰ (1), hostaside Ⅱ (2), hostaside Ⅲ (3), and hostaside Ⅳ (4), together with five known steroidal saponins (5-9), were isolated by the bioassay-guided fractionation from the leaves of Hosta plantaginea (Lam.) Aschers, a worldwide well-known ornamental plant. Hostasides Ⅰ and Ⅱ showed significant antifungal activities, and they could inhibit the growth of Candida albicans and Fusarium oxysporium with MIC values as low as 4 μg/ml.


Philanthropy: a priceless lesson in healthcare leadership--the Sanford Health story.
At Sanford Health, philanthropic leadership has been transformational in nature. Denny Sanford's $400 million gift to Sanford Health (the largest known gift to an American healthcare organization) demonstrates how philanthropic leadership transforms an organization by enhancing the role it will play in its community, region, and beyond. This article describes how the gift came about, the accomplishments in fulfilling the donor's intentions, the leadership initiatives and challenges associated with the gift, and its overall impact on the organization. Philanthropy can teach us things. For example, philanthropy can teach healthcare institutions lessons about core values, a compelling vision, and a commitment to action. These qualities are the essence of philanthropy. As senior executives and board members apply these lessons to planning, trust building, and communications critical to obtaining philanthropic support, their organization has the opportunity to move from success to significance in fulfilling its mission.


Prevalence and distribution of dental restorative materials in US Air Force veterans.
Millions of restorative procedures are performed annually in the United States, yet very little is known about their distribution in the general population. With increasing concern about potential adverse health effects of some restorative materials, a better understanding of the extent of exposure to these materials in the population is important. The purpose of this study is to report the prevalence, patterns, and distribution of dental restorative materials in a population of male veterans. This collaborative study with the US Air Force examined 1,166 male veterans to assess exposure to dental amalgam and other restorative materials. An inventory of dental materials in the study population was obtained through oral examinations. Dental materials were classified into five categories: (1) amalgam; (2) resin; (3) porcelain, cement, or temporary, including ionomer (PCT); (4) cast gold alloys/direct filling gold; and (5) other metals (OM). The mean age of the study participants was 52.9 years. Over 94 percent of the study participants were dentate. The study participants averaged 45.8 restored/replaced surfaces. Restored/replaced surfaces increased with age while the number of teeth decreased with age. The most frequently used restorative material was amalgam, averaging 19.89 surfaces per subject, followed by PCT (9.38), resins (8.99), OM (5.52), and gold (4.91). The distributions of restorative materials varied by age, arch type, and location in the mouth. The study population experienced substantial exposure to dental materials.


Transcanal endoscopic approach to lesions of the suprageniculate ganglion fossa.
The aim of this paper would be to describe the first case series of exclusive transcanal endoscopic approach to treat lesions with limited extension at the suprageniculate fossa. This endoscopic approach allowed a complete removal of suprageniculate disesases with low complication rates using a minimally invasive surgical route. This is a retrospective chart analysis and a surgery video recording review of these patients were performed in August 2015. From November 2011 to November 2015, 29 patients were submitted to an endoscopic transcanal lateral skull base surgery. From those 29 subjects, in 6 patients an exclusive endoscopic transcanal suprageniculate approach was performed to remove lesions located into the geniculate fossa. Surgical indications, pre-operative assessment, results were collected and the surgical technique were described. The final study group was composed of 6 patients. 3 male and 3 female; median age is 25.3 years old. In all 6 subjects it was possible to remove the lesions using an exclusive endoscopic transcanal suprageniculate approach. No intraoperaoperative complications were observed in any patients. The mean follow up period was 15.16 months. Exclusive endoscopic transcanal suprageniculate approach is definitely a minimally invasive technique and should be consider an optimal solution to treat lesions located in the suprageniculate fossa in some patients. We introduce a minimally invasive approach to the geniculate ganglion region in order to allow complete removal of suprageniculate disesases with low complication rates using a minimally invasive surgical route.


Albiziahexoside: a potential source of bioactive saponin from the leaves of Albizzia lebbeck.
Albiziahexoside (1), a new hexaglycosylated saponin, was isolated from leaves of Albizzia lebbeck. Saponin 1, which is an analog of cytotoxic albiziatrioside A (2), did not show cytotoxicity. However, 1 is a potential source of 2 and related bioactive saponins for medicinal use because leaves, which can be regenerated after collection, contain 1 in substantial quantity.


Evaluation of antioxidant properties of root bark of Hemidesmus indicus R. Br. (Anantmul).
Hemidesmus indicus R. Br. (Asclepiadaceae) is a well known drug in Ayurveda system of medicine. In the present study, antioxidant activity of methanolic extract of H. indicus root bark was evaluated in several in vitro and ex vivo models. Further, preliminary phytochemical analysis and TLC fingerprint profile of the extract was established to characterize the extract which showed antioxidant properties. The in vitro and ex vivo antioxidant potential of root bark of H. indicus was evaluated in different systems viz. radical scavenging activity by DPPH reduction, superoxide radical scavenging activity in riboflavin/light/NBT system, nitric oxide (NO) radical scavenging activity in sodium nitroprusside/Greiss reagent system and inhibition of lipid peroxidation induced by iron-ADP-ascorbate in liver homogenate and phenylhydrazine induced haemolysis in erythrocyte membrane stabilization study. The extract was found to have different levels of antioxidant properties in the models tested. In scavenging DPPH and superoxide radicals, its activity was intense (EC50 = 18.87 and 19.9 microg/ml respectively) while in scavenging NO radical, it was moderate. It also inhibited lipid peroxidation of liver homogenate (EC50 = 43.8 microg/ml) and the haemolysis induced by phenylhydrazine (EC50 = 9.74 microg/ml) confirming the membrane stabilization activity. The free radical scavenging property may be one of the mechanisms by which this drug is effective in several free radical mediated disease conditions.


Progress in Evaluation of Deep Artificial Defects from Sweep-Frequency Eddy-Current Testing Signals.
The article discusses the practical application of the method of electromagnetic non-destructive investigation of austenitic materials. To identify and evaluate deep artificial defects, the sweep-frequency eddy current method with harmonic excitation is used. The objects of interest are the surface electric-discharged machined notches, with a defined geometry, fabricated in a plate with a thickness of 30 mm. An innovative eddy current probe with a separate excitation and detection circuit is used for the investigation. The achieved results clearly demonstrate the robustness and potential of the method, especially for deep defects in thick material. By using the fifth probe in connection with the frequency sweeping of eddy currents, it is possible to reliably detect artificial defects up to 24 ± 0.5 mm deep by using low-frequency excitation signals. An important fact is that the measuring probe does not have to be placed directly above the examined defect. The experimental results achieved are presented and discussed in this paper. The conducted study can serve, for example, as an input database of defect signals with a defined geometry to increase the convergence of learning networks and for the prediction of the geometry of real (fatigue and stress-corrosion) defects.


Accuracy of heart girth tapes in the estimation of weights of pre-weaned calves.
Heart girth tapes (HGTs) are often used as an alternative to weight scales for calves. This study investigated the accuracy of HGT in estimating bodyweight and daily liveweight gain (DWLG) of pre-weaned calves, and the impact of inter-observer variation. In Study 1, 119 calves were weighed using HGT and electronic scales on multiple occasions. Mixed-effects models for both bodyweight and DLWG were used to determine the accuracy of HGT compared to the electronic scales. Simulation data were used to further analyse the accuracy of DLWG estimation including for factors such as the effect of group size on group DLWG estimates.In Study 2, 10 observers weighed 20 pre-weaned calves, using HGT and electronic scales. Mixed-effect model was used to investigate the impact of different observers on the accuracy of HGT on measuring bodyweights. Mixed-effects model results suggest HGT provides a relatively accurate estimation of weight (MAE: 2.66 kg) and relatively inaccurate estimation of DLWG (MAE 0.10 kg/d). Simulated data identified associations between time between weight dates and error in DLWG estimation, with MAE of individual DLWG estimation decreasing from 0.43 kg/d when 14 days apart to 0.08 kg/d when 70 days apart. Increased calf numbers reduced error rates of group DLWG estimation, with <0.05 kg/d error achieved in >90% of simulations when 12 calves were weighed 70 days apart. HGTs are relatively accurate at estimating individual bodyweights but are unreliable methods for measuring DLWG in individual calves, particularly weighed within a short-time period. Estimates at group level however are relatively accurate, providing there is a suitable period of time between weigh dates and an appropriate number of calves per group.


Vitamin D Supplementation during Intensive Care Unit Stay Is Associated with Improved Outcomes in Critically Ill Patients with Sepsis: A Cohort Study.
Vitamin D, as a common micronutrient, has been widely used in critically ill patients. However, whether supplementation of vitamin D in adult patients with sepsis can improve their prognosis remains controversial. Data from the Mart for Intensive Care IV database was used in this retrospective cohort study, and adult patients with sepsis were enrolled. Critically ill patients, admitted to intensive care units (ICUs) between 2008 and 2019 at the Beth Israel Deaconess Medical Center (BIDMC), were divided into the vitamin D supplementation group and non-vitamin D supplementation group. The primary outcomes were defined as all-cause in-hospital, 28-day, and 90-day mortality rates after admission to the ICU. A 1:1 propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and overlap weighting (OW) analyses were used to minimize selection bias and balance the baseline demographic characteristics. Regression and survival analyses were performed to assess the association between vitamin D supplementation and clinical outcomes in patients with sepsis. In total, 3539 patients with sepsis were enrolled as study participants; of these, 315 were supplemented with vitamin D during their ICU stay. In-hospital, 28-day, and 90-day mortality rates were significantly lower in patients with sepsis supplemented with vitamin D. Multivariate regression analysis showed vitamin D supplementation as a potential protective factor for in-hospital mortality with an odds ratio (OR) = 0.70 (0.51-0.96) after adjusting for all confounders. The hazard ratios (HRs) for 28-day and 90-day mortality were 0.65 (0.50-0.85) and 0.70 (0.55-0.90), respectively. The survival analysis showed that the vitamin D supplementation group had a higher survival probability within 28 and 90 days (p-value < 0.05). These results remained relatively stable post PSM, IPTW, and OW. However, we found no evidence that vitamin D supplementation could shorten the length of stay in the ICU or hospital. Vitamin D supplementation during an ICU stay was associated with improved prognosis in patients with sepsis, as evidenced by lower in-hospital, 28-day, and 90-day mortality rates and lower disease severity-related scores, but showed no influence on the length of stay in the hospital or ICU.


Superior Mesenteric Vein Resection Followed by Porto-Jejunal Anastomosis During Pancreatoduodenectomy for Borderline Resectable Pancreatic Cancer - A Case Report and Literature Review.
Pancreatic cancer represents the most lethal abdominal malignancy, the only chance for achieving an improvement in terms of survival being represented by radical surgery. Although it has been considered that venous invasion represents a contraindication for resection, recently it has been demonstrated that in regards to overall survival after radical resection, it is similar to the one reported after standard pancreatoduodenectomy. A 53-year-old patient with no significant medical past was diagnosed with a borderline resectable pancreatic adenocarcinoma invading the superior mesenteric vein. The patient was submitted to pancreatoduodenectomy en bloc with superior mesenteric vein resection; the two jejunal veins were further anastomosed to the remnant portal vein. The postoperative outcome was favorable; the patient was discharged in the 10th postoperative day. Although technically more demanding, pancreatoduodenectomy en bloc with superior mesenteric vein resection and jejunal portal anastomosis is feasible and might offer a chance for long-term survival in borderline pancreatic head carcinoma invading the superior mesenteric vein.


Bilateral rhabdomyomatous tumor relapsed as typical triphasic Wilms' tumor.
The authors report on a child affected with bilateral renal tumor, which was treated with cancer chemotherapy before and after surgery. Twenty-eight months after the discontinuance of therapy, a neoplasm was disclosed in the left kidney and then removed. Histologically, the bilateral tumor excised by the first surgery could be classified as biphasic Wilms' tumor, rhabdomyomatous variant, whereas the neoplasm removed by the second surgery was the typical triphasic Wilms' tumor. The authors suggest that preoperative chemotherapy might have played a role in the histologic changes of the initial tumor. Nonetheless, it is also tempting to postulate that the two histologic variants of Wilms' tumor could have occurred in the patient in spite of any treatment.


[The family of a patient with borderline personality disorder: burden of illness and interventions for caregivers].
The scientific literature focused on factors involved in the onset of borderline personality disorder (BPD) has given a central role to the families of these patients. The role of the family in understanding the disorder has gradually changed thanks to research that investigated the interaction of several factors in the development of this psychopathology. Recently, scientific literature on DBP has allowed to consider parents as no longer "responsible" for the development of the disorder, but as directly involved in interpersonal problems of patients and therefore a potential "ally" in the management of crisis. The aim of this study is to describe and quantify the family burden of BPD patients and browse specific interventions for the family of these patients. PubMed and PsycINFO have been used for review with the following keywords: "borderline personality disorder", "family", "psychopathology", "burden", "psychoeducation", "caregiver", "caretaker". Studies on family burden of BPD patients are still few. Research shows that the family burden of BPD patients is comparable with that of families of patients with schizophrenia. Clinical trials of interventions for caregivers of patients with BPD show that specific strategies can reduce the family burden and improve their self-efficacy. Scientific literature highlights the relevance of problems of families with a BPD member and the importance of involving them in the treatment of these patients.


Blur reduction of conventional film-based tomograms for pre-surgical evaluation of potential mandibular implant sites.
The usefulness of motion-based cross-sectional tomography to evaluate osseous support and adjacent anatomical structures for dental implant placement is limited by the inherent blurring in these images. The goal of this study was to develop a method to remove blurring while permitting accurate dimensional analysis of the potential implant site. Defined regions (anterior, cuspid, premolar, molar) on two preserved human mandibles were imaged using cross-sectional linear tomography. Algorithms were developed as a personal computer application to remove the blur and to aid in identification of the cortical plate borders and the mandibular canal. The data set of eight tomograms was digitized and the blur reduced with the developed algorithm. An operator measured the height and width of the mandible on each original tomogram and each deblurred tomogram in triplicate. Method error was calculated as the difference between direct caliper measurements of the respective skull regions and image measurements of height and width for both the original digitized tomograms and the deblurred tomograms. Method error using the original images (height: -2.72 +/- 2.15 mm; width: -0.58 +/- 1.36 mm) compared to the deblurred tomograms (height: -0.58 +/- 1.16 mm; width: 0.37 +/- 0.59 mm) was significantly greater for both height (t-test level of significance, P = 0.0047) and width (t-test level of significance, P = 0.0001). These findings suggest that the method developed may greatly improve the ability of clinicians to accurately assess the implant site using cross-sectional film-based linear tomograms.


Modelling event-related responses in the brain.
The aim of this work was to investigate the mechanisms that shape evoked electroencephalographic (EEG) and magneto-encephalographic (MEG) responses. We used a neuronally plausible model to characterise the dependency of response components on the models parameters. This generative model was a neural mass model of hierarchically arranged areas using three kinds of inter-area connections (forward, backward and lateral). We investigated how responses, at each level of a cortical hierarchy, depended on the strength of connections or coupling. Our strategy was to systematically add connections and examine the responses of each successive architecture. We did this in the context of deterministic responses and then with stochastic spontaneous activity. Our aim was to show, in a simple way, how event-related dynamics depend on extrinsic connectivity. To emphasise the importance of nonlinear interactions, we tried to disambiguate the components of event-related potentials (ERPs) or event-related fields (ERFs) that can be explained by a linear superposition of trial-specific responses and those engendered nonlinearly (e.g., by phase-resetting). Our key conclusions were; (i) when forward connections, mediating bottom-up or extrinsic inputs, are sufficiently strong, nonlinear mechanisms cause a saturation of excitatory interneuron responses. This endows the system with an inherent stability that precludes nondissipative population dynamics. (ii) The duration of evoked transients increases with the hierarchical depth or level of processing. (iii) When backward connections are added, evoked transients become more protracted, exhibiting damped oscillations. These are formally identical to late or endogenous components seen empirically. This suggests that late components are mediated by reentrant dynamics within cortical hierarchies. (iv) Bilateral connections produce similar effects to backward connections but can also mediate zero-lag phase-locking among areas. (v) Finally, with spontaneous activity, ERPs/ERFs can arise from two distinct mechanisms: For low levels of (stimulus related and ongoing) activity, the systems response conforms to a quasi-linear superposition of separable responses to the fixed and stochastic inputs. This is consistent with classical assumptions that motivate trial averaging to suppress spontaneous activity and disclose the ERP/ERF. However, when activity is sufficiently high, there are nonlinear interactions between the fixed and stochastic inputs. This interaction is expressed as a phase-resetting and represents a qualitatively different explanation for the ERP/ERF.