Mineral Trioxide Aggregate for Intruded Teeth with Incomplete Apex Formation.
The axial displacement of a tooth within the alveolar bone is called traumatic intrusive luxation. The treatment of immature permanent teeth with incomplete root formation is a challenging procedure, as the prognosis is uncertain. The objective of the present article is to report the successful treatment of traumatic intrusive luxation in teeth with incomplete root formation, where mineral trioxide aggregate (MTA) was used as an apical plug to induce apexification. A 10-year-old boy was referred to our department for emergency treatment of dentoalveolar trauma to the maxillary central incisors. After clinical and radiographic examination, the teeth were surgically repositioned and rigidly fixed. Three months later, a pulp vitality test of both teeth elicited a negative response. Endodontic therapy with an MTA plug was used to induce apexification as root formation was incomplete. The root canals were then filled. Clinical and radiographic examination was then performed again at 2 and 4 months later. The MTA apical plug was effective in inducing apexification and maintaining both teeth.


Partial resection and omentalization: a new technique for management of prostatic retention cysts in dogs.
The purpose of this study was to determine the results of a new technique for management of prostatic retention cysts in dogs. A retrospective clinical study. Eighteen client-owned dogs. Dogs with prostatic retention cysts were treated by celiotomy and drainage of the cysts. The majority of the cyst wall was resected and residual cyst cavities were packed with omentum. All dogs were castrated. Long-term resolution of clinical signs was achieved in all dogs, with follow-up periods ranging from 6 to 42 months. Five dogs developed urinary incontinence postoperatively. This persisted in two dogs, but was well controlled with phenylpropanolamine. In the remaining dogs, the incontinence was transient and resolved within 2 months of surgery. Partial cyst resection combined with omentalization and castration was a simple and effective means of managing prostatic retention cysts. The incidence of serious complications, including postoperative urinary incontinence, was low.


Leventhal's common-sense model and asthma control: Do illness representations predict success of an asthma rehabilitation?
This study investigates whether illness representations predict changes in asthma control or vice versa. Illness perceptions and asthma control were assessed in N = 113 asthma patients at the begin/end of an inpatient rehabilitation. Bivariate cross-lagged panel analyses showed that the illness representation dimensions Personal control, Consequences, Coherence, and Emotional representation predicted the change in asthma control, but asthma control did not predict illness representations. In multiple regression analyses with covariates, Personal control still predicted the change in asthma control. Illness beliefs assessed at the beginning of an intervention might help to identify patients with lower probability of treatment success.


Decoding the proteomic changes involved in the biofilm formation of Enterococcus faecalis SK460 to elucidate potential biofilm determinants.
Enterococcus faecalis is a major clinically relevant nosocomial bacterial pathogen frequently isolated from polymicrobial infections. The biofilm forming ability of E. faecalis attributes a key role in its virulence and drug resistance. Biofilm cells are phenotypically and metabolically different from their planktonic counterparts and many aspects involved in E. faecalis biofilm formation are yet to be elucidated. The strain E. faecalis SK460 used in the present study is esp (Enterococcal surface protein) and fsr (two-component signal transduction system) negative non-gelatinase producing strong biofilm former isolated from a chronic diabetic foot ulcer patient. We executed a label-free quantitative proteomic approach to elucidate the differential protein expression pattern at planktonic and biofilm stages of SK460 to come up with potential determinants associated with Enterococcal biofilm formation. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of proteomic data revealed that biofilm cells expressed higher levels of proteins which are associated with glycolysis, amino acid biosynthesis, biosynthesis of secondary metabolites, microbial metabolism in diverse environments and stress response factors. Besides these basic survival pathways, LuxS-mediated quorum sensing, arginine metabolism, rhamnose biosynthesis, pheromone and adhesion associated proteins were found to be upregulated during the biofilm transit from planktonic stages. The selected subsets were validated by quantitative real-time PCR. In silico functional interaction analysis revealed that the genes involved in upregulated pathways pose a close molecular interaction thereby coordinating the regulatory network to thrive as a biofilm community. The present study describes the first report of the quantitative proteome analysis of an esp and fsr negative non gelatinase producing E. faecalis. Proteome analysis evidenced enhanced expression of glycolytic pathways, stress response factors, LuxS quorum signaling system, rhamnopolysaccharide synthesis and pheromone associated proteins in biofilm phenotype. We also pointed out the relevance of LuxS quorum sensing and pheromone associated proteins in the biofilm development of E. faecalis which lacks the Fsr quorum signaling system. These validated biofilm determinants can act as potential inhibiting targets in Enterococcal infections.


General practitioners' perceptions of dealing with patients with pressured speech: a qualitative study.
Empathetic listening can be particularly challenging with patients presenting pressured speech, while time pressure and costs limit practitioners' availability. We aimed to explore general practitioners' (GPs') experiences when encountering a patient with pressured speech without pathological syndrome. Using a thematic analysis method, 19 semi-structured interviews were conducted with GPs purposively sampled in Ile-de-France region. Three themes emerged. First, misgivings were aroused when meeting a patient with pressured speech, including frustration, displeasure, and a struggle to maintain focus. Second, huge efforts were needed to adhere to the appropriate clinical reasoning and care for these patients who need more time and energy. The very definition of this condition varies from one clinician to another, and for some, psychiatric conditions were systematically associated. Third, implementation of specific strategies was required to adjust to these patients: trying to create distance with the patient, to organize a framework in which the patient with pressured speech can express him or herself, and even strategies to increase GPs' availability. The time and energy required to provide adequate care for patients presenting with pressured speech make it quite challenging, and this builds up pressure in the waiting room. But when medical demands take this form, there is a risk that clinicians will reject the patient or refer early to mental health services, leading to growing feelings of abandonment, the neglect of organic issues, and medical nomadism. Initial and continuing medical training focussing on advanced communication skills and multifocal approaches can foster long-term follow-up.


Primary tubercular chest wall abscess in a young immunocompetent male.
Chest wall tuberculosis is a rare entity especially in an immunocompetent patient. Infection may result from direct inoculation of the organisms or hematogenous spread from some underlying pathology. Infected lymph nodes may also transfer the bacilli through lymphatic route. Chest wall tuberculosis may resemble a pyogenic abscess or tumour and entertaining the possibility of tubercular etiology remains a clinical challenge unless there are compelling reasons of suspicion. In tuberculosis endemic countries like India, all the abscesses indolent to routine treatment need investigation to rule out mycobacterial causes. We present here a case of chest wall tuberculosis where infection was localized to skin only and, in the absence of any evidence of specific site, it appears to be a case of primary involvement.


MIDGUT ULTRASTRUCTURE OF FOURTH INSTAR OCHLEROTATUS TOGOI (DIPTERA: CULICIDAE).
The ultrastructure of the midgut of fourth instar Ochlerotatus togoi was investigated by light, scanning and transmission electron microscopy. This study was performed to provide information to help devise future control efforts aimed at the larval stages of this vector of filariasis. The fourth instar midgut was approximately 2 mm in length and consisted of three morphologically distinct cell types: epithelial, regenerative, and endocrine cells. There was a monolayer of epithelial cells on the luminal surface of the midgut, with multiple folds of the plasma membrane where it adjoined the basement membrane. Regenerative cells were scattered throughout the basal portion of the epithelium, along with endocrine cells. No evidence of division or differentiation was seen in any of the cell types. Six layers of the peritrophic matrix were observed in the gut lumen which separated ingested food from the midgut epithelial cells. Cytoplasmic protrusions were seen in many areas of the luminal midgut surface and numerous autophagosomes were seen in the epithelial cells of both early and late fourth instar larvae, suggesting autophagy is involved in the degeneration process of the midgut in preparation for pupation. This study provides a basis for understanding normal Oc. togoi larval midgut development. Further studies are needed to determine the factors that control larval growth and the nutritional state. Such information could be used to reduce adult fecundity and develop biological control mechanisms.


Childhood Depression: Relation to Adaptive, Clinical and Predictor Variables.
The study had two goals: (1) to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2) to identify predictor variables of childhood depression. Participants were 420 students aged 7-10 years old (53.3% boys, 46.7% girls). Results revealed: (1) positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and childhood stress; and (2) negative correlations between depression and personal adaptation, global self-concept, social skills, and resilience (sense of competence and affiliation). Linear regression analysis including the global dimensions revealed 4 predictors of childhood depression that explained 50.6% of the variance: high clinical maladjustment, low global self-concept, high level of stress, and poor social skills. However, upon introducing the sub-dimensions, 9 predictor variables emerged that explained 56.4% of the variance: many internalizing problems, low family self-concept, high anxiety, low responsibility, low personal self-assessment, high social stress, few aggressive behaviors toward peers, many health/psychosomatic problems, and external locus of control. The discussion addresses the importance of implementing prevention programs for childhood depression at early ages.


Proposal, design, and cost analysis of a hydrogen production process from cellulose via supercritical water gasification.
Hydrogen production from biomass, a renewable resource, has been attracting attention in recent years. We conduct a detailed process design for cellulose-derived hydrogen production via glucose using supercritical water gasification technology. Gasification of biomass in supercritical water offers advantages over conventional biomass conversion methods, including high gasification efficiency, elevated hydrogen molar fractions, and the minimization of drying process for wet biomass. In the process design, a continuous tank reactor is employed because the reaction in the glucose production process involves solids, and using a tube-type reactor may clog the reactor with solids. In the glucose separation process, glucose and levulinic acid, which cannot be separated by boiling point difference, are separated by using an extraction column. In the hydrogen separation process, the hydrogen purity, which could not be sufficiently increased with a single pressure swing adsorption (PSA) process, is increased to the target value by employing two sets of PSA columns. The overall utility cost is significantly reduced by $0.020/mol-H2 through heat integration. Our economic evaluation for this process results in a deficit of $0.015/mol-H2, as a price to be paid by the human for renewable hydrogen production from biomass at the present stage. By simply adopting the reported experimental condition, our process contains a large amount of water and sulfuric acid, which requires an enormous cost for the neutralizer, drying utility, and extractant. To improve the economic performance of the process, it is necessary to consider the reaction of cellulose solution at a higher concentration to reduce the burden of glucose separation. In addition, the effective use of the wasted hydrogen with a purity of about 95 vol% from the second PSA column may also improve the process economics. Whilst, the required energy cost for hydrogen production for our process is calculated to be significantly lower than those for other various representative hydrogen production methods: 0.37 (0.44) times less than that of steam reforming of methane with (without) CO2 capture, 0.15 times less than that of the water electrolysis by the electric power system, and 0.073 times less than that of electrolysis of water by wind power. This result implies the practical potential of our cellulose-based green hydrogen production scheme.


Arsenic uptake by lettuce from As-contaminated soil remediated with Pteris vittata and organic amendment.
Leaching of inorganic arsenic (As) from chromated copper arsenate (CCA)-treated wood may elevate soil As levels. Thus, an environmental concern arises regarding As accumulation in vegetables grown in these soils. In this study, a greenhouse experiment was conducted to investigate the ability of As-hyperaccumulator P. vittata and organic amendments in reducing As uptake by lettuce (Lactuca sativa) from a soil contaminated from CCA-treated wood (63.9 mg kg-1 As). P. vittata was grown for 150 d in a CCA-contaminated soil amended with biochar, activated carbon or coffee grounds at 1%, followed by lettuce for another 55 d. After harvest, plant biomass and As concentrations in plant and soil were determined. The presence of P. vittata reduced As content in lettuce by 21% from 27.3 to 21.5 mg kg-1 while amendment further reduced As in lettuce by 5.6-18%, with activated C being most effective. Our data showed that both P. vittata and organic amendments were effective in reducing As concentration in lettuce. Though no health-based standard for As in vegetables exists in USA, care should be taken when growing lettuce in contaminated soils. Our data showed that application of organic amendments with P. vittata reduced As hazards in CCA-contaminated soils.


[Low level educated community health workers training: a strategy to improve children access to acute respiratory treatment in Senegal].
Acute respiratory infections (ARI) are the leading cause of death in childhood. Most of children's deaths happen at home without health level first cares. However in Senegal only health workers are allowed to prescribe antibiotics. A competency-based training was developed to improve and assess the management of acute respiratory infections in young children aged 2 to 59 months by low level educated community health workers (CHWs) in 4 districts of Senegal. The first findings showed the CHWs capable of acquiring the skills needed to effectively manage ARI cases in accordance with the World Health Organization's ARI case management strategy. The aim of this study was to assess the quality of their management after a 1 year follow-up. We provided to CHWs 3 days course in ARI management. After the 3-day course, a 4-month follow-up was performed. We organized a 1-day refresher course every month and in every district. In order to assess the quality of management of CHWs we analyzed the management process and compared the CHWs classification to the classification of the first level health facilities. Twenty-three percent (3727/15,965) of IRA cases of district were managed by CHWs. Ninety percent (2738/3042) among them were well classified, well managed and well followed-up. But 28% of severe pneumonia cases were misclassified as pneumonia. About treatment, 22.5% of 'cough or cold' got wrong treatment with cotrimoxazole and 10.3% of severe pneumonia got cotrimoxazole without referral. Less than half of severe pneumonia benefited of the first follow-up and only 18% of the second. The results highlight that a CHWs low-level educated in French, trained and followed-up could apply the WHO algorithm of IRA management. They could help to give proximal care related to children ARI, to the community. But it seems useful of emphasizing the recognition of danger signs and the follow-up of severe cases.


Quantum Harmonic Oscillator Spectrum Analyzers.
Characterization and suppression of noise are essential for the control of harmonic oscillators in the quantum regime. We measure the noise spectrum of a quantum harmonic oscillator from low frequency to near the oscillator resonance by sensing its response to amplitude modulated periodic drives with a qubit. Using the motion of a trapped ion, we experimentally demonstrate two different implementations with combined sensitivity to noise from 500 Hz to 600 kHz. We apply our method to measure the intrinsic noise spectrum of an ion trap potential in a previously unaccessed frequency range.


Honoring Identity Through Mealtimes in Chinese Canadian Immigrants.
Mealtimes are opportunities for social interactions and expressions of individual and family identity, and serve as a microcosm of the broader lives of families living with dementia. The Eating Together study and its resulting Life Nourishment Theory (LNT) explicated the importance of mealtimes for honouring individual and family identities in the context of dementia. This sub-study examined a specific ethnocultural group with cultural food-ways and caring expectations, to determine if the concept of honouring identity needed to be modified or extended. Using active interview techniques, two Cantonese speaking researchers completed dyad/triad family and individual interviews with six Chinese Canadian immigrant families, recruited from two service providers in a large, urban, multicultural city. This sub-study provided insight into the challenges and rewards of mealtimes for Chinese immigrant families with dementia in the community and specifically provided further insights into the honouring identity concept. Although LNT and specifically the honouring identity concept was generally confirmed in this group, some culturally-specific themes were also identified. This work serves as a basis for future studies examining the meaning and experience of mealtimes in specific cultural groups living with dementia. Such work would confirm if the LNT can be applied to specific ethnocultural groups as well as the general population living with dementia.


Influence of hydroxyethyl starch on lipopolysaccharide-induced tissue nuclear factor kappa B activation and systemic TNF-alpha expression.
Several studies have shown beneficial effects of hydroxyethyl starch (HES) on organ damage in the treatment of severe inflammatory situations, but the mechanisms remain unclear. Nuclear factor-kappa B (NF-kappaB) activation is known to contribute to many aspects of inflammatory injury and organ dysfunction in critical illness, and tumor necrosis factor-alpha (TNF-alpha) is considered the most important pro-inflammatory cytokine. The present study was undertaken to test whether HES (200/0.5) has some effects on tissue NF-kappaB activity and systemic TNF-alpha expression induced by lipopolysaccharide in order to define a possible mechanism of the beneficial effects of HES. Male Wistar rats were randomly divided into seven groups treated with saline, lipopolysaccharide (LPS, 6 mg/kg), LPS plus HES (3.75, 7.5, 15, 30 ml/kg), or HES (30 ml/kg) alone. Two hours after LPS challenge, NF-kappaB activation in the lungs, hearts, livers, and kidneys were examined with an electrophoretic mobility shift assay. Four hours after LPS challenge, plasma TNF-alpha concentrations were measured using an enzyme-linked immunosorbance assay. 3.75 and 7.5 ml/kg HES suppressed LPS-induced NF-kappaB activation in the four tissues and decreased plasma TNF-alpha elevation. The effects of 15 ml/kg HES was only significant in inhibiting NF-kappaB activity in the lung and liver. No effect of 30 ml/kg HES was revealed in all the cases. Lower doses of HES may inhibit tissue NF-kappaB activation and systemic TNF-alpha elevation after LPS challenge, which might be helpful during sepsis.


Risk factors for nicotine dependence in Chinese patients with lung cancer.
Smoking is a poor prognostic factor for lung cancer. Nicotine dependence remains the major cause of failure of smoking cessation. We investigated the risk factors for nicotine dependence in patients with lung cancer. Eligible patients were identified from November 2014 to February 2015. Age, marital status, educational level, annual household income, occupation, histology of lung cancer, tumor stage, smoking status, neuron-specific enolase (NSE) level, drive gene mutations, sleep quality, and patient personality were assessed. Physical nicotine dependence was assessed by the Fagerstrom Test for Nicotine Dependence (FTND). In total, 202 smokers were included in this study. Univariate analysis showed that marital status and pain were significantly correlated with nicotine dependence. Pearson's correlation analysis showed that age at the initiation of smoking, attempts to quit, NSE level, and sleep quality were significantly correlated with FTND scores. Pain, more attempts to quit, and poorer sleep quality were significantly associated with nicotine dependence. These risk factors could help to prevent smoking in Chinese patients with lung cancer.


[Frequency of vascular variations and anomalies accompanying intracranial aneurysms].
Investigation of the sites of intracranial aneurysms and incidence of associated congenital variations or anomalies. One hundred and ninety cerebral angiography examinations that were positive for aneurysm were evaluated retrospectively. Fourteen cases with vasospasm were excluded and the remaining 176 patients were assessed for the location of the aneurysm and co-incidental vascular variations and/or anomalies. There were two observers in the study, one of whom was an experienced vascular radiologist. The most frequent locations of aneurysms were the supraclinoid internal carotid artery (32%, n=74), anterior communicating artery (30%, n=68), and middle cerebral artery bifurcation (23%, n=52). Twenty-eight patients (17%) had multiple aneurysms. Ninety-one (52%) patients had a vascular anomaly or variation. Hypoplasia or agenesis of A1 segment of the anterior cerebral artery was found in 48 patients, an azygous anterior cerebral artery in 1, a frontoorbital artery in 1, a duplicated middle cerebral artery in 1, early bifurcation of the middle cerebral artery in 9, persistent fetal origin of the posterior cerebral artery in 26, fenestration of P1 segment of posterior cerebral artery in 1, agenesis of P1 segment of posterior cerebral artery in 1, fenestration of vertebral artery in 1, double trunk visualization of superior cerebellar artery in 2 patients. Due to an increased hemodynamic stress, congenital anomalies of the intracranial arteries predispose to the formation of saccular aneurysms. Nomalies such as A1 hypoplasia or agenesis, azygous anterior cerebral artery, accessory middle cerebral artery and persistent trigeminal artery are detected more frequently in patients with cerebral aneurysms compared to the normal population. The location of aneurysms and the frequency of arterial variations and anomalies in this study correlated well with data found in previous studies.


Cooling water before panicle initiation increases chilling-induced male sterility and disables chilling-induced expression of genes encoding OsFKBP65 and heat shock proteins in rice spikelets.
In rice (Oryza sativa L.), chilling-induced male sterility increased when plants experienced low water temperature (Tw , 18 °C for 14 d) before panicle initiation. The number of mature pollen grains after chilling at the booting stage (12 °C for 5 d) was only 45% of total pollen grains in low-Tw plants, whereas it was 71% in normal-Tw plants (Tw not controlled; approximately 23 °C under air temperature of 26 °C/21 °C, day/night). Microarray and quantitative PCR analyses showed that many stress-responsive genes (including OsFKBP65 and genes encoding the large heat shock protein OsHSP90.1, heat-stress transcription factors and many small heat shock proteins) were strongly up-regulated by chilling in normal-Tw spikelets, but were unaffected or even down-regulated by chilling in low-Tw spikelets. OsAPX2 and genes encoding some other antioxidant enzymes were also significantly down-regulated by low Tw in chilled spikelets. The levels of lipid peroxidation products (malondialdehyde equivalents) were significantly increased in low-Tw spikelets by chilling. Ascorbate peroxidase activity in chilled spikelets was significantly lower in low-Tw plants than in normal-Tw plants. Our data suggest that an OsFKBP65-related chilling response, which protects proteins from oxidative damage, is indispensable for chilling tolerance but is lost in low-Tw spikelets.


Habitat selection of black grouse in an isolated population in northern Germany-the importance of mixing dry and wet habitats.
Wildlife habitats in general must provide foraging, hiding and resting places as well as sites for reproduction. Little is known about habitat selection of black grouse in the lowlands of Central Europe. We investigated habitat selection of seven radio tagged birds in an open heath and grassland area surrounded by dense pine forests in the northern German Lüneburg Heath Nature Reserve. This site carries one of the last remaining populations in the Central European lowlands. Using resource selection functions based on presence/background data, we estimated the probability of black grouse occurrence by availability of, or distance to habitat types as well as vegetation diversity indices. Black grouse preferred undisturbed and heterogeneous habitats far from dense forests with wide sand heaths, natural grasslands and intermixed bogs, diverse vegetation and food sources, low density of (loose) shrub formations and solitary trees. Wetlands were extremely important in a landscape that is dominated by dry heaths and grasslands. About 4% (9 km2) of the nature reserve was a suitable habitat for black grouse, mostly due to lack of open areas due to the amount of dense forest, and because smaller, open heaths are only partly suitable. We suggest that to improve habitat quality and quantity for the grouse, habitat patch size and connectivity must be increased, along with a mosaic of heterogeneous landscape structures in these habitat islands. Our results may be used to inform and improve black grouse habitat management in the region and elsewhere.


Thiosemicarbazone Derivatives as Inhibitors of Amyloid-β Aggregation: Effect of Metal Coordination.
Three thiosemicarbazone derivatives, namely 4-(dimethylamino)benzaldehyde 4,4-dimethylthiosemicarbazone (HL1), 4-(dimethylamino)benzaldehyde thiosemicarbazone (HL2), and 4-(dimethylamino)benzaldehyde 4-methylthiosemicarbazone (HL3), have been synthesized and characterized. The three palladium(II) complexes 1-3 were prepared respectively from HL1, HL2, and HL3. The crystal structures of two coordination compounds, namely Pd(L2)2 (2) and Pd(L3)2 (3), were obtained, which showed the expected square-planar environment for the metal centers. The ligand HL3 and the Pd(II) complexes 1-3, which are stable in buffered solutions containing up to 5% DMSO, exhibit remarkable inhibitory properties against the aggregation of amyloid-β, reducing the formation of fibrils. HL1, HL3, 2, and 3 display IC50 values (i.e., the concentrations required to reduce Aβ fibrillation by 50%) below 1 μM, lower that of the reference compound catechin (IC50 = 2.8 μM). Finally, in cellulo studies with E. coli cells revealed that the palladium(II) compounds are significantly more efficient than the free ligands in inhibiting Aβ aggregation inside bacterial inclusion bodies, thus illustrating a beneficial effect of metal coordination.


Heterotopic triplet pregnancy. Report of a case with successful twin intrauterine gestation.
Reports of coexisting multiple intrauterine pregnancies and ectopic pregnancy are extremely rare. We present one case with early sonographic diagnosis of heterotopic pregnancy, successful laparoscopic treatment and a subsequent normal pregnancy course and outcome of the intrauterine twin gestation. A 29-year-old woman, gravida 1, para 0, presented for her first prenatal visit at 5 weeks of gestation with pelvic pain. She had conceived with 75 IU leutinizing hormone and follicle-stimulating hormone and homologous intrauterine insemination. The sonogram confirmed a dichorionic twin intrauterine pregnancy and left tubal pregnancy at 7 weeks of gestation. The patient underwent a laparoscopic left salpingostomy and removal of the ectopic pregnancy. Level II sonogram showed a grossly unremarkable twin gestation at 20 weeks. Labor was induced at 37 weeks of gestation due to mild preeclampsia and underwent vaginal delivery without difficulties. The first twin was a girl, weighing 2,722 g, with Apgar scores of 9/9. The second twin, a boy, was delivered 10 minutes later, weighing 2,863 g, with Apgar scores of 9/9. Early sonography is essential for the diagnosis of heterotopic pregnancy, and timely surgical intervention can save the intrauterine twin gestation, with a subsequent normal pregnancy course and outcome.


[An unusual cause of chronic diarrhea: lymphocytic colitis].
We report a case of lymphocytic colitis in a 74-year-old woman presenting with watery diarrhea since 1 year and in whom previous extensive investigations were normal. The diagnosis could be made on the basis of typical pathological pattern in colonic biopsies. The outcome was favourable with salazopyrine therapy. The clinical, histological and pathophysiological aspects of lymphocytic colitis are discussed.


Interactions between soy protein from water-soluble soy extract and polysaccharides in solutions with polydextrose.
This study focuses on the investigation of the interactions between polysaccharides (carrageenan and carboxymethylcellulose--CMC) and soy proteins from the water-soluble soy extract. The influence of pH (2-7) and protein-polysaccharide ratio (5:1-40:1) on the interaction between these polyelectrolytes was investigated in aqueous solutions with 10% of polydextrose and without polydextrose. The studied systems were analyzed in terms of pH-solubility profile of protein, ζ-potential, methylene blue-polysaccharide interactions, differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and confocal laser scanning microscopy. Although the mixtures of soy extract with both carrageenan and CMC showed dependency on the pH and protein-polysaccharide ratio, they did not present the same behavior. Both polysaccharides modified the pH-solubility profile of the soy protein, shifting the pH range in which the coacervate is formed to a lower pH region with the decrease of the soy extract-polysaccharide ratio. The samples also presented detectable differences regarding to ζ-potential, DSC, FTIR and microscopy analyses. The complex formation was also detected even in a pH range where both biopolymers were net-negatively charged. The changes promoted by the presence of polydextrose were mainly detected by blue-polysaccharide interactions measures and confocal microscopy.


Pharmacodynamic Optimization for Treatment of Invasive Candida auris Infection.
Candida auris is an emerging multidrug-resistant threat. The pharmacodynamics of three antifungal classes against nine C. auris strains was explored using a murine invasive candidiasis model. The total drug median pharmacodynamic (PD) target associated with net stasis was a fluconazole AUC/MIC (the area under the concentration-time curve over 24 h in the steady state divided by the MIC) of 26, an amphotericin B Cmax/MIC (maximum concentration of drug in serum divided by the MIC) of 0.9, and a micafungin AUC/MIC of 54. The micafungin PD targets for C. auris were ≥20-fold lower than those of other Candida species in this animal model. Clinically relevant micafungin exposures produced the most killing among the three classes.


Strategies in the design of prodrugs of anti-HIV agents.
Control of AIDS requires development of special therapeutic strategies in order to reduce the level of monocyte/macrophage HIV infection, to prevent spread of HIV within the monocyte/macrophage reservoir, to maintain a therapeutically effective drug concentration in sanctuaries such as the brain and to overcome the problem of cellular resistance mechanisms. A popular approach towards this end has been the development of prodrugs of anti-HIV drugs. This review covers the different strategies devised for the design of prodrugs of anti-HIV agents with emphasis on the recent findings in this field of research. Thus, prodrugs of nucleoside reverse transcriptase inhibitors (NRTIs) including, 5'-O carboxylic ester derivatives, 5'-O- monophosphate analogues, macromolecular derivatives, prodrugs of purine nucleosides, prodrugs of acyclic nucleosides, homo and hetero dinucleotides, prodrugs of non-classical nucleoside analogues, boranophosphate triesters of NRTIs, and prodrugs of protease inhibitors including acyl-substituted prodrugs, prodrugs with increased water solubility, monophosphate prodrugs, and conjugates of HIV protease inhibitors with a reverse transcriptase inhibitor through spontaneously cleavable linkers, constitute the subject of this review.


Healthcare providers' understanding of data displays of clinical trial information: a scoping review of the literature.
Healthcare providers often encounter clinical trial results in the form of visual data displays. Although there is a robust literature on patient responses to data displays in medical settings, less is known about how providers comprehend and apply this information. Our study provides a scoping review of the literature on providers' reactions to and perceptions of data displays. We searched article databases (PubMed, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library) supplemented by handsearching. Eligible articles were published in English from 1990 to 2020. We identified 15 articles meeting our criteria. Studies with physicians were more prevalent (13/15) than those with other healthcare providers (6/15). Commonly assessed outcomes included objective (10/15) and subjective comprehension (4/15), preference for certain data display formats (6/15), and hypothetical decision-making around prescribing (4/15). In studies that assessed comprehension of clinical trial concepts, scores were average or below what would be considered mastery of the information. Data display formats that were preferred did not always correlate with better comprehension of information; lesser preferred formats (e.g. icon array) often resulted in better comprehension. Our findings suggest that healthcare providers may not accurately interpret complex types of data displays, and it is unknown if such limitations affect actual decision-making. Interventions are needed to enhance comprehension of complex data displays within the context of prescription drug professional promotion.


[Corrective rhinoplasty in a patient with cleft lip nose deformity].
The author presents a case of secondary rhinoplasty in patient with cleft lip nose deformity. The preoperative computer planning and the stages of the surgery were observed. Good functional and cosmetic postoperative results were achieved by means of bone-cartilage autograft--a fragment taken from nasal dorsum and implanted in the nasal tip region. There is almost complete concurrence between the preoperative computer modeling and the good postoperative results.


Ovarian control of prolactin secretion during late pregnancy in the rat.
The involvement of the ovaries during late pregnancy in the rat upon serum prolactin was investigated. Ovariectomy on day 17 or day 21 of pregnancy prevented the dramatic rise of prolactin found in sham-ovariectomized animals between days 21 and 23 of pregnancy. While animals ovariectomized on day 17 of pregnancy failed to carry viable fetuses beyond day 19 of pregnancy, rats ovariectomized on day 21 of pregnancy had viable pups in utero on day 23 of pregnancy. These data suggest that the rise in serum prolactin during late pregnancy is stimulated by ovarian factors.


Necrosis avid near infrared fluorescent cyanines for imaging cell death and their use to monitor therapeutic efficacy in mouse tumor models.
Quantification of tumor necrosis in cancer patients is of diagnostic value as the amount of necrosis is correlated with disease prognosis and it could also be used to predict early efficacy of anti-cancer treatments. In the present study, we identified two near infrared fluorescent (NIRF) carboxylated cyanines, HQ5 and IRDye 800CW (800CW), which possess strong necrosis avidity. In vitro studies showed that both dyes selectively bind to cytoplasmic proteins of dead cells that have lost membrane integrity. Affinity for cytoplasmic proteins was confirmed using quantitative structure activity relations modeling. In vivo results, using NIRF and optoacoustic imaging, confirmed the necrosis avid properties of HQ5 and 800CW in a mouse 4T1 breast cancer tumor model of spontaneous necrosis. Finally, in a mouse EL4 lymphoma tumor model, already 24 h post chemotherapy, a significant increase in 800CW fluorescence intensity was observed in treated compared to untreated tumors. In conclusion, we show, for the first time, that the NIRF carboxylated cyanines HQ5 and 800CW possess strong necrosis avid properties in vitro and in vivo. When translated to the clinic, these dyes may be used for diagnostic or prognostic purposes and for monitoring in vivo tumor response early after the start of treatment.


[Recent data on the physiopathology of hyperthyroidism].
Cloning of the TSH receptor has led to marked progress in the understanding of the pathogenesis of hyperthyroidism. Genetic studies in familial cases of Graves disease have allowed to dismiss the TSH receptor as a candidate gene. Loci harbouring genes probably involved in the occurrence of Graves' disease have been described. Purification of native TSH receptor has allowed to study directly and to characterize the autoantibodies directed against this antigen. In cases of non immune hyperthyroidism the implication of activating mutations of the TSH receptor and of the a subunit of Gs has been described.


The effect of catheters and coatings on the performance of palladium-nickel thermoseeds: evaluation and design of implantation techniques.
In the development of materials for self-regulating thermoseeds much effort is put in improvement of the self-regulating temperature control mechanism of the seeds. The catheters and coatings which are needed to implant the seeds or to guarantee biocompatibility, generally impair the optimized performance of the ferromagnetic seeds. The influence of various coatings on the performance of PdNi seeds has been investigated by means of one-dimensional modelling and calorimetric experiments. Implantation using thin walled catheters is acceptable provided that the catheters are filled with water to assure good thermal coupling. Air layers inside catheters should be avoided as they reduce the sharp gradient of the heat production at the Curie temperature significantly. An alternative for the application of catheters is to insert the seeds into metallic needles. The effect of shielding by the metal needle can be minimized by driving the seed into its saturated state using a high magnetic field strength. The thermal interaction between the seed and surrounding tissue can also be enhanced by placing PdNi, e.g. tubular, on the outside of the catheter or brachytherapy needle. An additional advantage of this new design is an increase in the heat production and the quality of temperature control due to an increase in the amount of PdNi. For permanent implantation seeds can be coated with an inert metal, ceramics or plastic. The performance of the seeds is not affected by any of the coatings if certain conditions are met. For plastic coatings the thickness of the coating has to be very thin, preferably < or = 20 microns, to avoid thermal isolation.


[Present situation in self-injection therapy with interferon-alpha for patients with renal cell carcinoma].
Interferon-alpha (IFN alpha) is often used for the treatment of renal cell carcinomas. The injections are frequently self-administered at home. To assess how this therapy was accepted by the patient we sent out a questionnaire. For the past 2 years until March 1993, this therapy was performed in our department on 52 patients, of whom 45 were selected for the study. All patients were informed of their disease and consented to the necessity of this treatment. Thirty-eight patients answered this questionnaire. Almost all patients injected this agent mainly by themselves. These findings suggested that they regarded this therapy as a strategy to be executed by themselves for the treatment of carcinoma. The main toxic symptoms in this therapy were asthenia, fever and loss of appetite. Leukocytopenia occurred in about half of the patients, of whom 1 patient required medication because of a rapid decrease in the white blood cell count shortly after inception of this therapy. The treatment was discontinued in 50% of the patients because of these adverse effects. Systemic toxicity disappeared after cessation of IFN alpha administration. Additionally, over 80% of the patients expressed concern about effectiveness, the duration and high cost of this therapy. The patients had to be repeatedly instructed about the method of disposing used needles and syringes. This study revealed that self injection of IFN alpha, which required strict management particularly at the initiation, can be performed at home. However, countermeasures must be taken against the side actions and an optimum regimen of IFN alpha should be established as soon as possible.


Volatile components from the roots of Solanum pseudocapsicum.
The volatile components obtained by hydrodistillation of Solanum pseudocapsicum roots were analyzed by gas chromatography-mass spectrometry. A total of 41 compounds, representing 50% of the oil, were identified. The oil was found to contain fatty acids (26.8%), terpenoids (7.6%), and aldehydes (5.3%) as the major components. The dominant compounds were hexadecanoic acid (24.1%), 2-methoxy-3-isopropylpyrazine (2.8%), and 15-methylhexadecanoic acid (2.1%). Other notable components include beta-elemene and delta-elemene. The high proportion of fatty acids in this plant could contribute to its medicinal properties.


Targeting ubiquitin protein ligase E3 component N-recognin 5 in cancer cells induces a CD8+ T cell mediated immune response.
UBR5 is a nuclear phosphoprotein of obscure functions. Clinical analyses reveal that UBR5 amplifications and overexpression occur in over 20% cases of human breast cancers. Breast cancer patients carrying UBR5 genetic lesions with overexpression have significantly reduced survival. Experimental work in vitro and in vivo demonstrates that UBR5, functioning as an oncoprotein, plays a profound role in breast cancer growth and metastasis. UBR5 drives tumor growth largely through paracrine interactions with the immune system, particularly through inhibiting the cytotoxic response mediated by CD8+ T lymphocytes, whereas it facilitates metastasis in a tumor cell-autonomous manner via its transcriptional control of key regulators of the epithelial-mesenchymal transition, ID1 and ID3. Furthermore, simultaneous targeting of UBR5 and PD-L1 yields strong therapeutic benefit to tumor-bearing hosts. This work significantly expands our scarce understanding of the pathophysiology and immunobiology of a fundamentally important molecule and has strong implications for the development of novel immunotherapy to treat highly aggressive breast cancers that resist conventional treatment.


Color Doppler ultrasonography in occlusive diseases of the brachiocephalic and proximal subclavian arteries.
The purpose of this study was to investigate the capability of color Doppler ultrasonography (CDU) in showing the brachiocephalic and proximal subclavian arteries and to determine the accuracy of CDU for diagnosis of occlusive diseases of those arteries. Two groups of patients were examined. The first group was examined with CDU to determine whether the brachiocephalic and subclavian artery origins could be seen. The second group, including patients with occlusive arterial disease, was examined with CDU before digital subtraction angiography (DSA). Results of CDU and DSA were compared. In the first group, the origins of 42 (84%) of 50 brachiocephalic arteries, 48 (96%) of 50 right subclavian arteries, and 25 (50%) of 50 left subclavian arteries could be displayed by CDU. In the second group, 8 (89%) of 9 lesions on the right and 23 (96%) of 24 lesions on the left were diagnosed correctly. Color Doppler ultrasonography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values of 88%, 94%, 78%, 97%, and 94%, respectively, for detecting major stenosis and 100%, 98%, 94%, 100%, and 99% for detecting occlusion. Agreement between the CDU and DSA findings was substantial for stenosis (kappa = 0.78) and almost perfect for occlusion (kappa = 0.96). The percentage of proximal left subclavian arteries shown on CDU was considerably lower compared with the right subclavian and brachiocephalic arteries. However, there was no significant difference between the two sides in diagnosing occlusive arterial diseases. With CDU, occlusion can be diagnosed more accurately than stenosis.


An overview of the recent trends in HIV/AIDS in the United States.
This paper reviews the recent trends in the HIV/AIDS disease in the United States focusing on how the disease has matured over time and has now started to affect population segments that were not typically considered at-risk. The data reveals that HIV/AIDS levels have increased among women while it has decreased among men. HIV/AIDS has disproportionately affected the African American population while the levels have declined among whites. The case fatality rates of AIDS have declined from about 93% to 6% between 1981 and 1995. Overall the epidemic has slowed in the United States and more people affected with this disease are living longer. This can be attributed to effective treatment available and the increase in the general awareness of the disease in the US.


Heat shock protein 70 in Alzheimer's disease.
Alzheimer's disease (AD) is the most common neurodegenerative disease that caused dementia which has no effective treatment. Growing evidence has demonstrated that AD is a "protein misfolding disorder" that exhibits common features of misfolded, aggregation-prone proteins and selective cell loss in the mature nervous system. Heat shock protein 70 (HSP70) attracts extensive attention worldwide, because it plays a crucial role in preventing protein misfolding and inhibiting aggregation and represents a class of proteins potentially involved in AD pathogenesis. Numerous studies have indicated that HSP70 could suppress the progression of AD with in vitro and in vivo experiments. Thus, targeting HSP70 and the related compounds might represent a promising strategy for the treatment of AD.


Patient engagement and patient support programs in allergy immunotherapy: a call to action for improving long-term adherence.
Allergy immunotherapy (AIT) is acknowledged to produce beneficial mid- and long-term clinical and immunologic effects and increased quality of life in patients with allergic respiratory diseases (such as allergic rhinoconjunctivitis and allergic asthma). However, poor adherence to AIT (due to intentional and/or non-intentional factors) is still a barrier to achieving these benefits. There is an urgent need for patient support programs (PSPs) that encompass communication, educational and motivational components. In the field of AIT, a PSP should be capable of (1) improving adherence, (2) boosting patient engagement, (3) explaining how AIT differs from pharmacological allergy treatments; (4) increasing health literacy about chronic, progressive, immunoglobulin-E-mediated immune diseases, (5) helping the patient to understand and manage local or systemic adverse events, and (6) providing and/or predicting local data on aeroallergen levels. We reviewed the literature in this field and have identified a number of practical issues to be addressed when implementing a PSP for AIT: the measurement of adherence, the choice of technologies, reminders, communication channels and content, the use of "push" messaging and social networks, interactivity, and the involvement of caregivers and patient leaders. A key issue is "hi-tech" (i.e. approaches based mainly on information technology) vs. "hi-touch" (based mainly on interaction with humans, i.e. family members, patient mentors and healthcare professionals). We conclude that multistakeholder PSPs (combining patient-, provider and society-based actions) must now be developed and tested with a view to increasing adherence, efficacy and safety in the field of AIT.


Development and validation of an ion-exclusion chromatographic method for the quantitation of organic acids in complex pharmaceutical products.
Effective quantitation of organic acids (acetic, malic, and lactic acids) present in total parenteral nutrition (TPN) pharmaceutical products for final product release purposes requires accuracy, precision, and specificity but less than optimal sensitivity. A chromatographic method relying on ion-exclusion separation and low-wavelength ultraviolet detection has been developed and validated to quantitate these organic acids in matrices containing 10-fold or greater excesses of other constituents (sugars, amino acids, and other inorganic salts) with no sample preparation other than dilution. Mobile phases at slightly different pH values effectively eliminates matrix-related interferences that were observed during the analysis of several products. The validation procedure used is discussed in terms of its strategy and results. Ultimately, the assay is found to be appropriate for the release testing of several compositionally diverse TPN products.


[The antimony conflict].
Antimony, which was already well known to the ancients, in the Middle Ages was known as Lupus metallorurn--the grey wolf--a key material in alchemists' attempts at purifying gold. Over subsequent centuries antimony returned within the bounds of conventional scientific and experimental knowledge, but inspired numerous studies, works of literature and investigations in important fields of medicine. Antimony has always aroused more interest than one might expect from a simple metal. The fact that it has been used since ancient times in cosmetics and then in alchemy gave it both positive and negative connotations, reflecting its possible uses and the benefits for health but also the potential harm. For a certain period antimony was virtually the symbol for a range of uses in alchemy or empirical medicine, in the face of modern scientific knowledge, and aroused debate that went well beyond its actual physical and chemical properties. Bernardino Ramazzini's work in the 17th-18th centuries signalled the recognition that the use of antimony was linked to health risks. Today it is put to many uses in many fields of industry and medicine, so our interest in this metal is no longer exclusively a question of history, but is highly topical.


Uncovering the expression patterns of chimeric transcripts using surveys of affymetrix GeneChips.
A chimeric transcript is a single RNA sequence which results from the transcription of two adjacent genes. Recent studies estimate that at least 4% of tandem human gene pairs may form chimeric transcripts. Affymetrix GeneChip data are used to study the expression patterns of tens of thousands of genes and the probe sequences used in these microarrays can potentially map to exotic RNA sequences such as chimeras. We have studied human chimeras and investigated their expression patterns using large surveys of Affymetrix microarray data obtained from the Gene Expression Omnibus. We show that for six probe sets, a unique probe mapping to a transcript produced by one of the adjacent genes can be used to identify the expression patterns of readthrough transcripts. Furthermore, unique probes mapping to an intergenic exon present only in the MASK-BP3 chimera can be used directly to study the expression levels of this transcript. We have attempted to implement a new method for identifying tandem chimerism. In this analysis unambiguous probes are needed to measure run-off transcription and probes that map to intergenic exons are particularly valuable for identifying the expression of chimeras.


Single muscle fibre contractile function with ageing.
Ageing is accompanied by decrements in the size and function of skeletal muscle that compromise independence and quality of life in older adults. Developing therapeutic strategies to ameliorate these changes is critical but requires an in-depth mechanistic understanding of the underlying physiology. Over the past 25 years, studies on the contractile mechanics of isolated human muscle fibres have been instrumental in facilitating our understanding of the cellular mechanisms contributing to age-related skeletal muscle dysfunction. The purpose of this review is to characterize the changes that occur in single muscle fibre size and contractile function with ageing and identify key areas for future research. Surprisingly, most studies observe that the size and contractile function of fibres expressing slow myosin heavy chain (MHC) I are well-preserved with ageing. In contrast, there are profound age-related decrements in the size and contractile function of the fibres expressing the MHC II isoforms. Notably, lifelong aerobic exercise training is unable to prevent most of the decrements in fast fibre contractile function, which have been implicated as a primary mechanism for the age-related loss in whole-muscle power output. These findings reveal a critical need to investigate the effectiveness of other nutritional, pharmaceutical or exercise strategies, such as lifelong resistance training, to preserve fast fibre size and function with ageing. Moreover, integrating single fibre contractile mechanics with the molecular profile and other parameters important to contractile function (e.g. phosphorylation of regulatory proteins, innervation status, mitochondrial function, fibre economy) is necessary to comprehensively understand the ageing skeletal muscle phenotype.


Genes and schizophrenia: a pseudoscientific disenfranchisement of the individual.
The biological model of schizophrenia remains the dominant model within mental health services. It has a powerful influence on the culture of mental health services; providing the structure for the delivery and selection of mental health treatments. There is widespread acceptance of a genetic cause for schizophrenia. Acceptance of a genetic cause is inconsistent with a person-centred recovery-orientated approach. The following paper provides a rigorous review of the underpinning research that supports the genetic argument. Appraisal of family, twin and adoption studies uncovers serious flaws in the methodologies and statistical analyses used in studies. These flaws not only artificially inflate the genetic contribution to schizophrenia but also invalidate many of the findings. More recent micro-imaging techniques have also failed to find replicable and consistent findings indicating a clear genetic pathway to schizophrenia. Freed from the implied pessimism of an unmodifiable genetic cause for schizophrenia, mental health nurses can confidently work to instil hope with people that have a diagnosis of schizophrenia.


Characterization of a monolithic immobilized trypsin microreactor with on-line coupling to ESI-MS.
The preparation and characterization of a miniaturized trypsin reactor using on-line coupling with an ESI-TOF mass spectrometer are described. L-1-Tosylamido-2-phenylethyl chloromethyl ketone-trypsin was covalently immobilized on poly(glycidyl methacrylate-co-ethylene dimethacrylate) monolith prepared in a 75 microm ID fused silica capillary resulting in a bioreactor with high local concentration of the proteolytic enzyme. Covalent immobilization of trypsin on this support was performed using the epoxide functional groups in either a one- or a multistep reaction. For on-line protein digestion-MS analysis the bioreactor was coupled with the mass spectrometer using a liquid junction microelectrospray interface. The performance of the reactor was tested using an on-line flow through the system with flow rates of 50-300 nL/min. The resulting protein consumption was in the atto- to low femtomole range. Proteolytic activity was characterized in a wide range of conditions with respect to the flow rate, pH, and temperature. Complete protein digestion was achieved in less than 30 s at 25 degrees C with the sequence coverage of 80% (cytochrome c), which is comparable to 3 h digestion in solution at 37 degrees C. Besides the good performance at laboratory temperature, the immobilized trypsin in the bioreactor also performed well at lower pH compared to the standard in-solution protocols.


Long non-coding RNA as a potential biomarker for prognosis of glioma: A protocol for systematic review and meta-analysis.
The molecular mechanism of Glioma is still unclear, and there are few early diagnostic markers. Therefore, it is urgent to figure out effective preventive measures, active diagnostic methods and rapid treatment measures. In recent years, relevant studies have revealed that long non-coding RNA (lncRNA) is associated with the prognosis of Glioma. However, these results have not been supported by any evidence. Therefore, this study carried out a meta-analysis method to analyze the relationship between lncRNA and the prognosis of Glioma. In addition, bioinformatics analysis was conducted to investigate the mechanism and related pathways of lncRNAs in Glioma. We performed a systematic search in electronic databases, including China National Knowledge Infrastructure, Chinese Biomedical literature Database, Chinese Scientific and Journal Database, Wan Fang database, PubMed, EMBASE, Cochrane Library and Web of Science, to investigate the potential association between lncRNA expression and prognostic significance and clinical features in glioma patients. Hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) were pooled to estimate the prognosis value of lncRNA by Stata16.0 software. The online tool AnnoLnc was applied to screen the co-expressed gene related to each lncRNA, David was used for gene ontology (GO) analysis and enrichment analysis of the signal pathway, and through Starbase, the possible competitive endogenous RNA network of lncRNAs was constructed. The results of this meta-analysis would be submitted to peer-reviewed journals for publication. This study will provide evidence-based medical evidence for lncRNA, so as to predict the prognosis of Glioma and bioinformatics analysis will provide ideas for the mechanism study on Glioma.


Estrogen receptors and histopathological evaluation of human breast cancer.
The breast cancers with positive ER, the anaplastic low level and the node non involvement were identified with good prognostic values. The positive estrogen receptors in 52 primary breast carcinomas were correlated with either big or small tumors, with node involvement or without it and either with or without sinus histocitosis reaction. The vascular and lymph infiltration, the undifferentiated and half-differentiated carcinomas, the high stroma component and the high number of mitosis were other parameters with were opposed to positive ER tumors. The prevailing age of the patients was postmenopausal.


Is the Use of Information and Communication Technology Associated With Aspects of Women's Primary Health Care in Brazil?
The use of information and communication technology (ICT) is on the increase in the health systems, representing a means of improving the quality of health care. This study analyzed the ICT incorporation in primary care in Brazil and identified the different aspects that may be associated with better quality in the care provided, in relation to certain aspects of women's care. We noted an unevenness regarding ICT incorporation in Brazil. However, the findings indicate an association between ICT and certain aspects of the quality provided in women's health care, which reinforces the need for further studies on this type of evaluation.


[Case of cryptogenic organizing pneumonia with radiologically detectable lung cancer after disappearance of infiltrative shadows by steroid treatment].
An 82-year-old man with fever and a cough was admitted to hospital. A chest radiograph demonstrated infiltrative shadows in the bilateral middle and lower lung fields and a chest CT scan showed the shadows in the bilateral upper and lower lobes. After admission, infiltrative shadows in the right upper lobe increased and transbronchial lung biopsy (TBLB) specimens disclosed organizing exudates in the alveolar spaces. After steroid treatment, the radiographic infiltrates disappeared but the irregular shadows in the right lower lobe were still present. Lung adenocarcinoma was diagnosed by TBLB specimens of residual shadows. Few cases of cryptogenic organizing pneumonia (COP) with lung cancer have been reported, and further consideration should be given to the relationship between COP and lung cancer. We should consider that diagnostic preparations for chest radiographic imaging can lead to the recognition of several respiratory diseases.


[Effects of absorption enhancers on intestinal absorption of lumbrokinase].
To explore the intestinal absorption characteristics of lumbrokinase (YJM-I) in the absence or presence of various absorption enhancers and to find the optimum intestinal site for YJM-I absorption. The absorption kinetics and absorption intestinal sites for YJM-I absorption were investigated with the method of diffusion cell in vitro, duodenum bolus injection, recirculating perfusion and in situ duodenum perfusion in vivo. YJM-I could be transported into blood and kept its biological activity across intestinal endothelial membrane after administration via duodenum site, whereas with lower bioavailability. Some of the absorption enhancers were shown good enhancement effects on intestinal absorption of YJM-I in vitro and in situ experiments. The order of enhanced efficiencies of various enhancers on duodenum, ileum and jejunum in vitro permeation experiments were shown as follows: 1% chitosan > 1% SDCh > 1% Na2EDTA > 1% SDS > 1% sodium caprylate > 1% poloxamer > 1% HP-beta-CD. The order of enhanced efficiencies of various enhancers on duodenum absorption of YJM-I in vivo were as follows: 2.5% SDCh > 2.5% Na2EDTA > 2.0% chitosan > 2.5% SDS > 2.5% sodium caprylate > 2.5% Poloxamer > 2.5% HP-beta-CD. The results indicated that the absorption of YJM-I could be enhanced by various enhancers, and duodenum was the optimum absorption site of YJM-I. Furthermore, bio-adhesive chitosan might be a potential enhancer of intestinal YJM-I absorption.


Aconitine-containing agent enhances antitumor activity of dichloroacetate against Ehrlich carcinoma.
Significant variability of anticancer efficacy of dichloroacetate (DCA) stimulated an active search for the agents capable to enhance it antitumor action. Therefore, the aim of this work is the study of capability of aconitine-containing antiangiogenic agent BC1 to enhance anticancer activity of DCA against Ehrlich carcinoma. DCA (total dose was 1.3 g/kg of b.w.) and BC1 (total dose was 0.9 mg/kg of b.w.) were administered per os starting from the 2(nd) and 3(rd) days, respectively (8 admini-strations for each agent). Antitumor efficacy of agents was estimated. Lactate level, LDH activity and the state of mitochondrial electron transport chain in tumor cells as well as phagocytic activity and reactive oxygen species (ROS) production of tumor-associated macrophages (TAM) were studied. Combined administration of DCA and ВС1 resulted in 89.8% tumor growth inhibition (p < 0.001), what is by 22.5% (p < 0.05) higher that that of DCA alone. This combined treatment was accompanied with a decrease of lactate level in tumor tissue by 30% (p < 0.05) and significant elevation of LDH activity by 70% (p < 0.01). Increased level of NO-Fe-S clusters and 2-fold reduction of Fe-S cluster content were revealed in tumor tissue of mice after DCA and BC1 administration. It was shown that combined therapy did not effect TAM quantity and their phagocytic activity but stimulated ROS production by TAMs by 78% (p < 0.05) compared to this index in control animals. Antiangiogenic agent ВС1 in combination with DCA considerably enhances antitumor activity of DCA via significant decrease of Fe-S-containing protein level resulted from substantial elevation of nitrosylation of these proteins.


Nutritional and metabolic studies in children on continuous ambulatory peritoneal dialysis.
A study was done of 15 children and adolescents, aged 2.5 to 17.5 years, who were treated by continuous ambulatory peritoneal dialysis (CAPD) for 6 to 24 months. Plasma albumin concentration decreased from 34.4 +/- 4.8 g/liter at the onset of therapy to 31.3 +/- 5.3 g/liter after 19 to 24 months. Children less than 6 years old had lower albumin levels (29.4 +/- 1.7 g/liter) than did the older group (36.3 +/- 4.2 g/liter). The lower plasma albumin was related to peritoneal protein loss but not to protein intake. Plasma free amino acid concentrations were not significantly modified. No changes occurred in the oral glucose tolerance test during the course of CAPD. Plasma cholesterol and triglycerides were abnormally high for age, with a correlation seen between cholesterolemia and peritoneal protein loss.


Role of a conserved pore residue in the formation of a prehydrolytic high substrate affinity state in the AAA+ chaperone ClpA.
The AAA+ protease ClpAP, consisting of the ClpA chaperone and the ClpP protease, processively unfolds and translocates its substrates into its proteolytic core, where they are cleaved. Unfolding and efficient translocation require ATP-dependent conformational changes in ClpA's D2 loop, where the conserved GYVG motif resides. To explore the role of the essential tyrosine of this motif, we investigated how two mutations at this residue (Y540C and Y540A) affect the rate at which the enzyme processes unstructured substrates. The mutations decrease ClpA's ability to process unfolded or unstable protein substrates but have only mild effects on the rates of ATP hydrolysis or hydrolysis of small peptide substrates. The mutants' substrate binding properties were also characterized, using single molecule fluorescence microscopy. The single-molecule studies demonstrate that the conserved tyrosine is essential for the formation of the prehydrolytic, high substrate affinity conformation observed in wild-type ClpA. Together, the results support a model in which destabilization of the high substrate affinity conformation of ClpA makes translocation less efficient and uncouples it from ATP hydrolysis.


An interoperable implementation of collective-variable based enhanced sampling methods in extended phase space within the OpenMM package.
Collective variable (CV)-based enhanced sampling techniques are widely used today for accelerating barrier-crossing events in molecular simulations. A class of these methods, which includes temperature accelerated molecular dynamics (TAMD)/driven-adiabatic free energy dynamics (d-AFED), unified free energy dynamics (UFED), and temperature accelerated sliced sampling (TASS), uses an extended variable formalism to achieve quick exploration of conformational space. These techniques are powerful, as they enhance the sampling of a large number of CVs simultaneously compared to other techniques. Extended variables are kept at a much higher temperature than the physical temperature by ensuring adiabatic separation between the extended and physical subsystems and employing rigorous thermostatting. In this work, we present a computational platform to perform extended phase space enhanced sampling simulations using the open-source molecular dynamics engine OpenMM. The implementation allows users to have interoperability of sampling techniques, as well as employ state-of-the-art thermostats and multiple time-stepping. This work also presents protocols for determining the critical parameters and procedures for reconstructing high-dimensional free energy surfaces. As a demonstration, we present simulation results on the high dimensional conformational landscapes of the alanine tripeptide in vacuo, tetra-N-methylglycine (tetra-sarcosine) peptoid in implicit solvent, and the Trp-cage mini protein in explicit water.


[The effect of increased secretory activity of the nasal mucosa on the duration of the recovery period after anterior tamponade with gauze tampons during surgery of the nasal septum].
To assess the effect on the duration and course of the nasal mucosa function recovery after anterior nasal packing during surgery involving the nasal septum and inferior nasal conchae combined with concomitant therapy with the herbal medicinal product Sinupret extract (Bionorica SE, Germany). The study included 25 males aged 18-50 (the main group), permanent residents of the Novosibirsk region diagnosed with deviated nasal septum at least 2 years ago. All patients underwent rhinoseptoplasty with nasal packing with gauze tampons for 24 hours at the clinical base of the Otorhinolaryngology Department of the Novosibirsk State Medical University. Patients of the main group received Sinupret extract 1 tablet BID for 10 days before the planned rhinoseptoplasty and 7 days after the rhinoseptoplasty. Patients in control group 1 (n=16) received Sinupret 2 coated tablets TID for 10 days before the surgery and 7 days after the surgery. Patients in control group 2 (n=16) did not receive secretory therapy in the preoperative and postoperative periods of rhinoseptoplasty. The herbal medicinal product improved nasal breathing. All studied parameters demonstrated the benefit of the treatment including Sinupret extract (p<0.05). On day 5 in patients of the main study group, nasal breathing was normal, and nasal crusting was reduced due to activation of the mucous membrane secretory function. Nasal mucosa ciliary clearance was better in patients in the main group than in patients in the control groups at all stages of the study. Sinupret extract for 10 days before and 5 days after the surgery helps reduce nasal crusting and restore nasal breathing by day 2 and normalizes ciliary clearance by day 5 after nasal packing. Due to the wide use of nasal packing with gauze tampons, otorhinolaryngologists commonly administer herbal medicinal products as a means of drug protection of the nasal mucous membrane.


[Influences of hyperinsulinemia in the lipid profile of hypertensive patients].
Hypertension and dyslipemia are associated with a greater frequency than that randomly expected. The increase in insulinic resistance hyperinsulinemia is one of the factors implicated in the pathogenesis of this association. In the present study the lipid profile of hypertensive patients is analyzed according to the degree of insulinemia. The lipid profile (total cholesterol, fraction linked to low density lipoproteins cLDL, high density cHDL, triglycerides and plasma apolipoproteins A1 and B were determined in 87 patients with essential high blood pressure. Moreover an oral overdose of 75 g of glucose was administered with determinations of glycemia, insulinemia and C peptide at the time of glucose administration, 60 and 120 minutes. Upon separation of the hypertense patients into two groups according to the insulinemia achieved following an oral overload of glucose, those hypertensives with a greater degree of insulinemia showed a significant increase in triglycerides (p < 0.05) and also a significant decrease in cHDL (p < 0.001). The hypertensive patients with lower insulinemia showed a significant increase in total cholesterol (p < 0.05) and fraction linked to LDL although the latter was not significant. Two different lipid profiles may be observed in hypertensive patients: one linked to hyperinsulinemia and characterized by an increase in triglycerides and a decrease in cHDL and another with no relation with hyperinsulinemia which is manifested by an increase in total cholesterol and cholesterol transported by the LDL.


Evaluation of the role of ATP-binding cassette transporters as a defence mechanism against temephos in populations of Aedes aegypti.
The role of ATP-binding cassette (ABC) transporters in the efflux of the insecticide, temephos, was assessed in the larvae of Aedes aegypti. Bioassays were conducted using mosquito populations that were either susceptible or resistant to temephos by exposure to insecticide alone or in combination with sublethal doses of the ABC transporter inhibitor, verapamil (30, 35 and 40 μM). The best result in the series was obtained with the addition of verapamil (40 μM), which led to a 2x increase in the toxicity of temephos, suggesting that ABC transporters may be partially involved in conferring resistance to the populations evaluated.


The role of STAT3 signaling in mediating tumor resistance to cancer therapy.
Signal transducer and activator of transcription 3 (STAT3) is activated in many cancer types and can regulate pathways involving tumorigenesis, cell proliferation, cell survival and angiogenesis. Upstream cytokine signaling through multiple trans-membrane receptors can enhance the activation of STAT3 and promote tumor progression. Importantly, STAT3 activation can also be induced via the Janus-activated kinase 1/2 (JAK1/2) and Src family kinases. Target-specific drug therapies have been developed to inhibit many of the upstream receptor and non-receptor activators of STAT3 and are now approved for clinical use. Recently, resistance to standard-of-care therapies has been linked to constitutive or unabated STAT3 activation, suggesting that combination therapy with STAT3 inhibitors may be of clinical benefit. Furthermore, STAT3 activity has also been shown to regulate self-renewal of cancer stem cells that are often refractory to chemotherapy treatment. This review will focus on STAT3 mediated resistance to cancer therapy and discuss strategies to overcome this resistance.


Dosimetric characteristics of a reusable 3D radiochromic dosimetry material.
To investigate the dosimetric characteristics of PRESAGEREU dosimeters. Commercially available PRESAGEREU dosimeters (size of 10 mm × 10 mm × 45 mm) were divided into two groups, with one of the groups placed at room temperature of 22°C (RT group) and another group placed at low temperature of 10°C (LT group). A total of 3 dosimeters (set of dosimeters) were irradiated at a time, with doses of 1 Gy, 2 Gy, 4 Gy, 8 Gy, 12 Gy, 16 Gy, and 20 Gy, at a nominal dose rate of 400 MU/min at temperature of 22°C. The dosimeters were irradiated three additional times by delivering the same doses as those during the initial irradiations (4 irradiation cycles). Optical density (OD) was assessed using optical CT scanning. Considering both linearity and sensitivity of the OD curves, R2 above 0.95 and sensitivity above 0.04 ΔOD/Gy were observed at the 1st irradiation (reading time ≤ 6 h) and 2nd irradiation (reading time = 0.5 h) for the RT group. For the LT group, those values were observed at the 1st irradiation (reading time ≤ 2 h), and the 3rd and 4th irradiations (both reading times = 0.5 h). Considering the reproducibility of signals in response to the same dose, dosimeters in the RT group showed average deviations among dosimeters less than 5% (the 1st and 2nd irradiations at the reading time of 0.5 h), while for dosimeters in the LT group showed average deviations among dosimeters less than 6% (the 3rd and 4th irradiations at the reading time of 0.5 h). For the rest, the OD curves were not linear, sensitivities of the dosimeters were lower than 0.04 ΔOD/Gy, and OD deviations at the same dose were larger than 6%. At room temperature, PRESAGEREU dosimeters could be used for dose measurement only for up to two dose measurement sessions. At low temperatures, usage of PRESAGEREU dosimeters for dose measurement seems to be possible from the 3rd irradiation. When reusing PRESAGEREU dosimeters, the OD curve should be re-defined for every measurement session because the shape of this curve depends on the irradiation history.


A success in Toxinology translational research in Brazil: bridging the gap.
Basic research is fundamental for discovering potential diagnostic and therapeutic tools, including drugs, vaccines and new diagnostic techniques. On this basis, diagnosis and treatment methods for many diseases have been developed. Presently, discovering new candidate molecules and testing them in animals are relatively easy tasks that require modest resources and responsibility. However, crossing the animal-to-human barrier is still a great challenge that most researchers tend to avoid. Thus, bridging this current gap between clinical and basic research must be encouraged and elucidated in training programmes for health professionals. This project clearly shows the challenges faced by a group of Brazilian researchers who, after discovering a new fibrin sealant through 20 years of painstaking basic work, insisted on having the product applied clinically. The Brazilian government has recently become aware of this challenge and has accordingly defined the product as strategic to the public health of the country. Thus, in addition to financing research and development laboratories, resources were invested in clinical trials and in the development of a virtual platform termed the Virtual System to Support Clinical Research (SAVPC); this platform imparts speed, reliability and visibility to advances in product development, fostering interactions among sponsors, physicians, students and, ultimately, the research subjects themselves. This pioneering project may become a future model for other public institutions in Brazil, principally in overcoming neglected diseases, which unfortunately continue to afflict this tropical country.


Tumoral Calcinosis of the Neck in a Patient with Systemic Sclerosis.
Tumoral calcinosis (TC) is rare in patients with systemic sclerosis but is associated with morbidity. Paraspinal TC may cause severe pain and potentially devastating neurological deficits. Surgical decompression by removing the TC masses and applying surgical techniques to support the spine have provided substantial relief of the symptoms in the majority of cases. However, death has occurred in the immediate postoperative period and can even occur after several months. Current indications for surgery include intractable neck pain and, most importantly, the development of neurological deficits. We present a patient with systemic sclerosis and symptomatic paraspinal TC in the neck treated conservatively for two years. This case report illustrates conditions permitting the sustained conservative treatment of paraspinal TC in systemic sclerosis patients.


Assessment of brain perfusion with MRI: methodology and application to acute stroke.
We review the methodology of brain perfusion measurements with MRI and their application to acute stroke, with particular emphasis on the work awarded by the 6th Lucien Appel Prize for Neuroradiology. The application of the indicator dilution theory to the dynamic susceptibility-weighted bolus-tracking method is explained, as is the approach to obtaining quantitative measurements of cerebral blood flow (CBF) and volume (CBV). Our contribution to methodological developments, such as CBV measurement with the frequency-shifted burst sequence, development of the PRESTO sequence, comparison of different deconvolution methods and of spin- and gradient-echo sequences, and the validation of MRI measurements against positron emission tomography is summarised. The pathophysiology of brain ischaemia and the role of neuroimaging in the setting of acute stroke are reviewed, with an introduction to the concepts of ischaemic penumbra and diffusion/perfusion mismatch. Our work on the determination of absolute CBF and CBV thresholds for predicting the area of infarct growth, identification of the best perfusion parameters (relative or absolute) for predicting the area of infarct growth and the role of MR angiography is also summarised. We conclude that MRI is a very powerful way to assess brain perfusion and that its use might help in selecting patients who will benefit most from treatment such as thrombolysis.


A new theoretical method for calculating the radiative association cross section of a triatomic molecule: application to N2-H-.
We present a new theoretical method to treat the atom-diatom radiative association within a time independent approach. This method is an adaptation of the driven equations method developed for photodissociation. The bound state energies and wave functions of the molecule are calculated exactly and used to propagate the overlap with the initial scattering wave function. In the second part of this paper, this approach is applied to the radiative association of the N2H(-) anion. The main features of the radiative association cross sections are analysed and the magnitude of the calculated rate coefficient at 10 K is used to discuss the existence of the N2H(-) in the interstellar medium which could be used as a tracer of both N2 and H(-).


Comparison of four markers of intestinal permeability in control subjects and patients with coeliac disease.
Controversy surrounds the issue of intestinal permeability in patients with coeliac disease, polyethylene glycol 400 indicating reduced and di-/mono-saccharide urine excretion ratios and 51Cr-labeled ethylenediaminetetraacetic acid (EDTA) indicating increased permeability. We assessed the suitability of polyethylene glycol 400, L-rhamnose, lactulose, and 51Cr-EDTA as markers of intestinal permeability by assessing urine excretions after simultaneous intravenous instillation of these markers and after oral administration in normals and patients with coeliac disease. After intravenous administration the 24-h urine excretion of polyethylene glycol 400, L-rhamnose, lactulose, and 51Cr-EDTA was 40%, 72%, 93%, and 97%, respectively. There was no significant difference between controls and patients with coeliac disease. Oral administration of the markers in an iso- and hyper-osmolar test solution demonstrates reduced permeation due to an osmotic retention effect of lactulose. In contrast, hyperosmolar glycerol increases permeation of all markers except L-rhamnose. Timing of urines and altering osmolarity is important for the behavior of individual markers but does not enhance the discrimination between controls and patients when the differential urine excretion of lactulose/L-rhamnose is used. The sensitivity of the urine excretion ratio of lactulose/L-rhamnose was comparable to that of 51Cr-EDTA used by itself. Whereas lactulose/L-rhamnose and 51Cr-EDTA showed increased intestinal permeability in coeliac disease, the permeation of polyethylene glycol was reduced. Permeation of the markers did not correlate significantly with jejunal histology. Correlations of marker permeation rates with test dose osmolarity in controls and patients with coeliac disease shows a variable lack of conformity, suggesting that the markers may permeate the intestine by different routes, which are affected to a different extent in coeliac disease.


Effect of an eco-friendly o/w emulsion stabilized with amphiphilic sodium alginate derivatives on lambda-cyhalothrin adsorption-desorption on natural soil minerals.
The effects of amphiphilic O/W emulsions, stabilized by the alkyl polyglycoside (APG) or cholesterol-grafted sodium alginate (CSAD)/APG systems, on lambda-cyhalothrin adsorption/desorption mechanisms on natural soil minerals (i.e., illite and kaolinite) were investigated. Sorption and desorption of lambda-cyhalothrin onto soil minerals was studied via batch equilibration to give insight into the adsorption equilibrium, kinetics, and thermodynamics of lambda-cyhalothrin adsorption onto minerals. The results indicate the following: (i) The adsorption processes for the APG system and CSAD/APG system include: rapid adsorption, slow adsorption, and adsorption equilibrium. The adsorption kinetics of pesticide on illite and kaolinite are in accordance with the Ho and McKay model, and the adsorption isotherm conforms to the Freundlich model. In addition, the adsorption processes of pesticide for the two systems on minerals were spontaneous and feasible (ΔG0 < 0), endothermic (ΔH0 > 0), and mainly involved chemical bonding (ΔH0 > 60). (ii) The equilibrium adsorption percentages of the pesticide on illite for the APG system and CSAD/APG system were 42.4% and 64.8%, and the corresponding equilibrium adsorption percentages on kaolinite were 40.8% and 61.8%, respectively. Moreover, the pesticide adsorption rate K2-CSAD/APG was faster than K2-APG, and its adsorption capacity Kf-CSAD/APG was greater than Kf-APG. Meanwhile, the pesticide desorption Kfd in the CSAD/APG system was smaller than that in the APG system. As a result, this eco-friendly O/W emulsion based on amphiphilic sodium alginate derivatives might provide a green pesticide formulation, since it could reduce the amount of lambda-cyhalothrin entering aquatic systems to threaten non-target fish and invertebrate species.


Stretchable electronic skin based on silver nanowire composite fiber electrodes for sensing pressure, proximity, and multidirectional strain.
Electronic skin (E-skin) has been attracting great research interest and effort due to its potential applications in wearable health monitoring, smart prosthetics, robot skins and so on. To expand its applications, two key challenges lie in the realization of device stretchability, and independent sensing of pressure and multidirectional lateral strain. Here we made a combination of rational device structure and artfully engineered sensing materials to fulfill the mentioned demands. The as-prepared E-skin took a simple orthogonal configuration to enable both capacitive mode for pressure sensing and resistive mode for multidirectional strain sensing, independently. Pre-cracked silver nanowire based fibers with helical microstructures were utilized as basic electrodes to endow the E-skin with intrinsic stretchability and strain sensing capability. Through dielectric layer optimization, the pressure sensing sensitivity was greatly enhanced, with a detection limit of 1.5 Pa. For application demonstrations, we utilized the E-skin as both flat and curved platforms for pressure mapping, and also as human motion sensors, such as palm and thumb bending.


Developing multiple shortened forms of virtual reality-based color trails test.
The Color Trails Test (CTT) is a pencil-and-paper (P&P) neuropsychological test. The CTT is divided into two parts that assess sustained visual attention (Trails A) and divided attention (Trails B). The CTT can also be performed in a virtual reality setting (VR-CTT) introducing a wider spatial range of targets. In cases of multiple assessments, repeating the same CTT configuration can bias the results due to fatigue and learning effects. The aim of this study is to create five different short versions of the VR-CTT. The different forms were created by rotating or flipping the original targets spatial layout on one of the axes and by ending it at ball #13. Healthy young participants (N = 15) performed the shortened VR-CTT forms (in a counterbalanced order), the P&P CTT and the original VR-CTT. We found no difference between the completion times of the five forms (p > 0.2), and a significant difference between Trails A and B across all forms (p < 0.04). Additionally, there was no evidence of a learning effect between trials (p > 0.4). Moreover, the shortened VR-CTT forms showed correlations with the P&P CTT (p < 0.05) and with the original VR-CTT (p < 0.06). These findings suggest that all five forms have an equal level of difficulty and that the different forms managed to mitigate the learning effects reported for repeated testing of the same spatial layout. This opens the possibility of applying the shortened VR-CTT forms for research settings and sets the basis for developing it into a clinical diagnostics tool.


Medication errors: ethical implications.
Errors in health care are receiving much attention today, although committing such errors is not a new phenomenon. Nurses are taught procedures so that they are less likely to make mistakes. Yet nurses do make errors. Although many types of errors can and do occur in the health care setting, this article focuses on a discussion of medication errors and related ethical implications. Several ethical issues may arise as a result of medication errors: harm to patients, whether to disclose the error, erosion of trust, and impact on quality care. Nurses' appropriate ethical responses to medication errors need to be supported. Changing the health care system will help nurses to promote patient welfare, lessen the chance of harm, and reduce the likelihood of medication errors occurring.


Disclosure and Psychological Well-Being of Sexually Abused Adolescents in Hong Kong.
The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents' psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers' sexual eroticism and externalizing behavioral symptoms. Disclosers' cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.


Thorax deformity and asthma bronchial.
In patients with bronchial asthma thorax deformity aggravates the respiratory function. The authors performed follow up examinations on 381 young adults who suffered from bronchial asthma in childhood. Thorax deformities were was found in 70 patients (28 pectus excavatum, 8 pectus carinatum, 19 thorax emphysematicus . 15 other and combined deformities). Comparing the recovered and non-recovered asthmatic patients, the state of the ill one was significantly worse with regards to thorax deformity. In the seriously ill patients thorax deformities occurred significantly more frequently than in the total number of patients. In the thorax deformity group asthma had an earlier onset and lasted longer in comparison with the whole of patients studied. Bronchial hyperreactivity and lung function values referring to chronic obstruction were significantly more frequent in patients with thorax deformity. Investigating physical exercise, the ratio of patients pursuing some sporting activity was similar, i.e. 50%, both in the total patient group and in the group of patients with pectus excavatum and pectus carinatum, while 90% of the patients belonging to the thorax emphysematicus group did not pursue any physical training.


National Survey of Neurologists for Transient Ischemic Attack Risk Stratification Consensus and Appropriate Treatment for a Given Level of Risks.
Patients with a new transient ischemic attack (TIA) have a 5% subsequent stroke risk within 7 days. The Canadian TIA Score accurately determines the risk of subsequent stroke risk; however, it is unclear if physicians will use this new scale or how it will be used. Our objectives were to assess: (1) anticipated use; (2) component face validity; (3) risk strata for stroke within 7 days; and (4) actions required, for a given risk for subsequent stroke based on the proposed Canadian TIA Score. After a rigorous development process (sample selection, key informant interviews, development of questionnaire following Dillman Tailored Design technique, cognitive interviews, and pilot-testing), a survey questionnaire was administered to a random sample of 300 neurologists selected from all neurologists listed in a national medical directory. The surveys were distributed using a modified Dillman technique. From a total of 265 eligible surveys, we received 140 (52.8%) completed surveys; 7 of 13 components comprising the Canadian TIA Score were rated as "very important" or "important" by survey respondents. Risk categories for subsequent stroke were defined as: minimal risk: less than 1%; low risk: 2%-4.9%; high risk: 5%-10%; critical risk: more than 10% risk of subsequent stroke within 7 days. Most (87.1%) of the neurologists would use a validated Canadian TIA Score. Neurologists appear ready to use a validated Canadian TIA Score in their clinical practice. Risk strata are definable, which may allow physicians to determine immediate actions, based on subsequent stroke risk.


Distinct subcellular localization of E-cadherin between epithelioid angiomyolipoma and triphasic angiomyolipoma: A preliminary case-control study.
Epithelioid angiomyolipoma (EAML) is a rare variant of angiomyolipoma (AML). Previous studies have demonstrated that epithelial (E-)cadherin is expressed in two subtypes of AML, EAML and triphasic AML; however, the expression pattern of E-cadherin remains unclear. In the present study, a preliminary case-control study was conducted to determine the expression pattern of E-cadherin between EAML and triphasic AML, the control, focusing on the subcellular localization and expression category of E-cadherin. No significant difference was identified in the age, sex, history of tuberous sclerosis, smoking and alcohol consumption between the two groups (P>0.05). In EAML, 9 patients were categorized as exhibiting a low risk of malignant behavior and the other two were categorized as exhibiting an intermediate or high risk of malignant behavior. The proportion of cases expressing E-cadherin, human melanoma black-45 (HMB45), melanoma antigen recognized by T cells 1 (Mart1/Melan A), smooth muscle actin and progesterone receptor were 95.5 (21/22), 95.5 (21/22), 86.4 (19/22), 77.3 (17/22) and 86.4% (19/22), respectively. E-cadherin was identified to be localized, using staining techniques, in the cell membrane and/or cytoplasm. The subcellular localization of E-cadherin was significantly different between EAML and triphasic AML; the majority of EAML cases revealed membranous and cytoplasmic staining, whereas triphasic AML cases demonstrated cytoplasmic staining (P=0.0093). The expression of E-cadherin may be positively associated with HMB45 (P=0.0044) and Mart1/Melan A (P=0.0049). The results of the present study identified that the subcellular localization of E-cadherin may be different between EAML and the control group of triphasic AML. Additionally, E-cadherin and melanocytic markers may be co-expressed in distinct subtypes of AML. A follow-up study with a large sample size to validate the results of the present study, followed by a mechanistic study based on cell lines to determine any significance, are warranted.


An end to lifetime blood donation ban in Israel for MSM would be a major step toward a science-based policy that reduces stigma.
In recent years, countries around the world have revised their blood donation policies regarding gay and bisexual men, and other men who have sex with men (MSM). The United States lifted the lifetime ban on MSM from donating blood in 2015, replacing it with a 1 year deferral policy allowing MSM to donate if they abstain from sex for 12 months. Other countries followed suit, while Italy and Spain have implemented deferral policies based on individual risk assessments regardless of sexual orientation. If Israel were to adopt a one year deferral policy for MSM, as recommended by Drs. Ginsberg et al. in this issue, the increase in risk to the blood supply would be minimal. Moving to a 1 year deferral policy would be an important step forward, but it could still be seen as stigmatizing to gay and bisexual men. We recommend that Israel consider a deferral policy based on individual risk assessment rather than a blanket deferral for all MSM. MSM can engage in low- and high-risk sexual behaviors. Those who consistently engage in low-risk behaviors, such as using condoms and pre-exposure prophylaxis consistently, pose little risk to the blood supply. An individual risk assessment policy would screen potential donors of all sexual orientations for low-, medium-, and high-risk behaviors. Potential donors identified as high-risk, such as injection drug users, would justifiably be subject to lengthy or permanent bans. MSM who engage in low-risk sexual behaviors would be allowed to donate without deferral. Medium-risk donors, such as men who have recently had unprotected anal sex with another man, would be subject to a deferral period of 1 month, which is in line with the window period of current HIV screening technology. Most fourth generation HIV tests can detect HIV within a month, and the nucleic acid test used to screen blood can detect HIV in just 9-11 days. Various studies have developed questions for ascertaining HIV risk among MSM which could be used in blood donor questionnaires. Using tablets or other technology that enhances privacy to conduct the blood donor questionnaire could improve collection of this sensitive information.